The core issues in the health care debate are quite clear but easily muddied. Citing sad stories is easy but finding real solutions is the problem. While most agree that reforms are needed, the issue is, what type of reform will actually improve care while lowering costs? The real question is, do we want a state controlled health care system or do we want a free market health care system?

Among the problems now crippling our health care system are the following three:

• Unfunded federal insurance mandates.

This is where the government demands insurers cover hundreds of various treatments. To use an example, it’s a little like the government going into a local drugstore and demanding they give each customer Band Aids, antibacterial cream and some sunblock because everyone has a right to these basic needs. The unintended consequences of these mandates (there are thousands) have been to drive up the cost of health care insurance. Some would call for capping insurance companies’ profits. A free market solution would allow the 1,300 or so different health insurance companies to compete across state lines, allowing people to customize their coverage in a competitive market. Presently state law decides which four or five insurers are allowed in each state.

• Astronomical payouts for pain and suffering in medical liability cases.

While no one wants a rigid payout scale for damages that excludes cases from a jury of their peers, the excessive payouts for medical liability cases have driven malpractice insurance costs up so high, many older doctors have retired and many young physicians have chosen specialties less threatened by legal problems. The unintended consequences of these lawsuits are fewer doctors willing to go into obstetrics/gynecology. One solution would be tort reform that would cap the pain and suffering payouts.

• Gross overregulation of the health care industry.

In the early 90s, the federal regulations for hospitals fit into a small booklet. By 1998, the book was three inches thick. This massive increase in regulations had the unintended consequence of causing hospitals to run in the red. An entire staff is required to work on insuring compliance. The failure to comply is costly. It can run into thousands per day. This burden alone has driven up hospital costs enormously. It isn’t just hospitals that are weighed down by over regulation: that is rampant through out the health care industry. It requires so much time and energy that actual patient care has suffered tremendously. While fraud is a concern and a certain amount of regulation may be necessary, it is essential to fight against the current gross overregulation.

In conclusion, many of the serious deficiencies we see today are primarily consequences of governmental intervention. Removing those intrusive mandates and laws alone would improve patient care, while significantly lowering costs. In addition, it would allow far greater freedom for patients as well as for their doctors. Again, the fundamental question is, do we want a federally controlled health care system or a free market version?

Lucy Wells

Poulsbo

Trash collection

There has to be a better way

It’s important, from time to time, to do a through cleaning of a house or apartment. Growing up, we did a throughough spring cleaning with the local “thrift stores” getting stocked up. The recyle center gets its fill and then there is the stuff designated as “garbage.”

When I do spring cleaning in Poulsbo, it means that I have to stack whatever I’ve designated as garbage in the garage and “put it out” whenever the city’s garbage pail isn’t full. It usually takes four weeks to get that accomplished.

There are times when garbage just doesn’t fit in a pail. In fact, there are times it won’t fit in any pail.

Take, for instance, the table top that has been in my backyard for 10 years now. The metal legs were recycled. But the top can’t be. Nor can I break the top into peices and put them little by little on the garbage can. So it remains in the yard or the garage.

On a recently cleaning, it took me six weeks to put out all the garbage one week at a time. Whatever was too big for the pail, was broken into pieces. That is, with the exception of one plastic container that a hammer won’t break. The cost of the container, 10 or 15 years ago, must have been $2.99 and it’s traveled through three moves. It just gave up.

The container unfortunatly is not recyclable. I’ve tried. I can’t break it with a hammer, I tried and the only thing i did was put a few holes in it. The pail won’t fit in the garbage bin without getting stuck.

So I tried putting it out this week in the pail. It stuck out one foot. Today it sits in the same spot it was prior to garbage pick up day. City Hall’s answer is that I purchase a $7 garbage tag, put the bin in a plastic bag and put it out next week.

If that’s all that City Hall can suggest, it’s no wonder why people are dumping in the wooded lots around Poulsbo.

You know, I’m only one person, with one large gargage pail.I cannot imagine what families must go through when they decide it’s spring cleaning time.

There has to be a better way for residents to dispose of household items every now and again.

In the mean time, if you have a sledgehammer and a good arm, contact me. I have a plastic box that needs to fit in a garbage bin.

Maria Marsala

Poulsbo