An Uncaring Nation

That other industrialized nations are able and willing to establish systems of "socialized" medicine shows up the United States to be uncaring and inhumane {Cover Story, July 7}. As more and more companies are cutting back on their health benefits packages, more and more people are left in the risky position of not being able to afford expensive medical treatment, should the need arise. Soon only the rich and the poor, those on Medicaid and Medicare, will have access to medical treatment. I would suggest that the government give financial assistance to those in training in the medical profession, regulate the salaries of the medical profession, and devise a system whereby everyone in the United States is eligible for needed medical attention.

Patricia D. Owens

Arlington

It's about time the U.S. joined the other affluent nations of the world in providing quality health care through a national plan.

Canada's system seems especially attractive to me. The claims procedure is refreshingly straightforward, and Canadian doctors' malpractice insurance rates are a fraction of ours. Of course, some American doctors (and lawyers) would have to drive Pontiacs instead of Mercedeses, but I think that's an acceptable price to pay for national health insurance.

James E. McGovern

Alexandria

Drug Testing Myths

The June 30 edition of Health contains a question: "Should pregnant women be tested for drug abuse?" and two quite divergent replies. Loren Siegel of the American Civil Liberties Union answered the question in the negative, and his reply contains several inaccurate or misleading statements.

Passively inhaled marijuana has never been shown to give a positive test for cannabinoids unless a non-marijuana smoker along with chain "pot smokers" are confined to a small, poorly ventilated space such as a closet-like small room or a sealed automobile. Yet the ACLU spokesperson makes the misleading general statement that urine tests in nonexperimentally controlled conditions could lead to positive tests for marijuana by passive inhalation of pot smoke.

In addition, we are unaware of any medications which will give a false positive tests for marijuana.

I have authored 15 scientific articles on drug abuse published in medical journals and I am certified for competency in drug abuse by the American Medical Society on Alcoholism and Other Drug Dependencies.

Loren Siegel makes the statement that "a physician doing his job will spot a pregnant woman who is a drug abuser." I know that I am unable to "spot" most drug abusers even by careful clinical examination despite my high degree of expertise.

Richard Schwartz, MD

Gerogetown University School of Medicine

The Desire to Quit

I would like to make a comment on Sandy Rovner's article "Where There's Smoke . . ." {Healthtalk, June 16}.

Ms. Rovner quotes Surgeon General C. Everett Koop as saying that 90 percent of the adults who smoke know that smoking is bad for them and that "90 percent of all smokers want to quit but can't." In my opinion, if 90 percent of smokers really wanted to quit, we would have 90 percent fewer smokers today. Having been a smoker for many years, I assure you that successfully kicking the habit is only a matter of desire.

Being intellectually aware of health complications and making intellectual decisions based on that awareness are not incentives enough to kick the habit. That is why smoking clinics have a much lower success rate than individuals who attempt to quit "cold turkey." I suspect that many of the individuals that fall in Dr. Koop's "90 percent" category are people who are intellectually aware of the health ramifications, but have not yet made a personal decision to quit.

Robert R. Reyes

Lorton, Va.

Hospitals With a Union Label

In reference to your article "In Health Care, a Move to Unions" {Health Business, June 16}, I believe that it is a good idea that nurses and other hospital workers join unions in order to protect their jobs, for which they have worked so hard. Nurses seem to be the backbone to any medical team and should have some "say-so" in matters that affect them.

With respect to the "influences" of union contracts on "how many people are on duty at hospitals" and "the quality of care" received by the patients, I believe that if anything, they would lead to better care, and in turn lead to better hospitals. When managed correctly, unions can benefit workers, and in the long run benefit the hospital.

The example concerning the Children's Hospital, and how the doctors opted not to take an increase in salary until the hospital was back on its feet, exemplifies this. Lack of benefits for the hospital workers, such as the maternity leave problem mentioned in the article, appalled me. Of all the industries in the United States, I would have thought that hospitals would be at the top of the list for allowing maternity leave.

Nancy Stanton

Herndon

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