Scrutinizing health-care reform

The Senate health reform bill would do everything that Victoria Reggie Kennedy says it would do ["The moment he would not want to lose," Sunday Opinion, Dec. 20]. It would make health insurance affordable for 30 million people. The problem, however, is that the bill does not have an effective mechanism to contain the rising cost of health insurance premiums.

As a retired federal employee, I belong to the same "health insurance exchange" that senators and House members belong to. Over the past two years, I have seen my health insurance premiums rise an average of 20 percent each year. With private health insurance companies as the sole "gatekeeper" for health care, and without competition from a public, nonprofit health insurance company, the sky will be the limit as far as premiums go. We can no longer afford this as a nation.

We should do now what we should have done from the beginning. We should offer the Medicare program as the "public option." It is a successful program, and it serves millions of seniors and disabled people. We could implement the change without skipping a beat. Let's do it for the good of America.

Marty Stark, Bridgewater, N.J.

--

For all the moaning on the left over the demise of a public health-care option in the Senate, as reflected in a Dec. 17 op-ed by former Vermont governor Howard Dean, "Reform that falls short," liberals are perhaps better off without it. The Democratic left wants a public option but only because it cannot get its real choice, a single-payer government system, and it not so secretly hopes that the public option would become the only option.

But if somehow the left were to get its dream government-run system, what would prevent a subsequent Congress or president from limiting coverage not only for abortions but also for other procedures to which they might claim to have moral objections, say any procedure developed through stem-cell research or for treating AIDS, which they might see as being the result of immoral behavior?

We now have a Democratic president and the most pro-choice Congress we are ever likely to see, and the Democrats in the House still accepted a drastic diminution of the right to choose, and the Democrats in the Senate went along with lesser but still significant abortion restrictions to get their 60th vote. Given our current political class, it is hard to imagine government money without a political agenda, and it all too easy to imagine what that agenda might be.

Charles W. Brooks, Washington

--

The Dec. 21 editorial about the proposed long-term care insurance program in the health-reform legislation ["Flawed aid for long-term care"] failed to mention that the proposed Community Living Assistance Services and Supports (CLASS) Act would create a board of trustees responsible for developing annual reports to Congress on the operation and status of CLASS funding.

The board's mandate includes both a 20-year and longer-term look to ensure continuing actuarial soundness, with recommendations to address potential problems. In addition, the Congressional Budget Office's analysis of the recent legislation confirms the plan's long-term solvency: "Premiums would be set to cover the full cost of the program as measured on an actuarial basis."

As the editorial correctly pointed out, 10 million elderly people and people with disabilities need long-term services and support, and that number will grow. We've been discussing this seriously as a nation at least since the bipartisan Pepper Commission concluded in 1990 that our country needed to move to a system for long-term care with many of the features in the CLASS Act. At that time, it was 21 years before the first of the baby boom wave turned 65, but that tsunami is now less than two years away. The time to act is now.

Larry Minnix, Washington

The writer is president and chief executive of the American Association of Homes and Services for the Aging.