Protesters in D.C. should get what they deserve

The thousands who descended on Washington this weekend to protest what they perceive as a misguided health-care reform certainly deserve to be heard. I only hope they find the same success in changing government policy that the millions of us around the world who protested against the misguided Iraq war found in 2002.

The president should politely acknowledge their view, then proceed to push forward full-steam ahead with the legislation America needs.

-- Mike Kelly, Bainbridge Island

Where were protesters during last term?

To the protesters in D.C over the weekend:

When our government spends billions of dollars to start an untenable war that at best sends our troops into harm's way without a clear goal or exit plan, and at worst actively kills innocent civilians, where were you the last eight years ["Masses flock to D.C. to vent on Obama, course of country," page one, Sept. 13]?

For eight years these D.C. protesters never breathed a word of objection. However, when our government wants to spend money to at most prevent people from dying as a result of inadequate, nonexistent or corrupt health care, and at least enact reforms to give people more health care options, they line the streets of our capital foaming at the mouth in protest.

Apparently they do not have a problem with people dying at war overseas and they do not have a problem with people dying here from lack of insurance. Now there's a "death panel" for you.

-- Sabath Mullet, Issaquah

If it's good enough for Obama, it's good enough for me

Question: What kind of medical coverage do all of our senators and representatives in congress, including the president, have?

Answer: They all have single-payer health-care coverage.

If a single-payer health-care plan is good enough for our president and for members of our Congress ["Obama finds his voice on health-care reform," Opinion, Syndicated columnist, Sept. 11], why not have it for the rest of us? Single-payer coverage would be by far the simplest, least expensive and most efficient health-care plan for all Americans; it would basically be Medicare coverage extended to everyone.

Health-care reform should just leave out the useless intermediaries: insurance companies that only create unnecessary bureaucracy and additional costs and don't actually provide health care at all. Let us move on to the best possible solution: single-payer universal health-care coverage for all Americans. At the very least, we need a strong public option.

-- Caroline Herzenberg, Chicago

The problem with health care? Look in the mirror

The Seattle Times editorial ["Needed health reform must contain costs," Opinion, Sept. 6] noting that health-care reform must contain costs identified part of the problems facing quality care as insurance companies, excessive specialist income, how medical services are delivered and paid, and high costs of new technology and procedures.

But I think The Times forgot something: U.S. citizens. Aren't we part of the problem when our behavior contributes to our poor health through excessive eating, lack of exercise, high stress levels and more?

Mom said to eat my fruit and vegetables and get plenty of sleep and exercise. Maybe if we listened to our mothers a little more, we'd be a healthier nation and could then afford as a country to ensure health care is available to everyone.

I'm just as guilty as many when it comes to making a poor choice for dinner and eating too much, choosing TV over taking a walk or working long hours. But throughout this health-care debate, it's made me think about my own behavior and my personal responsibility to help contain costs.

We're part of the problem, too.

-- Margaret Jones, Seattle

Cutting costs, but not with government health care

Medical costs are a bottomless pit. To control costs, does The Times suggest in its editorial, "Needed health reform must contain costs," that doctors work for free? That could happen because patients with chronic diseases usually get worse before they die. So much for paying doctors for better care and better outcomes. And heaven forbid that specialists who save lives should earn more than a tiny fraction of what professional athletes earn.

What unnecessary tests would you eliminate? Be honest: Limiting generosity and rejecting some people and procedures is rationing. "Death squad" is a harsh term, but ethics panels and review boards have always had to make tough choices. Our country cannot even make enough swine-flu vaccines for all of its citizens.

Insurance companies are part of the process. Without them, the government would have to provide essentially the same services, and without a profit motive it may not care if paperwork is handled properly and efficiently.

We must remember that we are the federal, state and local government and must pay for whatever we give ourselves and society as a whole.

-- Byron Gilbert, Burien

Please explain, how is health care not a right?

We can tell how crucial health-care reform must be because big money, with the help of the crazies, is out in force to defeat it! There has been such an assortment of shouted phrases and signs in the crowds like "Death Panels will pull the plug on granny!"

or "Obama is a Nazi!" or "The government won't let you see your doctor!" or "We don't have a clue what we're saying!"

There's one sign, very rarely used and not by the Zany Wackybirds, that at least is down-to-earth and adds to the discussion: "Health care is not a right."

The Health Care for All Washington organization has been using the slogan, "Health care is a right, not a privilege." The opponents of the health-care reform movement seem to differ on that.

I invite these people to take their time, compose themselves and write back to The Times and explain to me, very clearly, why they believe health care is not a right in this country.
The United States is the only industrialized country in the world that still treats access to quality health care as a privilege and not as a right for everyone. What would the Founding Fathers say about that?

I somehow have missed the reason why people and groups want to continue this disparity and also choose to sabotage this opportunity we now have to reform the system into something we can all be proud of, as citizens and residents of a free and compassionate nation.

I need detailed explanations from opponents out there to clear away my confusion. Please do not simply spew loaded phrases and distortions of the truth to make your arguments.

There must be some justification why we continue to fail to attain universal coverage, even though this country has been attempting since the days of Harry Truman. I'm waiting for those reasons.

-- David S. Gooding, Normandy Park

The horrors of health-care reform

Health-care reform must be stopped! Can you believe some of the reforms they have in these bills?

Did you know that if this health-care reform is passed, senior citizens over the age of 87 will be forced into hard-labor camps? Also, did you know that if you get rabies under these reform mandates you will be locked in a crate and shipped off to Armenia, and our government will be under no obligation to provide a return address? That's right, no return address! Not to mention, health-care reform will require all doctors to use only 14th-century techniques on the third Tuesday of every month.

Now if these testimonies weren't bad enough, recently someone told me that under this newly proposed reform plan all left-handed citizens who've never had the measles will have to get a frowny-face tattoo burned onto their foreheads! Oh, the horror!

I could go on. But I'm positive someone else will.

-- Brad Killion, Mount Vernon

What Canadians are saying about their neighbors

Canadians think we Americans are stupid. They joke about Canadian expatriates losing two IQ points every year they remain in the U.S.

They also think we are loud, rude and irrationally tolerant of violence. Next time you feel like giving a particularly polite Canadian a patronizing pat on the head, remember that under that calm exterior lies simmering disdain.

Last week, I heard a Canadian rhetorically ask, "What kind of yahoos take toenail clippers away from everyone boarding a plane and allow loaded guns at presidential town halls on health care?" So where do Canadians get that confident sense of superiority? Maybe it's the old saying, "Familiarity breeds contempt." They know virtually everything about us; we're largely clueless about them.

Or maybe it's something basic like their superior health-care system. It's not perfect, but everyone is deemed worthy of care.

With fear and anger, we talk of death panels, socialism, fascism and freedom. Canadians simply ask, "What kind of yahoos leave a population greater than that of Canada without dignified access to health care, just so the rest of them can keep their clunker of a profit-driven system?"

-- Sue Griswold, Mill Creek

Don't forget: Democrats heckle, too

With all the shouting, protesting and cowboy posturing about health-care reform, it makes me think that before we can reform health care in this country we need to reform behavior in ourselves.

Being a Democrat, it would be very easy to point fingers at the conservatives that act both immature and disruptive. But I think it's time to look back at the previous eight years and ask, "Were liberals any different?"

How many times did MoveOn.org draw a Hitler mustache on President Bush? How many times did Code Pink disrupt meetings or events attended by Republican leaders?

It's so easy to point out the splinter in someone's eye yet miss the plank in your own.

-- Jonathan Ursin, Seattle

Joe Wilson: the next Hulk Hogan?

Editor, The Times:

What an absolute embarrassment Rep. Joe Wilson is to this country ["Republican apologizes for heckling president," CloseUp, Sept. 10] and the institution he takes an oath to serve and represent. Wednesday night on an international stage, he showed his true colors -- that of a complete pompous buffoon.

I hope Wilson and his fellow peers with their juvenile signs and disrespectful twittering during the president's speech (a student would be tossed out of class for that behavior) are all ostracized by their peers from both sides of the aisle for their immature and disrespectful behavior. They all bring shame to the entire process and our fine country.

No wonder so little ever gets accomplished if they represent some of the players involved. Hopefully South Carolina will send Wilson packing and replace him with someone who can control themselves and represent them in a respectable and productive way.

He should get a job with the wrestling federation -- they thrive on grown adults shouting insults and hurling venom. He'd be a natural.

Hang your head, Joe. You can apologize, but your actions speak loud and clear.

-- Wendy Fosnight, Bainbridge Island

The real reasons for Republicans' opposition to health-care reform

After listening carefully to President Obama's speech and hearing the Republican response (by a rich doctor-congressman, Joe Wilson) I must conclude that the GOP has, in reality, only three reasons for being against the plan he outlined:

• Protecting the Republican bottom-line goal of easing the tax burden of the very wealthy.

• Protecting the profit margin of the campaign-contributing insurance and pharmaceutical and medical industries -- bribers, really.

• Hoping to defeat Obama's one big congressional issue of his first year in office just for the sake of handing him a defeat, rather than for any real philosophical or financial reasons.

In the 2010 elections, those House and Senate members who vote against whatever is the bill's final form had better be prepared for some spirited opposition campaigns -- maybe even in their party primaries.

-- Rod Belcher, Des Moines

Outburst was business as usual

Republican leadership and their pals shouldn't act surprised by Rep. Joe Wilson's rude and unprecedented outburst during President Obama's address to Congress.

After all, this is the party that encourages citizens to shout down legislators and interrupt them with shouting, screaming, insults and gibberish at public meetings.

Wilson knows the party line. He was just exercising the new democracy.

The chilling part? The same hypocrites also encourage loaded weapons at our president's speeches.

-- Peter O'Neil, Seattle

Wilson's accusation not far from the truth

Rep. Joe Wilson's shout "You lie!" was inappropriate during President Obama's speech, but what he said was true.

Obama continues to say 47 million Americans are not covered with health insurance when he knows full well that number includes 13 to 14 million illegal aliens.

Everyone with half a brain knows Obama will make the attempt to cover the people he is counting on becoming future Democratic voters. It just is good politics.

Wilson knew this and just couldn't restrain his frustration. Bad response and yet a true statement. Obama does know he is bending the truth.

-- Bob Allan, Woodinville

From a liar, an accusation of lying

Talking about no class, South Carolina Rep. Joe Wilson is the very personification of the concept. I find his outburst during President Obama's speech particularly egregious given all the falsehoods spewed out by the right on health-care reform.

In this instance I can't help but note the irony that, indeed, no provision in any of the proposed bills calls for coverage of illegal immigrants.

In other words, his shouting out "You lie!" when President Obama made this point clear was in itself a lie.

-- Marshall Dunlap, Kent

Gloating at president's struggles, offering no solutions

Editor, The Times:

Charles Krauthammer's syndicated column ["The president who fell to Earth," Opinion, Sept. 5] shows the attitude of the far right.

The emptiness they feel at not having a Republican president or a majority in Congress must be intolerable. Krauthammer and company attack President Obama and Democrats for what they are doing, or not doing, without a glimmer of an idea from any of the far right about how to fix a broken America -- other than to let business handle it.

They lie and innuendo about bills proposed while they only read sound bites the way news anchors on TV entice you to watch the news even after commercial breaks. They seem to delight in Obama's supposed loss of popularity, while they do nothing to fix the problems. Conservatives also forget the problems that we have now occurred on their watch.

Come up with better ideas before you criticize. America needs your help, not rancor. Do something constructive.

-- Gary S. Silverstein, Olympia

Obama's empty promises, not right propaganda, hurt him in the polls

In response to Charles Krauthammer's syndicated column, President Obama's poll numbers are dropping not because of a liberal doctrine but due to a lack of one.

It's the left of center that is in the majority in this country, and they are the ones who put Obama in office under the delusion that he was going to be any different from his centrist rhetoric.

Bogged down in two unpopular war occupations, reluctant to pursue illegal and unconstitutional behavior by the previous administration, refusing to even look at a single-payer health-care system and failing so far to address campaign promises such as rewriting trade laws that have exported American jobs and exploited the world's poor for private profits are the reasons Obama's poll numbers are down.

It's not because of any so-called liberal agenda, despite the propaganda from the ridiculous right.

-- Chris Anderson, Seattle

There's nothing grass roots about Obama's opposition

Charles Krauthammer can hardly contain his glee at President Obama's failing efforts toward reforming our health-care system.

Krauthammer ascribes opposition to Obama's policies to what he calls a "real grass-roots movement," but most Americans will readily recognize Obama is up against powerful and entrenched special-interest groups.

Public opinion has little to do with what happens in Washington, D.C. these days. This is especially evident when one considers Krauthammer's reference to the U.S. being a center-right country.

This needs to be examined more closely. A Pew poll from late June asked Americans if they would increase or decrease spending in various areas of the federal budget.

Overwhelming majorities favored increasing federal spending on health care, Medicare, education, environmental protection and government assistance to the unemployed.

Krauthammer can crow all he wants about this being a center-right country, but it simply isn't true. What is true is that the forces in control of our country are very much to the right of U.S. public opinion because of the dominant role money plays in our political system. In this light, it is particularly ironic that Krauthammer refers derisively to the "established lobbyist special-interest order of Washington."

Just who does he think these groups are, if not the powerful health-insurance interests who have organized so effectively against real change?

Krauthammer and his center-right colleagues may be quite pleased they have been able to maintain the status quo. But in the years ahead, as the American people continue to pay outrageous medical bills and have few options, they will look back upon this period as a lost opportunity and a tragedy.

-- Blake Wood, Seattle

Republicans let their jealousy show through

I never get tired of Republicans who are so jealous of President Obama they will do and say anything to bring him down (to earth, or better still, beneath it.) Looming larger than the jealousy, of course, is the real fear he might put his dreams into practice.

The 2008 election showed the majority of voters want a new vision for America, one that threatens those who have amassed great wealth under the previous regime. Even though they're in the minority, they have lots of money and mouthpieces like Charles Krauthammer to muddy the waters.

Just a reminder: A lot of people aren't interested in doing the right thing. Don't be fooled by this claptrap. And, speaking of Napoleon, can you imagine if we had elected John McCain?

-- Michael Johns, Seattle

Obama faces massive task while Republicans are bankrupt in policy

Charles Krauthammer's syndicated column likened the current presidency to a carnival with its barker. But the real shell games and cheap tricks preceded 2009.

Enron and Bernie Madoff cashed in, more enabled than challenged, as general living standards declined. Our Constitution and standing among other nations was trashed. Ignorance, belligerence and worship of the market mantra created a stable that needs thorough cleansing.

It's a massive task, which partly, not wholly, explains the Obama administration's spotty performance as it mounts a trial-and-error, not-doctrinaire, recovery.

This residue of the past should not deflect the 2008 electorate's move past the centrism Republicans at large, Krauthammer and those beyond him on the media's right fringe seek, for now, as a default position. Bankrupt in policy, they need something, anything, to halt progressives and swing the pendulum back their way in 2010 and beyond.

Their rhetoric and tactics demonstrate desperation, like just saying "No!" They play on deep fears in our politics and culture, provoke our worst instincts and dishonor our republican vision and democratic practice.

Krauthammer's column merits contempt and a deep, not decent, burial.

-- Milton Krieger, Bellingham

Name public option after Kennedy

Editor, The Times:

A better suggestion to naming a health-care-reform bill in honor of Sen. Ted Kennedy ["Honor Kennedy with meaningful reform," Opinion, editorial, Aug. 28] would be to name a true public option after him, for that is the most critical element of any reform that will extend coverage to those who lack it or lose it while bringing competition to private insurance companies to lower costs.

Kennedy twice introduced legislation to do just that. It was called "The Medicare for All Act," and it would have opened Medicare enrollment to any citizen who wanted it as an option to private health insurance.

As for Sens. Patty Murray and Sen. Maria Cantwell, each of whom has claimed Kennedy as a mentor and inspiration yet neither of whom has shown a lick of support for any meaningful public health-insurance option, naming such a public option after Kennedy might finally move them to support it.

-- Alex MacLeod, Shaw Island

Leave old Chappaquiddick wreck out of the picture

Was it really necessary to run that old photo ["A man some loved to loathe," News, Aug. 30] of Ted Kennedy's car being hauled out of the water? Didn't he do enough during his life to try to erase that dark chapter?

Let's get a positive outlook.

-- Marilyn Brashen, Kirkland

Why the sensation over Kennedy's passing?

Sometimes I feel like I'm in the minority about some things that just don't make sense to me.

Take for instance the 24/7 news coverage of Ted Kennedy's passing. I guess if I lived in Massachusetts and had benefitted financially or in other ways from the power exuded from the Kennedy clan I might understand it. But this is a guy who in 1969 drove off the road drunk into a creek and didn't seem to care about the woman drowning inside. The only real question here is: Was it murder or was it manslaughter?

It has always amazed me how the people of Massachusetts could elect Kennedy even once let alone allow him to make a career out of his congressional seat. From what I know about his career, he did assist in reaching consensus on quite a number of political issues. I suspect he felt guilty for what he had done and well he should.

I'm trying to remember if we had three days of mourning after President Reagan's passing. I think not.

He was only the president who brought down the Soviet Union, so how could he compare?

-- Don Means, Woodinville

Kennedy's mourners deserve to be focus of health-care debate

Watching the events surrounding the death of Ted Kennedy, I was struck by the thousands of ordinary people who came to pay their respects in a truly spontaneous fashion ["Mourners in streets remember Kennedy," News, Aug. 30].

No one organized their visits to the Kennedy Library nor the lining of the various roads and streets in quiet dignity along the way of his funeral procession.

Why aren't the millions of ordinary people like them the focus of the health-care debate? How in God's name did the proportionately minuscule number of people participating in unruly protests organized especially for the town-hall meetings come to dominate the discussion?

Surely America can do better.

-- Judith Frolich, Kirkland

Kennedy, a graceful and model public servant

Much has been written over the past few days about the impact Sen. Ted Kennedy made as a legislator and the way he interacted with the people he represented. My anecdote, perhaps more removed than some, is extremely memorable and important to me.

As a Massachusetts native who spent much of my early career working in homeless shelters and anti-poverty agencies, I was aware of the work Kennedy was doing on behalf of people living in poverty.

In 1994, while working for Kennedy's re-election, I wrote The Boston Globe a passionate response to an article about how many young people were unaware of -- or downright cynical about -- Kennedy's work.

"The under-30 crowd, of which I am a part, seems to be paying more attention to Hollywood than Washington, and the ridicule directed at Kennedy is more available to these voters than credits on his record," my letter in The Globe said.

A few days after my letter was published I got something in the mail that remains one of my most cherished possessions: a handwritten note from Kennedy thanking me. For me, it was like God stopping by on his way to work to pat me on the back.

In his lifetime of service, Kennedy represented more than just the people of Massachusetts. He represented the ideals and hopes of millions of young people like me who needed someone to lead the way -- to validate the work we were doing and the idealistic dreams we refused to let die.

As much as Bobby and Jack Kennedy remain my larger-than-life heroes, Ted Kennedy -- like Martin Luther King Jr. -- will always be the boots-on-the-ground ideal of what a public servant is: tireless, effective, fiercely intelligent and always graceful.

-- Jesse Ward Putnam, Seattle

Extend Medicare to all to honor the liberal lion

Sen. Edward Kennedy was a great champion of social justice, active on behalf of the less fortunate and a wonderful advocate for health-care reform.

What better memorial in his honor could we give him than an excellent new universal-health-care bill for the American people, extending Medicare to all?

-- Caroline Herzenberg, Chicago, Ill.

A perfect reason why reform is needed

Keven Drews, with dual citizenship in the U.S. and Canada, provided a stark contrast ["USA or Canada? I chose the country that saved my life," Opinion, guest column, Aug. 25] between his health care in Canada -- with lifesaving measures provided three times at no cost to him -- and the unaffordable costs the same care would have amounted to in the U.S.

His story supports Paul Krugman's call ["Night of the living Reaganites," Opinion, syndicated column, Aug. 25] for an Obama bully pulpit: "We're at what should be a turning point but are failing to make the turn."

-- Erin Scarlett, Seattle

Like Drews, my husband has gone abroad for care

Keven Drews' guest column hit a nerve, as my husband is also suffering from multiple myeloma and has had to return to England for treatment.

We are in our 70s and are having to live apart because we cannot afford the horrendous medical bills a serious illness can bring in "the richest country in the world."
I shall be traveling to the United Kingdom this week to be with him, and we will be leaving our lovely home in Renton to rent a small one-bedroom flat somewhere near the hospital.

We do need a government health option here in the U.S.
-- Pauline Warby, Renton

Is Canada, despite health care, an undesirable place to live?

After reading Keven Drews' column regarding his battle with multiple myeloma cancer, several things jumped at me.

First, I was impressed and inspired by Drews' strength, perseverance and determination as he fought and re-fought this insidious disease. I am also thankful he's achieved the level of recovery he's reached and pray he remains in good health.

Second, while the purpose of the column was to point out the failings of health care in this country, a few things were revealed between the lines.

He made several references to the fact that his preference was to live in the U.S. He said he was "forced" to return to Canada and "saddened" he could not stay here. He implied that living in Canada was an unfortunate necessity.

This reluctance to live in a country providing a universal-health-care program, touted by many here as the solution to our health care, brings up some unanswered questions.
What is it about our neighbor to the north that makes living there less desirable to the writer, despite all our faults?

Are the burdens of socialized medicine on Canadian taxpayers and businesses so repressive that the cost of living there is economically prohibitive? Many are in the 55 percent tax bracket on top of having to pay monthly premiums. Also, not mentioned in the column is that many Canadians, with the financial means, flee south to receive quality health care in a timely fashion.

I understand his appreciation for the Canadian system, and its benefits in his situation, but he still makes clear that given the choice his preference would be to reside in the U.S.

I've visited British Columbia numerous times and have found the land and people beautiful and hospitable. I hope to visit many more times in the future. During my visits I've never experienced or seen anything to make me wish I didn't want to be there. Yet, apparently the author has reason to wish returning to live in the U.S was an option.

It would be ironic that the Canadian universal-health-care system he speaks so glowingly of actually contributed to the conditions that made his relocation north unfortunate and sad?

-- Bob Brunswick, Bothell

An unforgettable moment with Kennedy

Editor, The Times:

In 1995, the Aberdeen High School choir made a trip to Washington, D.C. As a young staffer for Sen. Patty Murray and a graduate of Aberdeen High School, the senator asked me to accompany her visit with the students. After posing for pictures, answering questions and listening to a couple of songs, Murray needed to leave for a vote on the Senate floor.

Shortly thereafter, some of the talented students noticed Sen. Ted Kennedy looking at them over a balcony. He said, "I just wanted to hear where the beautiful music was coming from." The students implored the senator to come down to visit with them and, to my surprise, he obliged.

As he ambled up to the group of students, he shook my hand and whispered, "Who are these people, and why are they here?" I responded that they were from my hometown, a small town in Washington state, and were here to visit Murray.

Immediately, Kennedy whirled around and spoke to the students about the time Jim Whittaker was speaking with his brother about climbing Mount Rainier. He said, "Whittaker was telling Bobby that everyone should climb a mountain, or visit a national park, to remain close to nature, but Bobby turned it around on him and said that everyone should visit their government to ensure we protect beautiful places in our country like Mount Rainier."

Over the years, I had several opportunities to be in Kennedy's presence both in Washington, D.C., and Washington state. He always remembered I was from Aberdeen. And I will always remember how easily he related to "normal" people.

And, I'm confident those students will always remember their trip to visit their government. He will be missed.

-- Shay Hancock, Washington, D.C.

An era passes with Kennedy's death

And so, Camelot comes to an end.

For those of us who watched the'60s unfold as children, the passing of Sen. Edward Kennedy is particularly poignant.

Whatever their political affiliations, presidents and colleagues praised that his passion for causes was tempered by his willingness to compromise -- qualities lacking in today's polarizing politicians and pundits. And if they did not agree with him, they never questioned his commitment to those Andrew Jackson identified as "the humble members of society."

At a time when concentration of power in the president and vice president has rocked this nation and its Constitution to the core, I offer King Arthur's closing lines in Camelot in remembrance of the Kennedy's perseverance: "Thank you for saving Camelot. You have reminded us that a kingdom's strength is not based on the strength of the king but the strength of the people."

Kennedy promised at the 1980 Democratic Convention that his "work goes on, the cause endures, the hope still lives and the dream shall never die."

"By whom, now?" is the question that should haunt us in coming months, as public frustration simmers over perceived haves and have-nots.

Because if average Americans lose faith they can still aspire to prosperity, then what?

-- Douglas Jensen, Sequim

Name health-care reform after the Liberal Lion

The Kennedy family name will live forever in America's psyche, but none more so than Ted Kennedy's.

The Liberal Lion was passionate in his liberal social causes, but health-care reform was at the top of his agenda, and in the'70s he gave a firebrand speech that delineated what we as a nation must do to attain coverage for all. The way he went about it was with all the verve he could muster.

Kennedy had many friends across the aisle, as well as within his own party, and his death yesterday couldn't have come at a worse time, but I have a suggestion: Let us name our health-care reform in his memory.

How about the Ted Kennedy Health Care Plan?

-- Max W. Don, Mukilteo

Not just a lion of liberalism, a phoenix committed to justice

Who among us hasn't sighed -- especially during the George W. Bush years -- and wondered what John F. Kennedy might have achieved had he lived?

From the loss of Joe Kennedy Jr. in World War II, to the assassinations of John and Bobby Kennedy, to John-John Kennedy's unspeakable accident, it's easy to focus on what might have been.

Even when we speak of Ted Kennedy, whom we have only just lost, we may recall the "long shadow" of the Chappaquiddick car accident and bemoan the missed opportunity for another Kennedy president.

But Ted Kennedy was a phoenix. Call it penance for a fatal mistake on that bridge in Massachusetts, but he has served the people in the truest sense -- wholly committed to the causes of justice.

In 47 years in the Senate, he achieved his lion status through the force of his personality, passion and commitment -- especially when it came to universal health coverage, for which no one worked more tirelessly or spoke more eloquently.

Though the outpouring of grief and personal tributes are fitting expressions of our loss, the real tribute to Ted Kennedy's legacy will be when -- like Lyndon B. Johnson signing the Civil Rights Act JFK had worked to achieve -- President Obama signs into life Kennedy's dream of health care for all.

-- Teresa R. Herlinger, Portland, Ore.

Honor Kennedy with real health reform

Sen. Ted Kennedy spent a long and important career fighting every day for real health-care reform. We should all honor his struggle by letting our senators, Congress and president know we want and need real reform with a strong public option.

Don't let the squeaky right-wingers stop this.

-- Peter O'Neil, Seattle

Reform is all about saving those ill like Kennedy

The coverage of Sen. Ted Kennedy's death brings more attention to the partisan arguments regarding health-care reform. However, we must remember that reform is about saving lives. As an advocate for an organization without a partisan political agenda, I can tell you the reform bills being debated represent tremendous progress for people fighting cancer.

Under the existing system, even if a person is lucky enough to have affordable, quality health care, they risk losing that insurance. A cancer patient or survivor who is laid off or cannot work is virtually uninsurable. Annual and lifetime insurance caps can limit treatment, and pre-existing conditions can be used as excuses to limit or even deny coverage.

In comparison, the health-care reform bills would guarantee affordable access to treatment and prevention services. Annual and lifetime benefit caps would be eliminated, and no one would be denied coverage because of pre-existing medical conditions.

There is room for further progress, but we need reform now, so all Americans have access to affordable health care. We need Congress to make sure people no longer have to choose between losing their life savings and saving their life.

-- Ray Sasaki, Seattle

Civilized debates come without guns

David Sirota echoes ["First Amendment trumps Second Amendment," Opinion, syndicated columnist, Aug. 23] my personal alarm concerning the guns appearing at public meetings.

His Thomas Jefferson quote about watering the tree of liberty with the blood of tyrants -- that makes my blood run cold.

This madness has got to stop. There are means for civilized people to solve problems, and guns are not among them.

-- Mary S. Mitchell, Seattle

Firearms demonstrators well within their rights

David Sirota, thank you for telling the truth.

And the truth is you and your elitist colleagues hide behind your First Amendment rights to attack our Second Amendment rights. Just remember, as Thomas Jefferson said, "The strongest reason for the people to retain the right to keep and bear arms is, as a last resort, to protect themselves against tyranny in government."

Law-abiding gun owners are fed up with elitists like you who think they are above all others and use their positions to spread fear and disinformation to attack our Second Amendment rights. In fact, the publishing of arrogant and ignorant statements such as yours are the reason these protesters are carrying firearms.

While I don't necessarily agree with protesters carrying firearms at demonstrations, I understand why they are doing it, and I support their right to do so. It was journalists like you who fired the first shot by attacking our rights. It was politicians like Janet Napolitano, who as the head of the Department of Homeland Security disseminated an official report labeling supporters of the Second Amendment as "potential right-wing extremists/domestic terrorists."

How many attacks do you think a person will tolerate before he or she starts fighting back? These people are making a statement that they are not going to take it any more. Instead of continuing your mindless attacks on our rights, why don't you just start realizing there are people out there that do not have the same opinion as you, and their rights matter just as much as your rights.

I was both surprised and extremely pleased to see President Obama say these people are within their rights. He recognizes and understands why these people are making their statement in such a bold manner.

Obama is displaying a level head by not escalating this further. You, on the other hand, are trying to incite a riot.

-- Neil Foster, Renton

Group Health innovative, but maybe not affordable

I enjoyed the article about Group Health Cooperative ["Does Group Health hold answers in health-care debate?" page one, Aug. 23] and certainly have been satisfied with the quality of care I've received from it during the years when I was working.

However, as a model for affordable health-care reform, it is too expensive for the unemployed. The costs for my wife and I range from $10,692 to $12,932 annually for Group Health's two plans that are not burdened by higher deductibles or higher out of pocket limits. Couple this with their annual double-digit increases and those costs will hit $24,000 per year in just seven years.

Now I ask, how can the unemployed afford that or those who are forced to take Social Security early at 62 at a lesser amount and are too young to qualify for Medicare?

MSNBC just quoted today the average Social Security check as being $1,153 per month or $13,836 per year. Seems to me the Social Security check is not going to cover Group Health, food and rent.

We need some kind of health care that is truly affordable since many who don't think reform matters because they have employer coverage may soon find themselves laid off in this wretched economy.

-- Clayton Chinn, Seattle

Those who saw U.S. change should know better in health-care debate

When Jackie Robinson broke baseball's color barrier, angry people screamed that the national pastime was doomed. In the 1960s, anger erupted during the civil rights and women's liberation movements. Change seems to create fear, making people susceptible to misinformation and emotional appeals.

Sean Hannity and Glenn Beck lament the loss of the America they grew up in. I grew up in that America, too, and remember it was segregated --that I could be punished as a female college student for wearing pants on campus. That the search for communist conspiracies turned Americans against each other. That political assassinations became a too common occurrence. So I am amazed when I see people, who grew up like me in those tumultuous decades, angrily shouting at town-hall meetings.

Baseball did not end because Robinson played. Grandparents delight in seeing their granddaughters have opportunities for education and careers that were once denied them. Change is not a conspiracy but is often a positive in our lives.

We may have differences on issues, but by not listening, we become pawns in a narrative not based on facts or fairness. Conflict sells better than reasoned discussion. People who have lived through periods of hatefulness before should know better than to contribute to its rise again.

-- Nancy L. Snyder, Shelton

Nazi comparison only about socialist policies

Leonard Pitts Jr. secured his reputation as a fiery, emotionally charged writer with his post-9/11 syndicated column, but his pretended ingenuousness ["The other 'N' word," Opinion, syndicated column, Aug. 20] over the issue of comparing President Obama's plans for socialism in America to Nazi Germany's socialism goes too far.

No, Pitts; the right is not saying Obama wants to murder Jews, as Nazi Germany did. Most of us don't even think he wants to invade Poland.

The comparison -- and all radio hosts I've heard discuss it have been very clear on this matter -- is with the Nazi Party's socialism in their health care and economic policies.

What Obama is calling for isn't new; socialist societies have been failing for many decades now. The atrocities came much later and not necessarily as a result of the socialism, though that's a debatable point.

Presenting some of the facts can be just as dishonest as presenting untruths, Pitts. Please try to play fair.

-- Daniel Gilmore, Des Moines

Herbold's and Powell's economics don't make sense

The guest column in The Times from Robert J. Herbold and Scott S. Powell ["Government-dominated reform will not improve health care," Opinion, Aug. 23] only left me confused. But when I saw that both individuals were associated with the Hoover Institution, a conservative think tank, I realized sewing confusion was the purpose.

They vaguely state that collectivism fails dismally in economics. First, every other industrial nation has more government involvement in health care with better results and on average half the costs.

Could that be considered economics? Second, individuals will often exercise independent initiative and decide it is more efficient to make certain decisions collectively. This is reflected in our fire departments, police departments, parks, schools, military, roads, patent offices and more.

Herbold and Powell fail to admit that having government involvement in health care is not the same as having the government making computers or socks. But they need to take that disingenuous leap in order to make their straw-man argument that government involved in health care equals Chinese-style communism from the 1950s, among other unsubstantiated conservative talking points.

Health-care and insurance executives can make $100,000 an hour. Yet 18,000 people a year die from lack of health care. I guess that's the good economics Herbold and Powell subscribe to.

-- Mike Thies, Seattle

Code words and scare tactics, but no solutions

Gun-toting hecklers don't attend town-hall meetings because they're interested in quality health care for Americans. They are motivated by ideology, and their aim is not to participate in the national conversation, but to stifle it.

Robert J. Herbold's and Scott S. Powell's screed is merely another form of heckling. Their column is long on code words and scare tactics but short on analysis and ideas. With their rhetorical guns blazing, they contribute nothing to the national conversation about affordable, quality health care.

Herbold and Powell write that health-care reform represents "an irretrievable loss of freedom" that undermines individual responsibility and free choice. Fourteen times they use the term collectivist or collectivism, and they throw in references to socialism and narcissism for good measure.

But they never mention the tens of millions of American children and adults who lack health insurance. And they fail to address the imbalance between the cost of American health care -- the most expensive in the world -- and its relatively poor health outcomes.

Those shaping the health-care-reform effort have tried too hard to accommodate the Herbolds and Powells.

Responsible lawmakers should stop attempting to appease the unappeasable, and consign them to the margins by calling them what they are: ideologically motivated hecklers.

-- Matt King, Seattle

Too much Ayn Rand from elite Americans

Robert J. Herbold´s and Scott S. Powell's commentary in The Seattle Times sounds like it was written by a couple of guys who read Ayn Rand and suffered a -- dare I say it -- collective attack of foolishness. They purvey myth after myth about government and the citizenry´s relation to it in a democracy as well as the ultimate fantasy -- that the unfettered will of capital defines freedom.

Let us begin with what the authors mistakenly call the visceral reaction that members of Congress encountered this summer. Here they unfurl the banner of spontaneity, the idea that voters on their own have risen up in anger -- collectively? -- against an elite that wishes to impose a government program upon an unwilling people.

Let us leave aside the fact that if in America there is an elite, then plainly the authors are card-carrying members. It is more interesting to address the supposed viscerality of the voters' responses. In actuality there was next to nothing spontaneous about it. On the contrary, it was cranked up by demagogues in the media who equate the action of government with encroachment of personal freedom.

Yet the authors' argument that the president's reforms will fetter our freedom has an unstated corollary -- that in the context of health care the insurance companies are the embodiment of liberty. Anyone who has lost or been refused insurance, who has been dropped from their rolls or who has duked it out with them over coverage knows that to be a delirious proposition.

Finally the authors retail the myth, a Rand favorite, of government action as collectivism. In this myth, all government action is created equal. The Soviet Union and China are no different from Great Britain, France and Germany, or indeed from an America that finally seems willing to extend health-care coverage to all its citizens.

The authors, pillars of one branch of America's elite, have turned a tired crank. If that is the best they can do, then reasoned political discussion of life-and-death issues is in very deep trouble in America.

-- Edward Baker, Seattle

Guest columnists don't understand Kennedy's call

Robert J. Herbold and Scott S. Powell show us clearly that the right's chorus of personal responsibility as the solution to our health-care problems is an evidence-free mythology. In fact, they base their entire piece on President John F. Kennedy's famous inaugural line: "Ask not what your country can do for you, but rather ask what you can do for your country."

Herbold and Powell, he didn't say "but rather ask what you can do for yourself." Kennedy's statement was a call for each of us to contribute to the collective good, not to descend into the selfish individualism you advocate.

-- Aaron Katz, Seattle

Some required reading for health-care debaters

Kudos to The Seattle Times for printing an excellent guest column by Robert J. Herbold and Scott S. Powell ["Government-dominated reform will not improve health care," Opinion, Aug. 23]. These two guys really nailed it. It should be required reading by anyone interested in the current debate on whether or not to allow the federal government to become so heavily involved in our health-care system.

As the writers point out in such easy-to-understand wording, government health care would be a disaster, as a majority of Americans seem to be grasping. With the news now coming out of more and more trillions of dollars being added to President Obama's -- not Bush's -- deficit in the near future, the country simply cannot afford to let Uncle Sam further screw up the system.

-- Scott Stoppelman, LaConner

Diminished regulations, not collectivization, the threat to economy

Robert J. Herbold and Scott S. Powell try to compare failure of collectivization in the manner of Fannie Mae and Freddie Mac to an anticipated failure of collectivization in government-paid health care.

Encouraging borrowers to amass massive debt in an attempt to make huge profits cannot be equated to spreading risk over the entire population to make health care affordable. To bring about the housing crisis, regulations were diminished, thus encouraging fraud and foolish behavior. To obtain affordable universal health care, enforced regulations and standards would discourage abuse and foolish behavior. Collectivization, in itself, has nothing to do with it.

Read H.R. 676 instead of the endless explanations by Congressman Rick Larsen, Blue Dogs and agenda-driven think tanks that believe a single-payer health system will not work.

Denis Cortese of the Mayo Clinic ["Fresh ideas boost health reform," Opinion, syndicated columnist, Aug. 2] says it will work, and he has no incentive to deceive us.

-- James Bruner, Oak Harbor

Time for personal accountability from corporate crooks

I certainly hope The Seattle Times didn't pay Robert J. Herbold or Scott S. Powell for their thinly disguised market-knows-best rant.

Not only do they attempt to tag proponents of national health care as collectivists, but they blame the entire financial collapse on government bureaucracy. The financial collapse isn't due to the fact that twice in 30 years lenders have gamed the system with straw buyers and conveniently obfuscating financial instruments. No, financial collapse was due to government mismanagement and the suppression of infallible market forces.

Their thesis is hogwash, and until this country demands accountability out of both individuals and corporations, we will be systematically fleeced again and again. We need to treat swindlers harshly. No more country-club jails. Life sentences and hard labor.

Complete forfeiture of all property and equities including those belonging to anyone accepting transferred assets. And while we're at it, break up the corporate boards of directors who enable the "your lotto winnings are peanuts compared to my annual earnings" corporate pay structures.

Don't let businessmen tell us how to receive benefits that should be national services, or we are all going to become commodities working at the discretion of corporate overlords.

-- Michael McInnis, Seattle

Government shouldn't need to have all the answers

The article by Robert J. Herbold and Scott S. Powell was the best I've seen on the range of things it covered.

I hope there is still time to avert becoming just another country with citizens expecting the government to answer all of society's problems instead of taking personal responsibility for the choices made in life.

It's difficult to choose which of their points is best because the article is full of excellent ideas, but this one is right up near the top: "It is ludicrous to spend additional hundreds of billions for supposed health-care reform that will limit options, weaken competition and create the largest U.S. government bureaucracy ever while ignoring the reasons behind the insolvency of Medicare and Medicaid."

-- Jeanie McBee, Kenmore

Talking personal responsibility from an ivory tower

When Robert J. Herbold and Scott S. Powell claim in their guest column that "over the past 45 years personal responsibility has been marginalized by collective government policies," they presumably refer to the adoption of Medicare in 1965 but lack the guts to say so.

In their rant against "collectivist political power" from the sanctuary of the Hoover Institution's ivory tower, they display an insufferable arrogance and ignorance of the real world in which the United States is the only economically advanced country on the planet that doesn't or can't provide its people with the peace of mind of guaranteed adequate health care.

Herbold and Powell may have failed to notice that China, which they seem to offer as a model of economic and social policy, is still a communist-collectivist state that provides universal health care to its people.

I have no doubt that Herbold and Powell would also welcome the abandonment of Social Security and a return to the good old days of the late 19th century before the government started interfering with private industry by regulating child labor, wages, hours and the right of workers to organize.

-- Dan Levant, Seattle

Constitutional argument being used in the wrong way

Not since Publius and Cato battled over the ratification of the Constitution has such a base debate about the nature of government taken place.

One can notice that the rhetoric of the right seems not to be directly attacking the notion of a government-run option but the underlying notion of federal dominance. Many at Congressman Rick Larsen's town hall held high signs declaring the necessity of originalism, or the idea that we must look to the Founding Fathers as the arbiters of all modern Constitutional questions.

Most jurists, and even James Madison himself, dismiss the idea: "Whatever veneration might be entertained for the body of men who formed our Constitution, the sense of that body could never be regarded as the oracular guide in expounding the constitution."
We cannot look to the framers alone for the answers to the health-care question. We must look to the wording of our Constitution, both implied and direct.

Congress is responsible for ensuring the general welfare of the United States, and nothing is more general or basic than health. This does not mean providing people expensive cars or swimming pools; it simply means the government is responsible for taking care of the most basic societal requirements, such as ensuring a healthy workforce.

We must move forward on health care, and we must not let these frivolous arguments stand in the way.

-- Peter J. Wagner, Blaine

Democrats falling apart on health-care reform -- again

It looks like the Democrats are self destructing again. It happens every time they get in power. Whenever Americans give them votes enough to make a difference, Democrats start bickering among themselves and initiatives like health care fall apart.

This time they've sold out for 30 pieces of silver. When will people learn to think for themselves and stop looking for saviors?

First, single-payer health care was off the table, and now they're not going to consider the so-called public option, which would provide government health care for those unable to afford health insurance.

Obama is so desperate for something he can label health-care reform that he's sold out to the right wing and the insurance companies for a patch job to the current system, which means continued skyrocketing health-care costs and huge taxpayer-funded subsidies to insurance companies.

It seems no matter which side wins, millions of Americans lose and will still go without coverage, hundreds of thousands will go into financial ruin over health-care costs and insurance CEOs will laugh their way to the bank.

The Democrats haven't the courage to stand up to the moneyed interests and pass a single-payer plan that would cover every American regardless of income, age or prior medical condition. Single-payer works well in every major industrial western nation and the Government Accountability Office and Congressional Budget Office studies have stated that single payer would save billions in health-care spending. It would eliminate the administrative costs, waste and high CEO salaries of for-profit health insurance.

Until we take the money out of politics and adopt clean campaigns, we will continue to have the best government that money can buy, and we will fail to have a courageous Congress that would adopt such measures as HR 676, the single-payer health-care bill.

-- Howard Pellett, Anacortes

Obama clearly from another world

Those birthers who think President Obama is not a U.S. citizen are only partially correct.
Our group, earthers, contends he is actually from another galaxy.

Our proof? He is unquestionably way too smart and reasonable to be an earthling politician. Do you need additional evidence that he is a politico from another planet? He occasionally admits it when he makes mistakes, and he is faithful to his wife.

He's clearly not a terrestrial elected official.

-- Kevin Cole, Seattle, USA, Planet Earth

Why cooperative health-care is a viable alternative

There is a lot of interest in the health-care debate and in Congress about cooperative health care and especially in Group Health Cooperative here in Puget Sound. Since cooperatives may be a viable alternative, I feel I should share my own recent experience.
In December 2004, I had a major one-car accident. My chest was crushed, and I bled into my lung cavity causing major damage to my lungs.

A Seattle Fire Department Emergency Response team cared for me at the scene and transported me to Harborview Hospital. I spent about a month there in intensive care. Next I went to Regional Hospital for six months of critical care. From there I went to Kindred Hospital for another five months of critical care. Finally, I spent 100 days in Bothell Rehab center and then in February 2006, I went home for good.

You might suppose that to pay for this amount of care, (estimated to cost more than $1 million) that I would now be financially destitute. Not so. We have had to pay only a small amount of this. As a member of Group Health Cooperative, my eligibility for Medicare, the $10,000 from my car-insurance policy and the Seattle taxes that pay for emergency responses, the rest of the bill was paid for me.

My experience shows how all these programs can work together toward their common goal. I still use supplemental oxygen but other than that, after four and a half years, here I am.

I still live a pretty good life for an 85-year-old man thanks to cooperative health care.

-- Frank Baker, Bothell

A doctor is exaggerating the cost of preventive care

It is disappointing that a former physician such as Charles Krauthammer would put forth such a misleading analysis ["Preventive care is no panacea," Opinion, syndicated column, Aug. 15] of the cost of preventive care, using an expensive $500 hypothetical test for mystery disease X.

His example assumes that all expensive preventive tests would be given to all people regardless of risk, which of course is a wasteful approach. There are very economical examples of preventive medicine that Krauthammer conveniently leaves out, like asthma screening in children or blood pressure and glucose checks for adults.

Catching asthma early saves in expensive emergency-room visits. Identifying people who can benefit from inexpensive blood-pressure medicines saves money by preventing years of heart disease later.

The prevention examples I gave are cheap and take only a few minutes. This is not "nonsense" or "deus ex machina" as Krauthammer claims.

Nonsense is when you make up a hypothetical disease with an expensive test to support a flawed hypothesis that prevention will cost us money.

-- Mark Damberg, Seattle

More preventive care would save tax dollars

Charles Krauthammer wrote that prevention, on a societal level, costs more, not less. Prevention is much more than costly procedures, however. It includes vaccinations to prevent epidemics, counseling people about behaviors that can lower their risk for diseases, providing primary care to prevent expensive visits to emergency rooms and treating illnesses in a timely manner in order to prevent complications.

I have often seen patients that have been unable to afford their medicines, the supplies necessary to monitor their blood sugar or to obtain medical care. The result? After years of inadequate or no care, they develop blindness, kidney disease and/or foot ulcers.

At this point, they become disabled, finally get medical care from the government, and we taxpayers pay for dialysis, ophthalmic treatment, amputations and prosthetic limbs, vision services to teach the blind person how to function in the world and more. In addition, we have lost a productive member of our work force.

However, I agree that preventive care is not adequate to solve the problem of our country's high cost of health care. Until we address the problem of health care for profit, the costs will continue to escalate.

Single-payer health care is the answer to affordable, sustainable and universal health care.

-- Diane Bommer, RN and Certified Diabetes Educator, Port Townsend

Early care saves lives, money

This is not the first time I find Charles Krauthammer's statements over the top and downright wrong.

This time he is telling us preventive care is for the birds and a waste of time and money. With his overlong diatribes, using many examples, he is trying hard to convince the reader that preventive care would cost us more than it saves. Is he saying being healthy is more expensive than being sick? What kind of nonsense is that?

Preventive care should be the stalwart of health care. Fortunately, we have started on the road to preventive care, with tests for many diseases. A good example is seen in cancer detection. A test may not necessarily prevent the disease but discovering it at its earliest stage is saves lives and money.

Krauthammer, by saying preventive care is nonsense, is doing the public a disservice. One expects more from a syndicated columnist.

-- Jutta Kurtak, Bellevue

Without public option, no meaningful reform

I read in The Seattle Times ["Viability of public option in question," page one, Aug. 17] that the Obama administration is considering dropping the public option as one of its goals in current health-care reform legislation.

I would prefer a single-payer plan but was willing to compromise on anything that included a public option. If this feature were to be eliminated from the plan, then I am afraid it would lose all my support as well.

The fact of the matter is: Without at least a public option, no meaningful reform in health care can possibly take place. That is because, in the end, the insurance companies will still be in charge of the system.

Like any business in America, insurance companies are profit driven. As such, their objectives are always going to be to take in as much money as possible while expending as little as possible.

The health care of any of their customers will always come secondary to that principal. A public option is the only way to address this problem effectively. That is obviously why it is meeting so much resistance from the industry.

-- Marshall Dunlap, Kent

Gun toters just intimidating health-care discussions

Recently there has been a disturbing overlap between freedom of speech and the right to bear arms. What is the purpose of having machine guns, assault rifles and holstered handguns at playgrounds and town meetings? Where will this stop? Isn't the sole purpose to intimidate others, especially when many are shouting and suppressing those with polite and legitimate questions?

Gun toters intimidate those without guns. It's that simple. Why should guns be necessary at public forums on health care? Does the right to bear arms mean unarmed attendees should stay home out of fear, or alternatively, arm themselves for potential confrontations? What about the right to feel safe and secure when engaging in civil discourse about political matters affecting us all?

Police must hire more security for these events, even though the average non-gun toting person bears the economic burden.

Emotions have run high at the town meetings. What if somebody fires a shot in the crowd, creating panic and potentially a massacre?

Once again, the National Rifle Association has gone too far. Truly, it does not represent Middle America -- only the fringe.

-- Mark Litchman, Olympia

Protesters not trained to have weapons safely in a crowd

As a retired police officer, I was troubled by the sight of openly armed civilians at political rallies. But not for the obvious reasons.

I realize that each had a right to be armed, but from the images that I saw on television, none of those armed appeared to have the situational awareness that being armed in a crowd requires.

With the exception of one man, those that were portrayed wore holsters that were designed for concealment rather than secure weapon retention. Most had their hands holding other items like signs and microphones, making any attempt to prevent someone more sinisterly motivated from disarming them unsuccessful.

Being armed in a crowd, one must be constantly vigilant to protect the weapon from others. None of those that I saw were mentally prepared for such a misadventure.
Shame on them for being so cavalier with the safety of others.

-- Jerry Kempe, Shoreline

Trying to drown out free speech with fear

Why are the people bringing guns to political rallies not being charged with domestic terrorism?

It is obvious their only intention is to intimidate those of us who want a responsible dialogue. If liberals had done this they'd be hauled off to jail in a hot second. Of course, that's why we are liberals. We actually believe in free speech -- not drowning it out.
We believe in democracy, not mob rule. And we live according to certain moral credos such as, "Do unto others as you would have them do unto you."

That's the difference.

-- Rob Moitoza, Seattle

Inefficient system only to get more expensive

For five years, I worked as a physical therapist aide in a small clinic in Des Moines. During this time, I talked to hundreds of patients from all walks of life.

Sadly, they all had to deal with high health-care costs. It was heartbreaking to see people at their most vulnerable not only struggle with injuries but also financial insecurity and mounds of paperwork.

Our undependable health-care system is not a political game but a harsh reality for many Americans. I am sure most people know someone with health insurance who is drowning in medical debt or being denied coverage because they actually need health care.

Unfortunately, if we do nothing, this inefficient system will only get worse with costs predicted to double by 2016. Small businesses and families will be hit the hardest, and I don't how our economy can deal with these higher costs. Sens. Patty Murray and Maria Cantwell have to realize that we are done with rhetoric.

A public option will create the competition in the market that can cut costs and red tape. It is time to finally get strong reform and a dependable, affordable health-care system.

-- Tiffany McGuyer, Des Moines

Future after reform: a cool, free vacation in the hospital?

It's been hot in Seattle this summer, so let's get this socialized medicine up and running fast.

Because then instead of going to the mall to cool off, we can go to the hospital and not only get an air-conditioned room for free but three squares and a view.

Ding, ding, ding. What's wrong with that nurse? My dinner's cold and my bed pan needs a changing, or I'll lawyer up and sue for malpractice!

-- David Hagen, Seattle

A veteran who wants everyone to have his health care

As a combat-disabled veteran, I have been enrolled in the Veterans Affairs health-care system for more than 50 years.

The system has faithfully delivered the finest health care to me while residing in several states.

I am most grateful for the undivided attention I receive. The VA Hospitals in Seattle and American Lake are, by far, the most efficiently operated.

Why can't this nation offer each of it's legal citizens the same government care?

-- Curt Lint, Herron Island

A health-care solution in a vegan diet

Our nation is in the grip of a raging debate over reforming a grossly misnamed "health-care system" that threatens to bankrupt our economy. In 2008, U.S. medical costs reached $2.4 trillion, or 17 percent of our gross domestic product, growing at an astronomic annual rate of nearly 7 percent. That's $8,000 per person or $20,000 per household. It's a major factor in mortgage defaults underlying our economic crisis.

And these numbers don't even begin to account for the economic toll of lost productivity or the emotional toll of crippling disease and premature death.

The tragic irony is that these outrageous costs have little or nothing to do with health care and everything to do with medical care, directed mostly at alleviating chronic killer diseases that are self-inflicted through our flawed lifestyles.

Actual health care is absolutely free: It consists of regular exercise, adequate rest and abstinence from smoking, hazardous drugs and meat and dairy products.

Yes, meat and dairy. According to the U.S. National Center for Health Statistics, nearly 1.4 million Americans are crippled and then killed annually by heart disease, cancer, stroke, diabetes and other chronic diseases linked conclusively with consumption of animal products. That accounts for 70 percent of deaths from known causes, and presumably, for a similar percentage of medical costs, or $14,000 per household.

We have no control over the national costs of medical care. But each of us can exercise a great deal of control over our household's $14,000 share every time we visit our favorite supermarket.

-- Alex Nelson, Seattle

Not just politicians should be able to afford vacation, health care

Congress has adjourned for a month of vacation -- briefly interrupted by town meetings. Their family time is, I'm sure, financed via savings from the simplified health plan they enjoy.

It's only fair the House vote to pass the Affordable Health Choices Act once they reconvene so we, too, can afford to spend time with our families.

We promise to reinvest some of that savings into increased vacation spending next year in Western Washington; money not available to many working families who struggle to keep up with double-inflation rate premium increases under our current system.

-- Philip Bradford, Tacoma

America itself is sick with lies

Like viruses, two big lies infect America, threatening us more than any foreign terrorists: First, the illusion that our nation can sustain itself without taxing wealth, and second, the illusion that government is the enemy, when in fact our government is we the people.

Spread through propaganda funded by private corporations, these lies convince gullible citizens to vote against their own best interests. At town-hall meetings on health care, these gullible Americans shout down the very democracy and government that is the last best hope among nations.

Which is more democratic and American: We the people owning our health care, or health care controlled by an elite cartel of corporate profiteers?

-- Alfred K. LaMotte, Steilacoom

A taste of Bush's treatment for Obama

I nearly spit out my coffee when I read Paul Krugman's syndicated column in The Seattle Times ["Obama must deal with the death of his postpartisan dream," Opinion, Aug. 16].

He charges that President Obama is now dealing with an enraged right that denies the legitimacy of his presidency, threatens his health-care proposals and eagerly seizes on every wild rumor manufactured by the right-wing media complex.

This is such a vivid description of what the left did to President Bush over the past eight years, but now it's outrageous because it's happening to Obama?

Krugman's hypocrisy is his own business, but he shouldn't insult our intelligence.

-- Freddy McLaughlin, Seattle

Who is Congress really representing?

Editor, The Times:

So it's happened. Not only is single-payer health care off the table, but it looks like President Obama and Congress are ready to cave on the public option as well ["Viability of public option in question," page one, Aug. 17].

Democrats hold the White House and have large majorities in both houses of Congress, and yet they don't have the spine to pass a bill that might upset the Republicans and the insurance companies?

We should change our nation's motto to government "of the corporations, by the corporations and for the corporations."

-- David Pfeifle, Lynnwood

With present course, health-care reform will fail

How sad that The Seattle Times' Aug. 17 editorial ["End-debate distortions doom end-of-life care," Opinion], excellent though it was, needed to be written in the first place.

As someone who has spent the bulk of their career in health-care communications and desperately hopes this nation can find a way to seriously reform health care (including provisions for better end-of-life care and counseling), I greatly fear the current reform effort is likely to go the way of other doomed attempts to ensure all Americans receive quality health care.

One would think it would be relatively easy to fight hysteria and other manifestations of nuttiness with facts. One would be wrong. Unfortunately, the American landscape has become of late a place where disagreements cannot be registered without masses of wild accusations, vicious taunts and outright lies.

And if all else fails to vanquish an opponent, the death card often seems to do the trick. As a result, all of us suffer.

-- Mary Stanik, Minneapolis

In Post Office lines, an argument against government-financed health care

I can answer the question in your article about the fight against health-care reform ["Who's behind the fight against health-care change," Close-up, Aug. 17]! Who's behind the fight against health-care change?

Everyone in the Post Office line last time I was there. While waiting in line, everyone had something to say about health-care reform. No postal delivery on Saturday? What if that meant no health care on Saturday?

If the U.S. Postal Service is going bankrupt, why would I want the government running health care the same way? Bankrupt health care could be worse than expensive health care. Long lines, poor service and overworked staff led to frustration as we waited.

I know our health-care system isn't perfect, but making our medical care into something resembling our Postal Service is not the solution!

-- Lee Binz, Normandy Park

Lucky protesters obviously haven't had it tough enough

I have seen some of the footage of outraged citizens speaking out against health-care reform at town-hall meetings. It is their right to be outraged, their right to speak out and their right to influence the debate. Unfortunately, I can't share in this outrage --I'm not so lucky.

They are lucky they have never lost a job and had to worry about how to pay for coverage for their family.

Lucky they have not witnessed emergency rooms filled with people receiving care in the most expensive environment for low-cost preventive treatment because they have no insurance and no other way to receive care.

Lucky they have not had to witness their employer deciding how to address the double-digit annual premium increases -- by reducing benefits or increasing employee costs.

Lucky they have not known anyone whose lifesaving cancer treatments were stopped because a maximum benefit had been reached.

Lucky they have not known anyone with pre-existing conditions, which are used to deny coverage or make necessary coverage expensive.

Lucky they have never known anyone working two or three jobs who cannot afford health care still.

In the health-care debate, there are many things to be outraged about. I am outraged that for the last 15 years, private insurance companies have promised market-based reform that has never materialized.

It is outrageous to believe that it ever will.

-- Kevin Jahne, Seattle

Individual freedom won't disappear with health-care reform

Newsflash to everyone worried about losing your precious freedom in the face of health-care reform:

In Canada you are allowed to dance. You can also freely criticize the government.

Germany also allows dancing and kids can drink when they're 16 years old. And you can drink at public festivals without being penned up in a "beer garden." They even let you carry the glass around with you. You can also bring your dog with you to restaurants and to any park.

Travel more and you will learn that America no longer corners the market on freedom --if it ever did. In the meantime, take comfort in knowing that only in America you still have the freedom to choose between getting an operation and keeping your house.

-- Peter Poirier, Woodinville

Don't let emotion determine hospital's expansion

There are grave problems with the Seattle Children's hospital expansion ["Examiner calls Children's expansion too 'aggressive,' " NWThursday, Aug. 13]. that go beyond destroying a community's livability.

The first misunderstanding is that Children's hospital is adding more patient beds. Children's is petitioning the city for more square footage. It is the state that will determine how many beds can be added and, according to Children's own statistics, it is not eligible for the 350 beds it desires.

Like most hospitals in the area, when Children's refers to operating at capacity it is often referring to staffing issues not actual beds. If a hospital does not have the necessary staff-to-bed ratio, the hospital can be operating at capacity even with empty beds. As a tax-exempt entity, overbuilding would turn Children's into a financial succubus.

There seems to be blind allegiance to Children's hospital simply because it is a children's hospital. City planning should not be determined based on emotion, and no single entity, even one grounded in good works, should be allowed carte blanche to bypass building codes and laws.

Children's is a large institution and medicine is big business. Other area hospitals are quickly adding specialized pediatric services, and there is global competition for funding and prestige. In medicine, bigger is better.

-- Tonya Clegg, Seattle

Hospital opposition taking isolation to extremes

It appears on the surface that some well-meaning and well-placed citizens of the Laurelhurst community have raised their small but loud voice once again.

My family lived in Laurelhurst for six years, and we experienced firsthand the zeal these community leaders can direct toward elected officials. They have always fought Children's hospital, and if you look at the adjustments the hospital has made over the years, I'd think you'd agree that Children's has always been a good neighbor. Their push to isolate the neighborhood has always gone to extremes.

During our time in Laurelhurst, there was an organized effort to call the Seattle-Tacoma International Airport tower whenever a jet flight path made its way over our neighborhood.

This group wants to isolate the Laurelhurst neighborhood from everything. It fights growth. Why? Because it may create congestion, influence property values, impact driving times or other factors that the rest of Seattle is dealing with on a daily basis.

Laurelhurst is part of Seattle and Children's has always been a part of Laurelhurst.
Do not let a few well-placed citizens worried about their conveniences influence the next generation of health care for our children and our children's children.

-- Bill Blanchard, Kirkland

Seattle Children's not the only pediatric hospital in state

On behalf of MultiCare Mary Bridge Children's Hospital & Health Center, I would like to respond to an erroneous statement made in The Seattle Times Aug. 13 in the article, "Hearing examiner calls Seattle Children's hospital expansion 'too aggressive.' "
The statement, "Children's is the only pediatric hospital in the four-state region of Washington, Alaska, Idaho and Montana," is not accurate.

MultiCare Mary Bridge Children's Hospital & Health Center in Tacoma has been serving as a trusted pediatric referral center for children across the region since 1955. In fact, we often see patients from Alaska, Idaho, Montana, Oregon and even Canada.

As the designated Level II Pediatric Trauma Center for Southwest Washington, Mary Bridge operates one of the busiest pediatric emergency departments in the state. This high level of care for children continues throughout the hospital with a 13-bed Pediatric Intensive Care Unit and a Medical/Surgical Unit.

We also offer pediatric specialist physicians in a wide range of disciplines. Supplementing our inpatient services is a network of Mary Bridge outpatient clinics in Pierce, King, Kitsap and Thurston Counties.

-- Madlyn Murrey, Mary Bridge Children's Hospital & Health Center vice president, Tacoma

Deceptive ads have no place in health-care debate

I heard an ad last night on TV requesting us to ask our senator if "he" had read the health-care reform bill before he signed it.

First of all, no bill has been signed, and it is looking as if it will be a cold day in hell before one is signed.

Second, I resent that as an elder myself, I am being played.

The ad implied that my government will arbitrarily decide if I will live or die depending on a set of government positions connected to the elderly. The ad was disconcerting because it was meant to confound us.

But the folks who paid for that ad are not looking out for me -- they are looking out for their bottom line. I resent them because now that I have Medicare, I feel comfortable about my health care. I want the same for every human being in the United States.

It is obscene for them to try to make us afraid. They need to reach for their higher selves and not be trying to obscure what's really happening in Congress.

-- Cheryl G. Banks, Seattle

Feeling like puppets in health-care show

Recently we received an e-mail labeled, "Free medical care. Coming soon to a hospital near you. ObamaCare." The picture was of President Obama retouched to resemble an African witch doctor. The "C" in "ObamaCare" was drawn like a Communist hammer & sickle.

We are being bombarded with evidence like this that serious health-care reform is impossible, and we pass it on to each other. We're convinced: Americans can't have the kind of universal health insurance other developed countries have.

Why not? Because the health insurance and pharmacology companies don't want us to have it, and they know how to push our buttons. They even buy our national legislators before our very eyes.

It's bad enough being a puppet with invisible strings. It's really humiliating to see us dancing when we can see the strings.

-- Robert & Susan Stanton, Seattle

Take private insurance out of basic health care

The theory behind insurance is that many pay premiums and a few make claims. Insurance works for automobiles and homes because many pay premiums and few make claims. With health care, too many must make claims. It is doomed to fail.

People now pay huge premiums, co-pays and deductibles. People in many cases pay more in premiums than they would for basic health care. Most of this money is wasted on insurance-company bureaucracy, and no value is added to health care. Carrying the current cost of the health-insurance system is like trying to run a marathon carrying a man on your back.

The solution is simple. Eliminate insurance companies from basic health care. Let people pay for their own basic health care or have employers give a health-care account.

Insurance should only cover major health problems and surgeries.

For example, we now pay $6,000 per year for insurance for our single daughter.

She doesn't spend $6,000 per year for basic health care. If we used this $6,000 for her basic health care and a major medical plan, we would all be better off. There is no useful purpose served by forcing the doctor to send her bills to an insurance company for payment.

Without all the insurance bookkeeping, doctors would be freed from the overhead of insurance. Doctors could donate no- or low-cost service to people who cannot afford to pay.

-- Joyce Kormanyos, Sammamish

Why must health care be for profit?

One very significant issue remains perilously silent in the intensely conflicted and highly vocalized debate over the supposed reform of the health industry in the United States: Why must America's health industry be for profit?

American democracy may be capitalistic, but money can't buy everything, most notably human values. Consider the usually unrecognized but unquestionable success of Catholic education at all levels.

Faculty and administrator salaries there rarely compare with secular institutions, though the institutions most likely wish they could; they are equally founded on the spiritual values we identify as vocational.

Can "being in the business to make money" compare with the dedication of one's life? Historically, hospitals began as religious institutions, and modern science has created medical miracles, but has an essential element seems to have been lost in this discussion? And aren't we the poorer because of it?

-- Fr. John F. Foster, S.J., Seattle

Not just conservatives protesting 'Obamacare'

It's interesting to note there's not a word of concern heard from the Democratic leadership when Conservative speakers are shouted down by organized liberal students and those allegedly from unions and minority groups or when conservative guest speakers are uninvited by colleges and universities for fear their words might lead the students to become unruly.

But Democrats are screaming that those vocally protesting ["Rowdy protests at health forums," page one, August 6] against the Democratic-backed health-care plan at town-hall meetings are part of a Republican plot to get Obama. Worse yet, according to Sen. Barbara Boxer, these protesters are well dressed, and Speaker of the House Nancy Pelosi likens them to Nazis.

It would seem that in the Democratic leadership's opinion, it's only mean-spirited and uninformed conservatives who object to having a government-mandated health plan; that all loyal Democrats willingly accept the notion that their leaders know what's best for them, and thus wouldn't dream of publicly protesting against it.

This is yet another sure indication of the arrogance of certain members of the Democratic leadership that they so strongly and vehemently object to citizens openly and publicly opposing their agendas.

They apparently can't grasp the idea that every day more people are becoming aware of the fact that government often creates more problems than it solves and being in Congress does not magically endow one with wisdom, foresight and truthfulness.

-- Lee Fowble, Edmonds

Shouting out opposition not the way to exercise freedom

Nobody will deny the value of encouraging people to attend town-hall meetings and meet with their representatives. But when people are encouraged to attend for the purpose of disrupting discussion of issues, then we have a different problem.

Organized efforts and e-mail campaigns by the Republican National Committee, encouraging recipients to attend and disrupt town-hall meetings of Democratic members, should not be tolerated.

Real debate over health care should be encouraged; however, shouting down questions of the audience and not allowing a member of Congress to respond does not do that. In fact, it is a tactic that many voters are tired of seeing, which was voiced in last fall's election.

What is more troubling is that it is not a just an extreme group that is encouraging disruption of official meetings but the national committee itself, which claims to represent mainstream America.

There are many different feelings about health care in our country. All of those feelings should be voiced. However, when one side takes it upon themselves to shout out the opposition, it makes you wonder whose interest they really represent. It certainly is not the interest of freedom.

-- Richard Hildreth, Pacific

Can Republicans say yes?

Whether it's the Sonia Sotomayor confirmation or health-care reform or the Cash for Clunkers program or anything else that truly benefits the average American while threatening the profits of corporate America and the prescriptive moralizing of the religious right, the Republicans have proven they can say yes to only one thing: no.

-- John R. Scannell, Sammamish

Deceit has frightened people protesting at forums

The people who are confronting elected officials at health-care forums are angry and frightened at the thought of reform.

Of course they are. Very clever liars have told them that if health-care reform passes, they will no longer be able to visit their doctor and that illegal immigrants will be given free access to any doctor in the country.

Very clever liars have told them that if health reform passes, pregnant women who are carrying babies with Down syndrome will be forced to have abortions.

Very clever liars have told them that if health-care reform passes, their parents and grandparents will be put to death by the government.

The troubling thing is there are people who resort to using very clever lies because they have nothing else to offer.

The frightening thing is that very clever liars can fool so many otherwise intelligent, good people.

-- Catherine Alexander, Seattle

Protests born to keep government from taking over lives

Once again, The Seattle Times takes a liberal stand. The sub headline of the article about health-care protests reads, "Democrats say campaign orchestrated by GOP" [page one, August 6]. Are you serious? Can you not accept that the majority of the American people do not want the government to take over health care?

I am a member of the GOP, and I have not received one e-mail, letter or phone call encouraging me to go to a town-hall meeting. Organizers don't need to contact us. We are smart enough to figure this out ourselves, and there is a massive wave of support against more government in our lives.

Are you going to print that President Obama has contacted millions of Americans via e-mail, encouraging them to go to these town-hall meetings to show support for his plan? How orchestrated is that?

If The Times were truly unbiased and professional, it would run a follow-up article stating that this is a grass-roots movement -- because that's all it is.

Many of us are simply fed up by this administration's dishonesty and attempt to take over virtually every aspect of our lives.

-- Kathy Connors, Medina

Town-hall protests only taking cues from our organizer-in-chief

There is a saying attributed to Vladimir Lenin that goes, "Accuse others of what you are doing."

That slogan came to mind the other day as the White House and Democrats began a concerted campaign to portray critics of the President Obama health plan as a mob, as Nazis, brownshirts and agents of corporate special interests. Even more sinister, the people attending town-hall meetings in order to protest the Obama plan are accused of being organized.

Meanwhile, the White House has sent out an e-mail urging its supporters to attend those same meetings and has taken the unprecedented, Nixonian step of asking supporters to forward to the White House any e-mails or other documents that are critical of the Obama health plan.

We should remember that Obama began his career as a community organizer. His role was to identify grievances and mobilize organized dissent. Under the Constitution, that was his right.

But now, the Democrats are trying to demonize dissent and squelch public debate. Locally, Reps. Brian Baird and Jay Inslee are hiding from their constituents, apparently wanting to avoid inconvenient questions.

The plan seems to be, "Pass the bill, and read it later." This is neither transparency or democracy.

-- Stephen Triesch, Shoreline

Disruptive behavior adds nothing to health-care conversation

It is one thing to disagree with the health-care proposals backed by the Obama administration. It is quite another to interrupt the discourse with disruptive, rude and offensive emotional outbursts.

I support the health-care proposals, especially the government option, and I have good reasons for doing so. It is obvious that those who use screaming and the chanting of slogans to obstruct civil discussion on the issue are doing so because they lack a rational and coherent basis for their opposition.

And Rush Limbaugh has the effrontery to brand Democrats as Nazis!

-- Josiah M Erickson Jr., Seattle

Little legitimacy in protests at town-hall meetings

There are a lot of differences between the current town-hall protesters and Bush-era anti-war protesters.

Anti-war protesters were protesting an illegal war that we were lied to about. They only wanted a voice in their own democracy.

For that they were tear gassed, Maced, beaten with billy clubs and herded into free-speech zones, built well away from Bush political events where they wouldn't be seen or heard by the press.

Town-hall protesters are trying to disrupt legitimate democratic, public discourse. Many of them are being paid off or tricked into these protests by big insurance companies and pharmaceutical industry-shills. For that they are getting media attention as legitimate protesters. None are being Maced or tear gassed, or thrown into free-speech zones.

After all, we only do that to people who believe in freedom and democracy, not to corporate bigwigs who lie, cheat and disrupt civil discourse for nothing more than their own wealth and power.

Obviously money rules in this country. Democracy is secondary.

-- Rob Moitoza, Seattle

A tax for health care that people won't mind

President Obama indicated that he had two thirds of the cost of the reform paid for out of savings in his proposed plan. The other one third can be raised without hurting anyone.

Place a 50 cent tax on every stock, commodity and derivative transaction. Currently, the major brokers charge a $5.25 processing fee on every transaction on top of their commission.

Adding 50 cents to $5.25 would hardly stir up any objections. It's a win-win situation. The health-care reform will be paid for and the investors will feel good they were able to help millions of people to have access to proper health care with a 50-cent contribution.

-- Murray Levin, Mountlake Terrace

Employer-funded insurance should be eliminated

During the wage- and price-control era of World War II, employers began to offer medical coverage to employees as an allowable alternative to raising wages.

Inserting employer-funded medical care between the doctor and patient had no purpose other than to retain good employees. However, once started, it has been retained as the norm for larger employers, despite the problems it has caused in financing our health care. It served no medical purpose then, and it serves no medical purpose now. It should be eliminated.

It is a problem because large employers such as Boeing, because of risk spreading, can negotiate a much more favorable medical-insurance contract than can a small employer or an individual in business for himself or herself.

It prevents a level playing field being offered to individuals seeking medical insurance. We do not look to employers to provide group fire insurance for our homes. Individually, we shop around for a company offering good coverage at competitive prices in a fire-insurance market that has a level playing field.

Congress can facilitate elimination of employer-provided medical coverage by encouraging tax-free funds currently being paid for employee medical coverage to be distributed to employees as a tax-free increase in wages. Individuals would become responsible to purchase their own coverage. Medical-insurance premiums should remain tax-free.

Current union contracts requiring employer medical coverage could be allowed to expire over a reasonable period of time before funds for such coverage would lose their tax-free status for employers.

-- Ed Wittmann, Seattle

Let's have the same plan for all Americans

Isn't it ironic that the very health-care system Sen. Ted Kennedy demands for us ["With Kennedy ailing, it's still touch-and-go for health-care bill," News, July 27] would have resulted in his own death?

Yes, under the proposed health-care plan, Kennedy would have been sent home with pain pills to die.

Except, I forgot the national health-care plan in the works would not apply to Kennedy. In fact, it would not apply to any congressman or congresswoman, federal employee or union employee as a kickback for campaign contributions. It only applies to the rest of us peons.

Maybe a truly fair plan would be one all Americans would be covered under. Maybe if the politicians had to suffer with the rest of us, they would make better decisions for all of us.

-- Pauline Cornelius, Olalla

Blue dogs? I've got a better name for them

Thank you for publishing "Who's feeding the Blue Dogs" [CloseUp, July 31]. Now that it's been established these representatives and senators are all bought and paid for by the health-insurance industry, I believe the term "fiscally conservative" can no longer be used to describe them.

There's a more appropriate term for people who sell out principle and people for cash, but that word is probably not fit for a family newspaper.

-- Amy Hagopian, Seattle

Our poor choices are at fault for health-care failure

In response to a letter from Dr. Donald Sherrard ["Lower costs, lower mortality in Canada," Opinion, Northwest Voices, July 29]: I do not doubt the statistics he cites, but an important bit of information is missing.

As a nation, we continue to overeat and under exercise --60 percent of us are overweight and half of those are frankly obese This leads to an inordinate amount of heart disease, stroke, diabetes, gall stones and destruction of knee joints.

Do the other countries mentioned have that same profile? In addition, a good number continue to smoke, drink to excess, take drugs both legal and illegal and have unprotected sex. This leads to liver, lung disease, cancers, unwanted pregnancies and STDs, including AIDS.

Is there a health-care system alive that can continue to respond to all this? It seems much easier to blame insurance companies, doctors, hospitals, the American Medical Association and fast-food joints than looking in the mirror for the cause of the "system failure."

I'm concerned there is not enough money or any system that can deal with our health unless many personal changes occur. After all, the above items are all put into our bodies voluntarily. Pogo, the comic-strip character, said it quite eloquently many years ago, "We have seen the enemy, and he is us."

-- Charles R. Strub, M.D., Monroe

No break for Congress

Congress should not be allowed to take a break before passing a health bill. It just gives the lobbyists and health-insurance industry more time to buy more members of Congress. It is not like they have to work that many days a year anyway.

This is probably the one issue that will affect every citizen. Well, except for possibly our representatives. They will see they are taken care of.

-- Harriet Benjamin, Seattle

Some selfish doctors not helping health woes

It was refreshing to find letters published in The Times July 28 getting to the heart of health-care issues ["Health care: What is the cost of Canadian system?"

seattletimes.com, Northwest Voices]. One was especially telling because it was submitted by a doctor, Donald J. Sherrard. If only there were more physicians with his take on the problem. His final two sentences were perfectly on target: "Citizens should question strongly the assertions, lies and evasions of the health industry. They're after the big bucks, not your health."

I would also suggest that one part of the problem is the attitude of some, not all, doctors. They think their lofty professional status entitles them to live a lifestyle of the ultra rich and famous, and some who can't lower themselves to care for Medicare or Medicaid patients because the payoff is too slight.

Both attitudes fail to live up to the Hippocratic oath, which all doctors are supposed to observe in their practice.

-- Rod Belcher, Des Moines

Isn't eliminating a middleman good business sense?

Most people are smart enough to know that eliminating the middleman from a purchase is a good idea. Middlemen, after all, add very little value -- but always add cost.

Why then are people hesitating over reforming our health-care system? Our current system is completely dominated by middlemen. We give these companies our hard-earned money so they can enjoy fat profits while blocking our access to good health care.

That makes no sense whatsoever. Physicians don't like it. Patients don't like it. The middlemen, however, are fat, dumb and very, very happy.

Health-care reform is not socialized medicine. It's about removing the middleman's obscene profits and allowing we, the people, to get the services we pay for.

-- Debbie Terwilliger, Bothell

In the way of reform, six bought senators

Our thanks to Dr. Donald J. Sherwood for his eloquent letter to the editor spelling out the advantages of the Canadian health system over our inefficient, bloated hodgepodge.

Already the majority of Americans want reform of the type proposed by President Obama. Unfortunately, the next obstacle is the six senators -- Max Baucus, Jeff Bingaman, Kent Conrad, Mike Enzi, Chuck Grassley and Olympia J. Snowe -- who have sold their souls to the health insurance and pharmacology corporations for $3 million in campaign contributions.

They are blocking the public option without which, as President Obama has spelled out, it is impossible to have truly universal health coverage.

Somehow we must find a way past them.

-- Robert & Susan Stanton, Seattle

No price tag too high on health-care reform

Charles Krauthammer's "Obamacare vs. fiscal reality: the health-care nirvana fantasy" [Opinion, syndicated columnist July 26], concedes that medical costs are destroying our economy. True! His argument is that Obama's efforts to improve the health-care delivery system being worked on in Congress will be more expensive.

Obama's plan will provide medical coverage for millions of families who have none, for families whose wage-earner loses their job and for those with pre-existing illness.

Universal coverage is lifesaving for millions of victims of an inadequate system. Sure, Krauthammer, that may cost more. But don't we need more?

Let's support our Congress in its efforts to achieve a more efficient and inclusive medical system.

In the meantime, Krauthammer might offer a different solution than just more of the same.

-- Jack Ballard, Port Ludlow

No need to deal with Republicans

Regarding The Times' editorial ["Bipartisanship needed on health-care reform," Opinion, July 28], which says, "Health-care needs Republican votes to pass. Oh yes it does."

Oh no it doesn't actually. The American people soundly rejected the Republican Party in two elections, making clear they have no trust in the Republicans. Why compromise with a party that has no standing with the large part of the country?

More importantly, the Republican Party is opposed to any meaningful reform of the health-care system because that would harm the bottom line of its patrons in the insurance industry.

Republican attempts at "compromise" are stealth efforts to torpedo the whole thing. It takes two to compromise, and the Republicans are working to prevent a bill, not improve it.

The Democrats want bipartisanship for political cover, which is gutless. The Republicans want it to disguise of their attempts at preventing any meaningful bill from passing, an agenda they share with a large number of Democrats who the insurance companies have also got their hooks into.

Why do you want bipartisanship? To help your friends the Republicans in their attempts at preventing a bill? Or are you so enthralled in the conventional wisdom that bipartisanship is good government that you are blind to all these realities?

-- Brad Lowe, Edmonds

In health-care debate, don't forget the kids

We appreciate Lynne Varner's column ["Health-care reform: Push for kids," Opinion, July 29], which raised important issues of how to meet the needs of children in federal health-care reform. We in Washington state are justifiably proud of the health coverage we have created, Apple Health for Kids. We can be a model for the nation.

Reform should maintain the best of Children's Health Insurance Program, or CHIP, and expand coverage to all kids and adults. Kids are healthier when their parents are covered, and they are healthiest when their coverage meets their needs.

Varner mentioned kid-friendly legislation floating around. We are happy that one of these important bills was accepted in the House Energy and Commerce Committee Friday.

An amendment introduced by Rep. Diana DeGette of Colorado would prevent children from being moved into the new health insurance, Exchange, until Secretary Kathleen Sebelius of the Department of Health and Human Services certifies that coverage offered to children is at least comparable to the average CHIP plan.

We hope this important amendment will be included in the final bill the House considers and in reform passed by Congress. We are calling on the Washington delegation to pass health reform when they return from recess so that all of Washington's children and families can get the health coverage they need.

-- Paola Maranan, Children's Alliance executive director, Seattle

Cost of Canadian health care still lower than U.S.

Letter writer Dana Keith ["Canadians do pay for health care," Northwest Voices, Opinion, July 25] is correct in stating that Canadians do pay for their health care. As is the case with all government services, they pay with their tax dollars, just as one pays with a private health-care plan.

However, the total cost of the Canadian system is 10 percent to 11 percent of their gross domestic product compared with around 17 percent in the U.S.

In addition, all Canadian citizens are covered with a provincial Medical Services Plan, which receives funds from the federal government via tax transfers. The system is therefore a single-payer one, whereby everyone contributes to the care of all citizens.
Individuals choose their own physicians, who decide what care is required -- not the government, regardless of what you might hear on radio and TV talk shows -- and they do not have to ante up large sums for emergency and intensive care or even for infant delivery. The system works very well.

-- Stephen Calvert, Tsawwassen, B.C.

Lower costs, lower mortality rates in superior Canadian system

Dana Keith writes to tell us that Canadians pay for their health care by an increase in taxes. This is not new information.

Their health-care system is entirely supported by taxes. But the total cost of their health-care system is one-third to one-half of the United States' cost. This is well documented in data published in the New England Journal of Medicine and the World Health Organization, just to name two.

What do Canadians get for this? First, their entire population gets health. Compared to us, they live two years longer, have a lower infant-mortality rate and a lower maternal-mortality rate. I mention this information because it is the basis for how health-care systems are evaluated by health economists.

Based on the evaluations of health economists, Canada ranks in the top 10 in the world of health care. The U.S. ranks in the mid-30s, about equal to Cuba. Cuba spends about one-tenth what the U.S. spends to achieve the same results.

The U.S. spends more per person for health care than any other country in the world. This is largely, probably entirely, due to our health-insurance industry, which is very profitable but not in the business of providing health care. Michael Moore's movie "Sicko" delineates this well and has been repeatedly confirmed by studies and investigations since.

Citizens should question strongly the assertions, lies and evasions of the health industry. They're after the big bucks, not your health.

-- Donald J. Sherrard, M.D., Bellevue

Current health care poses real economic risk

The average cost of an employer-provided family health-insurance policy is on the rise and could nearly double by 2016 if Congress doesn't act now. This could mean economic disaster for every family and employer. We all should be working to avoid it.

That's why I can't understand why some in Congress want to block President Obama's plan to rein in these rising costs. Maybe it has something to do with the $2.7 billion in our health-care dollars that insurers and drug companies spent on lobbying over the past 10 years.

Our state's congressional delegation must put aside the political games and pass comprehensive health reform now.

-- Anthony J. Crawford, Bremerton

In 1,000-page bill, too much room for loopholes and earmarks

In reply to the excellent letters to the editor [Opinion, Northwest Voices, July 27], I have a question. If $500,000 from the manufacturers of paper and plastic bags is funding opposition to a 20-cent bag tax, what can we deduce about the billions of dollars being thrown at health-care reform by the insurance and pharmaceutical companies?

President Obama is not really urging Congress to just vote on a bill that is more than 1,000 pages long. He is urging Congress to enact reform that the deep pockets have stalled for decades. A 1,000-page bill is long enough and complicated enough to hide countless loopholes and benefits for special interests who are throwing money at our elected officials.

There is also a 30-page bill, H.R. 676, that has been recycled and improved since 1993, when it was buried by the same special interests that are fighting reform today. This simple, single-payer plan would use money collected from payroll taxes and redirected from other government programs to pay medical doctors and clinicians for medical services and devices, including long-term care and other desirable features that are neglected in the myriad private plans and the ill-defined public option offered as choices in the 1,000-page bill. H.R. 676 is simply an improved and expanded version of Medicare that would be adequately funded and thus insured to succeed.

H.R. 676 is co-sponsored by almost 90 members of the House of Representatives, including Washington Reps. Jim McDermott and Norm Dicks. The rest of the House is either influenced by the billions in lobbyist money or just waiting to see which way the wind blows.

Please blow fresh air into this sordid mess, and urge our members of Congress to pass a single-payer plan like what is described in H.R. 676. That is what a rational senator or representative would do.

-- James Bruner, Oak Harbor

Right-wing pundits have no solutions for broken health care

I am sick to death of the likes of Charles Krauthammer ["Obamacare vs. fiscal reality: the health-care nirvana fantasy," Opinion, syndicated column, July 26] once again rolling out the oldest red herring in the right-wing health-care arsenal: that the high cost of treatment in America is about lawyers and litigation.

In reality, the cost of lawsuits is less than 1 percent of U.S. health-care spending, and in states like Texas and Florida where vigorous tort reform has passed, health-care costs are skyrocketing along with the rest of the country. The most compelling piece I've read about health-care cost in America is by Dr. Atul Gawande. He compares the two cities of McAllen and El Paso, Texas. Both cities have virtually identical demographics, but health-care spending per capita in McAllen is nearly double El Paso's. The conclusion I drew was that in McAllen health care is focused on profits while in El Paso it is focused on patients.

You will never see Krauthammer publish the obscene CEO salaries routinely handed out in the health-care industry. You will never see him address the increasing number of physicians who own their own laboratories and surgery centers while refusing Medicare patients. You will never see him address the fact that rising health-care costs have the power to bring down the American economy. You will never see him provide his plan for change because he doesn't have one, and he doesn't believe health care is a right anyway. Krauthammer's column is not worth the paper it's written on.

In my opinion, the problem with the American heath-care system is that it is an inefficient, bloated bureaucracy with maximization of profit at it's heart rather than prevention or treatment of illness. For-profit health care is an unsustainable oxymoron.

-- Judy Neldam, Duvall

In my daughter's struggle, find why we need reform

My daughter died this week from a heart attack that could have been prevented. She had asked Washington state for medical help and was denied because she was $3 over the income limit.

She had blood-pressure problems that could have been controlled with medication, a cyst in her knee which made walking painful and her body did not make the red in her blood very well. She had to have several blood transfusions a couple of years ago due to this condition.

But after that, none of these issues were addressed due to money. Even low-income clinics want money, and she did not have enough to cover living expenses and co-pays.
Those of you who have medical coverage and are fighting single-payer health care should have such a tragic event occur to you. I think it is the only way you will understand what is happening.

Apparently, if you are poor, your life is of no value in this country.

-- Bernice Larsen, Puyallup

Medicare is a harbinger of national health-care failure

From personal experience, I reject the idea of government-paid health care for all.
Many people don't recall the establishment of Medicare and how it chased private insurance for seniors out of the market. Employers and insurance companies saw no reason to deal with the expense and administration of their plans in competition with the government plan. Obviously, this will happen again if the government starts covering all citizens. You will not be able to keep your current insurance whether or not you are happy with it.

Regarding the operation of Medicare, it is well known that its payments are seriously below market rates. Many doctors will not accept Medicare patients. I can name offhand four people who were notified by their large clinics that their Medicare coverage would no longer be accepted; just think how many more patients received that notification. I must travel to a neighboring city for a particular medical specialty because none of the local practitioners will accept Medicare.

Clearly, the government administration of Medicare is a failure. Why should we expand the program for an even greater failure -- and a terribly expensive failure at that?

-- Bernice Oberson, Kirkland

Congress, take your time on health-care reform

Why would any rational senator or representative vote, yea or nay, on a bill that is more than 1,000 pages long, that would not take effect for four years and that they had not read? Why would President Obama tell us such a bill was absolutely essential to pass within two weeks?

-- Al and Linda King, Olympia

Health care 'too expensive' because it's for the American people

Politicians are convincing the American people that health-care reform is too expensive, and the $1 trillion cost over 10 years must be paid upfront. Why can't we spend $100 billion annually to improve the lives of ordinary citizens? Why is this program too expensive, when compared with some of the other recently approved programs that have racked up similar bills? Why? Because the program will benefit the lives of real Americans.

In the last seven years, our representatives had no trouble approving our hard-earned tax dollars to be spent on a pre-emptive war in Iraq, which has cost us nearly a trillion dollars in six years.

In September 2008, Congress passed TARP, giving nearly a trillion dollars of our money to Wall Street. When the Medicare Drug plan was passed, the Congressional Budget Office also predicted the cost to taxpayers at nearly a $1 trillion over 10 years, benefiting pharmaceuticals.

The money isn't going to the military-industrial complex, the pharmaceutical complex or the wealthy CEOs on Wall Street, who give our politicians millions in campaign dollars. The money is going to you and me. Suddenly this program is too expensive and can't be rushed. What nonsense!

-- Glenda Tecklenburg, Mill Creek

What's with the delay on health-care reform?

I cannot believe Congress' inability to move on health care. Has our political system become so saturated with special-interest money that we have become unable to move legislation as critically important as health-care reform?

There has never been a time when the power in the House and Senate is actually primed for meaningful reform. What in the world is keeping lawmakers from moving toward universal coverage that includes at a minimum a public option that leads to modification of the insurance industry's stranglehold on health care?

How much more profit must be gained from sickness management and nonmanagement of cherry-picked populations? How much longer are we going to pay 10 times the amount for primary care in the emergency rooms for citizens that do not have coverage.

The whole notion of a single-payer system was taken from the table before it made it the first round of discussion. How much longer will the population be misled by the opponents of universal coverage trashing the Canadian system.

Canadians would revolt in masses if there was even the slightest attempt to modify their health-care system. If ever there was a time for U.S. citizens to rise to the occasion, this is it.

-- Michael Johnson, Shoreline

In time of need, money shouldn't get in the way

As a dual citizen, I have had the privilege to see both the American and Canadian systems at work.

My mother, an American, was diagnosed with a very aggressive brain tumor. My mother, never being a quitter, chose to follow the doctor's recommendation of treating the tumor even though she was given a less than 10 percent chance of survival. Though she had a premium heath-care plan, she had to fight to get her chemotherapy paid for.

In the end, the medical intervention extended her life by only a few tortuous months. No one profited except those providing the treatment. In the midst of his grief, my father worried about whether her insurance would cover all of the cost of her time in the hospital. In the end, the bills were paid but not without major financial uncertainty and anxiety.

In contrast, two years later, my four-month-old son was diagnosed in Canada with a cancer-like disease. We saw our pediatrician at 11:30 a.m. and an oncologist at 3 p.m. the same day, and he was admitted to begin tests two days later.

The care was entirely free and the only scars we bear are on my son's neck. I believe the care was some of the best in the world, and I trusted the doctors' recommendations. There was no discussion of money or motivation. We were able to focus on the health of our child.

In times of crisis, families need to focus on their loved one, not on who will pay the bills.

-- Wendy Ilott, Edmonton, Alberta

Canadian health care for all U.S. citizens

I heard Mary Scott of Mount Vernon interviewed on Canadian Broadcasting Corp. radio. She wrote The Vancouver Sun asking Canadians to write The Seattle Times with the truth about our health care.

I am a family physician in Ontario, and I hear complaints about waiting. But I also hear great compliments about how the system came through in spades when there was a major need in one's health. Nothing is perfect, but I never, ever hear of a patient loosing their home in Canada because they had health bills to pay.

I am amazed there is so much erroneous denigrating of the Canadian health-care system by some people in the U.S.A. We are such close neighbors -- clearly the truth should be more evident that it can be done much better than your current system. You do have wonderful facilities and great practitioners, but you also have millions with no insurance coverage.

I hope your voters choose a Canadian-like health-care system for the benefit of your whole population.

-- Gordon E. Riddle, M.D., Ottawa, Ontario

From an insider, private insurance is broken

I have experienced health care as a consumer, as a developer for an insurance company, as the director of information technology for a mental-health agency and as the bookkeeper for a provider. I'll admit I like and respect my doctor, but that is the only place where I have experienced our system as satisfactory.

As the bookkeeper for a provider recognized by about 20 insurance companies, my personal frustration has hit new highs. Our health-care system is too disorganized. No two companies have the same forms. Some have different billing systems for different services. Some use online systems, others require faxing, others require communication through the Post Office. Some require we return a form they send us and some use industry-standard forms. Some use both depending on the service.

When we are paid, it can be based on what we billed, but mostly it isn't -- it's based on rules unique to each company. Yes, they have shared the rules, but the rules change with each insurance company and even within a single company based on service provided.

The current system is in the process of self-destructing.

-- Steve Paul, Seattle

Prescription drugs should be part of reform

The $40 million the pharmaceutical industry spent lobbying Congress from April 1 through June 30 probably explains why lowering drug costs is not a major part of the health-care-reform debate. But it should be.

Pharmaceutical companies advertise their most expensive drugs in direct marketing to consumers and encourage Americans to ask their doctors to prescribe them. As a result, patients arrive at doctor's offices, demanding this or that medicine they've just learned about through advertising. The beneficiary is the drug industry, which earns huge profits and even gets a tax write-off for advertising costs.

Among industrialized countries, only the U.S. and New Zealand allow pharmaceutical companies to market directly to consumers. It was not allowed when I was younger, and I believe it should be outlawed now.

-- Vicki King, Seattle

Healthy health-care system will bring healthy economy

President Obama's speech ["Obama not backing down on health care," page one, July 23] shows a president determined to make a difference for this country and its citizens, despite the large political risks involved.

Obama understands and is trying to explain that the status quo is not a viable option. To those who talk about choice, and the prospect of losing it, need I remind you that for most of us our health-care choices are largely proscribed by our health-insurance policies.

But the big-picture issue, alluded to by the president, are the enormous economic implications of the current system. Spiraling health-care costs are an uncompetitive fact of life for doing business in the United States that give pause to multinational companies with options overseas. Our per-hour labor costs are often lower than many European countries and Japan, but when health-care costs are figured into the equation, the U.S. becomes an unattractive location for a new venture.

Thus, our long-term economic health, not just our physical health, will be largely determined by whether we act now to reform our health-care system and reign in costs.

-- Jonathan Ryweck, Port Townsend

Current system rations care by income

Editor, The Times:

Who will say no? Right now, health care is being rationed -- by cigar-smoking CEOs behind the closed doors of corporate offices. Wouldn't it be wiser, fairer and more American to take these tough decisions out of the boardroom and put them in the hands of professionals, patients and the public?

Should care be guided by unregulated profit motives or by science, compassion and rational policy? Insurance profiteers and conservative fear mongers always raise the specter of rationing when they feel threatened by rational health-care reform.

The truth is that we ration health care now -- mostly by wealth, employment and age. The question is: Should we ration by income or by outcome?

-- William R. Phillips, M.D., Seattle

Compared with private insurance, public option is cheap

Republicans love to tell you that President Obama's plan will cost more than a trillion dollars a year. What they don't tell you is that Americans are now paying more than $2.5 trillion a year on private health insurance!

That's more than twice as much! So, Obama is saving us $1.5 trillion.

-- Rob Moitoza, Seattle

End the tax cuts for wealthy to pay for new health care

The dilemma of where the money will come from to pay for single-payer government-provided health care seems to be escaping the fiscally responsible members of Congress. How about repealing the Republican George W. Bush-era tax cuts for the richest of our society, which have a 10-year cost of $1.7 trillion.

Why are Republicans doing all they can to push for a bipartisan health-care bill? We remember during the Bush administration there was no such thing as bipartisanship. They pushed, shoved and bullied the Democrats for eight years.

Congress must pay attention: 75 percent of voter want government-supplied health care of one kind or another. Private insurance is a complete failure and has been for quite some time.

-- Anne and Bill Dillon, Kent

U.S., don't let yourself be lied to about Canadian health care

Mary Scott from Mount Vernon wrote to The Vancouver Sun recently asking for comments from Canadians about the health care here in Canada and whether U.S. citizens are being lied to.

Wake up neighbors! Weren't you lied to about the weapons of mass destruction in Iraq? Why do you continue to believe outright and blatant lies so easily?

While there are some people who fall through the cracks or are dissatisfied with almost everything, I believe our health care is far superior to that of the United States overall.

You can bet those "dissatisfied Canadians" who are giving testimony of bad experiences on TV and elsewhere are getting paid handsomely by vested interests in the U.S.

-- Patricia Rust, Surrey, B.C.

Medicare 'efficient'? Those aren't the words I would use

In Michael Dean's letter to the editor ["My government coverage works," Northwest Voices, July 20], he claims Medicare is a government insurance program that works and is "very efficient." Dean either forgets or chooses to ignore several facts about Medicare.
First, the Medicare fund will be completely out of money in 2017. This means cuts to benefits, higher premiums, higher taxes or all three.

Second, many doctors are refusing to accept or severely limiting the number of new Medicare patients they accept because of Medicare's low reimbursement rates.

Third, Medicare is far from efficient. Billions of dollars of fraud goes undetected every year. The government spends hundreds of millions of dollars a year to fight Medicare fraud and abuse and only scrapes the surface of the problem.

Fourth, the medical-insurance plan President Obama and the Democrats want to pass will be financed in part by large cuts to Medicare benefits.

-- Jack Hurley, Bellevue

Medicare costs climb with add-on coverage

Michael Dean stated that he pays $31 per month to AARP for an insurance policy that covers the 20 percent of Medicare Part B costs not covered by Medicare.

This must be incorrect. The AARP Web site lists a monthly premium of $155.25 for Plan F, which is probably the most commonly purchased plan. The cheapest one available from AARP, Plan A, which covers the least, is $93 per month. This is in addition to a $97 per month charge taken out of Social Security checks.

Finally, he does not list the cost for the Medicare Part D prescription-drug plan, which again has a range of prices depending on insurer and coverage, but the best we could do after a thorough search by computer is $21.60 per month.

Altogether, this comes to $273.85 per person each month -- for the retired couple $547.70. This total does not cover long-term care, like in a nursing home. Such additional insurance would add greatly to the monthly premiums and be out of the range of most retirees.

We are both on Medicare, and we support a public health-care option for those not eligible for Medicare, but it is important that all the costs and what is covered are perfectly clear.

-- David and Renate Stage, Seattle

Want competition? Government is already preventing it

President Obama is right: We need more competition in the health-care industry. Many areas of the country lack adequate competition in health-care plans.

But what puzzles me is why he believes we need the government to provide competition -- after all, it's government itself that is preventing competition.

Currently, many states bar individuals from buying out-of-state insurance plans that don't meet state regulations. If the president is really serious about increasing competition, why doesn't he call for allowing individuals to buy health-insurance plans out-of-state?

This would surely increase the number of plans available to people while forcing insurance companies to reduce their prices to compete.

-- Preston Mui, Sammamish

What single-payer health care should look like

I am a nurse practitioner working at Harborview Medical Center in Seattle. I specialize in diabetes management and work closely with patients with chronic illness, many who are uninsured or underinsured, many whom deal with poverty, who deal with financial burdens from their illness or who don't treat their treatable illness due to lack of funds.

My dream for health-care reform is:

• Single payer is the only solution. I see no problem with no more insurance companies. The amount of monetary as well as time waste the current system has, given administrative costs, is extraordinary.

• Medical health includes dental health and mental health. We cannot separate these.

• Increased taxes to support these are fine with me, as I will both personally feel more protected, and I will be able to do my job so much better if my patients are protected.

• The system needs to be portable between states. We often see patients flown in from out of state for trauma care. A seamless system will not allow for cracks such as this.

• A "smart card" or other such device should be made to give medical history as well as prescriptions filled so this information can be shared between clinics, hospitals and pharmacies. This will significantly help to improve medication safety.

• Chronic illness management, in our current system, will continue to cripple our nation unless we make drastic reform. A nationwide approach with one payer is the only sound fiscal option to fully address this pink elephant in the middle of our living room.

-- Louise Suhr, Seattle

Canadians do indeed pay for health care

No less than three times did your article on Canada's health care ["Myths, truths of Canada's universal coverage," page one, July 21] mention that "government is paying" for Canadian health care.

I believe it is the Canadian people, the ones who, according to the article, "pay higher sales taxes -- up to twice as much," that are footing those bills. The idea that a "patient never sees a bill" is disingenuous.

Of course they do -- with every purchase and tax. The article also compares the "bills" between Canadian procedures and U.S. procedures, intimating that this is comparing the costs of the procedures.

Again, this is disingenuous. The actual costs of these procedures is never mentioned, only the bill the patient is responsible for. One could truly compare the two systems if the actual costs were compared.

-- Dana Keith, Auburn

Let's tax the wealthy for new health-care plan

Editor, The Times:

There seems to be a disconnect in many Americans' minds on health care: We believe the system is broken, yet we are satisfied with our coverage. This paradox is easy to explain. Most of us are one layoff away from losing our employee-based health-care plan. If you lose your job or get sick, the system appears broken and needs fixing. Then the question becomes: Who should pay for the fix?

The choices I'm reading fall into two categories: Tax those of us in the middle class who are still lucky enough to have health care provided by our employer or increase taxes on the very wealthy.

It is really hard for me to believe that after the past year's dismal economic news there would still be any objection to increased taxes on couples whose household incomes are still more than $350,000 annually.

-- Brett Moyer, Seattle

Health care should only be for those who can afford it

The Republicans have it right on health care. We are a capitalistic country. We don't want socialized medicine. If you can't afford to pay for your own insurance or treatment then you don't deserve medical attention. Neither should businesses large or small be forced to pay for the health care of their employees. Workers should be happy just to be employed and by virtue of that employment have the means to buy their own health care.
Poor people should not be allowed access to expensive treatments they can't afford.

One need only to look at the portfolios of rich people to realize their lives are more valuable then those without the money to stay alive. Wealth is the only true measure of worth. That's what makes a Picasso great art. That's what makes a Dom. Romane Conti 1997 taste so good.

We need true health-care reform. We should close the emergency-room loophole once and for all. People are stealing free medical treatment and raising health-care costs for the rest of us by receiving emergency-room medical treatment without first establishing whether or not they can pay for it. That's fraud.

We could further reduce the cost of health care by eliminating medical care for prisoners who cannot afford to pay for it themselves. Why should law-abiding citizens have to pay to keep convicted felons alive? Why should we reward them for their crimes? It makes no sense.

Medicare is the single biggest drain on our economy and needs to end. Old people with no money will die soon anyway. What's the point of keeping them alive for a few months longer?

I urge you to support the Republican efforts to derail Obama's push to raise our taxes for the care of the unworthy. Further, I implore you to send a message to Congress that you are no longer willing to subsidize health care for criminals, the old and about to die or the homeless.

-- Marshall Dunlap, Kent

Anecdotes don't show the flaws in Canadian health care

That was a pretty amazing article The Seattle Times took from The St. Petersburg (Fla.) Times ["Myths, truths of Canada's universal coverage," page one, July 21]. I don't know which is worse: placing "editorials" on the front page or using anecdotes to attempt to make a point.

I could fill the entire Seattle Times with such nonsense from the other point of view. My family is Canadian and although they are rabidly pro-Canada and anti-U.S., the stories they tell about their health-care system are not only plentiful, but truly awful.

The use of statistics can be very misleading. To claim Canadian health care gives them longer and healthier lives is to bring back the old saw: figures don't lie, but liers can certainly figure.

The only stat I have seen that I really believe is that the mortality rate from cancer there is 25 percent higher than here. I also know from personal experience that their emergency rooms are a joke, and their treatment of elders is disgraceful.

-- Steve Nyman, Seattle

Consider the real cost of Canadian treatment

I was frankly appalled to find a puff piece on Canada's health-care system masquerading as front-page news.

From the beginning, the article lauded the low price of Canadian health care without even considering the real cost of such treatment. The story even tried to minimize the issue of wait lists by treating it in the context of nonessential care. But what of the wait lists for broken bones or for the flu?

I'm not sure what's worse: The Seattle Times' glorification of a failed health-care system or its grotesque caricature of its opponents. No one can defend the American system -- a tangle of regulations and frivolous lawsuits in desperate need of reform. But just as communism sounded better in light of the Great Depression, so universal health care is only defensible in contrast to our nightmarish system.

Finally, the article betrayed a glaring lack of any balanced treatment or opposing views. If the reporter had trouble, all they had to do was go to any hospital and speak with a nurse. They're the ones who have to treat all the health-care refugees fleeing from Canada. They know the real costs of Canadian medicine.

-- Alex Binz, Normandy Park

A plan that covers the catastrophic, those in need

Here's my solution for health-care reform.

First, we should create a very basic, high-deductible government health-care policy that pays for major medical events only. Include everyone and pay for it with taxes. No one would ever again lose their home or be denied lifesaving procedures.

It would be cheap because it would be single payer and would include the whole pool of healthy and unhealthy people, sharing the risk universally. Billing would be simple for hospitals, which would be guaranteed payment.

Middle-class and wealthy consumers would pay for routine illness events out of pocket, just like getting your car repaired, or they could purchase add-on insurance from private companies, as they choose.

Poor people would get extra coverage for routine illnesses in free government or charity clinics. There will always be people who are so poor they can't contribute anything.
Wouldn't this solve everything at modest cost to the public, or I am just simple-minded?

-- Felix Mahr, Olympia

Sacrifices for other citizens are small price to pay

I love my health-care system, and with American relatives who are uninsured on their major illnesses due to layoffs and "pre-existing conditions," I've never understood why the American people accept the poor treatment they get in the majority. I am well cared for by the Canadian system, and so are the folks down the street struggling to make ends meet.

On an economic level, the working class here has more mobility -- I don't have to stay in a job to protect my coverage of pre-existing conditions. I don't have pre-existing conditions.

Canadian wait times have not been problematic for me; I hear this is the attack. Health care here works on a triage system. I've seen a number of specialists in my life, and I've gotten in immediately if my life appeared threatened. This seems practical to me -- those in danger of dying go first! I have never waited for long for other specialists.
If waiting two months to see a specialist is what I am asked to do to save the life of a fellow Canadian -- well, it's a tiny price to pay.

-- A. Brenneman, Vancouver, B.C.

A change in attitude necessary for reform

As our country debates the details of the absolutely necessary health-care-reform legislation, I feel that at the same time it is just as necessary for the American taxpaying public to finally grow up and accept its responsibilities. It is so troubling to see necessary reforms in jeopardy because of our inability to accept the reality that we need to step up to the plate, with everyone chipping in, to pay for what our country and all of its citizens need and deserve.

Throughout our travels in Europe, with many countries already having universal health-care systems in place, and while visiting our diabetic daughter who lives in Canada and receives excellent, timely care, we do not hear people complaining about having to pay taxes to pay for vital government functions.

Their systems work because their citizens are accepting their mutual responsibilities for supporting the public good. We all need to get with the program and realize our attitude of "not out of my wallet" is selfish, shortsighted and will in the long run be disastrous to our common good.

-- Lorraine Schwarm, Seattle

Obama's rush on reform will fix nothing

President Obama's plan ["Obama to begin full-court press on health care," page one, July 20] to enact health-care legislation by Aug. 7 is ludicrous in the extreme. Any health-care system, and particularly the American one serving more than 300 million patients, is enormously complex.

Any workable and meaningful changes will require significant planning and discussion before codifying into law. Although Obama and his advisers seem to feel drastically cutting health-care spending will correct all of the countries' economic woes, this is unlikely to be true.

He should not use the political capital he has from the "honeymoon" period of his recent election combined with our current economic troubles to push through health-care reform without doing the difficult planning that will be required to design a viable long-term health-care system.

This cannot be done in the next few weeks.

-- Ralph G. Althouse, M.D., Seattle

Make the senators do their jobs

I was outraged when I read the quote ["Alliances collapse as health debate picks up steam," seattletimes.com, Nation & World, July 19] from Sen. Jim DeMint, R-S.C., "If we're to stop Obama on this, it will be his Waterloo. It will break him."

Excuse me, but the object is health care, not party wins. The American public lost in 1993 when Congress was distracted by the change in party dominance and let all work on health care stop to prove Bill Clinton wrong. We, the working poor, lost.

No one picked up the points of disagreement and reworked them -- work just stopped. Because of that stoppage, health care is owned by insurance profiteers and pharmaceutical manipulators for CEO and stock gains.

If DeMint doesn't like what is being presented now, then he should work on what is wrong and make it better. He could ensure better health-care service for the cost, cut down on profits for the few, save lives and stop the ugly partisanship.

DeMint and others should restore the ethics in the job they were elected to do.
Members of the public and media should call out these politicians no matter the party and stop the political games. Make those elected get the job done.

-- Sue Karahalios, Oak Harbor

Demint is a disgrace to his office

I am outraged over the narrow objective of Sen. Jim DeMint, R-S.C.: "If we're able to stop Obama on this, it will be his Waterloo. It will break him." That a man elected to the Senate would ignore what is in the best interest of the United States and give no recommendations but just propose to defeat the president is repugnant and unprincipled.

President Obama has put forth a proposal to correct a lamentable dereliction of government. The Republicans sat on this issue for eight years and did nothing. This Republican has only the objective of stopping reform and crippling Obama.
He is a disgrace to his office.

-- David C. Hutchinson, Redmond

Representatives must keep an open mind on health care

Republican members of Congress accusing President Obama of staging a dangerous experiment with our health care should be ashamed of themselves.

How can anyone who has an ounce of morality advocate against the basic human right -- not luxury -- of quality, affordable health care for all?

This is not the time for partisan politics. This is the time for our elected representatives to pitch in and do what is right for this country. That includes keeping an open mind and taking part in appreciative discussions in order to cocreate the best possible solution.

-- Ellia Ryan, Seattle

My government health care is easy, and it's already in U.S.

I have been on a government-run health-care plan for 11 years. Not once have I ever been denied treatment. Not once have I ever been denied referral surgery recommended by my attending doctor.

When moving to another state, the only problem I experienced was finding a doctor that would see me within a month, only due to his scheduling problems.

I once recommend a drug to my doctor, one I had been on for high cholesterol for years. He said it was too expensive and switched me to a less-costly drug -- now my blood pressure is stabilized by a drug he recommended over one that a previous doctor recommended that cost me $300 a month. Now I pay $4 for a 60-day supply.

The plan I am on is run by the government, and it's called Medicare.

I do pay for it each month; the cost is now $97, up from $50 when I first started 11 years ago, and it has paid 100 percent of everything my doctor has requested over those years. I do carry coverage through AARP at $31 a month, simply because Medicare is only intended to cover 80 percent on part B -- physical exams, general visits and blood tests.

Bottom line: A government-run health-care plan is very efficient without many complications.

-- Michael R. Dean, Puyallup

Medical reform needs to include malpractice reform

The current proposed health-care legislation before Congress doesn't address one significant feature of medical costs. That feature is the enormous costs faced by doctors for medical-malpractice protection, averaging more than $100,000 per doctor every year. The lack of provision for this cost -- whether government or private health care -- is a significant loss to the consumer because it is passed on to the consumer by the doctor.

The lack of addressing this cost is not surprising since President Obama and many legislators are lawyers. To level the playing field of cost, there should be a cap on recoverable damages, if they're proven.

Otherwise, look for your co-pays to continue to increase to cover this nonmedical cost.

-- Bob Karns, Bellevue

Follow the steps of nonprofit insurers

The time has come to fix this nation's health-care system, and the path has already been blazed by nonprofit insurers like Kaiser Permanente and Blue Cross Blue Shield.

This program would not be a money sink as many critics claim. It would instead reverse the trend of American health care toward high costs and low quality, in which the middle class pays large sums for support that never materializes when it is finally needed.

Americans pay more for their health care than the citizens of any other industrialized nation. This expense might be justified if Americans received a higher quality of care, but the World Health Organization ranks America 37th in quality of care received. Without an overhaul of the health-care industry, our costs will continue to skyrocket, and we will continue to be underserved.

A public plan would be a powerful alternative to the inefficient and expensive machine we currently count on to keep us healthy. Even Americans with insurance can quickly fall through the cracks of hefty co-pays and loophole-riddled insurance contracts. The self-sustaining, nonprofit organization of a public plan would encourage private insurers to provide the best possible coverage or lose their customers.

-- Jacob Boen Helmholz-DeLay, Seattle

Insurance companies fighting hard to keep ruined system

If anyone still has any doubts that the insurance companies are fighting tooth and nail to kill health-care reform, they need look no further than the interview given to Bill Moyers July 10 by a former vice president of Cigna Insurance. The fear these insurance companies have of a government-run program is palpable.

And now we have the proof that there was a concerted strategy to defeat the Clinton administration's plan and any subsequent ones that would cut into insurance-company profits. They couldn't even let a documentary about health care around the world -- "Sicko" by Michael Moore -- be seen by the American people without mounting a full-frontal attack using scare tactics about "socialized medicine" -- as if what we have is adequate, affordable and fair!

A government-run system seems to work in every other industrialized nation, but they pay for it with a progressive tax system. The rate for Americans in the upper tax bracket is at its lowest in history. We can have affordable, quality health care for all if the richest among us are willing to give up a sliver of their income. Is that really too much to ask?

-- Jessica Lisovsky, Vashon

You pay insurer's profit margins, Canadians don't

Mary Scott of Mount Vernon recently asked Canadians to share opinions on our single-payer health-care system with our American friends. Having had "universal health care" here since 1965 certainly gives us a bit of history on which to express an opinion.

The proof is really in the pudding as no politician here would ever discuss killing our public system in favor of a for-profit model, as they know they would be trounced out of office --if not tarred and feathered.

The math is very simple: We pay health-care costs. You pay health-care costs plus insurer's profit margins. It doesn't take a genius to figure out which is higher.

Health care is a keystone of our Canadian democracy; we all share the pain, and we all share the responsibility of ensuring everyone gets covered. I suspect most Americans are much in the same vein of thought.

I myself have no complaints with our system, and although certain high-demand procedures like hip replacements do require waits, those are based on urgency of the requirement and not how many dollars you have in the bank. That's very frustrating for some as they want their elective procedures pushed ahead of a poor grandma's urgent requirement because they have a pocketful of money and those are the ones who go stateside and pay for treatment, which is fine. However, the vast majority of Canadians are satisfied with the overall system.

In most provinces there is no health-insurance premium, but here in B.C. we do pay a monthly fee. For my family of six that health insurance fee is $110 per month, which covers all doctor visits, hospital stays, surgical fees, etc. If one makes less than $25,000 per year, those premiums are reduced or eliminated entirely. Things not covered include drug costs, eyeglasses or elective procedures such as nose jobs or breast augmentation.

I go to whichever doctor I please and no government bureaucrat decides which tests or procedures I get; that would be my family doctor who makes those decisions. There is no such thing here as "pre-existing conditions," and I have no fear that losing my job puts my family's health care at risk since the two are totally independent of each other.

No Canadian has gone bankrupt due to medical bills. That peace of mind is a basic right of every Canadian, and though its not perfect, it is a very good system and worth exploration.

-- Bill Kroesen, Vancouver, B.C.

I moved to Canada for its health care

I was born in Seattle and now live in Vancouver, B.C., after having lived 16 years in New York City. I returned to Vancouver because of the Canadian health-care system.

I recently visited some relatives in the U.S. and was shocked to see the ads on TV denigrating the Canadian system and giving a very distorted view of the services.

Sure there are some flaws -- there are in any system -- but for $96 a month, my husband and I, both in our 60s, have all of our medical needs addressed, including all our doctors visits, hospitalizations, emergency care, surgeons, etc. As current research on best practices in medicine are integrated into the system, I am sure it will be even better.

I feel sad to see such heavy-handed propaganda foisted on the American public by those who are afraid of losing their considerable profits in the U.S. health industry.

-- Dr. Patricia J. Crawford, Vancouver, B.C.

Single-payer should at least be examined by Congress

President Reagan often chided Democrats with his famous line, "Well, there they go again." I found myself mumbling, "Well, there they go again" after reading David Broder's syndicated column ["Fault lines threaten health reform," Opinion, July 12] and after watching President Obama's nationally televised health-care reform town-hall program.

How can there be a serious health-care-reform debate without a mention of single-payer financing? Republicans and Democrats alike are wringing their hands trying to figure out how to pay for these reforms.

Dr. John Geyman, professor emeritus of Family Medicine at UW, informs us ["Don't discard pay-go option," Opinion, guest column, July 7] that "Single-payer financing ... will yield savings of some $400 billion a year. That's enough to assure universal coverage for all Americans while eliminating all co-pays and deductibles."

The next step, according to Geyman, is for single payer to be scored by the Congressional Budget Office, or CBO. Scoring is the process of estimating the federal budgetary cost or savings that would result from enacting a single-payer bill.

Sens. Maria Cantwell and Patty Murray sit on committees that are writing health-care reform legislation. Contact them and insist the CBO score single-payer.

We cannot afford to cede this debate to the big money of the insurance lobby.

-- Richard Hodgin, Seattle

Don't let Congress write the obituary on better health care

There were two disturbing obituaries in The Seattle Times July 12. One was of a dear member of my extended family, a young man who might be alive and well today if we had decent universal health care in this country. The other was David Broder's syndicated column ["Fault lines threaten health reform," Opinion] predicting the death of meaningful health-care reform in Congress.

In spite of the costly, inefficient, dysfunctional, patchwork system we are burdened with -- that I believe contributed to the death of my relative -- and despite overwhelming public support for a robust public plan, Congress remains beholden to the health-insurance industry. So the obituary of universal health care is being written and we seem doomed to mourn its death or to endure a crippled insurance-friendly plan on life support.

This is so because the insurance companies can devote so much money to lobbying, misleading advertising and elections. They scare the public with stories about rationing of care, lack of choice, government red tape and socialism. Yet the purpose of private health insurance is to maximize profits.

These companies do that by denying care, not providing it. It is they who are limiting choice and burdening medical-care providers and patients with wasteful red tape. Their claim of government inefficiency is contradicted by statistics consistently showing a wide margin of lower administrative costs for public plans than private. Insurance bureaucracy is the worst kind.

An industry that claims to believe in competition argues a public plan would be unfair competition, but its claim really is that it would be too efficient. Insurers are fighting so hard because they can see that a public plan would eventually end lucrative executive compensation and shareholder profits.

Their real fear is that a public plan would be so successful and so popular that it would obliterate the private health-care industry. Now that would be an obituary none of us need mourn.

-- Jerry Cronk, Shoreline

HR 676 holds promise for a successful national health program

Three cheers for Congressmen Norm Dicks and Jim McDermott for co-sponsoring HR 676, John Conyers' single-payer health-insurance bill. A growing number of physicians support this initiative as the fairest, most comprehensive, most fiscally responsible option on the table; those who are wary of "socialized medicine," which HR 676 is not, should visit the Physicians for a National Health Program Web site and read the FAQ page.

I urge the other members of Washington's congressional delegation to carefully consider HR 676's many advantages. These include truly universal coverage, unrestricted choice of physicians, low administrative overhead and substantial monetary savings. Merely tinkering with the present system will not achieve these goals.

As a physician scientist who has lived and worked -- and received good medical care --in countries with successful national health systems, I am filled with shame that we are not meeting this basic human need for all of our citizens here at home. It's time to stop shoring up a failed system and set up one that works.

-- George M. Martin, M.D., Seattle

Three great reasons to support a government-option plan

I support a government-option health-care plan for these very solid reasons:

First, we already know from experience with Medicare and the Veterans Affairs that it would only cost about 3 percent of receipts to administer the program versus 14 percent to 20 percent for public or private health-care companies.

We also know that examples of it in other advanced economies produce much better health results than ours by far. If you think we can't afford it, and we are the premier economy in the world, then ask yourself why can every other leading country and many smaller ones afford it?

Second, there will always be a need for private health-insurance companies because no government-sponsored plan will ever be able to pay for all the things people might want covered -- and that is as it should be. The key word in the prior sentence is "private" and not "public" companies because absolutely no corporation whose primary concern is shareholder value should ever be allowed to sell health insurance. Every health-insurance company should place its highest priority on its customers' well-being, not on keeping rates high for shareholder profit.

Finally, our country should not be hobbling businesses by insisting that individual businesses be responsible for paying for health insurance. They must compete against companies around the world that do not have that constraint. It is completely illogical for our country to be so anti-business.

Health-insurance corporations are betting you are too lazy to make time right now to call or write an e-mail. They are spending about $1.5 million dollars per day on registered lobbyists to keep things about the way they are now. Remember, more than half the people forced into bankruptcy by medical issues had health insurance.

If you don't care, why should Congress?

-- Paul Davallou, Anacortes

Look closely at impacts of universal health care in EEU

Editor, The Times:

I've got health care whenever I need it, for myself and for my family.

When we need it, we go to the appropriate provider and get it. Then we pay for it.

When we are short of money, we take advantage of current lawful protection and go to the emergency room and get it. Then we find a way to pay for it even if it means starting over.

You see, we do not need health insurance, and we do not want health insurance. The law protects all Americans in this regard; we get care, ability to pay or not.

Some never pay their medical bills under this system, so hospitals simply bill the government as is already provided for in existing programs, which require zero overhead for handling premium collections. Even if we had another universal system, the same people who did not pay their health bills before would not pay because they do not produce anything.

I am satisfied in this nation, which outproduces the European Economic Union by nearly 50 percent per person, that we can afford to spend, and should spend, more on health care. I deserve it for my enterprise. We spend double the amount per year on health care as our EEU counterparts, but our procedure costs are as low or lower, so we receive more than double the number of procedures as our EEU counterparts when and where we need them. We outproduce the EEU by 50 percent but only spend about 8 percent more of that bounty on health-care procedures. The rest we spend on what motivates us.

It's good enough we have social endeavor already established to care for those who cannot care for themselves and whose families and friends cannot or won't care for them. We have a system that wastes little.

Under the burden of heavy taxation for socialist programs designed to make things better, like universal health care, the EEU suffers from nearly double the unemployment rate, nearly double the poverty level and an average income level equivalent to our poverty income level.

Why are our politicians looking the gift horse in the mouth?

-- David Graham, Mill Creek

Savings should be passed to those who make healthy choices

While we wring our hands over the health-care dilemma, and I admit I do, we should keep a few things in perspective. Regence BlueShield is nonprofit ["Individual health-plan premiums cause pain," page one, July 9] so switching to a government plan is likely to do little or nothing to the basic real cost. It would just bury those costs into a complicated taxing system.

However, a recent article by the CEO of Safeway promises a path to those cost savings. Basically, Safeway passes on the savings to employees for practicing healthy lifestyles.

His claim is that 70 percent of the health costs are related to lifestyle and in particular weight, cholesterol, smoking and blood pressure. By encouraging employees to manage their weight, avoid tobacco and blood pressure and cholesterol levels, Safeway has not had to increase health-insurance premiums on those employees.

Maybe the state should allow Regence Blue Shield to discount premiums to those who practice healthy living and those who won't can pay for their expensive habits.

-- Bob Anundson, Sequim

A combo of health-care bills will make for a better system

The time has come for our elected representatives to pull together and ensure the best possible health-care plan for Americans. Sen. Maria Cantwell has voiced her commitment to the millions of children and their parents who have a right to a healthy life and need the access to achieve it. They have been denied for far too long, but Cantwell in particular needs to recognize the shortcomings of the two alternatives to a national, public option that will be forthcoming on day one.

The regional co-op model, Cantwell's preferred option, is open to bureaucracy, lack of continuity and consistency. A public option with triggers would delay the full implementation of reform, perhaps significantly. And neither of these alternatives would satisfy what three-quarters of this nation's citizens called for in a recent poll -- affordable, quality health care for all that is national, strong and available soon.

As the Finance and HELP committees work to combine their two bills in the next couple of weeks, I respectfully urge Cantwell to acknowledge the significance of the Congressional Budget Office's assessment that universal health care is not only affordable and will work, but it will also save the country money.

-- Ellia Ryan, Seattle

In Canada, my health plan even pays for the ferry ride

A letter from Mary Scott of Mount Vernon published in The Vancouver Sun July 10 asked Canadians to write to The Seattle Times with our opinion of the Canadian medical system. There have been many lies spread about our system by the opponents of President Obama's plans so maybe I can set a few things straight.

I lived in the U.S. for 40 years, but after three months residence in Canada, we were covered by the B.C. Medical Plan. The cost is only $49 per month each, although it is free in many other parts of Canada, and it covers almost everything except eyewear, dentistry, physical therapy and chiropractors. We also pay much higher "sin" taxes on liquor and tobacco, and those revenues go toward paying for the medical system.

I have paid about $150 per eye for an upgraded replacement lens, and $50 for an ambulance ride. My wife has had a couple of operations by two of the best surgeons in B.C., and she paid nothing. The plan even paid for the car ferry to get us back and forth to Vancouver for doctor's appointments and operations.

When we left the hospital, we did not get a bill, only a friendly wave from the nurse. Compare that with our daughter who just had surgery in Washington state and, though covered by a company insurance policy, is now facing a co-pay of thousands of dollars. Or our other daughter who pays $600 a month for medical insurance on herself and our granddaughter.

Depending on income, the province will pay up to 70 percent of the drug costs and that is also a huge help in retirement.

Maybe the Canadian system isn't perfect, but it surely beats the U.S. system in which so many citizens have no insurance because they cannot afford it, and others, like our daughters, face huge bills.

It seems obvious to me that the U.S. insurance companies are fighting with scare tactics against any change in the system for the simple reason that they don't want to lose their big profits.

-- Ted Brewer, Agassiz, B.C.

Canadians like their health-care system

Mary Scott from Mount Vernon wants to know if Canadians are unhappy with our health-care system. I would like to assure her that we are very happy with it, although there are people here -- people who can afford it as well as some clinic owners -- who want a system like the U.S. has.

Tommy Douglas, the father of health care here in Canada, is still one of our most revered heroes for his work.

The problems we have had with our health care are mainly a result of both federal and provincial governments skimping and cutting back on funding the last few years, which has caused problems with accessing doctors and facilities. Our premiers and prime ministers failed to foresee and plan for aging baby boomers and have now been surprised by it.

People on the whole here are thankful that our health-care system exists as a safety net in case the unforeseeable occurs.

In British Columbia, Premier Gordon Campbell recently had a forum on health care to discuss if perhaps a majority of people might want something different. But he was soundly defeated when everyone told him they liked the system as is just fine.
I would like to assure Scott that here in Canada, we do not hate our health-care system, and we fight tooth and nail against those trying to destroy it. If you heard differently, it is a lie.

-- Mariel Schooff, Coquitlam, B.C

General health must remain priority

President Obama's answer about a single-payer form of health care ["Questions and answers about health legislation," seattletimes.com, Politics & Government, July 8] revealed much about the reality of the health-care debate. Take the phrase, "[health care] is one-sixth of our economy, and we're not suddenly just going to completely upend the system."

One-sixth is about 17 percent, meaning 17 percent of all economic activity in the U.S. is used for the maintenance of our bodies. As meals are not included in that slice, can we not say the big business of health care is too big? Consider too that the Center for Bioethics and Human Dignity says money spent to promote general health is 5 percent of that one-sixth.

"An ounce of prevention is worth a pound of cure" runs the adage -- in America, we've been getting both. There is no doubt we cannot afford our current health-care system; the economic projections are too daunting.

It is time all parties in Congress join the Obama administration in calmly trimming the fat from the private insurance industry. While increased regulation and a public insurance option will reshape health care in this country, the priority must be general health.

-- Chris Boeckman, Seattle

Canadian health care would be a welcome change

Opponents of a public-health-insurance option caution that such a plan would result in "Canadian-style" health care. In support of this, here is a true story.

A cautious, self-employed Seattleite, I pay for the best private health insurance available. Good thing, because at 43 years old, after being diagnosed with an aggressive breast cancer, I received treatment at two top regional facilities: surgery at University of Washington Medical Center and chemotherapy at Seattle Cancer Care Alliance.

Weeks after my diagnosis, a lifelong friend in Vancouver, B.C., was diagnosed with a virtually identical cancer -- same tumor size and characteristics, same lymph node status, etc.

After tumor discovery, I received diagnostic tests after more than 30 days. Her tests took three. I waited five weeks for surgery; she was scheduled in two. Post-surgery, I waited five weeks to begin chemotherapy. Her chemo started in three.

In the end, my out-of-pocket expenses exceeded $30,000. Her bills were in the hundreds of dollars.

The UW just hired my reconstructive surgeon from the University of Toronto for his education in pioneering techniques. My friend's surgeon was Canadian, too.

So will a public plan result in Canadian-style health care? I truly hope so.

-- Kathleen Duke, Seattle

Don't leave the mess for insurance companies to fix

In response to The Seattle Times report ["Cantwell hints she might back Obama plan," NWWednesday, July 1] on Sen. Maria Cantwell's health-care stance: Opponents of a federally funded public option for health-care insurance argue that by themselves the existing health-care companies will take care of the problems. They have had decades to do this but haven't done so.

Premiums continue to rise, increasing numbers of poor or unemployed people must live without insurance and with substandard health care and others rightfully worry that a serious illness could bring their coverage to an end. Our existing system appears to work well for the healthy and the wealthy, but not for the poor, the unemployed and the sick. Meanwhile, reputable studies show citizens of other countries have equal or better health care at far less cost.

Somehow "the market" has failed to keep foreign cars and electronics out of the U.S. Upper and lower-level insurance workers and other Americans gladly use these products. How long should the health-care-insurance market be permitted to deny Americans the benefits of other nations with the bugaboo scare tactics of "socialism?"
To those who say, "I don't want the government coming between me and my doctor," I say, "I don't want a profit-motivated insurance executive coming between me and my doctor!"

-- Rev. Don Klompeen, Bothell

There's no competition under single-payer insurance regime

John Geyman, professor of medicine emeritus from the University of Washington, says ["Don't discard pay-go option," Opinion, guest column, July 7] a single-payer health-insurance regime would beat out private health insurance if they were competing on a level field. He touts H.B. 676.

Private health insurance would be banned if H.B. 676 were enacted. There would be no way to test Geyman's assertion.

-- Eric Tronsen, Seattle

Guest columnists are right on health care

The columns in The Times July 7 by Paul Krugman ["HELP for health-care reform," Opinion, guest column] and Dr. John Geyman about health-care reform are both enlightening and encouraging.

Krugman referred to HELP for health-care reform as "a historic opportunity." Yet he neglected to point out that universal care will provide early care for all children so that more serious illnesses are averted, thus moving into a more preventive mode and avoiding greater medical costs.

Geyman mentions Rep. John Conyer's H.B. 676 with 83 co-sponsors, which would provide universal coverage with a "savings of some $400 billion a year." This legislation was introduced several months ago and yet this is the first mention of it I have seen or heard in the media since then.

As past president of Physicians for a National Health Program and a member of the Institute of Medicine, Geyman should be given much more recognition in the media and the content of H.B. 676 should be fully presented for public awareness.

-- Dr. Norval Pielstick, Ferndale

Public option will weigh down Medicare

Those advocating for expanding Medicare as part of a public health option need to recognize the following:

First, many doctors refuse to take Medicare patients because of low reimbursement schedules, and Medicare patients have to pay for their own annual physical exams if they can find a doctor. Medicare payments to hospitals fail to cover patient costs, forcing them to raise prices for those insured by private-insurance companies to make up for shortfall.

President Obama plans to expand coverage to 44 million who are currently not insured, but increasing the number of Medicare patients will force hospitals to further raise costs for private insurers, causing them to lose members to the cheaper public option. Finally, Obama's plan to fund the public-option plan will cut some $600 billion to $900 billion from Medicare payments during the next 10 years.

As a Medicare user for the past five years, I don't look forward to the future if this plan goes through.

-- Bill Hirt, Bellevue

Public health care? Think twice after trip to DMV

Around Memorial Day, I was sick and needed to see a doctor. Deciding to seek medical care at 7:30 p.m., I drove to the Everett Clinic. I immediately saw a doctor, received a thorough evaluation and had my prescribed medication electronically sent to the drugstore. I picked up my prescriptions by 8:50 p.m. In a little over an hour, I saw a doctor, received a diagnosis, picked up medication and was home.

A few days ago, my son needed his learner's permit. We went up to the Everett Department of Motor Vehicles. The parking lot had no spaces so we drove around until one opened up. The room was packed. We took a number and waited for three hours to receive his permit.

Next time you make a trip to the DMV or the Post Office, ask yourself: Do I want government to be in charge of my family's health care? Our family sure doesn't.

Medical costs need to be addressed, but our care is the best anywhere in the world. We are not willing to give something so important over to self-absorbed, unprofessional politicians to monkey with -- like they are doing with our economy.

-- Laurel Christiansen, Everett

Those who can't pay disregarded in current system

For all those who think that we all have great health care here in America, here's a story that is all too common, but I don't hear anyone talking about.

I have a friend who was diagnosed with cancer. He runs a very small business, working as an independent contractor. Bottom line: He can't afford good insurance. After some initial radiation and chemotherapy, the latter doing more harm than good, his doctor wanted no more to do with him. He was told nothing about nutrition or any other aspect of overall health.

When he finally had a follow-up visit to that doctor, and asked about his various debilitating symptoms, the doctor told him nothing. "Come back in a month." (Yeah, I hope he can.) And the fact that he could barely stand up, fell regularly, was slurring his words badly and so on, meant little. "Take some vitamins," he was told.

Does anyone believe that a person with money -- or good insurance -- would have been treated this way?

America has its strengths. But it has its faults, and this is one of them.

-- David McKenzie, Federal Way

Like with Medicare, provisions for private companies will come

Sen. Olympia Snowe and Sen. Max Baucus are talking about an automatic trigger that would include the government option if private insurance didn't reduce health-care costs enough.

We seem to remember that when Medicare was overhauled the Republicans included a provision that guaranteed the private insurers they would make a profit, since there was no way they could compete with Medicare. The private insurers jumped at the opportunity -- witness the list of them in the Medicare booklet. It would not surprise us to see that type of provision included in this legislation.

What is it these politicians don't get about the 75 percent of the public, voters, wanting government-provided health care?

They had better wake up.

-- Anne and Bill Dillon, Kent

No government bureaucrat is worse than private insurance

It is with alarm that I listen to the debate on health-care options. Frequently I hear conservatives claim government cannot run health care, even though they can run our military. They say we would have a bureaucrat standing between us and our doctor. But we already do. That bureaucrat is the insurance company, which denies benefits and payments.

Conservatives also claim they want competition. No they don't. They only want the for-profit insurance companies to continue to bleed us dry. That is why they hate the idea of government-run health care. It is cheaper, more effective and a better value. It would put the greedy insurance companies out of business, unless they learned to offer a better value for consumers.

Conservatives also scream about an inheritance tax, calling it a death tax. The real death tax is what happens when people die prematurely because of inadequate access to quality health care. Then they die having exhausted their life savings, and their survivors are left with nothing but debt.

It is time for a change. Universal health care for all is a right. Conservatives are a choice whose time has gone.

-- Carol Barber, Kent

Cantwell needs to support public health care

Get off the fence, Sen. Maria Cantwell ["Cantwell hints she might back Obama plan," NWWednesday, July 1].

Your constituents are fed up with this "will I or won't I" support the public option game -- we want no triggers, no compromises, no regional deals, no watering down in health care.

I read an excellent analysis of the monopoly power insurers have in the health-care marketplace in the United States. It's more than just disgusting; it's inexcusable that a progressive senator from a progressive state still can't make up her mind.

This monopoly industry is crying about the loss of competition, and it's just déjá vu all over again. They've got a stranglehold in most of the smaller rural states, and they're pouring millions a day into lobbying to hold their position.

Free market, my sweet patootie.

-- Julie McCormick, Port Townsend

Innovation will save costs in insurance industry

Job loss through downsizing has decimated working Americans who pay the taxes driving our economy.

But drastically downsizing the work force may be inefficient. Cutting overpaid ineffective executives should be a first consideration.

Example: Boeing is losing money with continued delays in delivering ordered Dreamliners. Reassembled components are manufactured elsewhere to cut labor costs. Frequently these components are improperly made, with missing parts or faulty construction. When this happens local engineers and machinists have to solve the problem and find the hardware to complete a component that was not ready to assemble. Boeing engineers and machinists are to be praised.

Costly, insufficient health care cripples our economic recovery. President Obama finds fault with unnecessary medical expenses, like spending up to 20 percent of revenue on administrative tasks.

Obama would like to cut this to 3 percent, the bookkeeping cost of Medicare and his suggested optional government medical insurance. My current local private plan already does this at a savings of more than 50 percent from my previous plan by having computerized medical records and easy communication with specialists by phone or e-mail.

It won't be easy, but I believe we can reclaim jobs as well as insure American health care.

-- Bob Olson, Bellevue

For those in need, subsidize health care

Editor, The Times:

I hope many of your subscribers read Kyung Song's excellent article ["Even the insured are going broke," page one, June 28] regarding health insurance. The article implies that third-party payment of medical insurance by either private employers or the government is a contributing factor of the high cost of health care, and I agree. Slightly more than 90 percent of those who have medical insurance are partially or totally subsidized by their employers. Human nature will predictably overuse something that is free.

Additionally, to characterize private insurers offering their insurance policies in a free market is false. Song's article showed what happened in our state in 1993 when government regulations dictated what the market could or could not do when providing medical insurance. The result was that the market almost disappeared. Government regulations, particularly mandated coverage, does not make for a free market and significantly limits choice. Obama, Paul Krugman and The Times don't comprehend this.
The solution to this very important issue is to make individuals directly responsible for their relationships with medical providers and insurers. This can be accomplished with a universal medical-savings account system wherein employees could still be subsidized by their employers and those in financial need could be subsidized by the government. This would also serve as the long-term solution of the Medicare financial crises.

-- Bob Dorse, Seattle

Government plans have low overhead, no need for private giveaways

Richard Ralston's letter to the editor ["No real competition in public-option insurance," seattletimes.com, Northwest Voices, June 28] is outrageous. There is private competition to Medicare --the private Medicare Advantage plans. And get this: Our federal government gives the private insurers 12 percent to 19 percent more per patient than what they spend on each patient who has traditional government Medicare.

This was a giveaway to the private insurers who can't compete. In fact, this year half of United Healthcare profits were from Medicare Advantage plans.

Traditional government Medicare, our one-payer public plan for those older than 65, has an operating overhead of just 3 percent.

Private insurers have to pay huge CEO salaries, pay dividends, advertising, underwriting and more. Their overhead is between 10 percent and 40 percent.

Ralston's Web site has nothing to do with free choice.

I am 57, and I pay $20,000 for health insurance in North Carolina. I would love to buy into Medicare! I have no choice. In fact, the only reason I have any insurance is because I am self-employed. I have a business policy, and by law my provider has to sell me coverage.

If I tried to apply as an individual I would be denied. Some free choice!

-- Dr. Jim Matthews, Fort Mill, S.C.

HMOs exist but aren't the solution

Sen. Kent Conrad's proposal for a public health insurance co-op option B is a ruse. It is simply a means to maintain things as they are and prevent any movement that could lead to national single-payer health insurance.

Such co-ops already exist in several parts of the country. They are called HMOs. Examples like Kaiser Permanente and Group Health in Seattle have taken decades to achieve economies of scale, which yield optimal care at contained costs. Physicians must be hired or contracted and hospitals and clinics paid.

This requires substantial initial investment. Co-op startups in small communities are doomed because inadequate income from limited enrollees prevents the containment of costs and the gaining of traction. Even in larger communities, initial smaller scales of enrollment will prevent any real competition with larger existing insurers. It is the nationwide scale and the backing of our government that makes the real public option competitive and eventually capable of bringing health-care costs under control.

-- James Maynard, Sammamish

Tort reform another way to fix health coverage

Here we go again, another large rate increase from my insurance provider. As much as I hate more government interference in our lives, something has to be done about affordable health care.

Little oversight of these companies is akin to the banking meltdown. My wife was paying less than $270 a month with a high deductible for her coverage two years ago, but it will be $489 a month starting in August. These rampant increases must stop.

Tort reform is a good start; maybe doctors won't feel the need for so many unnecessary tests in order to keep their malpractice insurance from escalating (notice, another insurance company involved).

Insurance companies are part of the problem, but even more, we are pawns to attorney's games, plain and simple. To make it worse, so many of our politicians are attorneys, protecting their next job back in the private sector. It's a sorry situation at best.

-- Richard Eirich, Kirkland

Insurance execs follow anti-golden rule

Martha Koester nailed the insurance executives who told our lawmakers that they have no plans to rescind their present policies concerning health-care claims ["Private insurers afraid," Opinion, Northwest Voices, June 26]. Their business plan reminds me of a recent article published in The Seattle Times' religion pages about the golden rule, which said, "The anti-golden rule is the morality of Capitalism."

Some of our most powerful businesses in American history fit that statement. This is not the morality of our Founding Fathers. We need to send a message to our leaders in Washington, D.C., that we demand health care for all Americans now.

-- John Guevarra, Seattle

Reducing child abuse lowers future health costs

Three city police chiefs identified the importance of including child-abuse prevention and mental-health treatment in health-care reform in terms of crime and public safety ["Health reform fights abuse, crime," Opinion, guest commentary, June 3].

There is yet another cost to society, health care and abused children. Besides their lifetime of unhappiness formed through neglect and abuse, they are at greater risk for chronic disease.

The Adverse Childhood Experiences Study, referred to as the ACE study, informs us that the long-term consequences of childhood abuse can last well into old age. The study, done in the late ' 90s, first reported the relationship of childhood abuse and household dysfunction to increased risk for many of the leading causes of death in adults, including heart disease. Negative childhood experiences produced psychological risk factors, such as depression and anger, that increased the likelihood of heart disease over the traditional risk factors of smoking, physical inactivity, obesity, diabetes and hypertension.

Preventing or at least reducing child abuse is not just the right thing to do; the upfront cost is well-compensated-for in reduction of health-care costs.

-- Bertha D. Cooper, Sequim

Opponents of single-payer system more passionate, vocal

Reporter Katherine Long noticed the 2,500 people supporting single-payer health care, but not the 400 more-vocal opponents right across the street ["Thousands hit Seattle streets seeking changes to health care," NWSunday, May 31].

Her characterization of the socialized-medicine supporters as "mellow" was quite accurate, however. Brought in on charter buses, the marchers carried predominantly professionally printed signs advocating everything from abortion to open union ballots. It's unclear how many supported single-payer health care and how many just attend any union-supported event. Their lethargy suggested primarily the latter. They averaged only 13 attendees from each of the 190 organizations endorsing the rally.

The one source of enthusiasm at the rally was the emcee, who repeatedly called over the loudspeaker for them to "be louder than those people over there," referring to the supporters of free choice in medicine across the street. At one point he even suggested that the sound system was broken due to the noise disparity, although the opposition was merely a collection of unaided human voices.

The take-away from this gathering should be the strength of convictions of those who want freedom in health care. Their chants, such as, "Who will pay?" filled the air despite having fewer participants. Unfortunately, this more engaged and passionate community was omitted from the story.

-- Chad Mills, Redmond

Prescription costs alone are too much to handle

This report is prompted by The Seattle Times' Sunday article on health-care desperation [" 'You're no longer covered,' " page one, May 31]. Here is one case showing just how intolerable our health-care system is.

I calculated what my wife and I would pay per month for our regular prescriptions only if we were not insured for them: $614 for me and $693 for her, for a total of $1,307 per month or $15,684 per year. And these are pretty routine medications --no cancer, for example. We have also had $594 worth of one-episode prescriptions so far this year.

The poverty income level -- $18,300 gross for a family of three -- might keep them in prescription medications if they don't have any other living expenses.

-- Thomas F. Powell, MD, Olympia

Demand better options

Health-care reform can mean anything. What the public gets depends on what we ask for from Congress and the president.

The ridiculous and counterproductive segmentation of health-care providers into hundreds of lists and of patients into cherry-picked risk pools by parasitic middlemen must stop.

We must demand single-payer health care or, failing that, at least a public option, which must be:

• Universal -- everybody included, no exceptions;
  
• Publicly financed and privately delivered;
  
• Comprehensive -- all necessary medical care;
  
• Portable -- independent of employment status, place of residence, health status or age;
  
• Accessible -- free choice of any qualified practitioner.

My husband has access to those things with Medicare, so he gets to keep our doctor of the last 25 years. Being stuck with private insurance, I will have to give him up when my COBRA eligibility expires.

-- Martha Koester, Seattle

Obama must fulfill single-payer promise

Anything other than a single-payer system will make President Obama a liar. He ran on the single-payer system and now is caving in.

He thinks he can trust the insurance companies? Come on, now, get real. Vote only for single-payer --but make it better than Medicare. Medicare is not for the poor, either.

-- Judy Pintar, Issaquah

Stellar people, broken system

Dr. Roger Stark writes of a public option health-care plan: "It is not an exaggeration to say that our entire health-care system is at risk with this new plan" ["Obama's proposal is the noncompetition health plan," seattletimes.com, Opinion, May 18]. And this is bad news?

Do not confuse our excellent doctors, nurses, physician assistants and science with our broken health-care system. Our people and science are stellar; our system is broken.
True competition welcomes a public option. Let's see what the people choose.

-- Margaret Heldring, Seattle

Provide affordable options

The two opinion pieces on health reform by Dr. Roger Stark and David Sirota ["More questions than answers in Obama's health-care policies," Opinion, May 18] both don't get it. Our neighbors do not want to continue in the same uncertain, uncontrolled, unaffordable health-insurance market in which we now find ourselves.

Stark is playing the fear card. Reform means reasonable and needed regulation of the private market. Insurers are good people with terrible incentives.

On the other hand, Sirota wants the president to toss out all insurance companies and go with a government-controlled plan. While it is a tempting urge, my neighbors don't know what the new plan will be. They want to see what any new plan looks like and then they want to make the choice themselves. Conversely, they don't want Stark's proposal to continue with unbridled insurance-company policies and few good choices.

I think President Obama is heading the right direction -- keep what you have, provide affordable options, make sure there are real choices (even plans that are public, like state-employee insurance), promote positive changes in our creaky health-care system and regulate the insurers so they have an incentive to compete in ways that help us all.

-- Bob Crittenden, MD, Seattle

Government-run system any better?

After reading David Sirota's column, I wonder if the general answer to his question -- "Why Obama's insurance-industry-coddling inconsistency?" -- might not explain the greater problems with a single-payer health-care system run by the government.

That is, politicians often fall far short of promised ends -- perhaps because of "payback for campaign cash" or a "desire to appease powerful interests." But individual discrepancies often flag larger government inefficiencies.

While universal health care is ideal, health care provided by the government would present a host of problems akin to those already evident in the Obama administration -- inefficiencies that are the result of ulterior motives and static bureaucracy. Although private health care has its many problems as well, it is not necessarily inefficient.

My point is this: Private health care is not ideal, but can we be sure that health care run by the government would be any better? Would it really ensure the best coverage for those who need it?

-- Hugh Barber, Edmonds

Single-payer advocates excluded from reform talks

The recent Senate Finance Committee hearings on health-care reform have excluded those who favor a single-payer system, which would cover everyone with an expanded Medicare-like program ["Status quo in, single-payer out at the raucous Baucus caucus," Amy Goodman column, May 15]. That's because the Finance Committee is chaired by Montana Sen. Max Baucus, who allegedly has received more campaign contributions from HMOs and drug companies than any other Democrat.

Accordingly, he has solicited testimony from almost every part of the health-care industry, but has excluded testimony from anyone favoring a single-payer system. Anyone speaking up for a single-payer system has been arrested by police.

In my opinion, Sen. Baucus should be sued immediately for discrimination. A class-action suit on behalf of the American people should be filed immediately -- reminding Baucus that he and the other senators represent the American people first and the health-care industry second.

Are there any lawyers willing to take the case?

-- Roger Chapanis, Sammamish

Democrats deserve respect for commitment to issue

The Seattle Times' series of articles by Kyung M. Song concerning a new state law for organ and tissue transplants has been extremely well done and highly informative.

When reading comments, however, in response to the May 15 piece ["Gregoire signs organ transplant cap into law, despite last-minute concerns," seattletimes.com, Local News], I noticed one area where the actual facts and the impression readers had diverged.

Specifically, Rep. Eileen Cody, D-Seattle, who is also chairwoman of the House Health Care and Wellness Committee, has in fact strongly supported transplant-funding reform. Notwithstanding this fact, it is true that in her committee Premera Blue Cross was able to effectuate a troublesome amendment --an amendment that caused me to cease (for a while) supporting the bill's passage. I have expressed my concern to her.

Sen. Karen Keiser, D-Kent, has clarified legislative intent and Insurance Commissioner Mike Keidler has written that the troublesome language relates to certain complex clinical-practice issues and does not indicate an attempt to capture pre-transplant expenses as transplant costs under the new law.

I am not a card-carrying Democrat. I vote as I see it best to vote. The Democrats Cody, Keiser, Keidler and, yes, Gov. Chris Gregoire deserve great respect for their individual and collective commitment to the important health-care issue posed by organ and tissue transplants.

-- John Scanlon, recipient of a heart transplant, Kent

Consider the big picture

I am writing regarding The Times' editorial titled "A healthy dose of reality" [Opinion, May 13].

I have to wonder -- did the editorial board consider the unionized employees when it wrote this piece? The proposed cuts affect only the non-unionized county employees -- less than 15 percent of the county work force. This is the same minority group of employees that have been saddled with a pay cut in the form of furloughs.

What about the other 85 percent of the employees -- why are they not being asked to take cuts in pay and benefits? How can the county manage budget shortfalls when 85 percent of the employees are under union contracts?

A well-written editorial would have considered the big picture and not just the political grandstanding of two campaigning council members.

-- Mark McCulley, Seattle

Win McNamee / Getty Images

President Barack Obama, surrounded by members of Congress, applauds after he signed the State Children's Health Insurance Program (SCHIP) legislation in the East Room of the White House on Feb. 5. Obama is looking to further overhaul the nation's health-insurance system.

Editor, The Times:

As a registered-nurse at a medium-sized Seattle community hospital, I find the recent offer by the insurance industry to reduce its prices for health insurance ["Health-care sweetener for Obama," page one, May 11] akin to a bank robber making an offer to be let out of the bank if they agree to take $998,500 instead of a million.

What everyone fails to see is that insurance companies fail to deliver anything that we as a people can't do more cheaply ourselves. Public schools in this country are by and large respected and they are not for profit. They are an example of "socialized education."

Fire departments and police departments function the same in almost every municipality in the country. Imagine your response if when your house caught fire, you called 911 and the operator asked "Do you have fire insurance, sir?" The military is also "socialized," but most fail to see that.

To a lesser extent, credit unions are also "socialized" and they have shown they can compete with banks on rates and still deliver better service. By the way, banks tried mightily to keep them from being legal.

The wordsmiths of the insurance companies have demonized what people used to simply call tribal, community or national. It is time that we demand to be able to insure ourselves. Medicare is able to insure the elderly for a 3 percent overhead while insurance companies charge between 20 and 30 percent!

So instead of our employers paying premiums to a for-profit company, they would pay the premium to our government and we, the people, will use the premiums to pay health-care providers, diagnosticians, pharmacies, etc. for their services. As for the workers in the insurance companies who are presently on our payroll, they could go to work for the new National Health Service, or be retrained to do something useful, like be a pharmacist, ultrasound tech, doctor or nurse.

-- Thomas Booze, RN, Seattle

Kick out abusive insurance companies

The power of insurance companies is becoming more and more evident. Is it possible that a group of senior white men will be able to dictate to the president of the United States the terms of what's what on issues of health care? I sincerely hope not!

Just like the banks, the insurance companies in their greed did not foresee that increasing their premiums at unaffordable rates in unsustainable ways, denying claims, using endless discriminatory practices and granting huge CEO compensations would eventually lead them to offer changes that no one believes in. Our bankers became investors and ignored the consequences of high-risk investments, and where are they today?

I hope that President Obama will stand up to them and protect hardworking citizens from continued abuse from these insurance companies. They have no right to be involved with health care to start with.

President Obama can start by putting an end to Medicare Advantage Plans and then give Americans a choice of coverage that is affordable. People who are happy with their insurance coverage need not worry. They can keep what they've got. Making health care possible and affordable is what is needed for the millions of Americans who have no coverage.

-- Edyth Koch, Seattle

Laughable effort to contain costs

Forgive me this chuckle for [the] headline, "Health-care sweetener for Obama" [page one, May 11], but especially for the subhead "... industry vows to contain costs."

For years I have watched these health-related insurance companies and pharmacies raise rates ever higher and higher and always with the same justification, they say, of merely being competitive and keeping their heads above the economic flood of inflation. And now with a Democratic president and Congress, they want to look like the guys in white hats by "containing costs."

How laughable.

They might hunker down for now, but as soon as the next W. sits on the corporate knee, you'd better believe these companies will be back with rising fees faster than you can say "sick."

-- Bink Owen, Walla Walla

Corporations only care for profits

The for-profit private health-care-insurance industry is offering to try to reduce rate increases by 1.5 percent per year. They say this will save U.S. citizens $2 trillion over 10 years. We must not believe them. There are many reasons why.

Two trillion dollars buys a lot of corporate jets. Two trillion dollars buys a lot of vacation homes. Two trillion dollars buys a lot of fancy corner offices. Two trillion dollars buys a lot of Rolls-Royces. Two trillion dollars buys a lot of politicians.

The CEOs and boards of directors of publicly held corporations are legally bound to maximize profits for their shareholders at the expense of their customers. Voluntarily reducing premiums might even be illegal unless they can show the shareholders that this will actually increase profits.

The private, for-profit health-care-insurance industry is pledging 1.5 percent reductions in premiums. However, we currently pay about double what other industrialized nations pay for health care and our health-care outcomes are worse!

Write or call your senators and representatives today. Write the president. We need government-financed and -run health care now.

-- John S. Snow, Woodinville

Allow some healthy competition

The people who have given us the most expensive health-care system in the world are finally talking about reducing costs.

We need a Medicare-like system open to everyone. Let the private insurance companies compete with it if they think they can offer something better.

-- Bruce Pringle, Normandy Park

Errors can prove fatal

With our unemployment rate, it would make more sense for the U.S. to recruit some of those 400,000 unemployed nurses from the Philippines to alleviate the U.S. shortage than take medical transcription jobs away from Americans ["Overseas fingers type our medical records," News, April 21].

We are not "typists," as this article would imply. We are medical-language specialists with years of experience in providing medicolegal documentation of a patient's medical records. One typographical error can prove to be fatal in patient care.

The next time you visit your physician, ask him who he uses to document your health records.

-- Nancy Groceman, Seattle

Low accuracy rates, high liability

My name is Lisa Pike and I'm the owner of ScribeRight Transcription. Paul Watson's article was very informative, but I wanted to share some things that aren't known to the general public about the outsourcing of medical transcriptions services to Third World countries:

Security: The U.S. has gone through great pains to put the Health Insurance Portability and Accountability Act (HIPAA) in place, with heavy fines for noncompliance, but then allows our intimate health details to be sent overseas, where they are not protected by American law. Most American patients don't know this is happening and have no say in the choice to outsource.

Accuracy: The quality from most overseas companies is well below acceptable, and in some cases downright life-threatening. In one example a client gave us, a doctor dictated "sulfa," a very common antibiotic, and the English-as-a second-language transcriptionist typed "sea foam"!

In the last few years, several health-care groups, fed up with the low quality they were getting from outsourcing, have brought their work back to companies that have native English-speaking transcriptionists. The heavy editing they had to do after receiving back files ate up any savings there might have been.

Cost: The 10-15 cents per line quoted in the article is roughly the same, if not more, than domestic services charge. It begs the question: Why risk the high liability and put up with low accuracy rates when one can get the same price locally? If your average Filipino transcriptionist makes 20 percent of what her American counterpart makes, why aren't the outsourced prices 20 percent of what is charged here?

While some health-care providers consider it a "cyberspace miracle," others shudder at the thought of someone a half a world away deciphering their life-and-death medical data for $3 an hour.

-- Lisa Pike, president, ScribeRight Transcription Agency, Inc., Renton

Nurse-developed care models valuable

Although the AP story "Medicare to play big role in health care overhaul" [seattletimes.com, Politics & Government, April 21] states that "Medicare should become the test lab for making the entire health-care system less wasteful," it fails to mention round-table participant Mary Naylor's team-based care model that could very well help transform the American health-care system for the better.

Naylor, a registered nurse and professor at the University of Pennsylvania, created a program that is specifically geared toward improving post-discharge outcomes and lowering rates of re-hospitalization via a transitional care team led by an advanced practice nurse (APN).

A four-year trial (funded by the National Institute of Nursing Research) with a group of elderly patients hospitalized for heart failure found that the APN care model cut hospitalization costs by more than $500,000; this was compared with a group receiving standard care, producing an average savings of approximately $5,000 per Medicare patient.

Clearly, Naylor and her team have solutions that could reduce rehospitalizations, thus leaving patients healthier, while simultaneously saving our health-care system billions of dollars. America needs to start recognizing and adopting nurse-developed models of care; we will be a healthier nation because of it.

-- Patricia Ford-Roegner, CEO, American Academy of Nursing, Washington, D.C.

Virtual procedure more cost-effective than traditional

Noam Levey's article, "Inside look at health-cost battle" [News, April 19], unfortunately omits a total-cost comparison of virtual colonoscopy (typically less than $1,000) and traditional colonoscopy (twice as much). Some object to the former because "up to 20 percent of patients will have a polyp requiring that they get a follow-up optical colonoscopy to have the growth removed."

Consider two examples. In the first, five patients have traditional colonoscopy. At the cost of $2,000 each, total costs are $10,000.

In the second, five patients have virtual colonoscopy. Using a price of $1,000 (half as much), costs are $5,000. One patient ("up to 20 percent") has a polyp, requiring a traditional colonoscopy to remove it at a cost of $2,000. In this second example, total costs are $7,000.

And this second colonoscopy is "needlessly duplicative"? Further, "Some critics contend it could inflate the nation's skyrocketing health-care tab because a traditional colonoscopy is required if anything is found in the imaging" of the virtual colonoscopy? Even though it is a screening option recommended by the American Cancer Society?

Virtual colonoscopy looks like a way to reduce colonoscopy costs by 30 percent for those choosing it.

-- Jerry L. Lundry, Bellevue

Health-care plan is essential

Charles Krauthammer would criticize President Obama's aspiration to extend health care to all our people ["Foundation of Obama's domestic revolution constructed on sand," Opinion, syndicated column, April 19]. He keeps hammering on the theme of unsustainable costs for universal coverage. To solve this dilemma, he resorts to the vague and very tired conservative position: reform entitlements. That, we know, is code for cutting benefits.

I suggest Obama's health-care plan, though not spelled out in detail at this stage, is essential. In good conscience, we can't go on denying health care to some 45 million of our people. Until we do cover them, by whatever plan, their emergency care is usually provided and is a considerable cost to taxpayers.

Those of us fortunate enough to be covered have seen our premiums skyrocket in recent years. And that is not surprising, considering the costs inherent with private-sector coverage -- huge salaries and bonuses for corporate managers, millions spent every year lobbying Congress, blitzing our airways with drug commercials, paying dividends to investors and maintaining a bureaucracy to review and deny our claims. It's a wonder there's money left to pay the actual caregivers.

Obama has hinted that his plan would eliminate this waste and duplicity. And, as he claims, it probably would cost less.

-- Dave Ogilvie, Gig Harbor

Don't ignore innovative solutions

Many innovative structures are built on sand or worse -- a major sports arena in Mexico City is built on soil that is 85 percent water. Many other buildings are successfully built on land that Charles Krauthammer would call questionable. These feats are not new. All they take is an open mind and yes, more money than building on a solid foundation.

We do not have that solid foundation -- the economy we inherited from the past eight years is anything but solid. In fact, one might even consider that it is not even sand, but merely smoke and mirrors: the revered and respected Wall Street giant Bernie Madoff's unregulated and un-investigated pyramid schemes; the entire financial system; "Mission Accomplished"; the 285 pallets of cash simply lost in the Iraq war; or the billions of dollars billed by Halliburton for shoddy, fatal or nonexistent reconstruction.

The list of financial architectures predating Obama that have proven faulty and already collapsed would cover an island the size of Manhattan or, more aptly, Abu Dhabi.

Buildings built on sand must be monolithic in their structure, where they do not bend or twist at all. The study of their internal and external forces must be comprehensive. Most important, once built they must be able to sit upon the sand and not shift or sink with the whim of the winds or rains.

Casting fearful aspersions about change, at the same time ignoring the forces causing the collapse, is what got us this scattered, shambled house of cards in the first place. Ignoring innovative solutions only prolongs the pain. Let's see how new structures proposed by Obama perform before burying our heads in the sand and espousing doubt.

-- John Richards, Tacoma

Smokers should be held accountable for choices

Yes, it most certainly is unfair ... to the large majority of Americans who do not smoke ["Tobacco tax takes giant leap Wednesday," News, March 31].

The tax should be higher. Do the math. If a $0.62 tax increase on a pack of cigarettes and other smoker-related taxes are expected to raise an additional $19 billion in four-and-a-half years (that's $4.22 billion additional per year) and the estimated health costs related to smoking are $119 billion each year (from estimates of the Centers for Disease Control and Prevention), then the tax increase should be $17.48 per pack to cover these estimated health costs related to smoking.

Factor in the 5 percent of smokers who quit because they can't afford the higher price and the tax would reduce to $16.61 per pack. Add this to the conservative estimate of $4.80 for the average per-pack cigarette price in the U.S., based on data collected from states and territories at the end of 2008, and the new price per pack becomes $21.41.

CNN headline: "Smokers feeling abused as federal tax hike hits."

Boo hoo. Smokers should be accountable for their bad choices.

-- Gary Glenisky, Seattle

"Buy one, get one free"

The Associated Press

Pope Benedict on his African trip.

Editor, The Times:

Regarding your editorial about the Pope's position on condoms ["Pope Benedict's unfortunate message," Opinion, March 20], I say, Amen.

Now, tell him -- and while you're at it, all the school directors -- that we need to install condom dispensers right next to (or included in) the apple machines. If we can sell "forbidden fruit" for a profit, surely we can give away something that will guard against the spread of this 21st-century plague, AIDS.

How about: "Buy one, get one free."

-- Del Lawrence, Bellevue

A suspicious conclusion

"Research casts doubt on prostate-cancer screenings [News, March 19] is a suspicious conclusion to a very serious health issue.

The conclusion assumes that the screening has only one purpose when it actually has two. PSA blood tests detect changes in the prostate function and is a simple, nonaggressive test. If the test proves an increasing change in the PSA level, further tests are recommended. This change could mean an enlarged prostate or cancer. In either case, treatment may be necessary.

Another conclusion assumes that cancer of the prostate will remain in the prostate. If you are relatively young (50-60) determining the type of cancer and its growth rate is essential. Once it leaves the prostate, it can metastasize to other body organs. This may be life-threatening.

Past family history, age, lifestyle changes and types of cancer detected determine what should be done if enlarged prostate or cancer is indicated. Only the patient and doctor can make treatment decisions, not studies nor insurance companies.

Before taking heed of these health studies, one should investigate who is sponsoring the study. In most preventive-care studies, the insurance companies are behind the funding. Their conclusion should raise suspicion. I can say as a cancer survivor the PSA test saved me from possibly more serious health issues.

-- Jim Morris, Renton

A call for helmets on the slopes

Sonny Bono, Natasha Richardson and thousands of other skiers have lost their lives for the simple fact they are moving at highway speeds on nothing other than skis ["Natasha Richardson, 45, of British acting dynasty," News obituary, March 19].

Just like ballplayers and motorcycle riders never used to wear helmets, it makes no sense for skiers to wear no protection simply because it is tradition or inconvenient.

Moving here after growing up on the aptly named Plains, I always wanted to learn to ski. Since then, I've met too many people who have some skiing-injury horror story that eventually changed my mind.

For those who still want to ski, it really is time to consider requiring approved helmets on the ski slopes. Ski resorts will enjoy lower liability costs and these all-too-common tragedies may not end with so many devastated families and friends.

-- David G. Wright, Seattle

You Yanks should pay attention

Things that never happened while I lived in Canada and used the single-payer Canadian system (Ontario Health Insurance Plan -- OHIP):

-- Denial of benefits due to a pre-existing condition.

-- Denial of claim due to not approved provider.

-- Denial of claim due to not authorized service.

-- Denial of claim due to improper coding by provider.

-- Co-pay due at time of service.

-- Multiple invoices for a single provider visit.

-- Multiple calls to provider to determine the reason for the denial of claim.

-- Deductible percentage deducted from invoice due to service provider.

-- Billed for services rendered.

All of these have happened to me in the U.S. health-insurance system, except denial of benefits.

Oh for Canada's health insurance -- single payer.

-- Jay F. Johnson, Redmond

Low percentages does not equal low-bar charity care

The Times' article "Report: Health-care disparities shortchange minorities, poor" [Local News, March 4] may have had good intentions, but it misrepresented Virginia Mason's work to care for our community's underserved.

Virginia Mason (VM) is an integrated medical center with a downtown hospital and clinic, as well as regional clinics. When looking at charity care as a percentage of gross revenue, the total revenue included in this calculation matters.

At VM, unlike others, our gross revenue includes physician-clinic revenue, so comparisons with "hospital-only" systems are not "apples to apples."

When comparing Medicaid revenue as a percentage of gross revenue, readers should understand we do not provide pediatric-inpatient care, nor do we deliver babies -- two service areas with significant Medicaid use.

Clearly, our percentages will be lower.

Virginia Mason's community-benefit activities stretch well beyond the charity-care numbers reported. Among our subsidized health services we operate the Bailey-Boushay House, a nursing residence and outpatient center for people with HIV/AIDS and other life-threatening illnesses.

This nationally recognized facility has a 16-year history of offering residential and outpatient programs for the very people we were criticized for underserving. Many clients suffer from substance abuse, psychiatric illnesses and homelessness, and nearly half of those served in 2008 were people of color.

I'm proud of the work we do at Virginia Mason in service to our community, and I strongly encourage people to visit our Web site, www.virginiaMason.org/communitybenefit, to read the full story.

-- Suzanne Anderson, Virginia Mason Medical Center senior vice president, Seattle

Stopping to smell the stench in the stampede toward National health care

The first job I had after graduating high school was as a delivery man for the largest florist in Houston.

My duties included traveling to private residences, businesses, funeral homes and hospitals; Houston has one of the largest, most advanced medical complexes in the world. Most of the hospitals were a pleasure to deliver to, as they allowed access to the nurse's station, and I always enjoyed the labor-and-delivery floor, looking through the glass at newborns.

The worst place to go, even worse than funeral homes, was the Veteran's Administration Hospital. They made me go to the patients' room -- there were four or more patients per ward -- and there was always the stench of urine and someone moaning loudly or calling out for assistance. It did not matter what floor to which I was directed. I doubt things have changed much in the interim.

It seems to me that in our stampede toward national health care, we should all visit our local VA hospital and speak with a few of the registered patients there to find out how much they like the original form of United States "free" health care.

Maybe a trip to a nursing home funded by Medicare or Medicaid would also make a nice side trip.

Margaret Thatcher once said, "The only problem with socialism is that eventually, you always run out of someone else's money."

I say: Where there is no competition, there is no excellence.

-- Konrad Lau, Sedro-Woolley

Thank you for an immense, pork-spending bill

Sen. Maria Cantwell, D-Wash., sent out a very glossy 8 by 10 inch mailer asking us to call and thank her for the "hard work" she did in lobbying for increased health care for children.

So here is mine:

Thank you for using the stimulus package to increase the welfare program, even though the administration said there were no "earmarks" in it. Your bid was one of the 9,000 "earmarks."

Thank you for seeking to destroy the best health care in the world by introducing "health care reform." I am sure there will be more to follow in future stimulus plans or other so-called "government aide."

Thank you for making it harder on small-business owners who make a profit, so they can hire people like me who depend on this profit to support their family.

Thank you for letting America believe this plan will increase jobs when, in reality, it will grossly increase our national debt. My future grandchildren will be grateful, I am sure.

Finally, would you please thank Sen. Murray for all of her hard work in drafting the infrastructure of this immense, pork-spending bill?

-- Virginia McCallon, Kirkland

Refreshing loose ends

Every voice must be heard on health-care reform.

Although I cannot say for sure what President Obama's new health-care package will do for me in my future, I know it will help bring the change he promised. I am 18 years old, which means now that I am legal, I have to start paying attention to things like health care.

Obama's promise to make health care more affordable to Americans couldn't come at a better time. When people's budgets are tight and the country is going in to a deepening recession, it takes initiative like Obama's to actually get something done in Washington.

The one thing I admire most about the new health-care package is the specifics aren't laid out yet.

Obama has clearly stated compromise will have to happen in order for this new health-care package to work. It is refreshing to see and hear about politicians in Washington state willing to work together. If the health-care package is done right, it has the potential to put money back into the hands of the American people.

-- Erin Thenell, Shoreline

16-plus years serving most marginalized in Bailey-Boushay House

The Times reported Virginia Mason Medical Center (VM) provides less charity than other hospitals in the area, and that four community organizations accused it of "shortchange[ing] minorities and poor people" ["Report: Health-care disparities shortchange minorities, poor," Local News, March 4].

This accusation ignores the compassionate care that VM has provided at Bailey-Boushay House for 16-plus years to some of the most marginalized people in our community: those with HIV/AIDS; those who suffer from addiction, homelessness, and mental health problems; those who speak little or no English; and those who are as poor as poor people can be.

I was a Bailey-Boushay board member for nine years, and I can tell you during that time, when every year it seemed like we might have to close our doors for lack of money or government support and, thus, turn away those who desperately needed care, it was only because of VM's continued commitment that we stayed open.

It is also noteworthy that the ultimate goal of Bailey-Boushay, as stated in its strategic plan, is: "Equal access to positive outcomes."

For those who might deign to criticize VM, please don't look at just part of the story.

-- Denis Stearns, Seattle

Right time to bring disparate interests together

We could put meaningful sanctions on health-care facilities that do not provide translation services ["Report: Health-care disparities shortchange minorities, poor," Local News, March 4].

And, we could mandate what amount of uncompensated care will be required if a health-care facility is to qualify for the tax benefits of a nonprofit entity. We could mandate nonprofit, health-care facilities outreach to underserved areas of the county.

But, with auto manufacturers burdened with health-care costs, becoming noncompetitive and middle-class folks losing their health insurance, rather than applying band-aid solutions, it is time to address the more than 47 million uninsured and perhaps at least 20 million underinsured.

The uninsured and the underinsured do eventually get care, albeit later and more costly than would be timely health care.

The time is right for these disparate interests to come together in the common cause of adequate access to health care for all.

-- Larry Donohue M.D., Seattle

From drugs to doughnuts, we're hooked

It is only now that the health-care system is overtaxed, associated costs are overwhelming and medical research is most emphatically promoting the simple and cheap: prevention. In other words, diet and exercise.

Call me a cynic, but while whole industries -- from fast food to couch-potato, home entertainment to online shopping -- to say nothing of the medical-industrial complex, we're growing as the result of the public's bad choices. And, there's nary a peep about it.
Eating right and walking were intuitive to and permeated my parents' and grandparents' generations. They lived to be nearly 100; baby boomers and younger, who prefer to seek the fountain of youth through plastic surgery and pharmaceuticals, are dying off in droves.

It's no coincidence that President Obama's down payment/reserve proposal for universal health care was announced on the same day as the results of the latest cancer study.
The message is unmistakable: change now or pay.

Problem is, from drugs to doughnuts, as a nation, we're hooked. So which way do we go?

-- Karen DeLuca, Alexandria, Va.

Healthy work force means healthy economy

Let us not be misled by fearmongers. Good health-care reform should benefit all of us, either directly or indirectly. It is bad for the economy to have the your work force sickly. And worse yet, your nation's children who will grow up to be your work force, sickly and stunted.

If you want good plants, care for them. Water and feed them and let them have enough sun. Get them off to a bad start and you may never get a healthy plant.

The lesson is elementary: Economic recovery will follow health-care reform.

Quality, affordable health care will stimulate the economy. Medical bills are still the largest cause of bankruptcy in the United States. Let us offer some alternatives to people without insurance. Programs like "Basic Health" of Washington state offer a basic plan with premiums based on percentage of income.

Let's get people back to work and healthy. Let's make health care next on the agenda.

-- Pat Kaald, Issaquah

Use the money as it was intended to be used

I truly appreciated Lynne Varner's column, "Preserving a health-care lifeline" [Feb. 25], in support of Washington's health-care safety net.

It is extremely important the federal money designated for health care be used to maintain the essential services there for all of us in times of crisis or need.

Federal-stimulus money for health care is available to our state now. It is disconcerting to me that our state leaders could consider using these dollars to fill other budget gaps -- not bolster state health care as our president intends.

With insurance rates skyrocketing and layoffs increasing, more and more people are finding themselves on the rolls of the uninsured.

Programs, such as the Basic Health Plan and General Assistance Unemployable, are the last bastion of relief for many of our state's most vulnerable. This is something we should all understand right now because tomorrow any one of us could be in this position: vulnerable, exposed, at risk.

Thank you and please keep urging our lawmakers to help maintain our health-care system. Now more than ever, this is of paramount importance.

-- Thomas Trompeter, Renton

Quantity of life, not quality of life

Lynne Varner's column on preserving health-care funds missed two vital points ["Preserving a health-care lifeline," Feb. 25].

In the lineup of human needs, health care ranks number two only behind food. Money designated to improve health care must not be pre-empted by anything below that level.

Besides, it is no secret that current state affairs in America's health-care system decrees the quality of health care one gets is largely determined by how much wealth one has. Innovative developments are worthless because insurance companies declare them experimental and won't pay for them.

People are aware of this and are getting fed up.

We are talking not just about the quality of life here. We are talking about the amount of life. I, for one, will become a very unpleasant citizen if someone I love dies because of this unacceptable, unequal caste system of medical care. I won't be alone.

-- Harold Pettus, Everett

Leading edge in misleading journalism

The Feb. 19 article, "State doctors' group opposes mandatory MRSA screening" [Local News], represents the leading edge in misleading journalism. The lack of direct quotes from a medical professional speaks volumes.

I noticed the same thing in the original misleading Seattle Times series on MRSA. Could it be that while many professionals spoke with reporters, these reporters chose not to use any of their quotes?

Just one day earlier The Seattle Times printed a Los Angeles Times story indicating bloodstream infections from MRSA have dropped 50 percent in the last decade. My journalism teacher would have told me to provide more balance and more context. He knew that type of "journalism" doesn't serve the public's interest, but, rather, misleads the public and makes them more anxious, in order to sell newspapers.
The Seattle Times editors should know that too.

-- Susan Stoltzfus, Woodinville

Pulling the plug on the real issue

The MRSA article in the Feb. 19 Times is interesting as far as it goes, but it fails to explain why the Washington State Medical Association opposes bills in both the House and Senate.

I assume they have reasons for their opposition, the reporting of which would help readers like myself better understand the issue.

As it is, the article reads like a plug for The Times' great reporting on the rise in MRSA infections in Washington state hospitals.

-- Eric Weissman, Lake Forest Park

Twisting the numbers

I read your article on MRSA by Mary Engel ["Dramatic Drop in MRSA Found," News, Feb. 18] with great interest. The MRSA-infection rate in hospitals is shameful, especially since tightening basic-sanitation procedures could cut the infection rate exponentially.

About five years ago, my grandmother was infected by MRSA through improper sterilization during minor-back surgery. While fighting off the infection, she came close to dying several times.

My grandmother is a retired nurse. She was horrified by how the nurses, aides and doctors dealt with the contagious nature of her illness during her stay. She once mentioned that the sheets on her hospital bed, which had come into contact with fluid from her infected-surgery wound and should have been washed and sterilized separately, were instead thrown in with the other sheets from that floor for a quick wash.
Shortly afterward, several other people on her floor came down with MRSA.

Mary Engel has twisted the study to say something it doesn't. The study claims there has been a drop in MRSA infection during a centerline procedure, not an overall drop. In fact, overall MRSA-infection numbers continue to rise.

-- Patrick Andrews, Mill Creek

Playing it safe for our children

In reading your paper, I found both the editorial urging oversight by the state of body piercings ["Making a point about piercings," Feb. 18], and the news bite about a dog groomer being charged with animal cruelty for piercing kittens ["Pierced kittens," Newsline, Feb. 18].

I fully support the ideas expressed in your editorial, but want to comment on the animal-cruelty charge.

How many times have you seen little girls (even babies) wearing pierced earrings? Who is doing these piercings? My guess is any reputable shop would not do the piercings; it's mainly being done by the child's relatives or friends. Should a mother have the right to make this choice for her child? I would think if it's cruel to pierce animals, it's certainly cruel to pierce children.

I would like to see the Legislature take this a step further, making it illegal to pierce children, unless the child is old enough to ask for such a procedure, understand the ramifications and have the consent of a parent.

Certainly with all the associated health issues that can develop, we need to be looking out for children -- especially if their parents aren't.

-- Connie Loveridge, Covington

Sickening symphony of slashing the budget

In 1729, during a period of great economic uncertainty in Ireland, Jonathon Swift wrote "A Modest Proposal," in which he satirized the attitudes of those who devalue the poor by suggesting the poor simply sell their children as food. In these more enlightened times, our state lawmakers appear ready to dine on federal funding intended for the care of the poor.

On Feb. 2, the House voted to slash almost $5 million from the care of nursing-home patients for the remaining fiscal year (prior to July 1). By an 83-13 vote, Democrats and Republicans joined in a sickening symphony of praise for an all-cuts approach to budgeting.

The proposal went to the Senate and, on Feb. 13, the same Democratic Party that created Medicaid under Lyndon Johnson was united in its Senate vote to begin dismantling Medicaid's vital protections for nursing-home patients.

This budget-cutting comes before the legislature even gets around to addressing Gov. Chris Gregoire's biennial-budget proposal. Her no-new-taxes budget would cut 7.5 percent from nursing-home care as part of $130 million in Medicaid cuts to long-term care over the next two years.

Amazingly, state cuts to vital Medicaid care may occur at the same time the federal government increases its commitment to that care.

Indeed, even while it pillaged nursing-home funding, the House budget action assumed pocketing an additional $205 million in federal Medicaid contributions through July 1 alone and an additional $575 million for the following two years.

The actual increased Medicaid assistance to Washington from the federal stimulus package may be $2 billion.

Unfortunately, avaricious-state governments had united and defeated health-care advocates' efforts in Washington, D.C. to push "maintenance of effort" requirements. Such requirements would have prevented the perverse phenomena of reduced funding as additional federal dollars intended for care roll in.

Rather than address our economic crisis with the sorts of thoughtful ideas we've already seen from the Obama administration, both parties in Olympia are seemingly competing to see who can kick over the most wheelchairs through mean-spirited, social-service cuts.
Medicaid spending primarily goes toward wages. That's why it's recognized by economists as one of the best means of economic stimulus. Because caregivers are hardly wealthy, their earnings generally go straight back into the economy as spending.

And every dollar cut from state Medicaid spending surrenders a matching federal dollar. Thus, through severe Medicaid cuts, state government may destimulate the economy faster than the Obama administration can restore it.

Beyond this economic reality is the fact that vulnerable citizens, and those who dedicate their lives to caring for them, stand to suffer. More than dollars and cents are at stake. Nursing homes do not manufacture widgets. We provide skilled nursing care -- and life-transforming rehabilitation -- to people with serious medical needs, who are often at the worst points in their lives. And, we do so amid constant uncertainty created by ever-changing, state-reimbursement policies for roughly two-thirds of the patients on Medicaid.

For the last few years I've worked alongside the union representing caregivers to fight for better respect for low-wage workers. Gov. Gregoire has been a great help. Yet, now I fear our hard-won gains may evaporate due to state politicians' shortsighted reactions to this economic crisis. I fear Medicaid cuts will close facilities and displace both caregiver jobs and our state's most vulnerable citizens.

-- Jim Roe, San Juan Care & Rehabilitation, Anacortes

Not a lifelong tragedy

Your front-page story on the recent, traumatic blindness of Donnie Cheatham [ "In the flash of a bullet, a young man goes blind," page one, Feb. 6] once again raises the frustrating and complex issues facing today's at-risk youth. However, as a visually impaired person dedicated to providing services for the blind and partially sighted, I am compelled to offer some insight pertinent to the resultant aspects of the story.

It was mentioned that Cheatham is facing dependency on others for the rest of his life. But blindness in no way has to preclude Cheatham from a life of freedom and self-sufficiency. As in the familiar cellphone commercial, there is a veritable legion of compassionate experts ready to stand with Cheatham when he's ready to learn exactly how independent, fulfilled and successful life can be despite vision loss.

Everyday, I am inspired and amazed by people who are living proof of this.

Community Services for the Blind and Partially Sighted, right here in Seattle, is a nonprofit agency providing ongoing services such as vision rehabilitation, counseling, training in myriad practical and life skills, assistive technology and resources for information, education and support. Most services are provided at no cost and no one is turned away due to an inability to pay.

Cheatham's story doesn't have to be one of lifelong tragedy.

Paradoxically, the good news is that he is young -- he has the time to learn just how bright his future can be. Not everyone will need to know the great strides that have been made in vision assistance, but for people like Donnie Cheatham, he stands to be amazed.

-- Joyce Shoemaker, Seattle

Eliminate needless paperwork

Health-care providers in the trenches know what the problems of health-care delivery are. We are tired of being told how to practice medicine and take care of patients, so the insurance industry and pharmaceutical industries can benefit first.

Adopting new technology works in other industries. It needs to revamp health care to eliminate needless paperwork and bureaucracy.

Delivery of care can happen more efficiently and save money. We'd all like to see the cost of care come down and safety improve.

-- Hannah Albert, Vashon

Outgrowing the planet

I am writing in response to your Feb. 4 article about the mother of octuplets ["Mother of octuplets not feeling the love," News].

The Earth's population reached 6 billion in 1999 and is expected to be 7 billion in 2011, only 12 years later. It will then increase by another billion in even less time. At this rate, a baby born today will see the planet's population double within its lifetime.

This is happening despite all the rhetoric of its deniers; the population bomb is real.

It doesn't take an Einstein to recognize that the proliferation of the human species will outstrip the planet's capacity to sustain it and will present our next generation with one of its greatest, if not the greatest, environmental disasters.

Why should anyone be applauded or rewarded who contributes to or expedites this process?

-- Herb Aldinger, Seattle

Vaccines on the chopping block

Washington lawmakers lauded our State Children's Health Program (SCHIP) this weekend, hailing it as the best in the nation ["A partner in kids' health," Local News, Feb. 1]

While we may have the best state-subsidized children's health-insurance program, Washington has one of the worst child-immunization rates in the country. In on-time childhood immunizations, Washington ranks 39th according to the 2008 Healthiest State Report Card, the Institute of Medicine and the federal Centers for Disease Control and Prevention.

The state's goal of universal coverage for kids by 2010 is inspiring; it is the right thing to do. We are hopeful that Washington will continue to lead in this area, thanks to the determination of our leaders.

But, what is the plan to ensure these kids actually receive care, especially when the state's universal-purchase program for vaccines is on the chopping block? And, how will the state educate parents to ensure that children receive the right care, at the right place, at the right time?

We encourage our state leaders to be certain that the SCHIP expansion includes coverage for vaccines. We encourage them to do more to educate the public about vaccine safety. And we encourage them to implement a training schedule for the school employees and health personnel who implement immunization policies.

Washington is, and should be, a leader in health. Addressing our state's low immunization rate will go a long way toward healthy kids and a healthy state.

-- Greg Vigdor, Seattle

Unlike adoption, no concern for child's welfare

Given the scrutiny to which would-be adoptive parents are exposed, how could it be that a fertility clinic would provide an unmarried woman, whose competency has been challenged, 14 embryos to gestate with no apparent concern for the welfare of the brood to be produced ["Mother of octuplets wanted just one more," News, Jan. 31]?

In all the media frenzy, I have yet to hear or see any mention or concern for the fate of these children.

-- C. Wight Reade, M.D., Seattle

Giving physical therapists and patients a plan B

The Times recently reported on the Olympia rally attended by 625 physical therapists in support of Senate Bill 5230, seeking to lift the prohibition of spinal manipulation by physical therapists in Washington state ["Physical therapists, chiropractors square off over bill," Politics Northwest, Jan. 22].

I am a physical therapist affected by this issue. Physical therapy (PT) education programs nationwide are all required to teach spinal manipulation in order to be accredited. It is the accepted standard of evidence-based care for acute-spinal pain.

In Washington state, two of the three PT programs are state-funded with taxpayer dollars. Students graduate as Ph.D. PTs who cannot use this procedure in Washington state. They can move to 48 other states in the U.S. and perform spinal manipulation, and, when they do, they take the taxpayer investment with them.

SB 5230 will require all PTs to prove to the Washington State Department of Health (WSDOH) they have the necessary training to use this technique.

Passage of this bill allows a group of medical professionals to do what they have been trained to do based on evaluation of musculoskeletal dysfunction as part of their overall treatment plan, and allows the patient to choose the practitioner that fits his or her needs and philosophy of care.

-- Brenda Matter, Seattle

Truly a medical home

Carol M. Ostrom's feature on medical homes ["Curing what ails us," Pacific Northwest magazine, Jan. 18] points to the importance of centering health care around the patient. However, this feature ignores the 30-year track record of community health centers in the state.

Community health centers are health-care homes because they have all the ingredients of a medical home and they integrate medical, dental and behavioral health, as well as additional services to support the needs of the most vulnerable -- the low income, uninsured and underinsured -- for better health outcomes.

For International Community Health Services, this means offering culturally competent care and wraparound services, including translation and interpretation, education, outreach and eligibility services, which reduce barriers and maximize the effectiveness of care. Last year, they served approximately 16,000 patients in more than20 languages on a regular basis in the International District and Rainier Valley clinics.

They are a "one-stop shop" with a team of employees providing primary care and helping patients access the complex health-care system, including specialty care and, when needed, hospitalization.
They are not only a medical- and dental-health provider, but a friend and support system. They are truly a health-care home.

-- Teresita Batayola, Seattle

Blinded by short-term savings

I find the plan to cut funding for community family-planning nurses in an effort to balance the Washington state budget to be irresponsible and poorly thought-out.These nurses are part of an effective program that provides much-needed family-planning services to people with low incomes.

In such economic times when the rich are still richer and the poor still poorer, maintaining a program that is matched by federal funds ninefold, and that extends contraceptive services -- as well as prenatal care, annual exams and cancer screenings to women who may not be able to get similar services elsewhere -- is well worth holding close and dear.

While it is enticing to see the brief savings of the short-term cut, the only way we are going to heal the strength and structure of our financial systems is if we begin to think about the long-term effects.
Punishing people with low incomes and harming their health-care rights and services is not any sort of way to build back the foundation of our state's economy.

Positive growth will get us much further than endangerment.

-- Olivia Corrado, Seattle

Thousands with insurance, but without care

I am writing in response to Carol Ostrom's Sunday piece ["Curing what ails us," Pacific Northwest magazine, Jan. 18] about health care and innovative ways to improve it.

I am an internist, meaning I provide primary medical care for adults, and I am concerned that the biggest drawback to the "retainer" or "concierge" or "boutique" model of health care is not even mentioned in this fairly extensive overview of innovations in the delivery of health care. To quote Ostrom, "… a primary-care shortage looms -- here and everywhere. A bazillion baby boomers with complex chronic diseases are lumbering into geezerhood …"

In the face of this, Ostrom seems to tout the "retainer or concierge or boutique" model of health-care delivery (for those who can afford it), despite citing (and apparently ignoring) two important figures: The doctors in a Qliance style of "retainer-concierge-boutique" practice will carry about 500 to 800 patients each; a typical primary care provider carries about 2,500 to 3,000 patients.

I find myself wondering where the 1,800 to 2,500 patients who have been effectively abandoned by their boutique doctors -- those patients the boutique practice cannot or will not accommodate -- will now be receiving health care. Are those of us who are continuing to do our best to provide high-quality, primary care to our current patients now expected to expand our practices by thousands of patients so that patients who have been left behind by their boutique doctors can continue to receive health care?

If so, this is certainly a recipe for worsening the quality of health care, not improving it, as already overextended providers become even more overextended.

If not, the denying of health care to these thousands of patients is certainly another recipe for worsening the quality of health care, not improving it, as these patients are added to the ranks of those who have no access to health care, despite having health insurance.

It is clear to me that the appearance of boutique or retainer practices is adding to the shortage of primary-care physicians and is making it more difficult for patients to receive health care. It is not a model of innovative health-care that should be praised or encouraged.

-- Dan Stambor, M.D., Seattle

Sacrifice nothing, everyone benefits

As a family-practice physician for more than 20 years, I have seen both sides. Completing my family-practice residency and working for Group Health for five years, I left in 1995 to go into private practice with another family physician and a nurse practitioner at Woodinville Primary Care. We all wanted to spend more time with our patients and enjoy our practice more. This was our initial mission statement.

I am very pleased to say after 12 years, we are alive and well. Our appointments are half an hour, other than for single problems like colds or ear aches and complete physicals, which are 45 minutes. We have five other providers who work with us; the model of care is very similar to the Group Health Factoria pilot. Our phone calls on weekends are few because we take time to talk to our patients while they are in clinic. We do lots of preventive care and patient education one on one; I like to say we are preventive-care specialists.

We cofounded Puget Sound Family Physicians (PSFP) with three other clinics seven years ago. We benefited from insurance contracting and implementing an electronic medical record (EMR) together three years ago.

In comparison with another clinic of similar size in the PSFP group who sees twice as many patients in a year, our annual income is about the same. Our patient satisfaction scores in PSFP have consistently been high because we take time to talk to our patients. Our employees are stellar and generally stay a long time, considering every practice has some turnover.

We do not have a subscription practice. In other words, we don't have a surcharge above insurance, in order to provide patient-centered care. Our practice is self-sustaining with no large debt and we all make a living wage.

The bottom line: Primary care can be done in a sustainable way for both patients and physicians without sacrificing quality. We've been doing it for 12 years and plan to continue.

So, in answer to the charge that family practice is going to collapse, from my perspective, I don't think so. We just have to make it work the way it should for all of us.

-- Sally Edwards, M.D., Woodinville

Fighting a losing battle

It was refreshing to read in "Curing what ails us" that some physicians are seeing the wisdom of the naturopathic approach to medicine: more patient time, listening and prevention. However, as important as these are for improving health and reducing costs, they are not enough.

As long as the M.D. medical system is joined at the hip bone to the pharmaceutical industry, they will continue to fight the losing battle of, as they phrase it, "managing" symptoms instead of curing patients. The deaths, side effects and astronomical costs prove that chasing symptoms with drugs doesn't work.

While we in the naturopathic community are flattered to be imitated, real change to the disastrous medical system will not take place until all doctors, not just naturopathic doctors, stop covering up symptoms with drugs and start focusing on treating the underlying causes of disease.

-- Thomas Ballard, R.N., N.D., Seattle

The governor's promise

Gov. Christine Gregoire won my vote in 2004 with her promise of universal health care for all children in Washington state by 2010. She locked in my 2008 vote in 2007 when she signed the Cover All Kids Bill. It was one of those rare moments when the hope that accompanies a daring pledge starts to feel like reality.

I understand our state faces daunting budget challenges. But stepping back on this promise is not the way to solve them ["Goal to insure all kids could fall to budget ax," page one, Jan. 11].

We have a $5 billion deficit and the governor's answer is to cut needy children from the state's Basic Health Plan and limit access to those not yet covered? That's no answer; it's a shortsighted travesty that will make these hard times harder for everyone.

Gregoire's proposal to ax a quarter of a billion dollars from the state's insurance plan for low-income kids is not only a grievous breech of voter trust, it's an unacceptable breech of leadership.

Leaving nearly 80,000 children uninsured in Washington will only serve to drive up insurance costs -- for the state, for employers and for those of us who can still afford to pay for it privately -- as more and more families turn to emergency rooms in lieu of low-cost primary care. It is the very definition of the phrase "penny smart, pound foolish."

I understand the challenges of the current recession. But reneging on a promise to take care of our most valuable asset for a prosperous future, our kids, is disgraceful. Balancing any budget on the backs of the poor is unjust, especially in times of economic crisis. And especially when there are other, more just and equitable solutions.

The governor and our state lawmakers must consider all options. At the very least, before taking asthma medicine away from a child such as Sarah McIntyre, ask me, the voter, if I'd rather see the governor break her promise to kids or her no-tax stance.

-- Cheryl Murfin, Seattle

Arbitrary tax breaks

On Jan. 10, The Times presented two sides of the same coin about the budget shortfall ["Goal to insure all kids could fall to budget ax," Times, page one].

The story tells that low-income children's health-care programs are facing severe cuts. The report paraphrases Sen. Chris Marr, D-Spokane, saying about children, "They're cheaper to insure, and keeping them healthy now pays financial dividends later."

On the editorial page, The Times takes another view. "In session: legislation by a thousand cuts" and "A state out of money and also out of time" [editorials, Jan. 11] both claim that because the state has an immediate and serious budget shortfall, the editorial board advocates no expansion of health-care coverage for children, but no increase in taxes and no elimination of tax breaks.

The Economic Opportunity Institute, a nonpartisan, nonprofit, public-policy institute has studied the state tax structure. Their briefs on tax breaks show that Washington state had 567 tax exemptions on the books as of 2007. A 2008 analysis by the Washington Department of Revenue shows 302 of these exemptions saved business and individuals roughly $15 billion (yes, billion) in state and local taxes in the 2007-09 biennium.

So, there must be sacrifices in children's health care and teachers' pay, but no sacrifices by business?

-- Mary Ann Leskie, Tacoma

Insure children, ensure us all

Reneging on the promise to provide health insurance to all kids will have serious unintended consequences we will all pay for. Let's follow what's likely to happen to Sarah McIntyre as a good example ["Goal to insure all kids falls to budget ax," page one, Jan. 11].

As a child with asthma and a prior history of heart disease, if she does not receive her medications on schedule and skips doctor visits, it is only a matter of time before she will be rushed to the emergency room in severe respiratory distress. The medical bills from that ER visit and the resulting days of hospitalization will be costly. Her parents will be faced with possible bankruptcy if they try to pay the bills, or the hospital will have to write off its costs as charitable care (which raises the cost of care for all insured patients).

One way or another, we taxpayers will end up paying more for kids like Sarah. She'll pay the cost in unnecessary suffering, her parents will pay by losing whatever they have managed to save, and taxpayers will pay for more expensive emergency care than would have been necessary if Sarah received better medical insurance.

Wouldn't it be better, not just for Sarah and her parents, but for all of us, to pay the lower per-child cost of covering regular medical care and prescription medications for all children?

-- Sarah Weinberg, M.D., Mercer Island

A significant problem

A recent article about growing replacement teeth ["Chew on this: We'll soon be able to grow replacement teeth," page one, Jan. 6] correctly identified community-water fluoridation as a significant pubic-health measure that has, over a generation, drastically reduced dental disease.

It is estimated that more than 180 million Americans consume fluoridated water everyday because it is a public-health measure that saves far more money than it costs. More than 60 years of evidence has shown that water fluoridation is an effective way to improve one's oral health. That is why water fluoridation is endorsed by health, medical and dental organizations across the county. Yet, in our state, fluoridated water is only available to about 59 percent of the population.

Dental disease is a significant problem in Washington. Studies show that nearly 60 percent of elementary-aged children have preventable dental decay, a leading cause of school absenteeism.

As we look for ways to reduce health-care costs, water fluoridation is a classic example of evidence-based prevention that will save money and improve health. The return on investment is significant. For most communities, every $1 invested in community water fluoridation saves $38 in dental-treatment costs. Policymakers who support efforts to reduce health-care costs should also support efforts to fluoridate the water. Everyone benefits from good oral health.

-- Laura Smith, Seattle

Take it to the Legislature

Editor, The Times:

As an advocate for patients without insurance at a hospital, I was disappointed with your one-sided story about charity care ["No money, no insurance, no mercy," Times, page one, Dec. 30].

Every day, I see patients without insurance and every day, I see people approved for hundreds and thousands of dollars in charity care. The hospitals pay big money for private companies like the one I work for to screen and help patients apply for Medicaid and Social Security disability at no cost to the patients.
You are giving hospitals a bad rap.

While I agree that there are many people without insurance who suffer financially because of large hospital bills, there are 10 times that many who get financial assistance from hospitals and who are assisted with applying for state and federal benefits to help them get some sort of insurance.

As a former volunteer at Evergreen Hospital, I have seen, firsthand, hundreds of people approved for charity care.

As a former employee for the eligibility vendor for Harrison Hospital, I have seen hundreds, perhaps thousands of patients without insurance get approved for 100 percent charity care. The hospital I work for now has us complete a financial-aid application for every single person without insurance.

The hospitals don't want their patients to suffer financially and work hard to assist patients in getting long-term benefits if they qualify. We work closely with DSHS [Department of Social and Health Services] Medicaid programs to screen everyone for eligibility to see if we can help them find a longer-term solution to their problem of having no insurance.

The problem isn't with the hospitals; it is with the system.

Washington state Medicaid programs help the aged, blind, parenting children, children and the disabled. There are very few programs for people ages 19 to 64 who are able to work. There used to be a program that would help anyone who had a medical emergency in Washington state -- now that program only applies to illegal aliens.

An illegal immigrant can get their hospital bill covered by Medicaid in an emergency situation, but a working, taxpaying citizen who comes in with the same medical emergency cannot. I suggest you stop picking on the hospitals that provide quality medical care for free and start picking on the Washington state legislative system, which has the power to fix the problem.

-- Amy Bond, Auburn

An opportunity before the disaster

I don't know why prospective appointee of Health and Human Services Tom Daschle says he'll ask us what we think we should do about health care in this country. There's no need to ask the American people when you already know health-care costs are 16 percent of GDP [Gross Domestic Product] in the U.S., while it's 9 to 11 percent in single-payer countries.

Single-payer countries have the happiest, healthiest and most productive people on the planet. In the U.S., the first conversation one has with a new employer is regarding benefits. With today's medical bankruptcy rates of families in the U.S., we know those benefits have proven to be of no benefit at all.

With massive job losses, peace of mind is at an all-time low.

The single payer's strength is its focus on the general practitioners who are the backbone, blood system and brains of the medical community. Our lack of general practitioners in the U.S. also contributes to the unmanageable cost structure we have today.

Medical specialists are the modern version of the carnival barker desperate to get you into their tent with new gimmicks. These medical specialists have exploded Medicare costs, bringing other doctors and hospitals right along with them into this frenzied, money-driven system. Hospitals have entire departments dedicated to battling our fractured and bloated heath-insurance maze, multiplying those skyrocketing costs.

Seventy percent of the U.S. already supports universal health care. The absence of that health care displays the power the insurance companies have on political will. We must switch to a humane single-payer system that reflects popular will, immediately saves money and cares for everyone in this country.

These savings will wisely supply the money needed to train the additional doctors and nurses for the transition.

You don't have to ask the American people because the writing is on the wall. We know the Chinese proverb that disaster also means opportunity. In this country, we should demand that this current moral and monetary debt be treated as an opportunity before the disaster. Our peace of mind is a priceless gift that leadership has willfully failed to deliver.

-- William McQuaid, Seattle

Not so crazy

Rob Stein's Dec. 11 story summarizes a 2007 survey showing that more than one third of U.S. adults use alternatives to medical treatment, most often for musculoskeletal problems such as back and neck pain ["Use of alternatives to traditional medicine holding steady," Nation & World].

In an attempt to present a balanced story, Stein quotes longtime critics of alternative therapies and self-proclaimed "quackwatchers" who disparage these therapies as being "either unproven or disproved," "placebo" (acupuncture), or "one step above fraud" (homeopathy).

One critic cites the wide use of alternative treatments as "evidence of how gullible large segments of our society are." Given that persons with more education are more likely to use these treatments, could explanations other than gullibility explain the widespread use of these treatments? For example, maybe persons suffering from persistent pain or other afflictions that have not responded to "proven" medical therapies have found alternative therapies helpful.

A recent review by the American College Physicians and American Pain Society, found acupuncture, massage, spinal manipulation and yoga as effective as conventional medical treatments for low back pain. Given the limitations and risks of both conventional and alternative medicine and the fact that one in three American adults appear to find alternative treatments helpful, research evaluating their safety and effectiveness seems well justified.

-- Dan Cherkin, Seattle

Thanks to technology

It's a shame that patients across the country are suffering from MRSA outbreaks at our major hospitals, including Harborview Medical Center ["The MRSA mess: a culture of resistance," News, Nov. 20].
Thanks to The Seattle Times for shedding light on how a common, familiar infection can spiral out of control.

Hospital cleanliness and transparency about infection rates should be a given but it's not enough.
As many states have mandated, screening incoming patients for MRSA should be every hospital's obligation. The bad news is screenings can be costly for hospitals and it can take up to two days to get the results, which is often too late.

The good news is technology for MRSA screening and surveillance is getting better every day as life-science companies, including my own, find ways to simplify the technology and lower the costs via molecular solutions.

Imagine the incredible preventive benefit of giving health-care providers an easy-to-use, inexpensive tool that gives patients point-of-care test results in less than an hour. With improved molecular solutions technology, we can help our hospitals keep patients safe.

--Ryan Ashton, Salt Lake City

Not everyone's luxury

I agree with Marc Smason that overpopulation is a huge problem that will pretty much sabotage attempted solutions to a great many national and global problems ["Quit having babies, Northwest Voices, Dec. 2].

However, I am wondering how he plans to restrict every woman on the planet to "one child only for the next 20 or 25 years." Who exactly will do the restricting?

Are the same groups of religious fanatics that have treated women like brood mares for centuries, insisting on unlimited children and sometimes killing the women who don't comply, now going to reverse themselves and kill women for having too many children? Or are they just going to be good fellows and have a vasectomy after fathering one child?

Are clerics of several world religions suddenly going to stop insisting that the gods want women to breed themselves to death? Are warriors going to stop raping women as a weapon of terror against their enemies, knowing that the women will be blamed rather than the rapists?

Even our own president of the past eight years has exacerbated the population problem with his insistence on limiting access to birth control globally, for fear someone at a family-planning clinic somewhere would mention abortion.

There are plenty of women out there who would be happy to limit the size of their families if mentioning it would not bring destruction down upon their heads. If women everywhere had access to education about birth control and were truly free to make their own choices, perhaps no outside force would have to "restrict" them on the issue of family size.

-- Georgia Lockwood, Kirkland

An incredible disgrace

As a Vietnam veteran, I am recommending that no man or woman consider enlisting in any branch of our military at this time.

The Seattle Times story of Nov. 26, titled "Rule change leaves some injured veterans fighting another battle" [Nation & World], confirms that even after our government continues to promote the benefits of military life, once enlisted, they refuse to provide proper care for military members.

The lies and deceit become readily apparent when our young men and women are sent to war and after being injured, our government and the Pentagon conveniently find rules and excuses to refuse the medical care they need and deserve because their injuries "are not war related."

If after a Marine corporal was injured twice in Iraq by a roadside bomb and a land mine resulting in traumatic brain injury, a concussion, a dislocated hip and hearing loss, and after a woman Army sergeant shattered a hip and crushed her back and knees while diving for cover during a mortar attack are not war related injuries, I don't know what would be. Yet, both of these heroes and others have been denied thousands of dollars of benefits due to a little-noticed Pentagon rule change last March that redefined a combat-related injury they said was consistent with the "wounded-warrior" law passed by Congress last January.

Our government's refusal to support our injured troops is an incredible disgrace to our military and to our country. Our military disability system must be changed to show absolute support for our troops before any more of our young men and women should consider enlistment.

-- Gary Wilson, Shelton

Mike Siegel/The Seattle Times

Methicillin-resistant Staphylococcus aureus colonies from a Seattle, Washington hospital patient grow in a blood agar plate at a local lab.

Editor, The Times:

The Seattle Times investigative series on MRSA was a brilliant display of journalism and revealed the truth about how the MRSA epidemic occurred, not just in Washington state, but in any hospital in any state ["How our hospitals unleashed a MRSA epidemic," Times, News, Nov. 16; "MRSA's toll climbs, but hospital is slow to change," Nov. 17; "MRSA: Patients revolt against hospital secrecy," Nov. 18; "State to begin tracking hospital cases tied to deadly germ MRSA," Nov. 19].

In a time when newspapers are cutting back on personnel, news and space, etc., you have chosen to run an investigation that truly will affect positive change for this disease and much needed transformation within the health care industry.

There can be no mission more important than saving lives and saving people from needless pain and suffering; you have done that with your series on MRSA. The MRSA epidemic has been lying in secrecy for decades and I would hope that your dedication to public service will inspire others in the media to continue to expose the truth and protect citizens.

-- Jeanine Thomas, Hinsdale, Ill.

One of our favorite things

As health care costs rise, the expense of providing that care by companies has reached a tipping point of being excessive. As that occurs, employers drop coverage, creating a greater number of uninsured people. Individual coverage does not exist in most areas of the country, because it is too expensive to provide.

As a second option, the companies move to countries where health care is provided by government for their citizens. We then lose jobs as well as health care.

We already provide health care for a large percentage of our citizens with veterans programs, Medicare, Medicaid and prisons. These programs swell by the day as people leave prisons and jail and are no longer employable and companies close or lay off employees. People must give up most monetary security and ownership to qualify for any medical help from state governments, thereby impoverishing themselves.

At some point, the U.S. will have to decide to provide the basic safety net of health care to become a strong viable nation again. This is after having dropped to 26th place in the world for overall health of its citizens.

Is the GOP willing to sacrifice the health of the country's citizens for the illusion of power by working hard to defeat any progress?

-- Vicki Decker, Bothell

Don't just wait

As a 22-year survivor of breast cancer and a volunteer offering support to numerous breast-cancer patients through Reach To Recovery, I cannot remain silent when "watchful waiting" of a breast cancer is suggested ["Study says some cancers go away without treatment," Health, Nov. 25]. This gives false security to people who have trouble facing the reality of cancer.

I heard stories from women with advanced breast cancer who had delayed treatment because their doctor had advised watchful waiting. One woman's doctor said, "My opinion is that if a lump is not bothering me, I would not bother it." I heard this from a dying woman who went for evaluation of a "cherry-sized" lump in her breast. Other women with advanced cancer had delayed a mammogram because their medical insurance allowed a mammogram only once every three years.

A cancer can grow a lot in even one year. Get those mammograms. Don't be fooled by faddist notions like "watchful waiting."

When my small cancer was diagnosed, I thought of women who were still alive after breast cancer surgery: Shirley Temple, Happy Rockefeller and Betty Ford, as well as a friend who was alive and well 35 years after a mastectomy. I elected a mastectomy.

Nancy Reagan had a mastectomy for a small breast cancer about the same time as I did. She has reached the age of 87.

-- Lois Horn, Seattle

Don't discourage fitness

For a newspaper that endorsed former gubernatorial candidate Dino Rossi, I am surprised to see you going after more tax on business, especially yoga studios ["Yoga studios should be taxed like gyms," Editorial, Nov. 24].

Maybe the tax code does need to be cleared up to include professional services like lawyers, accountants, chiropractors, etc. There is a lot more money left on the table than the yoga mat.

With our nation's terrible level of physical fitness and obesity, gyms, yoga and Pilates studios are the last things that should be taxed. Even a tax credit would be a wise investment.

-- Steve Bell, Seattle

More than your average workout

As the owner of a yoga studio, I'm glad that the Washington Department of Revenue does its research better than The Seattle Times. Your statement that anyone who goes to a yoga class will know that it is merely physical exercise shows a lack of discernment.

The editorial board needs to read the number of articles The Times has published on the many benefits of yoga.

Revenue based its decision on two factors: the student's intent and the structure of the class. If the intent is physical exercise and the students simply follow along, then the yoga class is subject to retail sales tax. This type of yoga is generally found in health clubs and gyms. There is no denying that classes such as "abs yoga" are often yoga in name only.

However, yoga studios are more often where students go for instruction in the actual practice of yoga, which involves not only the body but also the breath and mind. The student's intent is to learn to do something that can be taken away from the yoga mat and applied to life. The intent and method of teaching are different. These true yoga classes will be exempt from retail sales tax just like martial-arts instruction.

The Department of Revenue did its research, listened, learned and understood that there is a difference. I commend them for their open-minded and fair approach during times when they are trying to find every possible source of money.

-- Pat Musburger, Shoreline

Kudos on series

Thank you for the Marc Ramirez series on Dante Rivera ["The fire inside Dante D," "Intervention: Where angels dare to tread" and "Dante's divine intervention: recovery -- and redemption," NWLife, Nov. 23-25]. Ramirez is a terrific writer, and those of us who have experienced alcoholism in our families know how accurately and movingly he portrayed Rivera's story.

I look forward to more from Ramirez, and I wish Rivera a wonderful life, one day at a time.

-- Molly Cook, Langley

It's about prioritizing

As registered nurse at Harborview Medical Center, I found The Times recent series of stories on the threat of MRSA in the community to be shortsighted and lacking perspective ["MRSA's toll climbs, but hospital is slow to change," Times, News, Nov. 17].

Harborview was portrayed to be flagrantly ignoring precautions that would prevent the spread of MRSA. What the stories didn't portray were the realities of a busy urban hospital that serves a very sick population.

Any decision to place a MRSA patient in a room with a non-MRSA patient isn't made out of neglect or ignorance, but out of necessity. When critically ill patients are admitted into our ICU for care, other less-ill patients need to transfer out. The decision comes down to either waiting for a private room to become available in a hospital that is almost always overcapacity, or placing MRSA patients with non-MRSA patients so that critically injured patients can receive lifesaving care as soon as possible.

What your stories fail to address are the difficult choices doctors and nurses make when prioritizing care. This too often means that saving a life takes precedence over ensuring every MRSA patient has a private room. As a level-one trauma center, these are the kinds of choices Harborview staff have to make on a daily basis.

-- Sacha Davis, Seattle

Whom to blame?

November is Lung Cancer Awareness Month. So it was only fitting Friday morning when I read the story about the multibillion-dollar tobacco settlement of 1998 being wasted by the states ["Not much of tobacco money aids health care," News, Nov. 21].

I say well done to Steve LeBlanc and Julie Carr Smythe on a long-overdue article regarding the shameful spending of the tobacco-settlement money -- money that was supposed to be used for tobacco-related illnesses. Instead, some states have chosen to spend it on museums, golf courses, broadband in rural areas and even balancing their budgets

It is shameful how tobacco-related diseases and the lung-cancer community have not seen much, if any, of this "blood" money.

These states need to be held accountable to those whom the money was originally intended to help. Lung cancer remains the No. 1 cancer killer of men and women in all ethnic groups.

In the U.S. alone, the daily number of lung-cancer deaths is equal to a 747 jetliner crashing every single day of the year. I say shame on all of you. Someone needs to be held accountable.
Another jetliner is about to crash.

-- Cecilia Izzo, Seattle

Seattle Times file photo

Money from the 10-year-old federal settlement with the tobacco industry should go directly into smoking-cessation programs and cancer screening, readers say.

How much longer?

Editor, The Times:

Thank you Steve Leblanc and Julie Carr Smyth for writing about the abuses in the use of "desperately needed cash" from the 1998 tobacco settlement that could go to fund affordable early detection of lung cancer ["Not much of tobacco money aids health care," Times, Nation & World, Nov. 21].

Those funds are being squandered for other uses throughout our country, even here in Washington state. Most of the tobacco-settlement moneys should be used to fund the detection of, research about and a cure for lung cancer.

Some 85 percent of those who perish from lung cancer are smokers or reformed smokers. There were 160,390 deaths resulting from lung cancer in 2007. That's more than colon, breast, prostate, liver, kidney and melanoma cancers combined.

The only way to survive lung cancer is early diagnosis when there are no symptoms. The 15 percent who survive today are usually accidental diagnoses. Lung cancer deserves a screening protocol like mammograms for breast cancer, colonoscopy for colon cancer and PSA [Prostrate-Specific Antigen] screening and pap smears, etc., for other cancers.

Affordable early detection of lung cancer deserves most of the tobacco-settlement money. How much longer will this society ignore the deadly epidemic of lung cancer, blame the patient instead of the cigarette companies and refuse to fund the detection and research? It is scandalous.

-- Peggy Cameron, Seattle

Fat chance

The fact that the government has hijacked large portions of the tobacco-settlement money for other purposes should come as no surprise to anyone. Give the government money and they will find numerous other ways to spend it.

Just look at the spending of the Washington State Lottery money. The surprise would be if the government actually spent the money in the way in which it was intended. Fat chance.

-- Bruce Miller, Issaquah

Find it early

With all the money being spent on smoking awareness and cessation, there is a glaring lack of funding to assist in early screening and education about lung cancer. ["Not much of tobacco money aids health care," Times, Nation & World, Nov. 21.]

Early screening of lung cancer is a very effective tool and has a high rate of success. If found early in stage one, lung-cancer patients have an 85 percent chance of surviving and undergo a much less expensive treatment.

Treating late-stage patients is expensive, painful and horrible for everyone involved, and there is a very slim chance of recovery. Our state needs to be putting some of that money into education for screening and assisting in the costs of screening for those who don't have the means.

Eventually, the state pays for a lot of medical costs to patients who are too late to help. The shame is that for much less money, they could save more lives. That is a bargain at any cost.

-- Michelle Crawford, Arlington

What would we do without
free enterprise?

Thank you for your splendid series on MRSA ["State to begin tracking hospital cases tied to deadly germ MRSA," Times, Nov. 19]. One more example of the glories of unfettered free enterprise, along with Melamine and Wall Street.

-- Jim White, Lake Forest Park

Get real

I was amused by the comments of Sean Tipton, spokesman for the Society of Reproductive Medicine ["How some couples' hopes for a child find new life," page one, Nov. 20]. This scientific "expert" failed to reach the logical conclusion of the science, and implicitly asks us to draw an illogical conclusion in the process.

He dons the hat of a moral philosophy expert with his quip that groups "want to elevate the moral status of the embryo to be the equivalent of an existing child." Wrong. Science shows the embryo to be a complete human being. "Child" is a stage of development of a human being.

He tries to prove his point by noting that only 25 percent of fertilized eggs (embryos) develop into babies. And what is the percentage of babies that develop into children, or children into adolescents, or adolescents into adults? Is a child less of a human being than an adolescent or adult?

Due to disease, accidents or other maladies, not all embryos will eventually become adults, nor children become adolescents. Yet, each and every one is a human being.

Equally bizarre were the comments by the [nation's leading advocate for privacy and a woman's right to choose] NARAL's Karen Cooper. Perhaps someday she will stop viewing unborn human beings through her abortion-lobby lens and start recognizing them as her fellow humans.

-- Dan Kennedy, Bellevue

More Monk, less House

The Times' series on MRSA pointed out our hospital-based MRSA challenges but did not mention that most people with MRSA infections are managed as outpatients at home. A better MRSA incidence would be found from our community microbiology laboratories. The stories also implied that individuals could be definitively tested to see if they carried or were cleared of MRSA.

When a person's nasal culture is negative, can they still become infected from their own skin flora or give MRSA to someone else?

When a person's nasal culture is positive, can they eradicate the organisms by taking antibiotics or will they always be colonized? Can antibiotics prevent surgical infection in a MRSA-colonized patient?

If Harborview should isolate MRSA patients, should a person at home with a MRSA-positive "spider bite" sleep in the same bed, use the same towels or even be in the same house as their spouse and school-aged children?

Cleanliness and hand washing are proven strategies back to Lister, Semmelweis and Pasteur -- nasal cultures less so. We need to be less cavalier and more compulsive about cleanliness at the systems -- both institutional and at personal levels.

We need less Dr. House and more Mr. Monk.

-- James Mhyre, Bellevue

You wouldn't eat
your friends, would you?

As Thanksgiving approaches and we plan our dinners, we need to think about what it is we are eating.
I recently saw a banner that read, "Holidays are Murder on Turkeys," and it hit me once again how horrible this time of year is for the animals that end up on our tables. We have many alternatives to eating turkeys -- from the infamous Tofurkey to the Celebration Roast made by Seattle-based Field Roast.

Take advantage of the opportunity to have a cruelty-free meal rather than one that is the result of slaughter. As children, we trace our hands and draw them into turkeys; we should continue to embrace that love of animals as we get older and show a respect for life by not eating them.

-- Amanda Schemkes, Seattle

Mike Siegel / The Seattle Times

Handwashing signs are prominent at the Harborview Medical Center burn unit. Harborview has increased signage as part of its response to infection problems, including the MRSA epidemic.

Not so simple

Editor, The Times:

I am grateful to Michael J. Berens and Ken Armstrong for bringing attention to the challenging problem of MRSA ["How our hospitals unleashed a MRSA epidemic," Times, page one, Nov. 16]. However, it is no longer accurate to state that "six out of seven people infected with MRSA contract it at a health-care facility" nor to imply that universal screening of hospitalized patients will solve the problem.

The epidemiology of MRSA has changed markedly over the past decade. A recent study published in the journal Clinical Infectious Diseases showed that 90 percent of MRSA infections in San Francisco are now acquired outside the hospital setting. Universal screening has appeared to reduce rates of MRSA infections at some hospitals but not others. One approach to MRSA control will not fit all situations.

To truly control MRSA, we need less-expensive screening tests, simple decolonization regimens, better antibiotics and an effective anti-staphylococcal vaccine. This knowledge will come from biomedical research, yet since 2004 the National Institutes of Health budget has declined more than 13 percent after adjusting for inflation. It is time for a renewed national investment in biomedical research that will lead to an improved understanding of how MRSA causes disease and how it can be stopped.

-- Ferric C. Fang, Seattle

Antibiotic dependence

One major oversight in your otherwise excellent "How our hospitals unleashed a MRSA epidemic" was the origins of bacterial resistance -- overuse of antibiotics.

Antibiotics kill the weakest bacteria, often allowing the strongest to survive and multiply. It's no coincidence that Staphylococcus aureus has evolved into a more lethal form, MRSA. It was the target of the first antibiotic drug -- penicillin -- which came into widespread use in the 1940s. The overuse of antibiotics is the root of the MRSA crisis.

We know that lifestyle factors such as exercise, stress and diet influence our ability to resist infections, yet once antibiotics became available the health of the human immune system was ignored by the dominant medical system. Likewise, natural antibiotics, which had been used for thousands of years, fell out of favor.

Perhaps the crisis of MRSA will help swing the medical pendulum back toward a whole-systems approach to infections: First strengthen the host and utilize natural compounds, saving drug therapy for last.

-- Thomas Ballard, Seattle

Clean up your act

I was shocked to read your first story about the MRSA situation. I learned about ordinary staph in 1953, when my first child was born. I went to a U. S. naval hospital, where they had had an outbreak the previous year, and were taking measures to regain their accreditation.

Procedures were strict. The floors were mopped with antiseptic each morning. When my baby was brought to me for nursing, I was instructed to first wipe the nipples with alcohol. And to care for my stitches, I was to pour a pitcher filled with a solution of water and green soap over them. I was there for five days, so the lessons were firmly implanted.

The next two children were born in civilian hospitals, and I was rather taken aback at their comparatively lax standards. Now I realize that many hospitals have become even more careless, compared with that rigid naval-hospital routine. I believe that this stems from an attitude -- incorrect as we now know -- that antibiotics can take care of everything.

I hope your series induces hospitals to really tighten up their procedures. The MRSA screen before surgery is surely less costly than risking the loss of a life.

-- Edna Peak, Des Moines

Another thing to fix

Thank you for including the story "Food aid to help poor farmers, too" in the Nov. 11 edition of The Seattle Times. It fleshed out the scanty information that I had on the problems with food-aid delivery to needy people around the world.

I knew that American food aid was required to be produced by American farmers and transported by American companies. I was surprised to learn that European countries gave all their food aid in cash. This assures that food can be purchased locally in the distressed nation or nearby, saving fuel costs and helping the local farmers as well as the hungry population.

The story noted that Canada allows one half of its food aid to be purchased in the local country or area. I was pleased to read that the Bill & Melinda Gates Foundation is also helping the United Nations World Food Program connect food aid with producers in distressed areas.

The U.S. needs to overhaul its farm policy to allow food aid to be purchased locally.

-- Patricia Palagi, Seattle

Mark Harrison / The Seattle Times

Hinda Kipnis, 77, who has severe rheumatoid arthritis, relies on help from Liuda Kazakova, a home-care worker with Solid Ground. The agency is shutting down its home-care operation.

The first to go

Editor, The Times:

Nonprofit organizations that are being forced to close their doors, such as Solid Ground, is surely a sign of the economic troubles this country is facing and the hardships that are to come. ["Home-care agency to shut down: 'We've reached the end of a cliff,'." Times, page one, Nov. 11.]

Unfortunately, it will be nonprofit organizations that will see the effects of the economic struggles first and most likely the hardest. They rely on donations and government funding; when these funds are cut, where do they have to turn?

Hearing that these organizations, which serve those most in need, are struggling to keep their heads above the water makes me wonder what will happen to those who benefit from those organizations. I watched my grandmother thrive living on her own with in-home assistance like that provided by Solid Ground. Once she was placed in a nursing home, her independence and health quickly deteriorated.

Solid Ground is allowing its patients to live life to their fullest and it is a sad sight to see them having to close their doors. I wish them the best of luck and I thank them for their service to the Seattle community.

-- Kirsten Phillips, Kirkland

Have you no compassion?

Do you think the voters are stupid? Nearly 75 percent endorsed Initiative 1029 because they know that better training of home-care workers means better care for their loved ones ["Initiative 1029: Compassion leads to faulty results," editorial, Nov. 6].

You had a clearly-stated opinion of opposition to the initiative before the election. The voters guide presented both sides of the issue. The people didn't buy your arguments.

Your fixation on SEIU [Service Employees International Union] has clouded your judgment. Look at the long list of supporters of 1029. This initiative had broad support throughout the state from people and organizations who understand the long-term-care system in the state and the need to have a well-trained work force to sustain quality of care.

-- Nancy Dapper, Seattle

Don't be selfish

I hope you have voted, or will vote for, Initiative 1000.

I have watched too much of the suffering that accompanies dying. I have had to stand by three of the most important women in my life on their journey though those last weeks of pain: my mother (of breast cancer), my first wife (of ovarian cancer) and now my second wife (of primary peritoneal cancer).

I do not know whether any one of them would have chosen to ask for an earlier release from their suffering. Most dying people do not.

I do wish fervently they could have had the option.

Of course, pain can be controlled better now than it could be 60 years ago, or even 40 years ago. But only at the great cost of erasing something essential in us. Powerful narcotics do things to your head.

Some people who claim to know God's will insist that it would have been murder to allow them to die a few days or weeks earlier.

I believe rather that God gains nothing, and we who watch gain nothing, and those who die gain nothing, by being forced to endure those additional days of needless, mind-bending pain and drugs.

I cannot believe that a merciful God could insist we have to drag anguish out to the very last minute, while the one you love slips in and out of a drugged consciousness, with lines of hurt etched on every inch of her/his face.

A few extra days at the end of 80 years, or even 40 years, of a full life does not seem very significant in an eternity.

We betray our own selfishness by hanging on to those who are dying in pain because we cannot bear to lose them. Whether it is on religious or humanitarian grounds, every part of me cries out to release them, if they are ready to go, while their minds are still clear enough for loving, final relationships to be rich and full.

-- Blaine Hammond, Seattle

Don't quit your day job

I have grown tired of the expensive commercials featuring actor Martin Sheen opposing the properly labeled death with dignity proposition [1000].

The language used by Sheen as spokesman for the opposition is disgusting. Not only does the commercial invalidate the rights of any individual suffering enough to be classified as terminally ill, it virtually accuses any such person of potentially committing a criminal act.

Sheen and those who have financed his program have no right to invade the individual rights of people in agony. Moreover, they imply without saying that the right to end one's life might be forced upon those involved.

It is Sheen who is conducting an inappropriate campaign for those obviously paying lots of money for his efforts, whether he personally benefits or not.

In short, he should get out of the lives of those who are suffering and get back to acting.

-- Joseph Honick, Bainbridge Island

Good for insurance companies, bad for society

On the surface, Initiative 1000 sounds like a personal choice we may want. However, a competent, rational person who wants to end their life early will find a way to do so ["Washington's Initiative 1000 is modeled on Oregon's Death with Dignity Act," page one, Oct. 13].

We already have the right to refuse treatment; we have advance directives, we have sedation for the imminently dying. Patients gain the least from this law, HMOs and insurance companies benefit the most.
The 77 million baby boomers lurching toward their declining years will strain the profits of HMOs and insurance companies.

The original writer of the Oregon "death with dignity" legislation was an HMO executive.

HMOs and insurance companies have by far the most to gain from a Yes vote. Assisted suicide cheaply eliminates some of their most costly policyholders, thereby improving corporate profits.

Booth Gardner, the frontman for the initiative, admitted in the New York Times (12/02/07) that this is only a first step toward a gradual shift of the culture so laws with more latitude will be passed. "I wish we could do a more liberal law . . . We're not going to go farther than that now."

Stop it now.

-- Cassy Escalona, Shoreline

It could be you

From the time I was in seventh grade, to the end of my freshmen year in high school, I watched as my mom slowly slipped away, losing a horrible fight to cancer. It is hard to watch someone you love so much deteriorate right before your very eyes into almost nothing.

That is why I support Initiative 1000. I-1000 will allow for physician-assisted suicide and will give patients the option of taking away their pain and suffering.

The process of euthanasia is not a daylong process; in fact, the minimum wait time is 15 days. In those 15 days, the patient must be proved to be an "adult of sound mind," must receive approval from two qualified physicians, and they must have at least two witnesses present during the signing of the documents.

Every step in the euthanasia process is very meticulous and must be followed precisely with no exceptions.
I strongly encourage voters to overlook their political or moral views on Initiative 1000 and vote yes,
because in a few years it could be you or even a loved one who is suffering; and wouldn't it be nice to be given the option of determining how your life will end?

-- Ami Throckmorton, Mukilteo

This isn't Monty Python

Radio advertisements featuring violins and reassuring words like dignity, safe and no mistakes, may cause us to lose sight of what Washington state's "Death with Dignity" initiative is really all about.

Initiative 1000 legalizes killing sick people. The image of Monty Python's medieval peasant exclaiming "I'm not dead yet" as he's whacked on the head and thrown atop a pile of corpses comes to mind.

The proponents of I-1000 use great words, but sadly have no idea what they mean.

When it comes to the word "dignity," the implied suggestion is that terminally ill people have already lost their dignity. But in truth, dignity does not come and go based on health and is certainly not found in suicide.

We are assured I-1000 is "safe," but suggesting that the most vulnerable people in our society contemplate suicide is really the opposite of keeping people safe.

"No mistakes" refers to Oregon's legislation and newest form of health care, which kills all its beneficiaries. I suppose it's only a matter of time before an Oregon doctor makes a "mistake" and is hit with a wrongful-life lawsuit. Oregon's law is the mistake.

-- Christopher Larsen, SeaTac

Let this choice be personal

My father was a hero, a decorated Marine officer who fought through three amphibious landings in WWII. He struggled for his own survival and for the protection of the soldiers who surrounded him. He often wondered what made his own life so precious that the Lord had spared him in the midst of so much horrific death.

Yet there he was six months ago at his 90th birthday party, telling guests that they couldn't leave without signing the petition for the Death With Dignity Initiative.

Why would a man so full of gratitude for the sanctity of life support such a thing?

Because by age 90 he'd seen so many friends and their families suffer heartbreaking illnesses. He agonized for those who suffered through that pain and fear all alone, without a family's support. He saw how carefully the law was written to prevent abuse. It creates the right to a reasonable choice of how to deal with end-stage terminal illness.

And although my father died peacefully and naturally soon after turning 90, he supported the initiative because he thought he'd need it himself.

Plenty of voices clamor to tell us this is wrong. For example, the archbishop found it in his heart to publish a four-page newsletter with all the associated costs to his flock for publication and mailing -- every word harped against I-1000. He then had the gall to claim "I am not telling you how to vote …"

Please.

It's a lie to claim you're not telling me how to vote. It's hypocrisy to use the church's righteous power and money only against this issue of personal choice. Lies and hypocrisy will always work in politics, but the truth of I-1000 goes far beyond politics and directly to the heart of our own lives and our precious loved ones.

Patients and their families who bravely choose to endure long illnesses, full of hope and faith to the final breath, deserve our respect, admiration and support. But their struggles should not be forced on others who wish to have the right, through their own prayerful consideration, to decide otherwise.

People deserve a choice, and I-1000 is crafted with the care and dignity that gives us all that choice.

-- Bill Walker, Bothell

Two important points
ignored in story

Your critique of Sen. John McCain's health-care plan neglected to mention two salient facts for the case where the employer discontinues paying health-insurance premiums for their employees ["Calculating what McCain's health plan would do," Nation and World, Oct. 24].

First, employees can decide to opt for less-expensive coverage, particularly if they are given the opportunity to choose from the much larger pool of insurance providers McCain is calling for.

The employer would also be able to give each worker most, if not all, of the $12,000 saved by eliminating their insurance premiums.

-- Bill Hirt, Bellevue

Allow me the freedom

I am tired of all the lies being spread about "death with dignity" (Initiative 1000) ["Death with dignity: approve I-1000," editorial, Oct. 5].

This measure simply allows doctors to prescribe medication for those terminally ill, competent adults who choose to end their lives earlier than the six months predicted by two examining physicians.

No assault on the disabled, no euthanasia, no "slippery slope" to some nefarious deeds.

I want this freedom to make my own medical decisions when my time comes.

-- Anne Thureson, Renton

Don't use it if you don't want it
The time has come for a law allowing terminally ill people to end their pain and suffering at a time of their choosing, but always with the appropriate safeguards that are spelled out in Initiative 1000.

Having witnessed my son's excruciatingly painful death from cancer, I think it is only humane to provide a means whereby he might have been able to escape at least a little of that agony.

For those who do not believe this is a good idea, you would not be required to take advantage of such a law if it were in place, but please don't deprive others of the opportunity when they are in agony in the closing days of their lives.

The decision to take one's own life is an intensely personal one, and one which should only be taken after careful soul-searching and, of course, only within the safeguards required under the proposed law.
-- Sylvia Moore, Seattle

Restoring faith in humanity

I am contacting you today in regards to the recent story on the Gates Foundation ["Gates Foundation gives 104 $100,000 grants for global health projects," Nation & World, Oct. 22].
The story was inspiring, to say the least.

I am a young college student and I hear the negative sides of economy, health care, education and politics everyday, and my faith in humanity becomes a little dimmer.

This story on how the Gates Foundation continues to contribute to the world community shows that humanity has a sidekick, and we can all learn how to help.

Bill and Melinda Gates plan to spend more than $1 billion in 22 countries for developing ideas in the medical world.

With all of the numbers we hear today for research on medication, $1 billion in 22 countries may not seem like a lot. But maybe it isn't just the money that will help a cause. The idea that in such trying times, people who may seem like they have everything in the world would be willing to give to such a fundamental cause can show the possible greatness from the human heart.

--Lindsay Knaus, Bellingham

Even if it kills me

I will vote "yes" for I-1000, even if it kills me.

-- Leo Shillong, Bellingham

Let them keep their dignity

My dad was diagnosed with colon cancer more than a year ago. When he wasn't improving, the doctor gave him horrifying news that he would die within three months. The hospital informed us that hospice would take over his care. Two nurses visited regularly at home.

Nurse Mickey treated my dad with compassion. If my dad experienced any pain, they took care of it. God blessed our family with my dad's presence for two months. During this time, each of us had a chance to say goodbye. Family members came and shared how my father made a difference. Childhood friends shared how they valued my dad's life-changing friendship.

It was hard to see my dad fade a little each day. Every moment was a precious gift from God. On Oct. 1, my father, Michael, died at 66. I will always remember my dad's never-ending faith in God and others. The hospice care gave my dad a chance to die with dignity. Initiative 1000 takes that dignity away. When we start playing God, we lose the value of human life.

-- Molly Feeney, Sammamish

Revoke their freedom
Regarding the child-abuse article [".'Never seen a case of abuse this bad,' detective says," Times, page one, Oct. 14], I think $20,000 each for bail is surely is not enough money to let those criminal "parents" out of jail.

According to the King County Superior Court judge, they were "not a threat" to the community nor a flight risk.

What does that really have to do with it?

Do we let killers out of jail because we're pretty sure they won't kill again?

Freedom for these two sadists should be revoked, just as they took away their child's freedom for years.
I don't care how loony that stepmother is; she needs a lot of jail time to remind her how it must have felt ... of course she'll get fed.
-- Jill M. Schultz, Seattle

Give voice to the voiceless
I am absolutely appalled after reading about the 14-year-old Carnation girl who was nearly starved to death by her stepmother and father. I hope that they get punished to the full extent of the law.

This was an open-and-shut case in just one month? How could any questionable situation be evaluated in that amount of time?

I don't know if CPS [Child Protective Services] didn't follow through properly on this or if they went to the limit of what was allowed by law. Either way, something needs to change.

We need to be less worried about "individual rights" and more diligent in protecting those who do not have a voice.
-- Sandi Weir, Kent

Do they really need approval?
Initiative 1000 would give despondent people no power they do not now have, but would implicate us all in their decision to kill themselves ["How we die: the Oregon experience," page one, Oct. 13].

According to the Washington state Department of Health, "814 Washington State residents died by suicide" in 2005. They evidently did so without interference from the government, politicians and religious leaders against whom the proponents of I-1000 warn us.

Anyone capable of self-administering lethal drugs, as the initiative specifies, is capable of killing himself without a doctor's prescription.

I-1000 would add only one element: our approval.

If the law and the public say suicide is all right, such "legitimacy" may well be the final argument that convinces a sick person to end his life, especially when the prestigious medical profession seems to endorse such a choice.

This initiative offers less than nothing to the sick, but would make us all complicit in despair.

I hope the people of Washington reject it.
-- James O'Callaghan, Maple Valley

It's not all about the money
The Seattle Times has recommended rejection of Initiative 1029 purely on concerns about cost and that a test would frighten immigrants ["Reject I-1029, a proposal to train and license long-term-care workers," Editorial, Oct. 8].

To appreciate the potential benefits of I-1029, one only has to have a loved one in long-term care. Our loved one was accosted and struck in her own room, and knocked down by another resident as the caretaker watched, apparently not knowing what to do.

Current law requires that long-term caregivers obtain only 34 hours of training. Workers can begin employment after an orientation; they have four months to get the remaining 34 hours. I-1029 would require long-term caregivers to obtain 75 hours of mandatory training and passage of a test.

Insufficiently trained persons staff the majority of long-term-care facilities in the state, with approximately 20,000 new long-term-care workers hired annually.

Long-term-care centers are now "holding bins" for persons who cannot speak English and who are ill prepared to meet the complex needs of persons with advanced Alzheimer's disease.

We urge "yes" on I-1029 on Nov. 4.
-- Shirley and Ray Murphy, Edmonds

Follow the money trail
We are the parents of a child with severe developmental and physical disabilities. We rely heavily on hired caregivers to help us care for our son. We've been lucky enough to have family members, friends and people from our community whom we trust and who have provided excellent care. These good people have already gone through adequate training and background checks by the state in order to provide this care.

If Initiative 1029 were to pass, the requirements to become and remain a caregiver for our son would be unnecessarily burdensome. We could ultimately lose these resources and not be able to find replacements that we would trust and have as much confidence in.

And the same is true for families all across our state. For some, these new requirements might actually apply to a disabled child's own parents or an elderly person's own children.

If I-1029 passes, the sponsors of the initiative are the ones who will benefit financially. It is being supported by Washington state's largest labor union, which will get tens of millions of taxpayer dollars to train their own members.

Don't be fooled by the ballot language that would make it appear that you would be voting for our best interests.
-- Evan Purcell and Ellen Norton, Tacoma

Take it from someone who knows
I am an Oregon doctor who is quoted in The Times article about assisted suicide ["How we die: the Oregon experience," page one, Oct. 13].

As I was characterized as "fiercely" opposed, I feel obligated to share at least one reason (of many more than space permits) for my stance.

In Oregon, the "safeguards" are like a sieve. Although patients are supposed to have mental-health evaluations when indicated, there were no mental-health referrals at all last year — none!

AP Photo/Courtesy Yes on I-1000

In this still frame from a TV advertisement produced by supporters of Washington state's assisted suicide ballot initiative, Nancy Niedzielski, who lost her husband Randy to brain cancer, is shown. The emotionally charged battle over end-of-life decisions has taken to the airwaves as Washington state voters decide whether to allow doctors to prescribe lethal medication to terminally ill patients.

At the same time, a recently published [Oregon Health & Science University] study confirmed that more than 48 percent of study patients seeking assisted suicide last year had either major depression or anxiety. At least three of 18 who actually took their overdoses had major depression, a condition that commonly leads to suicidal thoughts.

It saddens me that these individuals were given overdoses rather than care and treatment for their depression. Whether depressed or not, just hearing the "option" of assisted suicide from their doctors can further a patient's sense of isolation.

Doctors who give this option are encouraging patients to not value themselves and give up hope. This is corruption of our traditional medical ethic that protects patients.

Vote "no" on I-1000.
-- William Toffler, Portland

Change the mood; don't end a life
Great story about Initiative 1000 Monday. You covered many of the contentious points.

You pointed out quite accurately that referral for mental-health evaluation or counseling hardly ever occurs in Oregon, even though studies show that many patients requesting euthanasia are in fact depressed.

Many of them are not tired of living, but tired of living as they are.

With better comfort and treatment for depression, many of them would not be asking for help with suicide.

You stated that in Oregon and under Initiative 1000 "patients who might be suffering from mental illness are supposed to have a psychiatric evaluation." This actually is not true. The initiative says that the physician shall refer the patient for counseling only if he or she believes that the patient "may be suffering from a psychiatric or psychologic disorder or depression causing impaired judgment." The last three words are the crucial ones. If a patient is depressed but capable of making decisions for themselves, as most depressed patients are, then there will be no need to refer.

Patients seeking help with suicide under Initiative 1000 are highly unlikely to first receive treatment for their depression. I suppose that initially, there will be some referrals, but as time goes by, these will cease (as they have in Oregon).

Throughout history, the desire to commit suicide has always been considered de facto impaired judgment, and society has always intervened to prevent suicide whenever possible.

This will now be changed.

As long as a physician thinks the patient can make decisions for himself or herself, Initiative 1000 for the first time makes the decision to commit suicide a rational one, even if the patient is depressed. The initiative further empowers physicians to assist in their depressed patients' suicides.

This doesn't sound like much of a safeguard to me.
-- Doug Trotter, Snohomish

Pays to die, not live
Oregon Health Plan (Medicaid) patients have received health insurance letters informing them that cancer chemotherapy is not covered, but assisted suicide is covered. Advocates of assisted suicide stress choice, but what happens when assisted suicide is your only choice?

Barbara Wagner of Springfield, Ore., received such a letter this summer. The Oregon Health Plan will not pay the cost of surgery, chemotherapy or radiotherapy for patients with a less than 5 percent expected 5-year-survival -- even when that treatment is intended to prolong life or alter disease progression. However, such patients are eligible to receive comfort care, which in Oregon includes assisted suicide.

The message from Oregon, so aptly stated by Barbara Wagner, is, "We'll pay for you to die, but not pay for you to live." You have the choice.

The New York State Task Force on Life and the Law studied assisted suicide and concluded: "No matter how carefully any guidelines are framed, assisted suicide will be practiced through the prism of social inequality and bias that characterizes the delivery of services in all segments of our society, including health care."

Assisted suicide saves HMOs money.

I-1000 endangers your health. Vote "no."
-- Kenneth Stevens, Sherwood, OR

Do the right thing
I am an Oregon doctor and I would like your readers to know the true cost of I-1000, the assisted-suicide law.

My own patient developed cancer and became depressed, but instead of addressing the issues underlying suicidality, a colleague simply gave him a lethal dose of a medication to end his life.

Washingtonians need to learn the real lesson from Oregon's doctor-assisted-suicide law. Despite all of the so-called "safeguards," there have been numerous instances of inappropriate selection, coercion, botched attempts and active euthanasia that have been documented in the public record.

This, however, is not the worst of it.

The real tragedy in Oregon is that instead of doing the right thing, which is to provide excellent medical care, patient's lives are being cut short by physicians who are ignoring the things that lead to suicidality at the end of life.

This change in our profession -- away from "cure when possible, comfort always, but never harm" -- has me concerned.

This should concern Washington residents as well.

Don't follow Oregon's lead. Vote "no" on I-1000.
-- Charles J. Bentz, Portland

Where are these doctors?
I always thought Martin Sheen was a progressive individual.

For someone who lives in the Malibu Colony, he must be strapped for cash and will say what the going rate will pay.

What kind of doctors is he referring to that will not recognize depression?

Our government may be unskilled. There are no board requirements to be a president or a legislator, but are our doctors just a bunch of schlocks?
-- Leo Shillong, Bellingham

Give caregivers more training
Caregivers help seniors and people with disabilities lead healthy, productive, independent lives ["Reject Initiative 1029," editorial, Oct. 8]. Doing this every day is demanding physically, emotionally and mentally.

I know. I have been successfully doing live-in caregiving for 33 years. Currently, Washington state requires only 34 hours of training to become a caregiver. In contrast, it takes 300 hours of training to become a dog masseur.

Someone who has responsibility for a human life needs -- and deserves -- more time to learn the skills of this work! The more training and support one has, the better caregiver one will become! I-1029 makes this training time a reality and provides the support caregivers need to do excellent work by providing quality care for their clients.

I-1029 also closes a loophole in criminal-background checks that allow people who commit felonies, such as rape, to become caregivers. Vote to pass I-1029, and help people with disabilities live healthy, independent lives and be able to stay in their homes!
-- Lee Fitchett, Seattle

Let the dying keep their dignity
Watching my proud father die a humiliating, degrading and painful death from cancer reinforced my belief that terminal patients (those who have six months or less to live) should have the legal option to make a personal choice to die in a more dignified, humane way.

Some families have called this end-of-life prolonged suffering a "beautiful time." I doubt most terminally ill patients would use those words. There was nothing beautiful or compassionate about my father's death.

Initiative-1000 gives mentally competent adult Washington state residents the legal choice to make a voluntary, informed and personal decision with their physician and their families, to obtain and self-administer life-ending medication. Numerous safeguards are in place to protect the patient from influence or coercion. Oregon has had this law in place for 10 years and it has not been abused.

In a country founded on personal liberties and individual freedoms, isn't how one dies one of the most personal choices a human being can make?

You may choose not to exercise this choice for yourself, but do not deny others the right to make a different choice.
-- Jan Whitsitt, Medina

Get the facts, Sheen
As much as I loved Martin Sheen on "The West Wing," he is using his television persona to act as if he has actually read Initiative-1000.

Contrary to his statements in the TV ad, there are many layers of safeguards to assure the person making the request is not being coerced or is not mentally depressed.

There is plenty of time to allow the person to rescind his decision, and he can do so at any time.

It is insulting to assume any person making the request automatically needs psychiatric help.
-- Brian Hogan, Kent

Vote for choice
It seems Mary Lund ["Say goodbye to civil liberties," Northwest Voices, Oct. 8] has been lied to and has been frightened into opposing I-1000. Some unscrupulous person surely put into her head that the initiative applies to people with disabilities, which is totally not true.

I-1000 applies only to persons who have a terminal diagnosis.

The insurance companies are not involved; the decision is between the terminally ill person and their physician.

The great Steven Hawking could not avail himself of I-1000 despite his profound physical disability. Former Gov. Booth Gardener has a devastating illness, but the law would not apply to him either.

I-1000 is about civil liberties. It is about the right to choose.

Out of our own misguided sense of morality, possessiveness or fear of death, we deny terminally ill people a fundamental right -- the right to determine the future course of what's left of their lives.
I-1000 extends basic rights of choice we should all have.

Fear-mongering is a common tactic of those who want to impose their views and values on others. Don't buy it.

Vote "yes" on I-1000. Vote for choice.
-- Stephen Lamphear, Burien

Be informed
I read the letter from Mary Lund of Bothell with horror.

She claims that insurance companies could somehow drop coverage of her disabled child and instead offer to pay for fatal doses of medication.

Good grief. There is no such provision in I-1000.

To be eligible for a death-with-dignity prescription, two doctors must agree that the patient has less than six months to live and that the patient is able to make an informed decision about his or her decision.
No one can force a patient to make a final end-of-life decision.

If Lund fears the insurance companies, take them on, but don't force terminally ill people to endure pain and suffering unnecessarily.

Lund is spewing the kind of lies and scare tactics opponents are using to fight against I-1000.

I agree with her on one thing: Please be informed on the issue before you vote.
-- Chris Fruitrich, Seattle

Bad medicine
The legislation of I-1000 is terribly flawed.

It will lead the practice of medicine in directions it has not seen before in this state. The law attempts to remove the stigma of "physician-assisted suicide" by replacing it with "self-administration of a lethal drug." The law would, however, allow for the administration of the dose in the case of the disability of the patient.

This removes the "safeguard" of self-administration and allows for another to end the life of a patient.
Until now, this would be considered homicide.

The law requires that the patient have no more than six months to live in order to be enacted. This is incredibly difficult to predict, and physicians, including myself, are routinely wrong. Most physicians have had patients who have been discharged from hospice care due to their failure to die in six months and actually flourish under the care of the hospice staff.

An error of special concern is the requirement in the law that the physician lie on a patient's death certificate. In a case of self-administered medication under the statute, the physician would be required to state that the cause of death was not suicide, but the disease process that the patient suffered from. This is fraud at best, a redefinition of suicide at worst. What kind of precedent does it set to require a licensed professional to lie on a legal document in order to be in compliance with a law?

Section 18 redefines suicide by barring the use of the words "suicide," "assisted suicide," "mercy killing" or "homicide" in cases of death by self-administered medication in accordance to the initiative. There is no reasonable justification for this change in definition. Even the editorial board of The Seattle Times, which supports this initiative, states "Make no mistake. This is assisted suicide" ["Death with dignity: Approve I-1000," Times, editorial, Oct. 5]. In accordance with the above errors, the initiative would also bar any enactments of insurance-company clauses against suicide.

The arguments for suicide in dying are many, and some are compelling. Suffering is difficult to watch and to go through. Pain can be a brutal mistress. It is often argued that if a ventilator can be removed or antibiotics be stopped or a surgery refused, why can a prescription for death not be written?

As patients, we have the right to refuse intervention. We can deny the placement of a tube. A woman in the throes of a difficult delivery can refuse a Caesarean section and a person can refuse lifesaving transfusion because of religious beliefs. Removing a ventilator is in the same category; it is a refusal of an intervention by the patient or their representative and allows a disease process to take its natural course. It is not an overt act by another to take a person's life outside of the disease process.

This legislation is misguided. It will be broadened over time, as most laws are. The Americans with Disabilities Act will be used to force open such initiatives to allow those without terminal illnesses to obtain physician-assisted suicide.

Physicians unwilling to participate may at some time be sanctioned for not writing the requested prescription. If this seems far-fetched, the Washington Board of Pharmacy has recently decided that pharmacists, who do not give the abortion-inducing morning after pill to patients due to personal belief, can be sanctioned by the board.

I-1000 is bad medicine and should not be passed.
-- Chris Beard, Mukilteo

Scott Olson / The Associated Press

Sen. John McCain, foreground, and Sen. Barack Obama share a rare laugh during Tuesday night's town-hall debate in Nashville, Tenn.

Iraq is no success
Editor, The Times:
During Tuesday's debate, Sen. John McCain tried once again to pitch the Iraq war as a success story, asserting that victory -- a real "mission accomplished" -- is right around the bend ["Tension, but little venom," Times, page one, Oct. 8].

There is no victory cry that can be cobbled together on the backs of this war's human tallies: nearly 4,200 U.S. soldiers killed, hundreds of thousands of Iraqi deaths and humanitarian crises stemming from more than 2 million Iraqi refugees.

McCain uses "the surge" as justification for starting and continuing a war that has been wrong from the outset. The United States has dug its heels into Iraq, constructing the world's largest embassy in a country where our invasion and occupation has wreaked devastation and ruin. We are establishing permanent military bases against Iraqi requests, keeping U.S. military might on the watch and prowl over Mideast oil reserves.

McCain's position on Iraq does not signal good judgment, nor does his insistence that victory can yet be wrung from the Iraqi soil. It is representative of his penchant to march toward war, and his incomprehension about the desperate need for the United States to practice diplomacy rather than trumpeting the drumbeats and guns of war.
-- Nancy Dickeman, Seattle

Debate redundancy
What I saw Tuesday night was a repeat of the first debate.

It doesn't matter what the question was, the answer from either participant rambled on about this, that or the other thing.

Can we please have a debate? To debate means to argue, not continually give us your ideas on things. (Look up the meaning of the word "debate," if you don't believe me.) When will Sen. Barack Obama bring up the Keating 5? Is McCain blackmailing him or something?

It has been drilled into me that we use 25 percent of the world's oil, but only produce 3 percent. Got it. Tell me something new, or I'm sleeping through the entire next debate!
-- Steve Drake, Seattle

Bomb joke not funny, McCain
During Tuesday's presidential debate, Senator John McCain said he was "just joking" with one of his friends, when he sang "bomb, bomb Iran."

What a great joker!

Someone who thinks he is fit to be president is joking about bombing other countries? Wow!
I would have liked to have seen someone in the room ask him how he would feel if a politician from another country "joked" about bombing the United States.

I am pretty sure he would not like that joke at all and think that those people must be terrorists, according to his definition of terrorism.

This man shows anything but leadership qualities. He sounds and acts like a senile, old man, running around mumbling to himself and calling everyone else stupid.

I hope people of this country can wake up and see the evil they are facing before it is too late. They did not do that eight years ago, but, hopefully, they have learned by now.
-- Farokh Talebi, Kirkland

McCain's policies scary
Sen. John McCain and his logic (or lack thereof) scares me.

During the debate last night, he said that he wouldn't raise taxes for anyone, but he would lower taxes for some people. He even implied that he would lower taxes for as many people as Sen. Barack Obama will. But the money to run the country -- and, hopefully, to start paying off the national debt -- has to come from somewhere.

Under the tax plan McCain preaches, where will this money come from? If McCain doesn't plan to undo President Bush's tax cuts for the wealthy, we will lose even more revenue. This is not the way to handle the economic crisis.

Another thing he said that frightened me: He clearly stated that nuclear power is clean and safe. Excuse me, but does no one remember the Chernobyl disaster? I hope people don't buy into his unsupported lies.
Besides these twisted energy and economy policies, McCain said little about his own policies for the future, only saying what he has voted for or misquoting Obama. Sometimes, things he said about Obama were outright lies, with no more grounding in fact than the "safety" of nuclear reactors.

McCain is dangerous. I am grateful to all the war veterans, but that does not make someone suited for the presidency.
-- Kelsey Josund (age 15), Lake Forest Park

The candidates needed to heel
After watching the "town hall" debate and seeing the terse, frustrated look on moderator Tom Brokaw's face as he tried to make something meaningful of the evening, I couldn't help but think the debate commission should take a lesson from Larry and Kirby.

Kirby is a young, frisky golden retriever, and Larry is Kirby's owner. They are very loyal to each other. Rather than relying on an electric fence -- used in big areas where dogs spend a lot of time chasing deer or getting lost -- Larry gave Kirby an electric collar. It took a few times for the dog to realize that getting a little jolt meant stop and come back. Now all he has to do is hear the warning tone, and he gets the message and returns to base.

How much better the debate would have been if Brokaw could have had such a tool when the candidates wandered away from the question!
-- Bill Clapp, Seattle

Just doesn't make sense
Maureen O'Hagan's story on I-1029 ["Initiative would require more training for caregivers," page one, Oct. 6] was spot on in explaining the problems with the Service Employees International Union's costly and unnecessary initiative to more than double training requirements for a broad range of caregivers for the elderly and disabled. I would like to elaborate on a couple of points touched on in her article.

First, the $29.7 million estimated cost in the first biennium is only the tip of the iceberg. Among the many costs not included in this number is the cost to taxpayers for the FBI background checks, for which the FBI charges $85.

So with 20,000 new caregivers each year and assuming that employers hire two out of every three applicants, taxpayers can expect to fork over $2.5 million to the FBI each year.

All of these background checks -- including those for private agencies, homes and facilities -- would be funneled through the Department of Social and Health Services, which means we would need a new bureaucracy there just to process all the paper. DSHS would pay the FBI and could not pass the costs on to the applicants or employers.

The FBI checks can take six to eight weeks, leaving applicants in limbo longer than most would tolerate. This mess would degrade current practice at many agencies that already conduct 50-state background checks through private services that are quick, reasonably priced and far more complete and accurate than the FBI database.

Second, the comments by Nancy Dapper of the Alzheimer's Association for Western and Central Washington are not accurate. She says that Washington is "somewhat unique because people who are ailing have more opportunity to stay in their own homes" rather than go into nursing homes.

In fact, home-care agencies throughout the country, and in many other countries, are caring for seniors with Alzheimer's disease and other forms of dementia in their homes in large and growing numbers. There is nothing unique about Washington.

Dapper goes on to say that as a result of the move toward more home-based care, caregivers are increasingly performing services on a par with those performed in nursing homes. This is simply false. Home-care agencies are strictly nonmedical and are not licensed to provide the complex medical services available from skilled nurses in nursing homes.

Alzheimer's sufferers can receive a wide range of nonmedical care at home, including assistance with activities of daily living such as dressing, bathing and toileting.

Home-care agencies train their caregivers on these services today. Extending the training to include services on a par with those performed in nursing homes would require home-care agencies, and ultimately their clients, to pay for training they would be prohibited from using under their license.

The cost of care would increase with no benefit to the clients -- exactly the point made by Deb Murphy of Aging Services of Washington.
-- Tom Boughner, Sequim

Let's consult the money tree
Our seniors' wisdom and knowledge is the foundation for our families and communities. Should we deny them the compassionate care they deserve?

One of the initiatives on the November ballot is I-1029, the "training initiative" for all long-term care workers. It mandates new requirements for the hiring (FBI background checks), training (75 hours) and certification of a broad range of caregivers. Sounds like a great idea, right? Wrong.

Here's why:

The reality is I-1029 will harm both seniors and compassionate caregivers receiving and providing care services. Our company hires and trains caregivers to provide nonmedical home care to our greatest generation.

Training costs money, and for seniors who don't qualify for public assistance, those costs are ultimately passed on to them. The whole idea of nonmedical home care is to provide seniors and their families an affordable alternative to home health care when all they need to stay in their homes is help with household tasks and perhaps some personal care. We already provide targeted training for these nonmedical skills, and we do it efficiently to keep our fees reasonable.

We also provide supervision available to our caregivers 24/7. Should they encounter a situation they need help with, our staff is on-call and available to help. The added training required by I-1029 is not specific to the services we offer. It's a one-size-fits-all course including skills our caregivers could never use with our clients, such as caring for disabled children.

Our clients' fees would increase by about 25 percent because of this training.

I-1029 would make home care less available.

Requiring 75 hours of training will create a barrier to thousands of entry-level caregivers who just want to help seniors but don't want to spend two weeks in a classroom to qualify. If thousands of workers are eliminated from our care-delivery system at a time when the need is rapidly increasing, who will care for our seniors?

The provision for FBI background checks would degrade our current hiring practices. We already do a 50-state background check derived from court records, which are far more complete and accurate than the FBI database. Also, the FBI background check process takes weeks and is much more costly.

I-1029 would hurt all of us as taxpayers. With the nation facing a financial crisis and with the state facing a projected $3.2 billion budget shortfall, I-1029 would create a new state bureaucracy at a cost of at least $30 million in the first two years.

I-1029 would, however, benefit one group: union bosses at the Service Employees International Union.

Their Local 775 sponsored the initiative, and they wrote themselves into the bill by requiring that they do much of the training.

We strongly urge your readers to reject I-1029 by voting "no" this November.
-- Kelly Cavenah, Olympia

There's nothing wrong with more training
Concerning Monday's story by Maureen O'Hagan, we believe there is more that has been left unsaid.
First, this initiative has strong support and should not be dismissed as just a union effort. The SEIU [Service Employees International Union] may be the financial arm, but there is a long list of supporters. This initiative is good public policy.

Second, the issues addressed by I-1029 are not new.

In 2000 the Washington State Long-term Care Ombudsman Program authored a report on the failures in the community-caregiver system. A key recommendation was to establish a certification mechanism for community-based caregivers -- those who work in boarding and adult family homes. That certification was patterned closely after the one that now applies to aides who work in nursing homes and hospitals.

The substance of I-1029 is a compromise that we can support even though it may fall short of the ideal.
It addresses background checks, training and certification in a uniform way that treats Medicaid and private-pay providers the same way.

The curriculum will be relevant to the adult learner and flexible.

It allows providers to offer their own training curriculum as approved by DSHS [Department of Social and Health Services]. Nothing in I-1029 would prevent part of the training hours to be supervised on-the-job training. I-1029 is not one-size-fits-all as opponents argue.

Yes, $30 million is a lot of money, but it is less than one-half of 1 percent of the total Medicaid budget for the state. And, it is cheaper than the millions of dollars in lawsuits that DSHS has paid out for failures in our long-term-care system.

It is interesting that opponents of I-1029 made many of the same arguments in 2000 when the training standards were increased from 22 to 34 hours. They said it was too costly, inflexible and would put them out of business.

They were wrong then and they are wrong now.

I-1029 is a wise investment in the future of Washington's long-term-care system, and is not one that we can afford to postpone.
--Nancy J. Dapper, Seattle

Say goodbye to civil liberties

No pun intended, but the progressives have it dead wrong when it comes to Initiative 1000 ["Death with dignity: Approve I-1000," Times, editorial, Oct. 5].

Much like the Oregon law, which has been on the books for 10 years, the Washington law would, in effect, enable the insurance companies to wipe out civil liberties.

I have a disabled son. I don't want someone telling me that caring for him has become too costly, but that they will gladly pay for the pill to end his life "compassionately." This is a civil-rights issue. This is a disability-rights issue.

This is not a slippery slope. This is a blind leap over a precipice of no return.

Get informed, be shocked. Then get angry and vote "no" on I-1000.
-- Mary Lund, Bothell

Suicide is unacceptable
The Times concludes that, "On the grounds of compassion for the suffering, and recognition of the individual as a moral agent," we should vote for I-1000. Vote against I-1000 for the same reasons.

Compassion means suffering (passion) with (com) another and seeing the person through to the end -- not hastening it. This is much more difficult than turning away while the person injects himself or herself and commits suicide.

Yes, the individual is a moral agent. Choices one makes have moral implications -- for everyone. To legalize physician-assisted suicide, even for a few, is to begin to reshape it as a morally acceptable option for the many. The attempt to draw parameters around "acceptable" suicide is arbitrary and, thus, subject to change.

Why is physical suffering given greater weight than emotional suffering? Why is suicide only OK for someone who might die in six months? Why is suicide a tragedy when it falls outside these narrowly defined parameters but compassionate when inside them? Legalizing physician-assisted suicide opens it for discussion and implies its legitimacy.

Eventually, the discussion will be about broadening those arbitrary, narrow, "safe" parameters.
-- Brian Cummings, Port Orchard

Sheen's ad makes false claims
I much appreciate the effort The Times is expending to examine the claims made by candidates and groups supporting and opposing ballot issues in this election season.

My request is that you look at the claims being made by the two sides of the I-1000 (death with dignity) issue -- in particular, the radio and TV ads by actor Martin Sheen.

I loved Sheen in "The West Wing." He is not, however, well-cast in the role of death-with-dignity opponent. Sheen claims that "the 9,000 doctors" of the Washington State Medical Association oppose I-1000. In fact, that decision was made by the WSMA House of Delegates and executive board. Rank-and-file members of the WSMA were never allowed to vote on it.

Many physicians support the initiative. A quick check of the records in Olympia will reveal that more money from doctors has been donated to groups favoring I-1000 than those opposed to it.

Additionally, Sheen would have us believe that patients could opt for a lethal dose of medication even if they were suffering only from depression. This is not true. At least two doctors must certify that a patient is making an informed decision and is mentally competent.

One thing I can agree with the actor on is that patients should be treated with compassion. And what could be more compassionate than allowing someone to make an exit on their own terms, before physical conditions render the individual unrecognizable to his family?

Sheen should keep up the good work [acting], where his dialogue more often has the ring of truth.
-- Chris Fruitrich, West Seattle

Safeguards flawed in I-1000
I have strong opinions against the proposed Death with Dignity Act, I-1000. The safeguards are flawed.
The two objective witnesses can hardly be called objective if one witness may also be an heir, a beneficiary of the terminally-ill patient's estate. I-1000 leaves room for great anguish of the dying, as well as distrust and possible calamity within families in the moral and legal arenas.

Is anyone talking to the survivors of patients who chose to die under Oregon's Assisted Suicide law? Surely there must be trauma. Are there support groups to help counsel the families in this decision prior and following? Have there been lawsuits filed because of wrongdoing? Has there been any follow-up?

There must be safeguards in place and support for the dying, as well as for those who survive the death of a loved one before even considering I-1000.
-- Mary Cockerham, Lakewood

Thoughtful support
Thank you for your thoughtful, carefully considered support of I-1000.

The Times appropriately emphasizes the fundamental right of the individual to choose with dignity at the close of the life.
-- John Edwards, Seattle

I-1000 doesn't guarantee choice to die
I am against I-1000, due to the lack of safeguards.

The Times acknowledges that I-1000 requires "no witnesses" at the time of death. Without required witnesses, the opportunity is created for an heir or stressed-out caregiver to administer the lethal dose to Dad without his consent. Even if he struggled violently, who would know? With no required witnesses, I-1000 creates the perfect alibi.

Family members, of course, do this kind of thing all the time. The Times ran "Des Moines murder for hire brings 25-year prison terms" [Local News, Oct. 4], about a mother and son who hired a hit man to off her husband. Why should we pass a statute that rewards this type of behavior with a "get out of jail free card"?

Sadly, people commit suicide now. Let's help ensure that it's their choice.
-- Margaret Dore, Seattle

What empire?
In response to Lance Dickie's rumination on the waning American empire, ["As American empire wanes, the world shrugs its shoulders," editorial column, Oct. 2] consider this:

We are now paying for many decades of misplaced priorities in which a permanent war economy has trumped all concerns for domestic economic and social health. What would be on a domestic need-to-do wish list?

How about addressing education. Dickie reflects on the burgeoning global economy and the enormous political shifts contained therein. While we as a nation have been for many years inundated with the argument that education, science literacy and numeracy, along with refined technical skills are critical to a competent work force in an ever-evolving technological society, we have simultaneously witnessed a persistent erosion of vast swaths of public education.

In many communities, school facilities are inadequate and in some instances literally falling apart. This is a particular tragedy in many inner city schools where obtaining a decent education is becoming increasingly difficult if not impossible.

A full-scale commitment to reinvigorating public education could staunch the trends in illiteracy and innumeracy, and ensure that an educated citizenry can meet the economic and political challenges of an interdependent global community.

Salvaging our decaying infrastructure, ensuring that all citizens are properly housed, creating a truly accessible and just system of health care and assisting ready and willing workers with adequate and dignified employment are but a few areas of domestic concern that must be addressed if this nation is to reclaim its legacy of hope.

The path we have been on has been abysmal and we are now reaping the bitter fruits of that folly. It is high time to claim a new ethos and direction for America.
-- Joe Martin, Seattle

It's a funky reggae party
Talk about having the hemp pulled over your eyes.

Anybody who has ever smoked a joint will realize that 24 ounces of marijuana over a 60-day period is a ridiculously large amount ["State rule clarifies 60-day supply of medical marijuana," page one, Oct. 3]. That amount equates to roughly one half ounce a day.

It's enough to smoke about two joints an hour and host a nightly reggae jam in your living room. Add 15 plants and that's a lot of chronic.

Don't get me wrong, I'm not opposed to people having the privilege to smoke pot.

But the people making the rules on this are either oblivious to the effects of marijuana or fearful of acknowledging that they know them.

I'm astounded to learn that there are those making the argument that this amount isn't enough.

I'm still laughing at how the health department, the Governor and everyone else involved in this have been duped by a bunch of stoners.
--Kevin Reniche, Seattle

Choice to die not assured
The Times editorial about I-1000 states that 49 patients in Oregon used the Oregon assisted-suicide law to take their lives last year ["Death with dignity: approve I-1000," Times, editorial, Oct. 5]. The editorial further states that It further states that some of the 49 patients took their lives "because of pain, but most because they were losing their autonomy, their dignity and their engagement with life."

But Oregon's law, like I-1000, has no required witness at the death. For this reason, no one -- including Oregon or Tthe Times editorial board -- knows why these 49 patients took their lives or whether someone other than the patients took their lives for them. The Times is engaged in speculation.

Supporters of I-1000 claim that it allows an individual to die with dignity and that it supports patient autonomy. The real choice to "die," however, is not assured by I-1000. This is again because I-1000 has no requirement that there be a witness at death. Without a required witness at death, a stressed-out caregiver or heir could administer the lethal dose without the patient's consent. This is not personal autonomy for the patient.

I-1000 is a flawed legislation that puts vulnerable people at risk.

Vote "No" on I-1000.
-- Michael A. Patterson, Seattle

Times kudos
The Times' endorsement of Initiative 1000 gladdens my heart. As a retired nurse who worked primarily with cancer patients, I have given priority over the past 20 years to promoting this option, as well as educating others about for making choices about end-of-life decisions by means of advance directives.

The Times' coverage of this issue has been superb. The two-part series was professionally researched and clearly written. The editorials you have published have been fair and convincing.

If this law passes, I will be content at age 82 to know I have given my time, energy and money to a successful and compassionate advance for humanity.
-- Mary Watson, Gig Harbor

Reject I-1000
The primary goal of government is to protect the lives of its citizens. It shouldn't be involved in dispensing death to those citizens. The primary goal of a physician is to cure his patient when possible, comfort always, kill never. I-1000 undermines these fundamental goals.

All patients are vulnerable as they approach the end of life. A patient may worry about loss of autonomy and becoming a burden to loved ones. The appropriate response from the medical community is reassurance, care, compassion and practical assistance -- not facilitation of suicide. I-1000 would radically change the role of the physician from an advocate of healing to an accomplice in death.

Our profession has renounced medical killing. Assisted suicide has been rejected by the Washington State Medical Association and 48 other state medical associations in 48 other states. The Oregon State Medical Association supported a repeal of Oregon's assisted-suicide law.

Initiative 1000 is poorly thought out and dangerous. We urge Washington voters to vote "no."
-- Richard Wonderly, M.D., and James Gasparich, M.D., Seattle

I-1000 shows compassion for terminally ill
You are so right -- requesting life-ending medication is "the right of the terminally ill to decide for themselves."

If only we could all just die in our sleep, we wouldn't have to be faced with end-of-life decisions. How wonderful that would be. But, unfortunately, that's not the case for every person.

Those who must endure a death sentence because of a terminal illness deserve the compassion Initiative 1000 would allow.

Thank you for your reasoned approach to this issue.
-- Maureen Galbreath, Edmonds

Initiative modeled after safe Oregon law
I can speak from personal experience about Initiative I-1000.

My mom used Oregon's Death with Dignity law to hasten her death. When she had two weeks left to live, my mom was unable to do anything she liked. Hospice workers did a great job trying to keep my mom pain-free, but the truth is that at that point she was miserable.

My mom said her goodbyes, and with my stepdad and me by her side, took the lethal medication and passed away peacefully. My family is very grateful for the Oregon Death with Dignity law that allowed my mom a dignified death on her own terms.

Washington's I-1000 is modeled after onthe Oregon law with the same safeguards to make sure that no one will ever be forced to end their lifeinto this. The past decade of the Oregon law has shown that this is a safe law, used very sparingly, without one single case of misuse.

I greatly respect those who would never use this option because of personal or religious beliefs. This is a very personal choice. But please allow all of us to make our own decisions if we are ever faced with a terminal diagnosis. I urge you to vote "yes" on I-1000.
-- Jonathon Turlove, Olympia

Protect the doctors
Historically, people have resisted many social and medical advancements which over time have been shown to benefit society, such as: desegregation, women's right to vote, polio vaccinations, fluoridation of the water supply, anesthesia during childbirth, organ donation, admission of Jews to higher education, the horseless carriage, etc.

Opponents of these new ideas argued that catastrophic outcomes would result. In each of these cases, not only have these feared outcomes not occurred, but history later judged these changes as progress.

I-1000, the "Washington Death with Dignity Act," if passed, would likely be judged as a contribution to humanity in Washington state ["Initiative 1000 would let patients get help ending their lives," Politics & Government," Sept. 21].

The concept of a physician prescribing life-ending medication that the suffering patient might take during the last six months of life is a new concept for the medical profession, much as the social and medical changes were at one time.

The concept of a collaborative effort between the physician and terminally ill patient to plan the moment of death is new. However, this concept has been practiced throughout history, without the benefit of legal sanction.

Supporters of I-1000 want to provide legal protection for doctors and patients in situations which follow the safeguards provided by the proposed law.
-- Elaine Gordon, Seattle

Biden won the debate
Editor, The Times:
Sen. Joseph Biden clearly won the vice-presidential debate on Thursday night ["VPs deliver; will focus shift?" Times, page one, Oct. 3]. Gov. Sarah Palin clearly has no clue about what it's like to be in the national spotlight.

Paul J. Richards / APF / Getty Images

Democratic vice-presidential candidate Joe Biden and his Republican counterpart, Sarah Palin, shake hands following Thursday night's debate.

However, there is praise for Palin's performance on Thursday night. She had a few talking points, mostly on energy and statistical numbers, about Biden and Sen. Barack Obama's histories that seemed to be well-rehearsed and well-planned. But that's it.

When it came down to it, Palin simply did not address the questions from the moderator. She sometimes avoided the questions altogether.

Biden, on the other hand, looked like a real vice president -- something America has not experienced for quite some time. He laid out a clear case for why the Obama-Biden ticket represents the change America needs. Their change does a complete turnaround from the eight years of Bush Doctrine.

Biden made it clear that the Obama-Biden administration will make the middle class a priority. He also said they have a plan in place to bring home the troops from Iraq safely and responsibly, and to restore America's leadership to the world.

Obama and Biden are our beacons of hope in this fearful and stressful time.
-- Brandon Melton, Spokane

Palin is the oil-industry candidate
As a woman, I was delighted to see Gov. Sarah Palin give a good speech during the vice-presidential candidates' debate. I was glad she didn't "collapse into an incomprehensible heap" -- a scenario recently posited by a Washington correspondent when pressed to describe a situation that could force Palin off the Republican presidential ticket.

Because she has proved herself comprehensible at the podium, we can now concentrate on what she is saying instead of how she is saying it.

For instance, as a result of Thursday's debate, I now understand that Palin was selected as the candidate of the oil industry. Her stated mission is to open the Arctic National Wildlife Refuge to drilling. She wants to lower taxes on an industry that made unprecedented profits, while we paid $4.50 a gallon for gas. Forget her story about how she stood up to big oil in Alaska. They didn't need the profit Alaska denied them because they were raking it in down here. And that investment has paid off big in putting Palin on the "maverick" ticket with Sen. John McCain.

Her "energy policy" would destroy natural areas and contribute to global warming without doing a single thing to make the United States energy independent. Moreover, one of the first gubernatorial acts of this "Country First" candidate was to sign a contract with a Canadian company to build an oil pipeline in Alaska.

Palin was well-coached and made a folksy delivery, but her politics are all about giving wealth to the wealthy and otherwise preserving the status quo.
-- Wendy Shook, Tukwila

Jeez Louise, Palin
While I watched the vice-presidential debate, I waited on the edge of my seat for "gee willikers." Imagine my disappointment when Gov. Sarah Palin left that one out. However, she came very close, and I appreciate her efforts.

It was painfully obvious that Palin had completed a crash course in the George Bush School of "Ain't-I-Just-Plain-Folk."

Isn't it odd that we're made to feel bad about expecting more from someone running for vice president? With all the substantive women politicians out there, it leaves me with just one thought: "Aww, shucks!"
-- Ricky Barnes, Seattle

Neither won the debate
Well, the great debate is over, and, essentially, we are where we were the day before the debate. Gov. Sarah Palin has shown that she can deliver a line in a folksy way similar to Ronald Reagan, and Sen. Joseph Biden has shown that he has a firm grasp of the facts.

During the debate, Palin repeatedly didn't answer the question asked and dove directly into the sound bite she was instructed to deliver.

Biden at least first answered the questions and then went about his mission of tying Sen. John McCain to President Bush.

Based on this, I can't determine a winner or loser. We're just back to where we were: Who will make the better president, and who will lead us in the direction that this country needs to go in?

I don't know if Thursday night's vice-presidential debate helped anyone make that decision. It sure didn't help change my mind one way or the other.
-- Robert Oberlander, Issaquah

Answer the questions asked, Palin
Gov. Sarah Palin sidestepped the point of having a debate by not answering the questions asked and talking about whatever else she felt like. She even said that she was going to do this very early in the debate, which would have been a good time for the moderator, Gwen Ifill, to put a stop to it.

Interviewers and moderators in the media need to remember that, while they are supposed to remain objective, they are supposed to keep to the rules. When Palin so willfully did not answer the questions asked, she broke the rules of the debate and should have been called on it.

I guess that is how it will work, as it has for the past eight years, if the McCain-Palin ticket wins in November. They'll break the rules, and everybody will be too polite to call them on it until it is too late.
-- David Comito, Seattle

Play on words
Who took de bait in Thursday night's vice-presidential white flag of surrender? I thought Sen. Joseph Biden looked Palin comparison.
-- Leo Shillong, Bellingham

Sound professional, GOP
I find it curious how the current Republican philosophy appears to believe that speaking in a folksy manner, such as using the words "betcha," "gonna," "folks," etc., is somehow an endearing and appropriate way to speak.

What in the world makes them think that? We've endured this dumbing-down of the Most Powerful Person in the World for the last eight years. I want someone in office who not only acts like a president (or vice president), but sounds like one.

No, you are not my next-door neighbors -- you're the ultimate representatives of this country. Please represent us with dignity and intelligence, and have the grace to sound like you possess both.
-- Karen Thompson, Port Angeles

I-1000 simply another option
A practical hypothetical: Doctors tell you that you've got a horrible incurable disease that'll kill you in a few months ["How we die," page one, Sept. 21]. They describe the deterioration that will afflict your mind and body before you actually pass on. Putting it mildly, they don't paint a pretty picture. It seems foolish and masochistic to put yourself through all that ugliness. Worse yet, you'll be subjecting those you love to that same ugliness. You decide you don't want to make that sort of departure.
So what do you do? If you're lucky enough to reside in an enlightened state of our Union, you'll be able to acquire a dose of something that will neatly ease you into whatever afterlife you believe exists. You can die with some dignity. You can die while you're still recognizable to yourself and those you hold dear.
Why not turn Washington into an enlightened state? Vote yes on I-1000. Vote yes even if you don't intend to make use of it. That would be your choice. Let those of us who hold differently have our choice.
The thing about I-1000 is that, when it passes, no one is forced to use it. It merely provides an option, and it's always better to have options.
-- Bob Wojtyna, Woodinville

Doctors approve
There is considerable confusion about what the majority of Washington medical doctors think of I-1000.
Opponents of I-1000 in the Washington State Medical Association (WSMA), representing less than half of the physicians in the state, claim that most members are against I-1000, even though it was never put to a vote.
Proponents claim that the majority are for it.
A poll of WSMA members, run by an independent pollster who stands by its representative value, found 50 percent in favor and 42 percent against I-1000.
Some doctors have written letters to the editor to say that all of their M.D. friends are against it. Well, birds of a feather flock together. I am not a medical doctor, but I am acquainted with several of them, and they are all for I-1000.
It is true that I-1000 has been endorsed by the American Medical Women's Association, the American Medical Student Association, the Washington chapter of the National Association of Social Workers and the Washington State Public Health Association.
-- Susan Perigo, Lake Forest Park

Topic moot
Thank you for your editorial chastising the Gregoire campaign for trying to make embryonic stem-cell research the "core" issue of this campaign ["Stick to the election, get past stem cells," editorial, Sept. 23].
To reiterate, there are no state programs involving embryonic stem-cell research. Gov. Christine Gregoire has proposed no programs involving embryonic stem-cell research.
Therefore, this is a nonissue in the current gubernatorial campaign and a red herring to distract voters from the fact that the governor has no real accomplishment upon which to campaign.
-- Mark Ursino, Sammamish