Readers write: Letters to the editor, July 23, 2017

Try these safe behaviors for the Seward Highway gantlet

As a frequent driver of the gantlet between Anchorage and the Kenai Peninsula, I appreciated the two recent articles (July 13 and July 19) about safety concerns on the Seward Highway. However, it was a missed opportunity to inform your readers about safe driving behaviors. Rather than the DOT spokesperson simply describing the obvious of "chill out and allow for extra time," more helpful educational information could have been provided. I was also disappointed to read that the area between McHugh Creek and Turnagain Pass is a "shared responsibility" between the Anchorage Police Department and the Alaska State Troopers. In other words, neither is truly accountable for coverage. Further, it was telling that the Troopers spokesperson wouldn't respond to the reporter's inquiry of trooper staffing on the highway. I was hopeful that with the cancellation of filming the "Alaska State Troopers" reality show, more troopers would migrate back from Hollywood and have more presence. But it doesn't seem so.

Behaviors such as "high eyes driving" where you look two or three cars ahead instead of at the bumper in front of you to increase reaction time; journey and fatigue management techniques; proper distancing between vehicles; awareness of what is behind you before deciding to suddenly slow down to turn, etc., are all effective in reducing the risk of an accident. I suggest one of Alaska Dispatch News' reporters contact any of the energy or transportation companies in Anchorage who spend millions on safety programs and related employee education. Their safety professionals can provide useful information on safe driving behaviors that could be shared with your readers.

— Bill Polley
Anchorage

Free market is wrong approach to handling health care

Though several versions of the Republican health care bill have been presented and rejected, I doubt the subject is finished just yet. Through it all I recall hearing many times how we, as a country, need to let market forces determine the course of health care here. But can anyone please name one other industrialized nation that has a "free market" health care system?

A free market depends on having a product that is discretionary, not a necessity. If you want that new iPhone, new car, new house, most of the time you start from a position that you want it, not need it. I think we will all acknowledge that when we purchase goods, even those I just listed, out of necessity, we don't get as good a deal as when we can just walk away. When the product is literally a matter of life or death, such as health care, people will pay anything to stay alive. This is one of the reasons the "free market" idea doesn't work with this "product." According to NerdWallet, in 2007 62.1 percent of all bankruptcies were due to health care bills.

Many times, I have gotten a better deal on a car/truck because when I didn't like their offer I would just walk away and they would entice me back with a better offer. But, when people go to the doctor they do so because they need something resolved. Unless it is an elective procedure, the option to just walk away is removed from the situation. And the more serious the medical situation, the worse the bargaining position.

Look at the price of large, flat-screen TVs. When they first came out, they cost in the neighborhood of $10,000. Now, a 50-inch LCD can cost a mere $400. The initial cost was to recover the research and development of the product, and once those expenses were recovered the price came down to sell more units for larger profit. The same thing applies to hybrid and electric cars. Additionally, you can choose to buy a used TV, car or house. You can't buy used medical treatments.

But when you look at MRI scans, the cost of R&D was covered decades ago but the cost has more than tripled since then with no significant change in the technology. And why would the cost of such an exam range from $400 to $3,500?
Pharmaceuticals is another area where the "free market" doesn't work to the benefit of the consumer. Anyone remember Martin Shkreli? Or Bayer CEO Marijn Dekkers? In 2013, Bayer sued Natco Pharma Ltd., in India, after Natco was awarded a patent to be able to manufacture a generic version of Bayer's Nexavar cancer drug. "We did not develop this medicine for Indians," Dekkers said Dec. 3. "We developed it for Western patients who can afford it." It doesn't get any clearer than that.

In her book "An American Sickness: How Healthcare Became Big Business and How You Can Take It Back," Elisabeth Rosenthal describes that health care is one "market" where if a competitor jacked up their price, others with similar products will raise their price to comparable levels rather than stay low to increase sales. They know they have a product that is needed far more than wanted. That isn't government regulations determining that outcome; that is corporate greed.

Also, for a free market to work in health care would require winners and losers among the consumers. In this case, those who would live and those who would die. And those deaths are seen as acceptable, when it is morally repugnant.

— Jonathan Andrew
Anchorage

If we want top health care, we have a long way to go

None of the proposed health care legislation deals the real problem with our health care, which is its unorganized, chaotic and inefficient delivery system. We have the most expensive system in the world and yet we are 31st in longevity and 33rd in maternal and infant mortality rates. If I am going to have a procedure in a facility, I have no way of knowing that this facility has an abnormally high rate of infections, complications and deaths for this procedure. This information is available to licensing and accreditation agencies but not to me, the consumer. This needs to change.

Prevention is the cheapest form of health care. Hundreds of studies over decades demonstrate that for every dollar spent, the return is a reduction in future health costs of $3 to $8. Prevention takes many forms. Immunizations, smoking cessation programs and in-depth epidemiological research are just a few. All pregnant women should have access to full prenatal care and nutrition. The modern science of epigenetics has clearly demonstrated that inadequate prenatal care and poor nutrition has multi-generational medical and social consequences resulting in increased costs for decades.

Public health and school nurses along with local epidemiologists are often the first people to detect new community-wide health threats and deserve an expanded role in the health care system. This should go along with increased funding to the Centers for Disease Control and Prevention so that nationwide responses can be initiated quickly.

The conversion to electronic medical records should receive sufficient funding to be accomplished in the next five years. It should give control over the information to the consumer. It has the potential for greatly decreasing medical errors.

We should not pay for procedures and treatment that have proved to be ineffective for the condition they are applied to. Price rises in drugs that are over 10 years old should be restricted to 1 1/2 times the CPI.

We need to increase the ability of the FDA to track serious side effects that arise after a drug is on the market. Vioxx is a classic example and was withdrawn by the manufacturer. Currently there is increasing concern about drugs called PPIs (proton pump inhibitors) having serious side effects with long-term use.

We need to investigate why a procedure costs $15,000 in one place and $50,000 in another place with the same outcomes, and why a person with treated and stable high blood pressure sees their provider once a month in one place and once every four months in another place, again with the same outcome.

These are just a few of the many actions that are readily available to us right now to reduce costs and improve outcomes.

— Peter Jenkins, RN
Eagle River

It's time to stop killing those Upper Yukon-Tanana wolves

Last week, as I read the Department of Fish and Game's press release about the suspension of their wolf control program in the Upper Yukon-Tanana area, my response was, "Oh, is that so?" It was not surprising, really, that wolves were not responsible for the decrease of the Fortymile caribou herd in the region, and that there were other more significant scientific reasons, such as nutritional stress, partly due to climate change and too high a birth rate.

An interesting part of the news about the suspension of the wolf control program, however, was that they're not going to suspend the program until next year. I thought, how strange, especially when you have scientific data that clearly says that it could be terminated right now. Hmmm, something fishy here, no doubt, especially with budget shortage mandates the way they are in Alaska this year and forecast to get worse in future years. As Jim Kowalsky pointed out the other day in his letter, in fiscal 2013 alone, ADF&G's own report stated that $390,500 of public funds were spent on killing wolves in the Upper Yukon-Tanana area, which translates as $12,790 per wolf killed. Aside from the determination that intensive management of this kind was unnecessary, as it turns out, the budget used to accomplish this was a complete waste of our public money. And whether the new surcharge on hunting licenses will pay for the extension of the wolf killing program or not is immaterial to me.

Since the Board of Game never listens to the likes of me and others who value predators for viewing purposes alone, it appears now that only Fish and Game Commissioner Sam Cotten can terminate this needless destruction of wolves in the region. So I ask him to not delay any longer and invoke the more scientifically reasonable and humane approach of ceasing this insane program this year. As the old saying goes, insanity is doing the same thing over and over again and expecting different results. It may be this is exactly what we have here.

— Frank Keim
Fairbanks

Sen. Murkowski: Please save my health care lifeline and vote no

I've survived melanoma, Hodgkins lymphoma and a rare cancer of the pancreas. I'll always have to take monthly injections — that cost $10,000 a month — to keep my tumors from spreading. Without quality, affordable health care, my tumors would spread, leading to my early but preventable death.

Access to comprehensive health coverage is my lifeline, so I'm scared about proposals being considered by our U.S. senators that could strip away health coverage for millions of Americans. As an American Cancer Society Cancer Action Network volunteer in Alaska, I even traveled to Washington, D.C., to personally urge Sen. Murkowski to vote no on the poorly named Better Care Reconciliation Act. It would greatly harm millions of cancer patients and survivors like myself. Yes, the current law needs improvements, but the ideas being considered could result in millions of people losing health coverage over the next decade.

While I thank Sen. Murkowski for her support, she must continue to fight for patients like myself, and vote no on the Senate's Better Care Reconciliation Act or on any attempts to fully repeal current law without an equal or better replacement. It's time for lawmakers to come together and work on a bipartisan solution for improving health coverage for Alaskans and all Americans.

— Steven Taylor
Anchorage

The views expressed here are the writers' own and are not necessarily endorsed by Alaska Dispatch News, which welcomes a broad range of viewpoints. To submit a letter under 200 words for consideration, email letters@alaskadispatch.com, or click here to submit via any web browser. Submitting a letter to the editor constitutes granting permission for it to be edited for clarity, accuracy and brevity. Send longer works of opinion to commentary@alaskadispatch.com.