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Americans' health care is already being rationed

Rationed care is bad care | April 11, commentary

Health care is already being rationed

Having represented injured and ill persons in my law practice for more than 37 years, I have to wonder how Dr. David McKalip has managed to miss the "rationing" of medical care which has been with us my entire life.

For starters, people without insurance certainly know only a weak dribble of care gets through the supply hose to them. This is because our society has elected to ration America's limited medical care primarily to those who have insurance or enough money.

Then there are those who have been injured on the job and frequently have to beg to get what they require unless they have an attorney serving as a battering ram.

Even the insured patient faces the back-office preauthorization team at the health insurance company and the forbidden drug list. Some procedures and drugs, judged to be necessary by many doctors and patients, aren't available because they cost too much.

We are delusional if we feel "rationing" has not been with us for many years. The present system is simply the capitalistic method of rationing that assures the best care for the well-heeled among us. Referring to this system as "the sacred patient-physician relationship" may allow our medical providers to feel good about themselves, but it is, unfortunately, a snow job.

Nobody needs to worry about leaving "their doctor's office wondering if the doctor is working for them or serving a rationing plan." The doctor is already serving a rationing plan. It is just not a very good one for most Americans.

Dr. McKalip's suggestion that Americans can just save their way to high-quality medical care at the lowest cost is, sadly, why it may be a mistake to "trust your doctor" to create a fair health care delivery system for our nation.

Robert J. Carroll, Palm Harbor

Rationed care is bad care | April 11

Our health care system

is in need of reform

I certainly agree with the broad concept in Dr. David McKalip's commentary. However, I must take issue with the thrust of his column. First, other than platitudes about the patient-physician relationship, he offers no solution to the problem of access to health care in the United States.

He attempts to minimize the number of uninsured by saying that 9 million are not American citizens. Day in and day out I see children and teens who do not have insurance. They are not aliens but simply are in families where working parents are not able to provide insurance because of cost, often $8,000 to $10,000 per year.

In regard to infant mortality, no matter how it is counted the United States is not in good shape compared to other industrialized countries.

Finally I agree that health care is now rationed but not by a board or agency but by the ability to pay. The causes and solutions are not simple, but one fact should be clear. Health care cannot continue to be financed and rendered as it currently is.

We need a different system of health care financing, we need real tort reform and, yes, we need to curb unnecessary testing, prescribing and surgery by physicians. We need better trained and better reimbursed primary care physicians.

Health care is too complicated and important to be trusted to the market and to be bought and sold on Wall Street as a commodity. Health care financing and delivery can be reformed without destroying the patient-physician relationship but rather result in strengthening that relationship.

David Cimino, M.D., St. Petersburg

Rationed care is bad care | April 11

We deserve better

Everyone agrees that health care costs are growing faster than any other segment of our economy. Our best projections show unsustainable economic demands that both the public and private sectors cannot meet. One cornerstone is adopting clinical standards that improve the delivery of quality health care. Another is the electronic medical record to give health care providers as complete and easily accessible medical records as possible, thereby avoiding the repetition of unsuccessful approaches.

It is unexplainable how physicians disagree over accepting proven clinical standards or electronic medical records. Commonsense hand-washing to prevent spreading infections from patient to patient and giving antibiotics in a timely fashion prior to surgery are examples. These clinical standards and many others are produced by intensive clinical research performed by physicians themselves.

What Americans want is health care that is affordable, quality-driven and appropriate using the right medical tools at the right times. We want and demand better answers with lower costs from our health care providers and must count on our legislators to ensure that these changes, vital to the public interest, occur.

Stuart Berney, Tampa

Study: 1 in 5 American 4-year-olds obese April 7, story

A system overwhelmed

This study shows how severe the decline in the U.S. population is becoming. The article fails to point out that this is only for obesity. You can add the overweight (and those becoming obese) to that total.

It's horrifying to see how deep this overweight crisis is becoming. In spite of all our schools, Americans don't know the first thing about eating healthy and the necessity for exercise. That's why we are the sickest people in the industrialized world.

Here is the main reason our health care system is collapsing with out-of-control costs. It is like a dam being overwhelmed.

Ronald A. Baltrunas, Clearwater

Insurance should match home value April 10, story by James Thorner

Companies call the shots

Please give me the name of James Thorner's insurance company, the one who agreed to lower his coverage. I have tried and tried to get my homeowner's insurance coverage reduced only to be told I am insured for "replacement value." Every insurance company I have contacted tells me what the coverages will be.

If I insist, I am given dire warnings about the financial consequences should something blow my house into the next county.

B.J. Mitchell, St. Petersburg

Insurance should match home value April 10, story by James Thorner

Inspection helps

James Thorner's advice about homeowners getting their insurance bill reduced because of declining values is fine.

Another way to reduce the premium is to get a home inspection by a licensed inspector. I did, sent the report to my insurance company, and received a substantial reduction in my premium, mainly because I had a hip roof (sloped on all sides) and hurricane fasteners on the roof trusses.

However, this reduced premium was partly offset because of the requirements of Florida's Building Code. If at least 30 percent of your home is destroyed by hurricane, fire, etc., the entire structure must be rebuilt to comply with current building codes. Depending on when your home was built, this could mean a new roof, garage doors, windows, etc., which could exceed your insurance coverage. To guard against this, the homeowner can buy additional coverage.

Edward Cox, Spring Hill

Insurance should match home value April 10, story by James Thorner

Construction costs count

This article misleads readers into thinking the value of their home matters when it comes to homeowners insurance.

The replacement cost of a home is not related to its real estate value. The cost of construction may be more or less than the home is worth on the real estate market. It is critical people understand this and insure their home accordingly.

I am the general manager of a local remodeling company, and I can assure you the cost of construction has not dropped anywhere close to what real estate values have dropped. It costs the same today as it did two or three years ago to replace your house.

Byron Hood, Clearwater

Americans' health care is already being rationed 04/14/09 [Last modified: Wednesday, April 15, 2009 3:31pm]
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