Beware of those who claim quick and easy answers to health care challenges

Beware of those who claim quick and easy answers
to health care challenges

EDITOR:

When the fox tells you what a great job it’s doing at guarding the hen house, watch out.

An opinion piece written by the director of “an association of insurance companies,” published in the Aug. 17 Vindicator, is a case in point. Many of the assertions in that piece are true: Americans would be healthier and medical expenses would ease a bit if people ate less, exercised more, stopped smoking and took their pills faithfully.

However, pretending that simple actions like these will do much to rein in the continuing explosion in health care costs only postpones the day when our nation can begin a serious drive to define and solve that problem.

The essay, which presented the health insurance industry in a favorable light, appeared just a few days after Forbes magazine published a report that paints a very different picture. The Forbes article describes widespread failure of cost control by health plans, in part because of cost-plus contracts with employers that contain little incentive to detect overbilling, excessive medical services and other abuses.

Criticism of the insurers should not be overly harsh, though, because our medical nonsystem has become so complicated that it is essentially unmanageable. The factors that make it that way include the incredible complexity of the human body and its diseases, self-serving practices by healthcare institutions and the for-profit companies that sell medical goods and services, bureaucratic excesses, the sharp practices of the tort law system and the vagaries of human nature.

The claim that a program of chronic disease management for city employees in Asheville, N.C., cut costs by 42 percent in its first year should be viewed with suspicion. Improving patient compliance should actually increase expenditures early on because of more frequent prescription refills and the expense of augmented professional contacts with patients. The economic payoffs come in future years in terms of fewer heart attacks, strokes and diabetic leg amputations. The early savings observed in the Asheville Project more likely resulted from increased use of generic medicines, deterring unnecessary tests and treatments, and more effective control of fraud and administrative errors.

The actions recommended in the Aug. 17 article represent only baby steps on the long, tortuous and bumpy road to resolving America’s healthcare mess. Don’t expect a cure for this problem soon, and don’t believe candidates for United States president who pretend that they can solve it promptly if they are elected to that office.

ROBERT D. GILLETTE, M.D.

Poland

Give your grandparents
the respect they deserve

EDITOR:

Where have we failed in teaching our children to respect older adults or grandparents?

Our families are failing because of the lack of respect of family. We need grandparents or older adults as neighbors who can fill that role in children’s lives, to help them do everyday chores or just to listen to them. Grandparents have a wealth of stories to tell; all they need is an audience of children to listen to them or maybe to help them plant a few vegetables or to clean up things that are too hard for them. Children, listen, give them the chance.

IDA M VANDYKE-GREGORY

Youngstown