This merger is another sad chapter for local health care
Per your article about Mercy Hospital's acquisition by UPMC Health System ("UPMC, Mercy Merge," Sept. 21), the photo with dark clouds hanging over Mercy seems appropriate. It is indeed a sad event to have this proud, valued institution assimilated by the embodiment of monopolistic avarice and power.
If this announced merger does occur, I hope Mercy will be able to retain some degree of autonomy and not become totally absorbed into UPMC's culture. I further hope Mercy will be able to continue to sustain its heritage as a Catholic institution offering exemplary patient care to those who have financial resources and also the same level of quality care to those who do not have financial resources.
This region suffered a loss when St. Francis Hospital became a victim of the shifting health-care environment and interplay of dueling systems and insurers.
Let's hope Mercy continues to be Mercy to serve future generations needing quality physician, inpatient and outpatient care at the same level we have been fortunate to receive.
A.V. PAPA JR.
Bad for costs
The Sept. 26 article "Impact of UPMC, Mercy Deal Uncertain" irresponsibly downplays the effects that the UPMC/Mercy hospital merger will have on local health-care costs.
Hospital systems like UPMC, in general, have two primary sources of leverage when negotiating contracts with health insurers: 1) access to their services and 2) competition among health plans.
Given the dominance of Highmark in the Pittsburgh health insurance market, the former is all that really matters for UPMC. Every time UPMC acquires another hospital in the Pittsburgh area, it strengthens its position against insurers who want competitive access to UPMC hospitals.
Insurers like Aetna and HealthAmerica, which have already been denied access to UPMC's Shadyside and Presbyterian hospitals, might find themselves shut out of Mercy completely. Highmark, on the other hand, will continue to leverage the West Penn Allegheny system and other hospitals against UPMC when negotiating rates, but each loss of an independent hospital like Mercy hurts Highmark's position.
Some might argue that it is high time someone put Highmark in its place, but a UPMC monopoly would be far worse for consumer health-care costs than a Highmark monopoly. Even insurance companies like Highmark with huge local market shares remain wary of threats from outside insurers like HealthAmerica, Aetna and recently United -- seeking to make inroads.
A UPMC monopoly faces no such threats, unless someone decides to build more hospitals.
The writer is a student in the health law program at the University of Pittsburgh School of Law.
Local health-care megalomaniac Jeffrey Romoff is at it again. Although Mercy Hospital approached UPMC about a merger ("Mercy Initiated Merger Talks to Stay Open," Sept. 22), this latest acquisition will only momentarily quench his thirst for monopolistic dominance of all health care in Pittsburgh and surrounding areas.
What's next? Allegheny General? Highmark Blue Cross Blue Shield? There really isn't much left to gobble up around here, which is a lose-lose-lose situation for everyone.
First, the consumer loses when competition is eliminated. We all know that. Second, the employees lose. UPMC employees have seen decreased benefits along with higher co-pays over the years. Acquiring Mercy will only make the stakes of the game worse. Third, the city loses because of the lost tax revenue it could gain from UPMC.
Just think how all those tax dollars could help out the dire financial situation in our city.
There is already public outcry over the $523 million profit for the past fiscal year made by this "nonprofit" organization.
I would strongly urge Mayor Luke Ravenstahl to work with City Council to come up with a plan to exact UPMC's fair share of revenue due the city, based on the amount of taxpayer-funded city resources UPMC uses on a yearly basis. It certainly wouldn't generate the money that property tax would, but it would definitely make the mayor a local hero to win a showdown with UPMC.
About our premiums
As a busy physician, who remains in Pennsylvania in part thanks to MCARE (Medical Care Availability Reduction of Error fund) abatement, I rely on your newspaper to keep informed.
After missing live coverage of the Swann-Rendell debate last week, I read the account of the debate and questioned one statement in the article ("Swann, Rendell Scrap Over Pay Raise," Sept. 26). Regarding this sentence: "The MCARE fund pays half a doctor's malpractice insurance premium and the state pays the rest" -- was this Mr. Rendell's explanation of the MCARE fund or was this the PG's explanation?
In any case, no one should be misled. MCARE abatement is exemption from total or partial payment into the state catastrophic loss fund for malpractice cases. This is in exchange for promising to stay in Pennsylvania to practice medicine.
No one but the doctor, not MCARE, not the state, is responsible for paying the doctor's malpractice insurance premium.
KYLE LINGENFELTER, M.D.
Most computer security experts agree: We need a paper trail
Your Sept. 29 front-page article "Professor Shows Flaws in Touch-Screen Voting" propagates a number of misconceptions about voting machines that need to be clarified. You present one computer security expert, Edward Felten, showing how the machines can be hacked and expressing his opinion that the machines need to be equipped with voter-verifiable paper trails. The rest of the article then goes on to discredit his worries, by quoting voting officials and other experts. The impression conveyed is that there are two camps, pro-paper and anti-paper, of equal popularity, making equally strong arguments.
But this is a false impression. The vast majority of computer security experts are convinced the best currently available method to improve the security of elections is to supply the machines with a voter-verified paper trail, as recommended by Professor Felten. The Verified Voting Foundation has collected the endorsement of more than 10,000 people, including thousands who are professionals in the computing field. In a survey taken of the membership of the Association for Computing Machinery, more than 95 percent of those responding also take this position. The number of computer professionals who take the opposite position is minuscule, with good reason. Paperless systems are susceptible to undetectable manipulation by attackers, undetectable manipulation by the companies that make the machines, software errors, hardware errors and misconfiguration errors by poll workers. The certification processes in place are totally inadequate to prevent these problems -- indeed, there is no known certification process that could.
The article also claims that "only minor glitches" were encountered in the May primary election in Allegheny County using the new paperless voting machines. This statement is flatly contradicted by "Allegheny County Elections Board Ratifies Vote Totals" (Post-Gazette, June 13), which described very serious complaints that were raised against the voting process used in that election. In view of such obvious problems, why should we believe these machines are accurately carrying out the unauditable parts of their job -- like counting the votes? Why should voting require such a leap of faith when we could have voter-verified paper ballots? Twenty-seven states already do.
Professor of Computer Science
Carnegie Mellon University
The letter also was signed by Roger Dannenberg, associate research professor, Department of Computer Science and School of Art; David Eckhardt associate teaching professor, Computer Science Department; Adrian Perrig, assistant professor of computer science, electrical and computer engineering, engineering and public policy; and Michael Reiter, professor of electrical and computer engineering and computer science, all of Carnegie Mellon.
We need backup
In response to Jack Hathaway's Sept. 27 letter ("Have Some Faith"), in which he says, "I will cast my vote on Election Day and accept the results whatever they may be": I wonder how many Americans can accept such logic given the numerous recent reports of polling irregularities and Election Day mishaps as a result of the new electronic (paperless) voting machines.
Rather than sit back and hope that everything functions smoothly on Election Day, Pennsylvania citizens should contact Sens. Rick Santorum and Arlen Specter and urge them to support the emergency legislation introduced by Sens. Barbara Boxer, D.-Calif., and Christopher Dodd, D-Conn., that would require states to have paper ballots on hand on Election Day, in case the voting machines malfunction.
While prevention is usually the best cure, voters should also be prepared to demand a recount should there be an Election Day fiasco. We are not living in a truly democratic society until every vote is counted.
The writer is operations coordinator for the Pittsburgh League of Young Voters.