Tyler Cowen's intellectually devious article about hidden or opportunity costs in Medicare for All ("Medicare for All: How to count costs," Opinion Exchange, Nov. 10) astutely avoids one important point: The U.S. ranks 27th worldwide in providing health care.
Above our system are 26 MFA-type systems that have lower infant mortality, longer life spans, lower costs and none of the private-insurance malaise that excludes you from care if you have pre-existing conditions. Leaders of these countries have not banned their providers from seeking competitive bids on drugs the way Congress bars Medicare from seeking competitive bids. Those wanting to keep their insurance are an elite group of workers with employer-provided care and the very rich who clearly get above 27th in their level of care. But, that small group should not dictate to us continuation of a system that completely fails 40 million and is so ineffective as to put us at such a low ranking.
Money is power. But just maybe people's concern for their health, and an objective understanding of our failures, will lead to a better system where United Health won't be paying $18 million to its CEO.
Richard Lee Breitman, Minneapolis
CAPITALISM
Raised eyebrows at that analysis
In regard to a letter writer from New Brighton on Nov. 10 addressing Bonnie Blodgett's piece about Prof. David W. Noble ("The two worlds according to David W. Noble," Nov. 3):
Two things got my attention — first, the rhetorical method of acknowledging problems with a capitalist system, but ultimately saying the status quo is just fine. In a nutshell, "I feel your pain, but it's best if the pain continues." More important, it illustrates our problem with political discussion. People would rather make assertions (not argue) about what labels should apply to people or policies, not what's happening on the ground. Who benefits, who gets hurt, etc. never enters the discussion. It's just all blood-flecked-spittle-style rhetoric about socialism, freedom, capitalism, the individual, blah blah blah, without ever talking about what is actually going on. It's a kind of romanticism.
Second, the writer says that "private enterprise and private property have done more to alleviate poverty than any other political system." Really? For who? All sorts of people have been kept out and forced out of the economy. Like unintended deaths dismissed as "collateral damage," a lot of the economic comfort we associate with America could be called "collateral benefits." The point being, they're unintended. The income inequality we are seeing is in part due to corporations and the .001% realizing they were leaving money on the table (public health, education, environmental protections, etc.). They now have the means (a supreme court, legislators, media) to fine-tune the efficiency of their harvesting. Call it late-stage capitalism.
The writer spoke about the contest between Communism and capitalism. The writer Fran Lebowitz said it best: "In the Soviet Union, capitalism triumphed over communism. In this country, capitalism triumphed over democracy."
Nick Gorski, Stillwater
CULTURE
As the world burns around us, we focus on bread and circuses
I was bemused at how the front page of the Nov. 10 Star Tribune reflected what appears to be the intransigent, primitive state and interests of our culture and, indeed, our species: the large photo panel in the middle of the page recording the manic celebration of a sport that causes thousands of brain injuries to young athletes each year, i.e., the ritual of football ("Golden U-phoria").
On the side column of the front page an expansive, uncritical article begins lending serious attention and, it follows, credence to a gross superstition: "Exorcisms, once rare, turn legion." Can one now expect unbiased articles reporting a curious uptick in witch burnings?
The first, football, a ritual of vicarious territoriality, violence and tribalism; the second, one of religious authoritarianism, of conditioned fear. Both exorcises (excuse the pun) are expressions of evolution's diseased undercurrents and vulnerabilities.
Lost are the intellectual and cultural movements once reflected in unionism and the beat generation that were generated by educations that were actually universal in their scope. Literacy, critical thought? Our universities are becoming expensive, narrowly focused trade schools that produce compliant, submissive consumers.
The Star Tribune seems attuned to the cultural commonalities of our times and adverse to how serious news is meant to engage the better natures, concerns and neurons of the public. Admittedly there are excellent articles occasionally found within the paper, almost as much print as is dedicated to sports. Yet the world and its media grow timid as the grotesque nature of economic growth expands, as Australia burns, as the Earth warms and the ocean's ecologies collapse ... turn to page 28.
But hey: Hurray for us, we won the game!
Thomas Evans, Bemidji, Minn.
MENTAL HEALTH LAWS
A good start, but we need facilities
My wife and I read the op-ed by U.S. Rep. Tom Emmer in the Nov. 15 paper ("We need to make it easier to get help for mental health") and wanted to say something as mental-health professionals ourselves. We both have worked in inpatient units all over the state and have extensive experience with the mentally ill. Neither my wife nor myself has ever heard of an IMD, also known as an Institute of Mental Disease. This term is not known among many of the people that actually work with the mentally ill here in Minnesota.
Emmer cites a statistic that the U.S. has 97% fewer beds in psychiatric facilities than in the 1950s. We are trying to understand the logic of expanding access to psychiatric facilities when there are fewer of these facilities available to people. We can talk about making it easier for people to get mental health care, but they have to have somewhere to go, and those places no longer exist.
Emmer states that his bill will eliminate the arbitrary cap on the number of beds for providers who receive a fixed reimbursement. I think that sounds good on paper, but removing an arbitrary cap doesn't magically create beds for people to stay in.
We appreciate Emmer's work in bringing attention to this issue.
Dan and Sadie Watts, Northfield, Minn.
• • •
I admire Emmer's advocacy for people with psychiatric illnesses. Yet I find it difficult to reconcile this with the fact that the party in which he is a prominent member plus the Trump administration (which Mr. Emmer strongly supports) are suing to have the Affordable Care Act overturned.
The Republican Party offers no viable alternative to the ACA. They do not view health care as a human right. Wellness is difficult to achieve, be it physical or mental, if one does not have access to care early on. People without insurance benefits have limited to no access to adequate mental health care.
Mary G. Alberts, Eden Prairie
ACHIEVEMENT GAP
Intervening during K-2 is too late
It's meritorious that the Minneapolis School District plans to attack "the achievement gap between white students and students of color" by "doubling down on building students' skills in kindergarten through second grade" ("Mpls. schools focus on K-2 skills to close gaps," front page, Nov. 15). Having spent nearly 50 years in public education, spending the last 15 years volunteering in an urban elementary school, I would suggest that the district seriously consider moving its starting point to 2 or 3 years of age. Sadly, required pre-K programs are not part of the educational landscape in Minnesota or any other state.
Preparation for a successful school career begins long before kindergarten. Sometimes, when I'm working with a first grader as he or she tries to master the ABCs or counting to 10, I shed a tear as I realize how far behind my students already are.
George Larson, Brooklyn Park
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