Preventive care is the way to go
I mostly agree with Thomas Friedman's column, April 14, that we need to act boldly. However, it is incorrect that we have to destroy Social Security in order to save it. Without making a single change, SSI is solvent for a long time. That's not to say that there will not be political pain associated with developing the general fund revenues required to replace those which Congress absconded to make their books look better. Truth requires we acknowledge that the system, as designed, works fine.
Medicare and Medicaid have problems because of our approach to caring for our health. We believe we have "the best" health care in the world, but what we have is the most expensive and exhaustive set of procedures without the comprehensively positive outcomes.
Other nations have far better results. and we have some things to learn if we want to control our cost spiral. Rationing is not what I mean. ObamaCare strives to drive behavior toward preventive care, applied well before bad circumstances necessitate drastic (expensive) action.
In any rational world, the Republicans, whose system ObamaCare is, would be claiming victory, but their chosen politics of party before country deny them the option. The only losers are the people.
Bill would ensure quality care
An advertisement in the April 19 paper paints an erroneous picture of a bill to safeguard patients who receive spinal injections for pain. HB 1896 would require that these invasive procedures be performed or supervised by a qualified physician. Supervision would be required if the procedure is performed by an advanced practice nurse (APN). The bill applies only to procedures in unlicensed facilities.
The bill covers only invasive procedures and injections that involve the spinal cord, or surrounding structures and other large pain nerves. If performed improperly these techniques may not relieve pain, can worsen pain, and can even lead to paralysis or open spinal surgery.
Presently, APNs may perform these procedures with little training and without supervision. No school of anesthesia in Tennessee teaches nurse anesthetists any of these procedures beyond occasional observation. The standard clinical requirements of nurse practitioner schools do not grant certification in these procedures.
While it is never advantageous to have immediate access to substandard care, taxpayers should also be concerned about the costs.
Medicare data shows that 58 percent of spinal column (spine bones) facet injections performed and billed by mid-levels nationwide were performed in the state of Tennessee. Tennessee physicians only billed for 2.9 percent of nationwide injections by physicians. Tennessee citizens do not suffer chronic back pain 20 times more frequently than people in other states. It is logical to conclude that APNs greatly over-utilize these procedures.
This bill will help to ensure quality patient care and will conserve substantial health-care dollars. Patients deserve nothing less.
JOHN McCARLEY, M.D.,
Chattanooga-Hamilton County Medical Society
Nation follows Europe's lead
Paul Krugman, the highly regarded financial expert and economics professor, got on the wrong side of Wednesday's editorial page (April 18). He should have gone from "left to right" with his brilliant oversight of "Europe's economic suicide." In reading his comments, especially the sidebar, he summed up America's current financial dilemma very succinctly. He said, "Rather than admit that they've been wrong, European leaders seem determined to drive their economy -- and their society -- off a cliff." Nothing could more accurately describe the present economic state of our nation and the drastic need for "change" in the coming election. We too ... are committing "economic suicide."
Thanks, Paul. You are right! Welcome to the world of reason.
C. BRUCE SPENCER
Update uranium processing plants
Re: Uranium processing facility in Oak Ridge, Tenn.
In response to skyrocketing costs as well as concerns by GAO and UNFSB government agencies about the design and criticizing the rush to accelerate construction of the uranium processing facility, I request letters to Congress asking their careful consideration of alternative options such as suggested modernization of existing facilities.
Cost estimate for UPF continues to go up. Current estimates place the price tag at $6 billion to $6.5 billion -- 1,000 percent growth from the original estimate of $6 million just five years ago for this stockpiling life extension program. A combined program to consolidate operations and upgrade current facilities sufficient to maintain manufacturing and production capacity for the foreseeable future could be accomplished at dramatic savings compared to construction of a new facility.
We rely on our elected officials to make prudent decisions about spending our tax dollars. It is a difficult task. I believe Sen. Lamar Alexander, as a respected leader of the Energy and Water Committee, can make a difference by taking a strong stand to oppose any "rush up" funding of the UPF in Oak Ridge until further study and findings are available. It's your money!
BETTY B. JOHNSON
Editor's rants always the same
I've been reading the Free Press editor's opinions since well before the merger, and every day it's been the same ol' same old. I'd say he started the daily rant long before the rant became a feature in the Sunday paper.
His two tenants have always been (1) lower the tax rates (benefit the wealthy), and (2) broaden the tax base (eliminate the federal earned income credit, or tax the poor. The low-income people turn their tax breaks into necessities like food and medicine, while the wealthy turn theirs into summer homes and yachts, but if we mention this, the Free Press editor accuses us of envy and promoting class warfare.
We see many pictures of him smiling, but that's because he and his kind have sunk the knife so deep into our backs.
The Free Press editor, along with the Mitt Romneys in our country, verify an old saying: A working person voting for a Republican is like a chicken voting for Col. Sanders.
There's no reason for income earned on investments to be taxed at a lower rate than income made from labor. Republican greed is palpable and unsatiable, and they are willing to put our most vulnerable at risk to feed it.
'Science' still looks for a bone record
Once again a reader/writer asserts that "religion" is ignorance and "science" is truth. That's like saying that apples are ignorant but oranges are brilliant. There is almost nothing that can be seriously compared either between the two nor even within each one.
Within "religion," Christianity embraces life for every person. Within "science," I learned that the atom was the smallest form of matter. Now if a quark came up and bit me from behind, I would not know how to react unless I read a more modern textbook. The point: "religion" tends to be fixed while "science" treads a zigzag, back-and-forth trail while it tries to reverse-engineer how it all happened.
Narrowing within the Darwinian branch of stubborn thought, it might be informative to know how Mr. Darwin saw his theory. It is reported that he personally wrote the foreword to its seventh printing, and as he looked ahead down the dark corridors of the future, he said that it all depended on finding a bone record of species "A" warping itself into species 013." "Science" is still looking. Outside the Bible. (Could it be a religion?)
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