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Conserva-care caveats

September 25, 2009

Re "Conserva-care," Opinion, Sept. 20

What nonsense. William Frist wants to "incentivize" folks to live a healthy life, thereby shrinking costs. OK -- but try getting couch potatoes to do it. And those like me -- living the healthiest of lives, yet I've fought back cancer twice only because Medicare authorized the right tests.

David Frum wants non-state-regulated insurance companies that will "squeeze" their suppliers. If doctors like my son are squeezed any further, most will quit medicine.

And Richard Viguerie: "Don't discourage profit ... [it] drives better prices, service and products." Ridiculous. When our local, nonprofit hospital became for-profit, all the best nurses were fired. Their incompetent replacements burned up equipment in the autoclaves. However, within weeks, a dozen administrators had new cars.

Maralys Wills

Santa Ana

I read with interest all four opinions from the conservatives. I particularly thought that Frum had some good ideas. Private-sector insurance companies are not nearly large enough. I agree with his premise of allowing insurance companies to sell their products across state lines and regulate prices. As Frum said: Establish "a federal regulatory authority over the whole insurance marketplace and get the states out of healthcare altogether," that's the way to go.

Patrick Dooley

Upland

::

I find many of the assertions in these opinions ridiculous. Frist writes that "we need a system that concentrates on keeping us well so we need less 'healthcare' and fewer 'preventive interventions' in the first place." Mammograms and colonoscopies are saving lives every day by identifying cancers at earlier stages, which will end up saving money.

Furthermore, all the "healthy behavior" in the world will not prevent certain diseases from killing you. They must be caught early and treated.

And Frum's comment is shocking. Just ask a family doctor in Appalachia if he isn't already being squeezed by insurance companies that find every excuse to delay or deny payment.

Nader Ameli

Harbor City

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Regarding "Conserva-care," why were all these bright ideas not promoted and enacted during the Bush administration? At that time, the prevailing view was that our healthcare system was flourishing under laissez-faire capitalism. Even during the Obama administration's efforts at reform, these ideas have been hard to hear amid the contrarian rants.

Underneath these suggestions lie several big problems, including the myth that ours is the best healthcare system in the world. That might possibly be true if one did not count the millions left out or about to be dropped out of it.

And by its very nature, the healthcare market has its consumers in a pressured bargaining position -- which inevitably creates profits for the vendors rather than better health outcomes.

Stan Cole

Whittier

::

The responses of conservatives invited to present their vision of what healthcare reform should be demonstrates the bankruptcy of their vision.

For those uninsured because insurance is too costly, healthcare reform is about making insurance with decent benefits available with a subsidy that makes it affordable. On the subsidy issue, the conservatives were silent.

For those uninsured because preexisting conditions make coverage unavailable, reform is about requiring insurers to offer policies at reasonable cost to everyone. Again, silence.

For those who are insured, reform is about guaranteeing coverage and fair dealing from the insurance companies through tighter regulation, restricting rescission and a public alternative to for-profit insurance.

For everyone, healthcare reform is about keeping health insurance affordable by controlling the growth of healthcare costs. The conservatives' calls for less regulation and insurance that simply pays providers less and shifts costs from insurers to patients is just a sugar-coated version of the current system, which has failed to control costs.

Jack Needleman

Los Angeles

The writer is a professor of health services at UCLA.

::

Frum's opposition to government-run healthcare is right. His proposed solution is dead wrong.

Health insurance companies have too much power now -- they overcharge and abuse patients already. Frum's assertion that shrinking the market to a few big insurers will serve our interest is absurd.

Monopolies never serve customers well. There is no consumer market in healthcare now. Your employer picks your plan and picks and pays your doctor -- no patient choice or competition holding cost down.

The answer isn't more powerful health insurance moguls or a government takeover. It's patient choice: forcing health insurers and providers to compete on cost and quality like every other business in America.

John Shadegg

Phoenix

The writer is a congressman from Arizona.

::

While I am no fan of Frist, I agree with his approach of actively promoting wellness. He specifically talks about diet, exercise, smoking and drinking. His approach would generate real savings; healthy people run up fewer healthcare costs.

But how do you influence diet without creating more government intrusion into our lives? How do you reduce smoking without increasing the cost of tobacco products or putting them completely under government control?

Don Stewart

Santa Rosa, Calif.

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