Like a single-payer system? Check out England's waiting times
Regarding "Single-payer system is likely the best path to universal
coverage" (Letters, Nov.
13):
I think the letter by Bob LeBow, MD, of Boise, Idaho, opposing market-based solutions to universal health coverage and favoring a single-payer government-based system oversimplifies the issue.
I am proud of the policy that our AMA has endorsed that really has the ability to insure so many more people in an equitable way. It has four basic principles:
- Individual ownership and selection of policies at group rates.
- Refundable tax credits inversely related to income substantial enough so that nobody should have to spend more than 5% of their income on health insurance.
- Defined employer contributions.
- Health marts or purchasing cooperatives for pooling risk.
I recently visited the Web site of the National Health Service in Great Britain (http://www.doh.gov.uk/waitingtimes/booklist.htm), where they have a system such as Dr. LeBow advocates.
Waiting times for procedures and hospital admissions are listed for June (http://www.doh.gov.uk/waitingtimes/booklist.htm).
I recommend everybody visit the site and decide whether American citizens would put up with an average waiting time for a hip replacement of 185 days in the West Midlands or as much as 256 days in the Southeast. The best waiting time average is 156 day
s for gynecologic admissions.
No system is perfect, but we need an American system for people who live in the United States. We can't import somebody else's problems as a quick fix.
--Joe Heyman, MD
West Newbury, Mass.
Editor's Note: Dr. Heyman is chair of the AMA Council on Medical Affairs.
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Canada proves single-payer's faults
Most of us are propelled into medical school by the great character virtues of compassion and justice. These same virtues keep us practicing and functioning despite the oppressive forces of managed care, crushing barratry and shrinking remuneration.
So when we learn about the millions of uninsured, these same virtues compel us to promote the seemingly innocuous solution -- national health insurance.
However, like Hobson, we can be blinded by our noble virtues unless we look at the whole picture. Blinded because we treat medical issues based on clear evidence and, when uncertain, ask for a consultation from a specialist. Yet when we are confronted
by social issues like the uninsured, we ignore both evidence and consultations.
Such blindness causes some doctors to ignore the evidence provided by a great social experiment in that country to the north of us. No country is more like the United States than Canada. Yet we hear little and heed little about Canada's social failure.
The evidence of Canada's national health care is clear. The system is imploding not because of lack of compassion but rather because of mandates, rationing, closures and shortages of equipment.
The end result is confiscatory taxes and a health system no better than ours. As bad as consumerism and capitalism are, national health insurance in the end is worse. There are hundreds of thousands of Canadians in this country -- physicians (I among t
hem) and otherwise -- who are available to confirm the failing health system in Canada.
--Calvin Ennis, MD
Escatawpa, Miss.
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Government, not physicians, should pay for medical interpreters
Regarding "Doctors resent being forced to find, pay for interpreters" (Article, Nov. 20):
The government is telling physicians they should hire bilingual staff or other alternatives. However, these suggestions are not tenable. Immigrants coming to this country, either legally or illegally, speak over 100 languages and various dialects. It i
s impossible to handle all these demands. If we provide translation services for one or two of these languages, are we not discriminating against others?
The responsibility for this Tower of Babel is the excessive immigration policy of the federal government. The federal government should be held responsible for any costs incurred with the use of interpreters. English should be the official language of
the United States. People who immigrate to the United States should have a grasp of English.
--Robert F. LaPorta, MD
Dix Hills, N.Y.
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Report both sides of debate on global warming
Regarding "A hot future" (Article, Nov. 6): I read this story with apprehension after seeing its most dramatic illustration, which seemed more in keeping with a current Hollywood production than your p
aper.
I remind you that the article described the problems that could develop if the predictions of warming occur. We know that many scientific groups have come down on both sides of that issue, but your illustration for your article does nothing to describe
that lack of unanimity.
I believe AMNews should identify those who disagree and attempt to weigh the evidence.
--Harrison L. Rogers Jr., MD
Atlanta
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