William A. DeVan’s Nov. 24 letter set out four options for employers struggling with the burdens of the Affordable Care Act but offered no suggestions for workers who need medical care. Let me see if I can think of any:

1) We can send them to an emergency room, where they can wait for hours to be seen by someone who will recommend that they go to their own doctors for follow-up care.

2) We can require hospitals to provide emergency care regardless of the patient’s ability to pay, but since emergency rooms are not equipped to provide continuing care, the patient’s problem will probably return, requiring another trip to an emergency room.

3) We can bill uninsured patients for their care, take their homes and life savings, and drive them into bankruptcy.

4) We can force care providers to bear the burden of serving people who cannot pay.

Oh, wait, those are the things we do now.

The only original option I can think of is to shoot indigent patients, but then we would have to provide Social Security benefits for their survivors.

Unfortunately, none of these options eliminates the burden on society of providing minimal care for the uninsured. Of course, the burden on employers could be eliminated through the adoption of a single-payer system, such as Medicare, for everybody. But that’s unlikely to happen in our lifetime.

Sara Kaltenborn, Silver Spring