Medicare advice in stars | Nov. 23
Incentives can bring bad medicine
Conventional wisdom supports the concepts of health screenings and preventive medicine. So it is no surprise that Medicare is now rating Medicare Advantage plans on the basis of one to five stars, as outlined in this article. However, there is a darker side to this practice of rewarding health plans, and their physicians, for meeting such measures.
Recently, I saw a 90-year-old patient in my cardiology practice, who belonged to a highly rated plan mentioned in the article. She was cared for at home by a devoted daughter who accompanied her to the appointment. Her mother suffered with dementia, and therefore could not provide much history. However, the daughter was distressed that her primary care doctor had insisted, more than once, that her mother have a colonoscopy and mammogram. There is absolutely no evidence that these tests improve, or extend, the life of a nonagenarian. Indeed, doing these tests in this setting is not only a waste of money but potentially dangerous.
After reading the article, it is now probable that the incentive to order is likely based more upon physician and HMO monetary rewards than improved quality of care. Unless and until this issue is addressed, the Medicare system will continue to squander money on unproven so-called "pay-for-performance" goals. These goals still have unproven benefits in holding down the costs of Medicare, let alone improving the lives of its subscribers.
David M. Mokotff, M.D., St. Petersburg
Problem of empty seats
I find it amusing that we talk about building a new baseball stadium when we cannot even sell out 85 percent of the seats to a Bucs game. If we can't even sell out a Bucs game when they are on a winning streak, what makes anyone believe we will sell out a Rays game? This is a football area, not a baseball area.
Chris Creus, Clearwater
Rubio's pander problem | Nov. 24
Molehills and mountains
The editorial on Marco Rubio's "pander problem" is just another example of the advance liberal scouts at the Tampa Bay Times beginning the assault on a possible Republican candidate for president. Creating a pathetic nonissue of Rubio not knowing the exact age of the Earth to build an image of the senator as a dolt is below even your normal standards.
Rubio is not a scientist. I would imagine the majority of your readers have no idea how old the Earth is, but I would wager most would know there are 50 states and not 57 as Barack Obama once stated. That was ignored by his fawning press.
If the Times would at least have the courage to have one conservative column each day, it would expand your readership.
Tony Suarez, Dunedin
Give him time
It looks like Sen. Marco Rubio is frightening the press now. With three articles in two days attacking him because he may believe the message from God, what will be next? Please just allow him time to prove himself. He may prove to be just what we need to correct the course of our great nation.
Robert E. Hagaman, Homosassa
The next time you do a story on Marco Rubio, I want to do the interview. We have millions of people out of work and are in danger of a recession, and the big story is about how old the Earth is. If anyone wants to know how old the Earth is, look it up. Let's ask Rubio some real questions.
Henry Creasap, Clearwater
A tipping point on same-sex marriage Nov. 25, editorial
Tipping point reversals
The editors of the Tampa Bay Times are appearing cocky with their editorial predicting a tipping point in same-sex marriage.
If history can be a lesson, "tipping points" can quickly be reversed. One of these tipping points occurred with the 18th Amendment, establishing Prohibition, which passed with two-thirds of the states approving it. The other was the Equal Rights Amendment, passed by both houses of Congress. We know about the resulting reversals. It turns out most of Americans did not want either amendment.
The fact is that most people in the United States are not in homosexual relationships. Most marriages are heterosexual. Americans are showing their position on the issue by applying it to their personal lives, which is indeed poignant. Again, most Americans do not want homosexual marriages as the law of the land.
Christopher Martinez, St. Petersburg
Trouble bubbling | Nov. 25
Protect precious resource
This article written by Craig Pittman deserves an award; it was an eye-opener.
None of us can survive without pure water, so what once was a recreational use of our springs has become an issue of paramount importance for the survival of future Floridians.
In California there are coastal areas that do not allow any further development due to water issues. Probably other states do as well. Egypt has a growing problem with the countries upstream on the Nile that want to limit Egypt's use of their only water source.
Thank you for allocating the space in Sunday's paper that did this issue justice.
Yesnie Carrington, Seminole
Spotlight on key issue
Put simply, without clean water we cannot survive. Our government is in charge of providing us clean water. It is truly depressing to read Craig Pittman's well researched article to find out that our state is doing next to nothing to preserve our clean water supply.
Cities and counties continue to grant permits to private businesses without regard to the consequences. Providing clean water should be at the top of the priority list. Thanks to the Times for waking us up to this important issue.
Paul Riffel, Tampa
Drive-by hail of fire deadly | Nov. 25
Being 18, I find it sad that my generation has taken "beefing" between two cities to such an extreme. When we reach the point where lives are taken over territory and pride, we have stooped to an ultimate low. This generation needs a major intervention.
Shira Simmons, Orlando