Printed letters, December 5, 2013
Dr. Michael Pramenko’s commentary on Obamacare raises many interesting questions, but it fails to provide any answers, other than Obamacare is the best solution in all cases.
Many health care solutions are more realistic, less expensive and certainly less cumbersome than using a myriad of state and federal exchanges — most of which function poorly, if at all.
A simple solution would be an expansion of the Medicare program to cover all Americans, regardless of age, with a standard package of benefits and coverage as we currently insure our seniors.
To avoid the feared outcome of a single-payer system, private health insurers could bid to provide coverage to the Medicare system regionally, much as they do now for Medigap coverage, Medicare drug plans and Advantage plans.
This expansion of coverage demographically could be paid for by a modest increase in Medicare payroll taxes, amounting to much less than employees currently pay for their portion of employer-provided health coverage and what individuals pay in personal premiums.
Pramenko chides the Republican-controlled House for failing to pass any legislation improving Obamacare, yet he surely realizes that, with a Democratically controlled Senate and executive branch, it would amount to a moral victory at best.
Likewise, his statement that Obamacare is an alternative to socialized medicine is disingenuous, since the individual mandate and the requirement of individuals to pay for coverage they will never use, like childbirth coverage for elders, is in fact pure socialism.
He is accurate in his assessment that single-payer, socialist systems in developed countries provide higher quality and lower-cost health care.
His aversion, however, to this solution, with private insurers supplying the government with the operational and market support its exchange clearly needs, ignores an obvious alternative to Obamacare.
Pramenko deserves the ink for his health care knowledge
Here’s the answer to Richard Rininger’s question, “Why does the Sentinel keep publishing Pramenko?”
On one hand, Dr. Michael Pramenko, M.D. — as a practicing primary care physician, past president of the Colorado Medical Society and former member of both Club 20’s Health Care Policy Committee and the Federal Advisory Board for Section 1322 of the Affordable Care Act — is perhaps the most qualified and knowledgeable local commentator available.
Consequently, Pramenko’s columns are consistently fact-based, and they carefully explain the public policy considerations that underlie that “market-driven” approach (originally conceived, endorsed and successfully implemented by “conservatives”) for extending affordable access to health care to 40 million-plus Americans.
On the other hand, local critics of the ACA — including Rininger and Gary Montgomery (“Obamacare website problems are just the tip of the iceberg”) — offer only unsubstantiated assertions of an “unworkable financial mess this law has created” and/or similarly unsubstantiated (but presumably dire) prognostications of “ultimate effects.”
Among the financial facts which Rininger ignores is that the ACA has already extended the actuarial viability of Medicare by reducing its future expenditures by more than $700 billion. It has already contributed to dramatic reductions in annual health care spending and cost increases, and average premiums for policies offered on ACA exchanges were 17 percent lower than expected, saving another $147 billion in subsidies.
Meanwhile, Montgomery’s “iceberg” floats on references to Cuba, Venezuela and a financially-independent Canadian provincial premier who (on his doctors’ advice) opted for heart surgery in Florida — in 2010. Beginning in 2014 under the ACA, Floridians (many for the first time ever) will also have access to similar quality care.
That’s why the Sentinel publishes Pramenko’s (and contrary) opinions.
Ripped jeans inappropriate as part of medical attire
This letter is in response to the letter Nov. 29 to the editor headlined, “Medical assistants should change their greeting protocol.” What about what they are wearing?
I object to a nurse wearing jeans with many rips up and down the legs, even exposing bare skin. Why not wear scrubs?
I recently was in a clinic in Helsinki, Finland, where everyone wore dark blue scrubs, even the doctor and clerks. It looked “medical.”
‘How are you?’ is a greeting, not a request to recite woes
This is in response to the letter to the editor published Nov. 29. Upon entering a medical facility, you are asked how you are by a friendly nurse or receptionist and you take issue with the greeting. Really?
“How are you” is a salutation, not an invitation for a recitation of your woes.