"Too much money" (Special Report, July 11) underscores the contradictory situation of low growth, excessive savings, and low interest rates affecting the leading countries of the world. Could you imagine the state of the U.S. economy without this [current-account] deficit partially offsetting excessive U.S. savings?
Economists who were trained in the 1960s and '70s under Keynesian macroeconomics perhaps more easily recognize the historic dangers that excessive savings represent: These are a reflection of an unbalanced capitalist system, generally a precursor to recession, and can only be addressed through the collective actions of governments.
Keynes elaborated the causes of the Roaring Twenties [prosperity] and the disastrous Great Depression of the '30s: too much wealth and income in the hands of too few people, excessive levels of private investment, and a reduced government sector eventually lead to hard times for all.
Unfortunately, the recent conference of the leaders of the Group of Eight demonstrated once again the inability of the world's wealthy nations to deal with the true underlying unbalanced economies, just as they were unable to do so in the 1920s and '30s. You were correct to alert your readers to "hold onto your hats."
Economist Bunnar Myrdal wrote that the world would grow toward peace through international investments and trade. The interlocking of world economies would make war unthinkable. Perhaps this glut of capital might become a peace dividend if it results in increased international investments. One reason China hesitates in taking action against Taiwan is the huge economic impact. China's interest in Unocal (UCL) may be one more opportunity to increase the ties between U.S. and China that build toward peace.
I hope this article will be followed by more discussions of the flooded market and new world economic possibilities.
As we made clear to you ("The Rich boys," Investigative Report, July 18), Marc Rich does not have and never has had any financial interest in Trafigura. One of the reasons we set up an independent operation was a fundamental difference in business ethics and practice.
We also strongly refute the implications of impropriety in your report. We operate to the highest possible standards, do not contravene international law, and distance ourselves from corruption of any kind. We are confident that U.N. investigations will conclude that we are the innocent party in the Ibex incident.
My compliments on finally tackling this oily business. What is missing, however, is a closer description of those with whom Marc Rich and associates are so extremely well-connected. I realize that Bill Clinton and his wife were among them, and then probably other influential Democrats. But then I did not sense much Republican opposition [to Rich's Presidential pardon]. If it takes a constitutional amendment to revoke a controversial pardon, then the entire process needs to be changed. To grant a Presidential pardon for dubious reasons should become an impeachable offense. Would that not be fairer than the current system?
"Is heart surgery worth it?" (News: Analysis & Commentary, July 18) legitimizes what I've been telling my patients. I am an internist who has been practicing "risk management" for several years and who has witnessed heart attacks and the call for invasive cardiac procedures in my clientele virtually disappear. With more than than 3,000 patients, I have not hospitalized a nonsmoker for an acute coronary event during the past seven years.
Physicians are reimbursed generously for treatment, penuriously for prevention. Counseling patients, outlining drug treatment options, and applying techniques to foster compliance are all labor-intensive. The doctor who does that is able to see far fewer patients per hour and is going broke. With reimbursements optimized for churning people through the mill, and with a greater than 20% reduction in Medicare-allowed fees per visit looming, individual preventive doctor-to-patient counseling is becoming obsolete.
Health-care inflation would be much easier for America to manage if we based incentive to providers on outcome rather than on process. We have a good model for that: It is how the business world works.
Harvey Lerner, M.D.
St. James, N.Y.
I guess I'm an urban legend. I'm that healthy, active post-surgery patient Dr. Nortin M. Hadler described as such in your article on heart surgery. Ten weeks after my triple bypass in May, 1995 (at age 53), I was bike riding around Block Island, R.I., with my then-teenage son, something that would have been impossible before the surgery because of angina. I was able to return to jogging, coach soccer, and later took up snowboarding with my son. I still work full-time. I walk three miles a day, and last weekend I kayaked six miles with my daughter.
Dr. Hadler cites the risk of surgery, but says little about the risk of having a fatal heart attack while waiting for drug therapy to work when the left anterior descending artery is more than 95% blocked, as it was in my case. I'll take the known risk of surgery over the unknown but probably greater risk of waiting for drugs to kick in and reverse clogging any time.
Michael J. Clowes