Medicare for all is the right direction, but more is needed

As a retired cardiologist who has practiced in both prestigious medical schools and in community hospitals, I say Dr. Bill Wood ("Medicare for All," Sept. 13 Midweek Perspectives) is right on the money about the need to put the whole country on Medicare.

But this is only half of the cure for our dysfunctional health-care system. The other half requires that Medicare develop unbiased and scientifically accurate means to evaluate outcomes and costs for every doctor and hospital. Higher-quality, lower-cost providers should then be paid more for each service than lower-quality, higher-cost providers.

This is the only truly market-based solution to our current morass. The Institute of Medicine advocated for this a few years ago. Even the socially conservative George W. Bush agreed with this when he said recently: "People deserve to know what their health care costs, how good it is and the choices available to them."

I plan to elaborate on the need for this in a forthcoming book describing my experiences in 32 years in medicine in New York, New Jersey and Pittsburgh, all the profits from which will go to charities dedicated to improving the quality of patient care.

RICHARD R. SCHNEIDER, M.D.
Shadyside

---

System fails patients

I strongly support Dr. Bill Wood's call for medicare for all (Sept. 13). Every day I treat psychiatric patients who do not have health insurance. Many qualify for insurance on paper, but they do not know how to get it, or it has been inexplicably cut off.

I have seen patients with long-standing mental illness who have their benefits terminated because they did not send in paperwork -- even though they were in the hospital and unable to read their mail. When they get out of the hospital, they cannot pay for medication and they get sick again.

The current system is insensitive to the needs of the weakest, poorest and sickest patients.

SARAH E. FLANDERS, M.D.
Squirrel Hill

---

More about Plan B

The writer of the Sept. 12 letter "Plan B Falsehood" tells us that the morning-after pill cannot cause an abortion. That is technically correct; Plan B cannot cause any harm to an embryo or fetus after pregnancy has taken place. However, this drug may prevent a fertilized egg from implanting in the uterus. The official Web site for Plan B (go2planb.com) tells us this drug works in the following way:

"Plan B works like a regular birth control pill. It prevents pregnancy mainly by stopping the release of an egg from the ovary, and may also prevent the fertilization of an egg (the uniting of sperm with the egg). Plan B may also work by preventing it from attaching to the uterus (womb)."

Both Rick Santorum and Bob Casey Jr. believe that life begins at the point of conception. This means that they feel that a fertilized egg is a human life worthy of human rights protections, including the right to life. Therefore, logically speaking, they both should oppose a drug that may cause the destruction of a fertilized egg prior to pregnancy by "preventing it from attaching to the uterus."

JOHN LEWANDOWSKI
Bethel Park

---

Focus on transit

In the Sept. 14 article "Wi-Fi Goes Live," everyone seems so excited about the idea that Pittsburgh is on the forefront of something great that is going to solve all of the city's problems and help with the revitalization of Downtown.

They even have the audacity to intimate that "low-income residents" will be able to access the Internet from anywhere in Downtown. However, these people will have no way of getting there and no way to get to work to make the money to afford a computer with a wireless card, or one at all, if they cannot get to work via bus.

Wake up, people. Pittsburgh is facing a fundamental transit crisis that must be solved immediately for anything in the city to function properly. If there are no buses going Downtown on the weekends and evenings, as might happen with service cuts, there will be none of the behind-the-scene workers, such as janitors and maintenance personnel, to keep Downtown functioning, so all those people with laptops can enjoy sipping Starbucks and shopping at Ikea.com.

Without transit, this city will plummet into the doldrums and be forgotten about long before it's time.

ED SCHNEIDER
Bloomfield

---

About party loyalty

I need to respond to the multitude of negative letters published concerning Sen. Rick Santorum. A main complaint seems to be his "rubber-stamp approach" to the Republican administration policies. It seems that the letter writers would like Mr. Santorum to "go against" his party.

Yet when a Democrat did this very thing, the Democratic Machine crucified him. The Democratic Party completely turned on a good man who had dedicated his public service career to the party. He is one of the few Democrats who would win my vote.

I hope Sen. Joe Lieberman of Connecticut wins his bid as an independent. Going against the Machine seems to ensure political suicide.

ANNE GRAHAM
South Strabane

---

Highway savings

Pennsylvania has a large funding deficit for highways. One way to use our tax dollars more efficiently would be to merge PennDOT with the Pennsylvania Turnpike Commission. This would eliminate duplication throughout the two agencies.

ARTHUR FLEMING, M.D.
Forest Hills

---

Care for bicyclists

I have been reading the letters on bicycling you have published recently. I ride my bike regularly and would like to plead for just a bit more care for the bicyclist.

I know that many bicyclists are arrogant risk-takers, but at least they are taking risks only with their own lives. When drivers pass too close to a bicyclist, they are taking no chance of injuring themselves, but if the bicyclist were to move just a bit in the wrong direction, the driver could seriously injure or even kill the cyclist.

I have been passed many times by cars trying to whip their way around a line of stopped traffic so they can be first in line at a red light in my lane, or by cars passing me at high speed, with just inches to spare. Please give us a foot. Your cars protect you; our bicycles do not protect us.

JON WEBB
Squirrel Hill

---

A purpose for plant

With regard to the plant that David Letterman gave as a gift to Mayor Luke Ravenstahl ("Ravenstahl Finds Letterman's Spotlight Bittersweet," Sept. 15), he should have donated it to Phipps Conservatory in memory of our late Mayor Bob O'Connor.

He certainly was someone who wanted to keep our city green and flourishing.

MELANIE LINN GUTOWSKI
Bloomfield

---

Some continue to exploit 9/11 for political gain, while others die

In reading your Sept. 13 article "Ex-Pittsburgher Killed in Iraq Fighting," I feel a personal loss. While the religious right is still exploiting 9/11 to win the election, it leaves some of us wondering, what is really going on?

Don't we have a right to the truth? Shouldn't scare tactics for reason of political gain be looked down upon? The fact is that we are not any safer. All they have done is scare us. People are dying in a war that is based on a lie. It is insulting that any regime would use the deaths of thousands to lie to its own people, especially here in America.

The war in Iraq has nothing to do with 9/11 (our president has said it himself). The Iraq war has also infuriated the entire Middle East, if not the rest of the world. I feel less safe as a result.

Intensifying restrictions on the rights of our citizens while bombing countries that have nothing to do with 9/11 is not only un-American, it is plain irrational.

The Republican administration that is currently in power (with the exception of a few) has blatantly ignored the recommendations of the 9/11 commission, of its constituents and of the entire world.

Our government officials work for us, we don't work for them. This is no longer an issue of politics. This is humanitarian. People are dying. This must be put to an end.

ADRIENNE McGRAIL
Mount Washington

---