Prescriptions for Health-Care Reform

Wednesday, September 9, 2009

David Ignatius ["A Medical Revolution Via the Cleveland Clinic," op-ed, Sept. 6] referred largely to matters of group practice, payment arrangements and preventive medicine when he wrote that the president "saw what works when he visited the Cleveland Clinic." But just as important for "reforming the health-care system" is the doctor-patient relationship.

Last month, I e-mailed the Cleveland Clinic to inquire about testing and treatment because an in-state doctor to whom I was referred for a troubling issue could not see me for two months. The next morning, a clinic representative phoned to offer me an appointment within 10 days. I flew to Cleveland, where doctors in two specialties each met me at the precise hour of my appointment; took thorough histories and answered my many questions; offered diagnoses and treatment options that I got nowhere else; and coordinated my care with each other and with my local doctor. Each Cleveland doctor has followed up with me since I returned home.

I'm still amazed at how moving -- and unusual -- it felt to be treated with this kind of respect and skill when seeking health care. President Obama should listen to the Cleveland Clinic's patients as well as to its administrators.


Wicomico, Va.


President Obama, in calling for a specific plan for health care, shows that he doesn't understand or appreciate the benefits of freedom ["President Says His Critics Lack Health-Care Answer," front page, Sept 8].

Not all the solutions are known by any preselected group of people, nor are they known today. New problems will arise and new solutions will be needed tomorrow. If we were free, many people could devise ways to provide good health care.

What is needed is not a thousand pages of legislation but the repeal of a thousand pages of restrictive laws and regulations.


Silver Spring


In his Sept. 7 Outlook commentary "10 Things I Hate About Health-Care Reform," Arthur M. Feldman was correct in one respect: The Democratic health-reform package concedes far too much to private insurance companies, which need to supply more value for the money they receive. However, the rest of his prescription was simply a call for more money -- for doctors, for hospitals, for research. But the crisis in health care tells us that our public and private systems for financing health care have reached their limits. Something has to give.

Dr. Feldman ignored the fact that every other advanced country now provides health care to all its citizens, with better health outcomes, for far less than we spend. Indeed, the Dartmouth Atlas of Health Care, which analyzes variations in costs and types of care, found that piling on high-tech services does not always produce better outcomes: We can do more with less.

We need to put aside American exceptionalism in favor of pragmatism, and learn from other countries as well as from successful models here.



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