Readers write: Letters to the editor, August 9, 2017

In health care industry,
illness is asset, not well-being

In the Aug. 2 ADN, Charles Wohlforth concludes, persuasively, that a single-payer plan cannot practically be implemented in the United States. He plausibly states, "Our society won't tolerate a massive nationalization of private assets and individual careers." (This is not strictly true: Insurance companies would not be nationalized.) He concludes later that health insurance companies would go out of business and for-profit providers would become nonprofit. True. However, it seems to me that as long as a large part of our economy sees illness as an asset and wellness as a potential liability, that no form of health care reform can ever work as well as it should. Dr. Paris apparently agrees, claiming that as long as "the for-profit insurance industry (is) in the equation, you really cannot accomplish those goals" of providing universal coverage, better benefits, and lower costs.

Those companies of course make a profit in part through the premiums paid by the insured. Wohlforth makes a startling claim, that "Our government currently pays more for health care per American than countries that already have universal coverage." So it seems to me any increase in tax to cover universal coverage would be less than what most people currently pay in premiums. It looks to me like a net gain. People who are invested in health insurance companies will just have to adjust their portfolios. The money will flow somewhere else.

A third point, not discussed in his article, is an extension of my point that certain segments of our economy see illness as an asset. Wellness is a liability for certain restaurants and food processors who are convinced they can increase profits by selling more food, and more harmful food, than anyone should eat. Personal responsibility can only be part of the fix; corporate responsibility must be a part of our health care reform.

Restaurant food labelling is a simple and exceedingly useful tool in this regard, but like one would expect, the Trump administration has prevented this from happening.

Wohlforth is concerned Alaska's problems in health care are particularly difficult, presumably in part because of our small population, and offers Vermont as an example of a state that failed to establish a single payer system. It would have been exceedingly useful to know, however, that in 2016 the population of Vermont was only 624,594, while Alaska's population was 741,894. If our insurance pool is too small, then theirs is too. But the insurance pool in the United States is more than 325.5 million. Finally, Wohlforth uses some language to suggest a government program such as expanded Medicare should be viewed with suspicion, such as "top down," and "sweeping away the entire system and having a government agency run it." However, it would be useful to know that administrative costs for Medicare, (by most accounts; the right wing tries to find ways to dispute this) are much lower than at private health insurers. Here is where we find much of the real waste, and potential savings.

— Clarence Crawford
Anchorage

Planned Parenthood protected

I know I speak for thousands of Alaskans who are proud Sen. Lisa Murkowski listened to her conscience and voted against the life-threatening health care repeal. Murkowksi's action particularly safeguards the lives of Alaskans and their access to health care by supporting Planned Parenthood. I know my baby was born healthy thanks to the care we received from Planned Parenthood. Arriving back in Alaska before my job — and insurance coverage — began in 2014, I needed an ultrasound. Planned Parenthood provided me with the ultrasound; it was there I saw my daughter's face for the first time. Staff came back into the room to congratulate and celebrate with me.

My family thanks you for this vote, Sen. Murkowski. We encourage you to stay strong and keep listening to Alaskans.

— Kerry Brown
Anchorage

Stay strong Lisa, and carry on

I want to publicly thank Sen. Lisa Murkowski for voting to protect access to health care for Alaskans. I am both proud and impressed by her vote. I am proud because her vote shows she knows putting her constituents first was, and is, the right thing to do. I am impressed because I now know that she has the courage and strength to vote outside of her party line. Bravo, senator. Stay strong and carry on.

— Carol Green
Palmer

Single-payer health system can be had with US ingenuity

In his column regarding a single payer health care system (ADN, Aug. 2), Charles Wohlforth rightly points out Americans currently spend more per person for health care than any other developed country. What do we get for our yearly
$3.2 trillion? Compared to other industrialized nations, we rank 25th in preventable deaths, we leave 28 million uninsured, and our businesses are losing their competitive edge due to the cost of employee health insurance.

Attempts at incremental, market-based reforms have failed to return our nation to its position as a global leader in health care. But it is not beyond our grasp.
A single-payer solution would save
$500 billion annually by eliminating the "middle men," the private insurance companies and their third-party administrator subsidiaries that siphon profits out of the system, but contribute nothing toward patient care.

Wohlforth notes investor-owned health care entities such as for-profit hospitals, surgery centers and nursing homes would be required to reorganize as nonprofit entities under a single-payer plan. But he is wrong to equate removal of the profit motive with "massive nationalization of private assets and individuals' careers." To be clear, the delivery of care would remain as it has always been: a mix of public (VA and IHS) and private care. Hospitals and doctors' offices would be privately run. We simply need to eliminate the profit motive and conflicts of interest that drive up health care costs for everyone.

The Senate's failure to repeal the Affordable Care Act has opened up a new national dialogue on the future of health care. While some may argue for more market-based tweaks to our health system, Wohlforth correctly points out in a previous column that "increased competition" can never work in rural states like Alaska because of its small population and isolation from larger markets.
We can either act boldly to achieve universal, high-quality health care at lower costs, or we can bow to Wohlforth's assessment that it can't be done. As for me, I'll put my faith in American ingenuity and determination any day.

— Carol A. Paris, MD
president, Physicians for a National Health Program
Nashville, Tenn.

Murkowski, McCain, turncoats on ACA repeal, need ousting

The flip-flops by Sens. Lisa Murkowski and John McCain are intolerable. Murkowski voted for repeal in 2015 but now has mysteriously voted against it. Others have called her courageous. Courageous? How about treacherous, lying and traitorous.

McCain used the repeal of the Affordable Care Act to get re-elected. Then he votes against it. These politicians need to be held accountable. Both of these senators should be driven from office.

The federal government has no business in the health insurance industry. Those duties not specified in the Constitution are left to the states. The free market is the best solution with a government safety net for the indigent. We have seen government health care and it is not good.

— Michael Lavallee
Soldotna

Thank you Lisa, keep it up

Thank you, Sen. Lisa Murkowski. I am only a sometime supporter. I generally lean to the left of the senator on most issues. However, in this matter, Murkowski has consistently shown she cares more about good policy than about partisan advantage. While I am sure I will continue to disagree with her about many things, I am reassured we have at least one senator who will work with both Republicans and Democrats. She supports Republican values and positions more than I would prefer, but Murkowski also strives to find policies a broad spectrum of Americans can live with and support. I hope she will continue in that spirit.

— Robert Reagan
Chugiak

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