Readers write: Letters to the editor, September 5, 2017

Make Alaska Singapore? It might be answer to health care
If, as the recent state-sponsored health care reports conclude (ADN, Aug. 31), we could save big bucks by consolidating insurance plans for public workers and Medicare recipients, how about taking it the next logical step and consolidating everyone in Alaska into one large insurance plan and save even more? Maybe even have a single entity (government?) run the plan. Preposterous, you say. Then consider the following.
Let's first admit that the point of insurance is to pool risk, for the maximum benefit of those in the pool. The larger the pool the more the risk is shared and the greater the ability of the pool to influence the cost of medical care. As Charles Wohlforth recently admitted (ADN, Aug. 2), controlling costs for medical care remains the only long-term solution. So, is there a model out there that might serve us better than the mixed bag of conflicting incentives inherent in our current system?
Maybe. Ross Douthat recently opined that if we "Make America Singapore" (Google it) we might improve health care outcomes for everyone and reduce overall cost. Singaporeans pay for much of their day-to-day health care out of their own pockets and have a government-run single-payer system to cover catastrophic illnesses and extended hospital care. The program requires mandatory contributions by individuals (and employers) to health saving accounts, which are used to pay routine medical costs. This creates "skin in the game" for consumers and helps keep the health care providers' costs in line.
Can America become Singapore? Probably not right now, with all the vested interests involved and the conservative distaste for government paternalism. But the recent state-sponsored studies are looking at how we can reduce costs right here in Alaska. Maybe the answer is to "Make Alaska Singapore."
— Mike Jens
Anchorage

Our health care system needs a complete rethinking
The BCRA as promoted by Sen. Dan Sullivan and Rep. Don Young is a farce. It was written in secret with no public input solely as an instrument to advance the Republican agenda. It failed to address the two most important aspects of health care, which are quality assurance and cost control. Iatrogenic deaths (deaths caused by various medical errors) run over 250,000 per year in the last 10 years, according to Johns Hopkins University researchers. It is now recognized as the third leading cause of death after heart disease and cancer. In addition, there were the millions of other complications that also resulted from medical errors. This in a system that is the most expensive in the world. Over 30 other countries do better than us in both areas.
The health care system needs a complete rethinking. To do it properly, Congress should open the committee system to hold public hearings from all who are involved in providing and funding health care in this nation. I would expect that to do it properly would take at least a year. Areas to look at should include the cost of education for health care professionals and how it is funded, alternatives for the current pay-for-service model, promoting evidence-based practice, developing comprehensive health and wellness programs, opening up data on quality assurance, infection control and outcomes of disciplinary actions to the public, limiting all administrative cost to no more than
10 percent and requiring all supplements to meet FDA standards for purity and content. These are just a few of the issues that need to covered.
Much of the information needed to implement solutions to these problems is readily available, both here and abroad. There is no quick fix. It will take years to bring our system to where it should be — leading the world. But we must start now.
— Peter Jenkns, RN
Eagle River

My solution to the monument question
This is supposed to be a democracy. If a question arises concerning the retention of existing historical monuments, let the registered voters of the town, county or city where the monuments exist vote for retention or removal. Then act on the majority opinion. If more are offended, remove it — if more prefer it to remain, leave it.
We should not allow ourselves to be offended by a flag or any other symbol because it is the current fad, or politically popular, but if the majority wish to do so, I'm willing to remove the symbol until the current fad changes.
I would, of course, see any monuments to Gen. Phil Sheridan ("The only good Indian is a dead Indian.") torn down, as well as the monument to 7th Cavalry troopers killed at Wounded Knee, all monuments to those who fought the Mexican War (even Robert E. Lee publicly complained that it was a contrived war), and who fought in the Spanish American War (triggered by Hearst and with the willing connivance of Teddy Roosevelt).
And I should endorse the burning of all books that recount acts that might tend to make us uncomfortable. If we follow up on this, the only history that remains in the next century will be "feel good" history — and we will learn absolutely nothing from the study of it that will help us handle the future.
— Don Neal
Anchorage

State student achievement test scores are misleading
As a recently retired elementary teacher, I believe the spring 2017 achievement test scores released by the state are misleading. First of all, in the past four years the tests given have not been the same. For one reason or another, test formats and publishers have been changed. There has been no consistency. Secondly, the PEAKS test given the spring of 2017 was not "kid friendly" or "kid appealing." For elementary students as young as 8, this was a real concern. Third, there was last-minute training given to teachers on administering the assessments and very little time given for students to use the practice test provided by the PEAKS publisher. All these influenced student attitude, motivation at test-taking time and scores.
I think there is a real need to look at how the state has been cutting the funding of public education. At the Anchorage school where I taught last year, night custodian positions were cut. Classrooms were only vacuumed twice a week and the trash was not always dumped. What message does this send to students when they walk into their room at 8:50? Teachers usually require their students to clean up tables, desktops and the floor as 3:30 approaches. But pencil shavings, dirt from the playground, and small paper scraps still remain. And what about materials teachers need to teach? We have less and less as the state cuts more and more funds. Then there is the deteriorating condition of many of our school buildings, which is appalling. When buckets and garbage cans are set out to catch water in hallways and classrooms, floors are dug up because of sewer leaks, and air handling units installed in the 1960s cannot keep a building warm in the winter, one has to ask if this can possibly be an adequate environment for young children to learn, feel comfortable and safe, or thrive.
Public education needs to be a top priority for the state Legislature. For that to happen, it most be a top priority for all voting citizens of Alaska. Children really are our future.
— Karen Avila-Lederhos
Anchorage

True happiness in North Korea
A sight to see that would be matched by no other, would be to witness the North Korean people, one day, clapping from true jubilance, not by the oppressive and rehearsed version they are subjected to routinely.
— Rolf L. Bilet
Anchorage

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