Down here on the farm, we really appreciate efforts to get us a little reasonable medical care ("Hillary's health-care team needs an injection of reality," Economic Viewpoint, May 10). Back when I was in school, we used to talk about the law of supply and demand. When I was farming, I kept running into this law, usually with adverse results. If there were a lot of soybeans, the price was low; when there was a drought, the price went up: This is the effect of supply.
Let's look at the disease that our medical system suffers from. Prices and availability of medical care are symptoms of the disease, not the disease. The disease is the imbalance of supply and demand. The results, so far, have been a comparative reduction in the general health of the nation and the concentration of wealth in two areas: physicians and insurance companies.
It seems to me that you folks keep talking about how to control the price of medical care from the demand side and aren't really concerned with the supply side. Let's work on supply. The medical community has pointed out that more doctors have not in the past reduced the cost of care. This is true for two reasons: Medical insurance has eliminated the effect of price on demand. Second, in order to create competition in the medical community, the number of doctors must increase at a rate much faster than the general population.
Create a national medical school.
Let students pay for their educations with several years' service in places where doctors are scarce.
Many of the things we go to doctors for could be performed by nurses, nurse practitioners, and midwives. Turn these people loose; let them practice on their own or in cooperation with doctors.
The idea of national service fits well here, but you have to provide more schools and training opportunities.
Declare war on illness. Use the
This will not work unless done on a grand scale and will require major changes in our system of providing medical insurance.
You cannot fix the health-care problem in this country by messing around with "managed competition." You either have to eliminate the profit motive from the insurance industry or the government is going to have to fund universal health care. You guess which will work and which will cost an arm and a leg. Preventive medicine and personal responsibility for our own health will have to replace going to the doctor for every ache and pain.
The only treatment for our country's health-care problems has to be radical and extensive. Tinkering around with the symptoms is only going to make it worse. Either fix it or let it alone.
Right on, Paul Craig Roberts! The trouble with America's health-care insurance is that it is no longer insur-ance in many cases. It has become prepaid care with no participation in cost by the recipient. Insurance is a misnomer for such a plan.
Insurance should not cover routine expenses that one plans on, such as teeth-cleaning or an annual flu vaccine. When routine and expected expenses are covered, the cost is inflated by the additional paperwork required by the doctor and the insurance company that's paying the bill. Such costs have to be added to the insurance risk of the unexpected, true insurance costs that are rightly insured.
F. Eliene Mitchell
Roberts does not have his facts correct when he says that the "37 million uninsured Americans consist primarily of people who are temporarily without coverage while between jobs." The truth is that more than 75% of those without health insurance are working or are the dependents of people who are working, including many children.
This is a major problem for these people, and it is adding to the nation's problem of providing minimal care to the poor, including the elderly poor covered by Medicare. It's no wonder that our hospital emergency rooms are overwhelmed with critically ill patients who cannot pay.
James C. Ritchey
Mission Viejo, Calif.