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Letters to the Editor is a periodic Kaiser Health News feature. KHN welcomes all comments and will publish a selection. We edit for length and clarity and require full names.


Unsolicited Advice For Corporate Titans

I am a retired health care consultant who has been involved in health care financing and delivery since 1973. I read with keen interest how these three titans of Industry are going to increase quality and reduce costs simultaneously with technology and effective business systems (“Expert Advice For The Corporate Titans Taking On Health Care,” Jan. 31). Well, I wish them luck. First of all, quality health care is about 60 percent technology and 40 percent art (knowledge). Secondly, experience shows you can quantify the technology, but you can never quantify the art. If you make mistakes, people die. We cannot now allow computers to make life-and-death decisions on humans. Leave that to the professionals.

— Thomas J. Garvey, Merrick, N.Y.


— Matthias Lehmphul, Berlin


We were disappointed KHN’s “Expert Advice” did not include input from advocates for a single-payer system. So, here is an open letter to the CEOs of Amazon, JPMorgan Chase and Berkshire Hathaway.

Dear Messrs. Jeff Bezos, Warren Buffett and Jamie Dimon:

We agree with you that health care is among the greatest issues facing society today. Your tremendous resources provide a unique opportunity to advocate for a health program to benefit all Americans: a universal, single-payer system.

Mr. Buffett describes our profit-based health system as a “tapeworm,” a parasite whose survival depends on its ability to drain nutrients from the host. How did our health care system reach that sorry state?

Our nation faces a catastrophic failure on two levels. First, the market has failed to deliver affordable health care to those who need it most. More importantly, our elected officials have failed to enact the reforms that could remedy health care’s woes because they are unwilling to offend big donors from the insurance and pharmaceutical industries. Instead, they’ve nibbled around the edges with incremental reforms like the Affordable Care Act. The ACA not only failed to kill the tapeworm of profit-based health care, it fattened it up with government subsidies, fueling the twin drivers of health costs — profits and administrative bloat.

Adding one more well-intentioned layer to our labyrinthine health care financing arrangements cannot fix them. We must move to one simple, nonprofit financing system, known as single-payer or “Medicare for all.” Mr. Buffett recently said that as a nation “we can afford to do it.” Medicare for all would bring desperately needed financial stability to the lives of everyday Americans, to every unit of government, and to businesses large and small.

We urge you to meet with policy experts who have studied this problem for decades, as well as the health care professionals operating at the front lines. Physicians for a National Health Program is a 22,000-member nonprofit research and education organization that advocates for single-payer health care. Our “Physicians’ Proposal for Single-Payer Health Care Reform” is a research-based plan for expanding health coverage to all Americans while eliminating the waste and profiteering of private insurance, and the inefficiencies they inflict on doctors and hospitals.

— Carol Paris, M.D., president of Physicians for a National Health Program, Chicago


Steering Readers Wrong?

Thank you for your articles and education for our senior population. But your article “No Car, No Care? Medicaid Transportation At Risk In Some States” (Jan. 30) makes it sound as if transportation fraud is rampant. My concern is that people read stories like this, and then make up their minds that because there is too much fraud we should eliminate the benefit. Someone needs to pressure Medicaid and Medicare to explain why they are not scrutinizing claims or bumping the names up to the Social Security Death Index. If they did that, they could catch the cases in which dead people’s identities were being used.

— Linda Chavez, Claremont, Calif.


— Sheldon Weisgrau, director of the Health Reform Resource Project, Lawrence, Kan.


Omission On Nuclear Fission Mission

Thanks to Sarah Varney for the article bringing to national attention the important issue of securing a molybdenum-99 medical radioisotope production facility in Janesville, Wis., and the importance for national security of having one in the United States (“Inside The Global Race To Deliver A Vital Radioactive Isotope Used To Detect Cancer,” Jan. 16). The article is comprehensive and well-written, but it falls short by concentrating on one company. Other viable companies work to produce molly-99 as a commercially viable product. Some work with proven technologies that have passed FDA approval for other producers. Among them is Coquí RadioPharmaceuticals, whose CEO, Carmen Irene Bigles, is a Puerto Rican woman.

— Carene Raldiris, Miami


Their Siblings’ Keepers

Thank you so much for the article “Her Sister’s Keeper: Caring For A Sibling With Mental Illness” (Jan. 9). My sister Jody and I grew up 13 months apart with Jody in the lead. Jody had a complicated birth that led to a lack of oxygen and borderline developmental disabilities. At 30, she was diagnosed with schizoaffective disorder. So much in your article rang true for me. I lived Jean’s life as Jody lived Ruby’s. Thank you for highlighting siblings. I am now in a role to help family caregivers. So few are the siblings that I personally identify with. Thank you for such an honest, dignified and loving portrayal.

— Robin Nobling, executive director of the National Alliance on Mental Illness Davidson County, Nashville


I just want to say thank you. I, too, am the guardian for my schizophrenic sister. My life with my sister is and has been very similar to what was described in the article by Jenny Gold. After I read it, it helped me so much emotionally and gave me strength. I am not alone.

— Janet Brew, Jacksonville Beach, Fla.


Your article on caring for mentally ill siblings almost 100 percent mirrors my life. My brother has schizophrenia. He was incredibly handsome, a star athlete and an outstanding academic student. He was sweet, funny and kind. His background is so similar to Ruby’s in your story. And, selfishly, I feel robbed. I never got to have a good, fun life with my amazing brother. Of course, he never had a life, either. His disease started when he was 19 and a stellar student at Penn State (today is his 60th birthday). Please keep writing these stories. They’re important.

— Claire Gawinowicz, Oreland, Pa.


A Jaw Drop On Dropping Coverage For Hoosiers

This Twitter user weighs in on Kaiser Health News’ Feb. 1 story “Indiana Medicaid Drops 25K From Coverage For Failing To Pay Premiums.”

— Erin Gilmer, lawyer and health and patient policy advocate, Denver


Words Ring Harshly

In the story “When Nursing Homes Push Out Poor And Disabled Patients” (Dec. 20), I find the term “wheelchair-bound” offensive. Wheelchairs liberate people. They enable people to move more freely in their environment. The label “wheelchair-bound” makes these people sound more dependent or helpless. Thank you.

— Liz Pazdral, executive director of the State Independent Living Council, Sacramento, Calif.


3-D Vs. 2-D Mammograms? No Contest

In response to your article “When You Need A Breast Screening, Should You Get A 3-D Mammogram?” (Jan. 16), the science-based answer is “yes.” Studies involving over hundreds of thousands of examinations have all shown that Digital Breast Tomosynthesis — 3-D breast cancer screening — finds cancers that are not evident on 2-D mammography. One of the more recent evaluated almost a half-million examinations and showed a major increase in cancer detection.

The death rate from breast cancer had been unchanged for at least 40 years prior to the start of mammography screening in the U.S. in the mid-1980s. Soon after, in 1990, the death rate began to fall. It continued to fall as more and more women participated in screening and as we have improved our ability to find breast cancers earlier so that today there are almost 40% fewer women dying of breast cancer each year than would have had screening not been instituted.

DBT detects 20-40 percent more cancers than conventional Full Field Digital Mammography, and reduces the recall rate (women called back from screening for additional evaluation) by 10-40 percent. These are major improvements and should be available to all women.

— Daniel B. Kopans, M.D., professor of radiology, Harvard Medical School, Boston

[Editor’s note: Dr. Kopans was part of the team that secured the first patent for digital breast tomosynthesis in 1999.]

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