Your Views

Tuesday, August 11, 2009

Health Care: What We Need, What We Don't

Rationing health care ["Rationing Care Is Standard Practice," Aug. 4] is always the norm. The real issues are about health care's costs and its efficiencies and effectiveness. One way to solve these issues would be to offer more scholarships for medical students, which would increase the number of doctors. The government could also provide tax credits to small businesses to cover, say, 60 percent of the employer's health insurance costs. The employer and employee could then share the remaining 40 percent. This would be a lot cheaper than what the president and Congress are proposing.

A lot of folks object to Obama's plan not just because it's more rationing but also because it increases costs and limits the freedom to choose a private insurer. Our family has Blue Cross Blue Shield, and we like it very much. I am eligible for medical care at the Veterans Administration but prefer not to go there because it doesn't seem to be as good as private facilities. .

We do not need another bureaucracy to get between our doctor and us.

Michael D'Andrea

Olney

The article cites extreme examples involving lung transplants, ICUs, LVADs, dermatologists, etc. These are all limited and scarce resources that have to be rationed in the United States, as anywhere else in the world. What most Americans are afraid of, and rightly so, is the type of rationing that occurs in Canada and the United Kingdom over routine tests and procedures, like colonoscopies, knee replacements and cardiac workups, that result in unnecessary and grossly underreported morbidity and mortality. What we don't need and what the writer's argument reeks of are the core principles underlying the Obamacare playbook: rationing, or the denial of routine medical care.

Jayesh Dayal, MD

Potomac

Dangerous Habits

"Packing a Heavier Warning" [Aug. 4] made me wonder if we have our priorities straight in this country. I'm amazed the federal government and surgeon general are putting so much effort into tobacco warnings while seeming to look the other way when it comes to stronger alcohol regulation.

Let's compare the two:

1. Nicotine is a drug, and so is alcohol.

2. Cigarettes cause lung cancer. Alcohol destroys brain cells and damages your liver.

3. Alcoholism is a disease, sometimes requiring inpatient treatment. Chain smoking by itself is not considered a disease.

4. Excessive alcohol consumption impairs your ability to drive. Cigarette smoking has no effect on your driving skills.

5. Secondhand smoke inhalation is a health risk. Support groups, such as Al-Anon and Alateen, try to help with the mental strain that comes with living with an alcoholic.

After those comparisons, why are breweries, wineries and distilleries allowed to push their products on TV if tobacco companies are not? Would you rather have your kids attend a party where booze is served or an alcohol-free party where smoking is permitted? How many brawls have been started because someone had too much to smoke?

There isn't a "lesser of two evils" here. Until someone thinks a Smokers Anonymous group is necessary, beer, wine and liquor should be taxed and regulated to the same degree as tobacco products.

Michael A. Mobley

Bethesda

In the past six months or so, thousands of smokers have stopped inhaling tar, particulates and numerous chemical additives in tobacco smoke. Instead, they are inhaling smokeless vaporized nicotine from electronic cigarettes to help them quit. You would expect organizations such as the American Lung Association, American Cancer Society and American Heart Association to be overjoyed. But they are pressuring the Food and Drug Administration to pull these products off the market, claiming they have not been proven safe and effective.

Their claims are in contrast to the more than 12,300 people who have signed the online "Electronic Cigarette Petition" asking the FDA to keep these products available. These users report that after using the electronic cigarette they have no cravings and no desire to go back, and that it's safer than the tobacco smoke they used to inhale.

Elaine D. Keller

Springfield

Overcoming Isolation

As a psychologist specializing in grief and loss, thank you for "A Serious Illness Can Isolate a Family" [Aug. 4]. A similiar article about isolation after a traumatic death of a loved one would also be welcomed.

Last week I was on the phone with a man whose 44-year-old wife recently died of a sudden heart attack. Because his grief appeared to be out of control, his primary care physician called 911 during an office visit and committed him to a local hospital's psych ward. There he lived with patients in active psychotic episodes, and the staff didn't understand his plight. You can imagine how this added to his trauma. His grief symptoms, however, were natural reactions to an abnormal, traumatic experience.

Seemingly out-of-control initial symptoms of grief can frighten health-care professionals who want to help but who instead inflict more pain. As someone who has experienced traumatic loss, such grief doesn't frighten me. I work with the person to normalize what is happening so he can develop coping skills to face his future.

Ursula Weide

Bethesda

My family and I have vascular Ehlers Danlos syndrome, and I do not consider this a terminal disease. My father had it, and three of us inherited the disease from him. We've lived full lives: One of us is a doctor and others are teachers; we are mothers, aunts and uncles. My neighbors, family and co-workers are supportive. My outlook on life is positive, and I live each day fully. I am sorry the writer feels isolated. EDS support groups can help.

Kathleen Henne

Oak Hill

Reporting Doctors' Conduct

Othello Oca wrote that he wished physician ratings Web sites existed in 1989 so he could have reported a doctor ["Your Views: Second Opinions About Doctors," July 28].

Such an egregious act as pulling a bedsheet out from an elderly man, causing him to fall to the floor, should be reported to the hospital administration as well as to the state board where the physician practices. Posting it online will not likely help hospitalized patients, who do not necessarily have a say in who is treating them. For less urgent concerns, individuals should speak with the doctor directly and give him or her a chance to respond. This is a better alternative than publicly and unfairly trashing a professional's reputation online.

Dalal Musa

Arlington

Better Than 'Lollipops'

When sighted people think of how to help blind people, the usual thought is to restore or replace the ability to see or allow the blind to "see" in another way [" 'Lollipop' Helps Reveal Shapes to the Blind," July 21]. Yet sight is only one of the tools that facilitate living.

I have been blind since 1950 and have lived a full life, including going to college, traveling, working, getting married and raising kids. As part of the National Federation of the Blind, I've learned that technology can be a help but believing in your own abilities and learning techniques of blindness -- "the tricks of the trade" -- are far more important than any particular device.

Tom Bickford

Silver Spring