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Health care: delivery system flawed, quality is "world's best'

The administration and lawmakers are debating the existence of a "health care crisis." I think the answer is pretty simple: If 37-million Americans do not have ready access to appropriate health care, that's a crisis.

Those uninsured have been receiving medical care. But it's often delayed, and received in hospital emergency rooms or other inappropriate, expensive medical settings.

Yes, our health care delivery system is flawed. But the quality of health care regularly provided to most Americans is without question the world's best. While we want to achieve universal access, it must not be accomplished by compromising quality.

Medical decisions should be made by health professionals and doctors, not administrative clerks or government bureaucrats. Would you prefer an MD or an MBA making your medical decisions?

Congress and the administration must begin to rely on and seek guidance from health professionals who, surprisingly, have been largely ignored in major reform discussions. If you were to reform the legal system, you would consult lawyers. But health professionals _ despite their expertise, knowledge and medical training _ are treated as "special interest" groups.

Everyone involved in the health system reform debate must defend the goal of maintaining the highest quality care. Access to poor quality medicine defeats the purpose of system reform.

Forget the health care "crisis" debate. That's largely a matter of semantics. We must reform our health system based on quality. Universal access to fine medical care is the only sensible solution.

Joseph T. Painter, M.D., National President,

American Medical Association, Houston, Texas

In her Feb. 27 article, Health care's tough choices, Gina Thomas made several specious and misleading statements. I will specifically address three.

First, she states that the American Medical Association's "ambitious and lofty goals for 1994" include encouraging home safety inspections and CPR training. From the context, it is clear Thomas is belittling the AMA for their half-hearted attempt to contribute to the public welfare. In fact, if the public would engage in these simple actions as well as wearing their seat belts, exercising regularly and not smoking, they would be healthier and medical costs would drop dramatically. If followed, simple advice like this would be of more benefit than all the MRIs and wonder drugs combined.

Second, Thomas laments only 100 of 1,200 members of the county medical society volunteer at Tampa's Judeo-Christian Clinic. In fact, that number represents 8.5 percent of the total membership that volunteers at one facility. I suspect that the total percentage that does volunteer work somewhere is actually higher. For argument's sake, assume that even 10 percent volunteer one evening a month. I have my doubts that an equal percentage of attorneys, accountants or plumbers volunteer their professional services for free. If they did, I have further doubts that they would be at the same risk of litigation that these volunteer physicians undoubtedly are.

Finally, Thomas states the "entrepreneurial spirit rules, sad to say, in one of our most precious assets: our health." If only this were the case. In no other aspect of Americans' day to day life is the government more involved and are the rules of the free market more subverted. If individuals were allowed (or forced) to bear the responsibility for their own health care decisions, then not only would they engage in the above-mentioned preventive health care behavior but they would also hold physicians accountable for every dollar spent and thus be healthier and save money. Since the free market works adequately in all other areas of our society and economy (including the provision of such essential commodities as food, shelter and clothing), it makes sense that it would work in health care, too.

Steven Dickerson, M.D., Tampa

Chuang-Tzu and Learned Hand

Re: Are conservatives really fools?

A recent letter to the editor implied that those individuals who think along the lines of conservative ideologists' principles are fools. The writer's accusation, based on the Tao philosophy of Chuang-Tzu, deserves a response.

First, the letter writer should have found a more credible source than Chuang-Tzu for support. In The Complete Works of Chuang-Tzu, by Burton Watson, it can be found that Chuang-Tzu believed that words can express only a small fraction of Tao (the way of man). Because of this belief, Chuang-Tzu concluded that "when the men of old died, they took with them the things that couldn't be handed down"; and, that reading the words of long-dead sages is nothing more than reading "the chaff and dregs of the men of old." Thus, if one accepts the philosophy of Chuang-Tzu as used by the letter writer to attack conservatives, then one likewise has to accept it as "the chaff and dregs of the men of old."

Aside from questioning the credibility of the source material, why such a venomous accusation by the letter writer? Some would agree that the following words of Learned Hand, a 20th century American jurist, might be appropriate: "There is no fury like that against one who, we fear, may succeed in making us disloyal to beliefs we hold with passion, but have not really won."

A. E. Roberts, St. Petersburg

No more experts?

Re: The "miracle man" never did have rabies, Feb. 22, about James Smith and an erroneous diagnosis of rabies. I'm not surprised. The Centers for Disease Control has no qualified medical experts now. The CDC has become too involved in social issues, such as gun control, to maintain a scientific, medical expertise.

K. P. Long, New Port Richey

DUI attorneys defended

Re: Feb. 23 letters regarding DUI defense attorneys.

As a third-year law student at Stetson, I cannot allow the vicious attacks on criminal defense lawyers to be printed without a response.

The Sixth Amendment to the U.S. Constitution requires that every accused person have the right to the assistance of legal counsel. Having the assistance of a lawyer is necessary because of the complicated nature of a criminal proceeding. The defense attorney's obligations, among others, are to ensure that the accused receives a fair trial (which includes testing the validity of any Breathalyzer results) and to guarantee that the witnesses testifying for the state are not motivated by bias, prejudice or other self-serving reasons.

When the state unleashes its vast power to prosecute someone, often people's constitutional rights are trampled upon, and the accused is faced with the prospect of losing the very thing that makes America great _ his or her liberty. The defense attorney merely ensures that the state, before depriving the accused of his liberty, affords that person constitutional due process.

I hope that none of the letter writers are ever wrongly accused of committing a crime, for then they may have to resort to using one of us "ivory-tower sleaze-bags."

Vincent E. Schindeler, St. Petersburg

As it is, as it was

Re: Doonesbury and Tonya: My way, March 1.

Hooray for Garry Trudeau. Not only does he tell it like he sees it, but he also sees it like it is. And that's the way it was.

JoAnn Frank, Clearwater

"No' votes for casinos

Why are some legislators so concerned with "nickel-and-dime" bingo games which give enjoyment and recreation to so many elderly and very rarely lead to an addiction, but they want to promote the creation of casinos? Speaking from 40 years of experience through marriage, this will result in heavier losses and heartaches for families of gambling addicts, not to speak of a higher crime rate.

Again, as with everything else the public is led to believe, this will be beneficial to the state by generating more financial gain (but for whom?) without realizing the consequences. There have been more broken homes, loss of jobs, etc., attributed to gambling than many are aware of. Is this worth it?

There are enough gambling opportunities in this state already.

R. G. Harrison, New Port Richey

Casino gambling is like a bad penny that won't go away, but the cost to all of us could be much higher. In 1991 we were told that casino gambling would help restore education. With the experience of the lottery, we knew better and didn't go for it. Now it comes with promises for health care. Proponents use any argument the public might buy.

The common factor in all pro arguments is an appeal to penury and greed. It's free money for the state because no one is required to gamble, unlike taxes which hit us all. It will bring in tourist dollars, allowing us to solve our problems with other people's money. And who knows when we'll be the lucky winner and get rich quick? Sounds like a no-lose idea for Florida.

As a clergyman for almost 40 years, I have seen first-hand the sad condition of family units where a member was addicted to substance abuse. And money is the substance most often abused.

Income that is needed for food, shelter, clothing, education and quality of life goes instead for drugs, gambling and quick but temporary pleasure. The temptations in our increasingly free society are already hard for many to cope with, and as more of them are legitimized by the state, the situation only gets worse.

Will casino gambling help us in our time of need? I wouldn't bet on it!

George LaBruce, St. Petersburg

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