Debate Over Canadian Health Care

At the end of the article on whether the United States should copy Canada's health care system {Cover, Nov. 27}, a medical student asks, "Do you really think someone on welfare should have the same care as someone who has money?" The question should be, "If you are on welfare and your child's best chance of surviving leukemia is an expensive bone marrow transplant, should he be denied that treatment?"

In this country, we must decide if medical treatment is a right or a privilege. Why do we believe that we have a right to quality education provided by the state in our public schools, yet we argue whether the state should provide publicly funded (socialized) medicine?

Just as the wealthy can opt for private schools and extra tutoring, certainly they will always be able to augment their health care by choosing additional, even redundant, treatments, and traveling anywhere in the world to seek the advice of countless specialists.

But while the wealthy will be able to pay for a greater variety or quantity of health care, the rest of us have a right to the same quality of health care. Andrew Lewis Fairfax

I certainly am on the side of Drs. Steffie Woolhandler, David Himmelstein and the Physicians for a National Health Program. They seem to be showing leadership and are not afraid to challenge both convention and the foundation of a large system.

The present system in the U.S. is inefficient from a functional perspective and unjust and outdated from the patient's perspective. I hope that during this new decade, more of our senators and members of Congress can show the will and courage to break with ideology and tradition and start making the government itself responsible for providing financial coverage for health care for all of its citizens. Robert A. Weichsner Fairfax City

The article mistakenly gave the impression that physicians who oppose a Canadian-style health system in fact oppose most changes that would extend basic health insurance protection to the uninsured. Nothing could be further from the truth.

The American Society of Internal Medicine and most other physicians' groups wholeheartedly support change. However, we believe that the best way to ensure access to health care for those who lack it is to build on the merits of our current system, not toss it out in favor of an untested alternative.

We agree strongly that the U.S. health care system is in need of reform, and we are working hard for change. In the process, however, we believe that we should keep what's good about our system, which spreads the cost across the public and private sectors and allows us continued freedom of choice.

Proponents of the Canadian system believe that we should have a program in which the government becomes responsible to pay for all health services. Those who watched the recent budget reconciliation debates might want to think seriously about whether they really want the fiscal soundness of their health care system to become a political football in the reelection of 535 members of Congress. Joseph F. Boyle, MD Washington

It is shocking that we, as world leaders, are one of the few countries that do not have a national health plan. The insurance companies are not providing good medical care. You can see this in government during the November open season when so many employees are changing health plans because of dissatisfaction. If we adopt a health plan such as Canada's, we will effectively control malpractice insurance, which sends physicians' costs so high. We'd put the lawyers out of business, and insurance companies could get out of the health care business. The American Medical Association would have a coronary. Let's do it! Eileen Gold, RN Arlington

The Inspector General's Role

The story about Inspector General Richard Kusserow {Policy, Nov. 27} overlooked a few important considerations that, to my mind, more than rebut the American Medical Association's contentions. The AMA's call for his ouster from his position at the Department of Health and Human Services because of a mistake that he made regarding one doctor, which he promptly retracted prior to its airing on national television, is unwarranted. What about the many thousands of frail, elderly Americans on Medicare who have been saved from the consequences of being subjected to impaired, incompetent or unscrupulous health care providers?

Before being so quick to criticize, the AMA would do well to remember that the intrusion of the Inspector General in their industry would be greatly reduced if the AMA did more policing of its own ranks. It is only because of their laxity that the Office of the Inspector General has been able to compile such an extensive list of adverse actions against health care providers.

Let all the facts be weighed before any conclusions are drawn or actions taken. The public should rest easy knowing that at least Dick Kusserow has not been co-opted by the industry he's charged with overseeing for waste, fraud and abuse. What would be truly worrisome is if the AMA commended him for his fine performance. Thomas R. Burke Alexandria {The writer is the former chief of staff of the Department of Health and Human Services}

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