September 9, 2017

Examples of Letters to the Editor

From Letters to the Editor, The Tennessean (Nashville), 10/21/03
U.S. health-care system allows people to die

As Dr. Charles Eckstein (”We can do better than British and Canadians on health care”) advised in his Oct. 17 Nashville Eye column, I went to the American Medical Association’s Web site and reviewed its plan for health insurance reform. What I found there was a plan to ”induce most people to purchase health insurance” by providing tax credits.

To its credit, the AMA proposal does attempt to break the anachronistic link between employment and health insurance, but it leaves individuals to find their own way in a bewildering health insurance marketplace.

The AMA plan fatally assumes that people will choose to buy health insurance, whether they are employed or not, because the tax system will refund part or all of what they pay. The document recognizes the unfair burden of the current system on the poor, but it fails to recognize the depth of poverty and the irrelevance of the tax system to daily decisions about whether to pay for food, rent or medicine.

Dr. Eckstein pulls out the tired canard of ”socialized medicine,” saying Canadians are ”suffering and dying on waiting lists.” Sadly, the free-market arrangements that dominate health care in the U.S. have left Americans to suffer and die because they were uninsured and too poor to even get on the waiting lists. This is a moral outrage. We clearly must arrange our affairs so that health care is distributed equitably.

A straightforward way to health-care equity was proposed in August by 8,000 (not ”a few,” as Dr. Eckstein wrote) physicians. In the proposal, everyone pays according to his means through progressive taxation, everyone has the same insurance, and everyone has equal access to care.

It’s a second opinion that’s worth a look, at

John Lozier
National Health Care for the Homeless Council


From Letters to the Editor, The NYTimes, 5/19/16
Re: “Why a Single-Payer Plan Would Still Be Really Costly” (The Upshot, May 17):

As a physician who favors a single-payer plan, I cannot disagree with your analysis about the high cost of moving to this type of health care plan.

Our present system is really all about profit — from the medical device makers to the pharmaceutical industry to health care workers and medical administrators to insurance companies. The challenge to bring down costs, under this system or single-payer, is large.

Yet we have seen what the free market has done over the last 70 years, and it has not been a success in terms of cost control. Indeed, health care costs are going to get significantly worse if we continue our present system, a combination of private and government payment.

Only a single-payer system has any chance to control costs yet guarantee that all citizens will have health care coverage. To stand pat with free-market fervor or to go backward, such as eliminating the Affordable Care Act, will deprive many of medical care while still driving up costs.

In the long run, the present system will cost far more than a single-payer option, and the sooner we proceed in that direction the better.

Middleton, Wis.

The writer is a retired internist.


From Letters to the Editor, The NYTimes, 5/19/16
Re: “Why a Single-Payer Plan Would Still Be Really Costly” (The Upshot, May 17)

Our health care costs more because our administrative costs, a result of a financing system that relies on for-profit insurance companies, are so high. Some of those costs are borne by physicians, who must pay for complex billing systems, denial management, preauthorization requirements, collections management and bad debt, as well as devoting patient time to discussing insurance coverage rather than medical issues.

If we substantially decrease those costs to physicians, as a single-payer system would do, we could decrease insurance payments to physicians and still give all of them a raise. No economic miracle involved; just a matter of the people who do the work, rather than a wasteful middleman, taking home the money.


The writer is a retired internist.


From the Napa Valley Register Mailbag, 3/10/17

A letter to State Sen. Bill Dodd: I attended the Town Hall meeting held Feb. 21 at Napa Valley College. Overall, I thought it a very good event. However, your responses on the issue of the “single payer” option were woefully inadequate, You dismissed this option as “unaffordable” yet failed utterly to address one question (not mine) that spoke directly to that matter.

California has a population of 38.8 million according to 2014 census figures. This makes it about the size of Poland and larger than Canada, Australia, Taiwan, New Zealand, (the list goes on and on.) All of these countries have “single payer” systems yet you purport that California is not large enough to support such a system on its own. Why?

The GDP of California is roughly equal to that of France (6th largest in the world), again a country with a single payer system. This is well ahead of Australia, Canada, Norway, Denmark, Sweden, New Zealand, (and on and on) These countries all have “single payer systems” yet California cannot afford it? Why? You never answered this at all – you just deflected.

The issue is not one of affordability but of having the political will to tax sufficiently to pay for it (yes, the taxable revenue intake in California is lower than those countries I have mentioned and yes I am aware of the problem of “tax room” given that the federal government also imposes taxes on California citizens and businesses).

Given that a large percentage of the population is already receiving funding from public sources (per the panelists that evening, for example) the marginal cost of extending this to the population as a whole would be sizable but not insurmountable.

Again, I suggest that the problem is less one of money than it is of having the political will to do what is right: treat healthcare as a basic human right that is available to all.

David Campbell