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May this health standoff lead to real change

After reading numerous articles and diverse opinions about the dilemma we are facing with the Highmark-UPMC tussle, it appears that what we may be experiencing in Western Pennsylvania is the beginning and perhaps tip of the melting iceberg of a dramatic change in health care management, reimbursement and provision of care.

Fretting and gnashing teeth over who will control the markets and care, what CEO gets along with whom, wondering how and when powerful politicians, government agencies or private donors will step in, and the anxiety of (wondering) to whom and where one will go for care is conducive neither to good health nor to the marketplace.

In the PG Business section, Harold D. Miller points out in his July 3 column, "Health Care 'Business as Usual' Not Good Enough," that bigger is not cheaper or better. However, I tend to agree with Andrew Thurman, who was quoted in the July 3 article "UPMC, Highmark Embroiled in Classic Bad Split-up" that in the end, Western Pennsylvania may have to settle for a single all-powerful health care provider/insurer.

After insurance rates soar further out of reach and we experience a decline in health care quality and/or accessibility, then maybe a national health care policy that eliminates our dependence on the current health-care profit barons and in turn provides a just and affordable level of basic care for all citizens will not look so foreboding.

Regent Square

Our role for them

I am writing to urge the Post-Gazette to use the correct terminology when referring to those of us needing health care here in southwestern Pennsylvania -- in particular when reporting on the ongoing fiasco with UPMC and Highmark.

We may be a "patient" to our doctors, but to UPMC and Highmark we are "customers."


Violation of rights

Since April, several stories have aired on television and appeared in newspapers, including the Post-Gazette, about eight Pittsburgh state prison corrections officers who were suspended without pay or benefits for alleged ethics violations.

Nearly five months later, no explanation has been given for the suspensions, despite state civil service guidelines that mandate the Department of Corrections must detail specific reasons for taking such drastic action.

To make matters worse, the officers have yet to be even interviewed, let alone charged with a crime. This is a clear violation of each officer's rights to due process, and it's something that never should happen in the United States of America.

If these officers are going to be charged with a crime, charge them. Otherwise, restore the wages and benefits their families desperately need.

Pennsylvania State Corrections Officers Association

ALEC's mission

As the national chairman of the American Legislative Exchange Council, I want to respond to "Analysis Finds State Legislation Copied From D.C. Group" (Aug. 3). ALEC is a transparent, nonpartisan, 501(c)3 organization dedicated to advancing the principles of free markets, limited government and individual liberty.

ALEC is a resource for state legislators across the country to find sound policy solutions to today's complex issues with a primary focus on fiscal responsibility and economic growth in each policy area. ALEC believes a vibrant private sector is good for the economy and job creation and, when faced with policy decisions that have an enormous effect on our society, legislators should hear from those who are affected. No one would consider writing an education bill without talking to teachers, or health care legislation without talking to doctors. So why would we do it in any other area?

The simple fact is that no matter what we discuss at a conference, we each have to make a decision whether it is good for the people we represent. If so, whatever may begin as a model bill must go through the legislative process unique to each state. The bills are subject to legal review, committee hearings, amendments and floor debate before legislators vote to reject or adopt it and a governor signs it into law.

It's an entirely democratic and transparent process and to suggest otherwise misleads the public.

America is a representative democracy and legislators are elected by the people to represent the people. As state legislators, we try to find the best solutions to growing the economy, creating jobs and utilizing taxpayer dollars effectively and efficiently. ALEC helps us fulfill this goal.

National Chairman
American Legislative Exchange Council
Washington, D.C.

The writer is a member of the Louisiana Legislature.

Guardian of the rich

I'd like to commend PG staff writer Laura Olson on her Aug. 3 article on the business-financed American Legislative Exchange Council and several of its members, including state Rep. Daryl Metcalfe, R-Cranberry, and the way that ALEC prepackages legislation for lawmakers to introduce in Harrisburg ("Analysis Finds State Legislation Copied From D.C. Group"). The article was based on an analysis by Keystone Progress and referred to four pieces of legislation that differed only by a word or two from the ALEC "model" legislation.

One of the measures that ALEC and the Republicans seek to block is a key provision of the federal Affordable Health Care Act -- presumably because the well-heeled parties at ALEC don't want the gravy train known as soaring health insurance premiums to stop running anytime soon.

Another measure deals with that drumming conservative call for privatizing government services. Who really believes that businesses primarily interested in maximizing profits are going to do a better job of providing essential services than government employees, who work at reasonable wages and seek no profit? (Remember just a few years ago when the city's trash collection was put up for bid and the city employees put the private firms to shame?)

I can understand why wealthy Republicans who are also greedy would help elect politicians sworn to protect their burgeoning bank accounts at all costs. I cannot understand why hard-working people of modest means would ever throw their vote and their money away on a Republican guardian of the rich.

North Side

Balancing budgets on the backs of the poor only costs more

We have been hearing a lot about the need to cut our costly entitlement programs, with some saying they are wasteful, we can't afford them anymore, etc. I would like to share just what it means to balance a budget on the backs of the poor.

These are some of the highlights of Pennsylvania's 2011-2012 budget presented in the newsletter of the PA Health Law Project. Beginning this fall, Medical Assistance recipients will see drastic cuts in their benefits. The Medical Assistance Transportation Program is changing. People who drive to their appointments or pay someone to drive them will see their reimbursement cut from 40 cents to 12 cents per mile. Worse, people who rely on ACCESS, the county shared ride system, will see their rides go from no cost to a $2 co-pay for each one-way trip. You may not think it is much, but think of this: Seniors ride the same system for $1.50 a ride. And if you happen to be a dialysis patient, you are making 13 round trips a month -- that's $52 just for that one aspect of your care. Remember the pie chart where folks are trying to decide between food and utilities? Now, being able to get to medical appointments will be part of the pie, too.

In addition, prescriptions will be limited to six per month beginning in January 2012. Maybe at first glance that sounds OK, but it only takes a chronic illness or two to far exceed that.

Aside from the cruel nature of these anticipated changes, I don't think it will save any money. Dialysis patients who can't afford the $4 to get to their treatments will end up needing to call 911 and go to an emergency room for a far more costly treatment. If this were to happen over and over again with many patients, it will be a self-made disaster.

By the way, will a limit be imposed on the governor or the Legislature or their staffs or families as to the number of prescriptions they may take? Aren't their benefits paid for by the taxpayers?

Squirrel Hill

The writer is a nephrology social worker.

We welcome your letters. Please include your name, address and phone number, and send to Letters to the Editor, 34 Blvd. of the Allies, Pittsburgh 15222. E-mail letters to letters@post-gazette.com or fax to 412-263-2014. Letters should be 250 words or less, original and exclusive to the Post-Gazette. All letters are subject to editing for length, clarity and accuracy and will be verified before being published.


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