THE PUBLIC MIND: HARD CHOICES ON HEALTH CARE REFORM BEGIN WITH YOU AND ME, NOT WITH WASHINGTON

To the Editor:

As you have noted (Perspective, Apr. 6), health care reform is a hot political topic. The major problem is the focus seems to be on the providers. While there are significant issues with providers, the so-called solutions will quite likely be worse than our current problems.

Government has yet to develop any program that works. The inherent problems with Medicare and Medicaid are subjects of entire books. Yet our politicians lack the courage to face those problems, much less offer any real solutions. Before you support some effort at national health insurance, please visit a Veteran's Hospital. This is the reality of our first attempt at a national health insurance program. While there are many fine health care professionals and excellent services through our Veteran's Hospitals, the problems are extreme and too readily apparent.

The insurance industry paints itself as a "hero of the revolution," yet it is the insurance companies who refuse to cooperate on common coding standards and utilization of the same claim forms. They also fail to thoroughly explain their standards, claim processes, and so forth to policy holders or providers. The resulting confusion and duplication significantly increase the costs of care.

There is also great duplicity in the press as to the numbers of uninsured. Uninsured does not mean a person has no access to care. It only means the uninsured person may have little choice about where to receive care. Regional Medical Center in St. Louis provides excellent care to all who appear at the ER (Emergency Room). It also provides superb outreach services to the community. Other area hospitals don't have the same obligation to serve does that mean the uninsured don't have care? No, it only means they have to go to Regional.

Lack of services in rural areas is a separate problem having nothing to do with insurance. Individuals living in rural areas lack access to many basic services. There is no rational economic solution to such a lack.

We also have to begin taking responsibility for our own health and welfare. Our weight, drinking and smoking habits, exercise regimen, diet, and related matters all affect our health. It is not up to someone else to fix what you have spent years abusing. It is up to you.

Unfortunately, health care reform must begin with a decrease in government programs. Rights and entitlements must be removed and self-responsibility put in their place. By forcing people to become more responsible for themselves, better choices will be made and health care will be improved. Admittedly, this will result in severe short-term problems for specific individuals. But we'll be better off in the long term.

Solutions to many of our country's problems will require individual sacrifice. But that is the basic foundation of our country. Our ancestors were more concerned with making life better for their children and grandchildren than with their entitlements. It's amazing to watch our older citizens today, concerned only with the size of their social security check or their investment returns. The cost of their health care, through the mismanaged and overburdened Medicare program, seems to be of no concern. But its effect on their children and grandchildren is proving to be overwhelming. We hear about our senior citizens' rights; where are their responsibilities?

Freedom carries the responsibility to make hard choices. And often the right choices mean a lot of hard work for a long time to come. These choices begin with you and me, not with Washington.

Gerald L. Nicholson

Cape Girardeau