Rendell's plan insults doctors and their value
As a primary care doctor and a licensed, board-certified family physician, I have a few words for Gov. Ed Rendell regarding his health-care overhaul ("Rendell Wants More Health Care by Nurse Practitioners," Dec. 12).
To achieve my dream of becoming "the town doc," I spent four years in college, four years in medical school, three years in internship and residency and four years as a military doctor and officer. Do not insult me, sir, by saying I can be replaced by a less-trained provider.
If you want to improve health-care delivery, give the 93 percent of graduating family doctors who are fleeing the state a reason to stay.
Address the medical liability crisis and reform the system so that the MCARE fund (i.e., slush fund for trial lawyers) will become obsolete. With affordable "malpractice" premiums, we could offer the full scope of family medicine to Pennsylvanians, including obstetrics. Allow physicians to collectively bargain with the giant insurers and HMOs so we can afford to stay in private practice, instead of being forced out of business by declining reimbursements and pushed into salaried positions, where we are replaced by less-trained "physician extenders" (can you say "scabs"?).
You obviously don't value the profession I love. You can label whomever you like as a "primary-care provider," but I have news for you, sir -- my Medicaid patients specifically ask for "the doctor."
Before cancer took him from us in February, my father, a Korean War veteran and retired postal worker, thanked me for putting "Dr." in front of his family name. I should hope this hard-earned title still has meaning in the commonwealth.
VERONICA SANTEE, M.D.
Remember the PAs
Gov. Rendell would like nurse practitioners -- non-physician health-care providers -- to have expanded responsibilities. When considering health-care reform, physician assistants, also non-physician health-care providers, should be included.
PAs are health professionals licensed to practice medicine with physician supervision. PAs exercise autonomy in medical decision-making. PAs provide quality, cost-effective health care within the team approach to medicine. They evaluate and diagnose patients, prescribe medications and provide appropriate medical and surgical treatments.
The Pennsylvania Society of PAs worked diligently with the state Board of Medicine and the Pennsylvania Medical Society to improve our regulations. We have recently achieved changes to our regulations with M.D.s, and we are still working hard to advocate appropriate changes to all our regulations.
EMILY BELZ, P.A.-C
Talk to Iran, yes
Thank you, Professor J. David Slocum, for your well-reasoned essay on the advisability of President Bush opening talks with Iran, and congratulations to the Post-Gazette for printing it ("A Nixon For Our Time," Dec. 17 Forum). It does Pittsburgh proud to be among the first to rise above a media pack that has been conditioned to see only evil in Iran.
Mr. Slocum's comment that, "no ideological backdrop exists today comparable to communism and the Cold War" is particularly poignant. A generation of young Iranians still suffers the effects of their eight years of war with Iraq, which Western powers fueled in order to keep communist Russia at bay. Among the 100,000 civilians who died in that war were 5,000 inhabitants of the village of Sardasht whom Saddam attacked with mustard gas in June of 1987. While Iran may feel badly used by the United States, I am not aware of any real way that Iran has harmed the United States.
It's too bad Mr. Slocum didn't provide more details concerning the diversity of cultures that exist in the Middle East -- for example, the differences between Persians and Arabs -- as well as a very strong assertion that there is no indication that Iranians desire to Islamicize the globe, but he alluded to the points and, if the gods are kind, President Bush will connect the dots.
Selling out the Pens
I was in complete and utter shock upon hearing the news of Isle of Capri's bid for a slots license, and the Penguins' best chance of survival in Pittsburgh, being defeated.
Mario Lemieux has repeatedly indicated that he gave state, county and city politicians every chance to come up with a plan to save the Penguins prior to entering negotiations with IOC which precluded further talks with these government officials. These officials supposedly turned their backs on the Pens until the Pens could, legally, not talk with them anymore because of their talks with IOC.
It was only then that these sneaky politicians floated a half-hearted "Plan B."
If Gov. Ed Rendell, county Chief Executive Dan Onorato, Pittsburgh Mayor Luke Ravenstahl and the rest of their cronies think that Pittsburghers will ever forget that they forever lost the Penguins to another city, they are sadly mistaken. If they think the overwhelming voter revolt against the politicos who tried to raise their own salaries was something, wait till you see the message at the polls we send these jokers who have blood on their hands.
Two transit tips
After reading so much about public transportation -- its problems and solutions -- it seems to me you have overlooked one important resource. I am referring to senior citizens. On Port Authority transit, seniors ride free (except 7-8 a.m. and 4:30-5:30 p.m. weekdays). I see no reason why they shouldn't pay for something that would benefit them.
In California seniors pay $12 per month. Those who cannot afford even that pay $6. In New York City, seniors pay half. I'm sure there are many seniors who can afford this and would be glad to pay if it meant better service. I am one of them.
And while we're making changes, how about getting rid of that insane system of, during rush hour, paying when you leave the bus. Whatever time is saved by allowing people Downtown to board by the back door is more than lost waiting for people to squeeze through massed bodies, to say nothing of the discomfort and inconvenience.
It would be much more efficient for people always to pay upon entering -- and always to leave by the back door. This must be the only city in the world that has this crazy system.
Regarding your Dec. 19 editorial "Candid Camera": There may have been a time when traffic citations (and parking tickets) had a primary purpose of discouraging disruptive or dangerous behavior.
Increasingly, however, traffic fines serve as a source of income obtained from citizens who have violated a legal restriction (think of the rural communities whose budgets are funded from speeding tickets). Sadly, it is now acceptable to propose that an elaborate and expensive system designed to increase the number of citations can provide the funds to pay for both installation and maintenance of the monitoring system and for projects such as highway maintenance.
Thus, the guardians of public safety propose to build a system which cannot succeed unless dangerous behavior (running a red light) continues unabated or, if things go well, actually increases.
In the long term such a system for financing road projects will fail if dangerous behavior, the number of citations and the number of accidents decreases. A cynic might suggest that the violations will continue because the fines will be carefully regulated to be an irritant rather than a deterrent.
An alternative is available. If those responsible for the safety of the citizens would reclaim the basic goal of decreasing dangerous behavior, they could justify an enormous increase in the fines associated with running a red light. I would suggest an initial fine of $2,000 (escalating by $1,000 with each offense).
No cameras required, just a sincere desire to make the roads safer and widespread publicity regarding the increased fines.
The real voting problem: third-party or independent candidates are shut out
Paper ballots may stop votes disappearing from recounts ("In Praise of Paper" by Bruce Schneier, Dec. 3 Forum), but they won't stop candidates disappearing from Pennsylvania ballots.
2006 saw no Pennsylvania third party or independent statewide candidates because unfair rules required over 67,000 ballot access signatures. Major-party statewide nominees needed only their 2,000 primary election signatures.
When the Green Party's U.S. Senate candidate attempted ballot access, Democratic Party lawyers filed suit resulting in ballot denial and a staggering $1 million fine.
Incumbent parties use law and crippling financial threats to silence candidates who serve us all by bringing uncomfortable topics to political debate. Thus, paper backups won't stop disappearing debate from disappearing candidates.
What will? The Voters' Choice Act.
Since 2005, PaBallotAccess.org, a coalition of Libertarian, Green, Constitutional, Reform and other parties, has promoted the VCA. It would implement fairer ballot access rules. We need to push this again in the 2007 Legislature.
While unverifiable recounting is a concern, a far greater concern is censoring debate by unfairly prohibiting ballot access.
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