Today's Sunday paper contained two letters on health care:
Medicare has not kept up
The fact that Medicare is in financial trouble and that “the problem could get a whole lot worse” (front page article, Sept. 23) should not be a surprise to anyone.
Enacted in the mid 1960s, Medicare policies have not evolved to meet the challenges of generational changes and the complex medico-economic demands of our society. A large portion of its budget is spent on specialty care to support heroic measures at the end of life, giving more financial incentives to providers based on “fee-for-services,” rather than to more true value-based preventive and primary care.
This year, Oregon politicians had the opportunity to step up to the challenge and advance new approaches and demonstration projects that may make Medicare more sustainable for current and future generations. But, under the pressure of various interest groups, they failed to give the Archimedes Movement (WeCanDoBetter.org) such a chance. Citizens should continue to work for effective changes by raising their voices with the newly formed Oregon Health Fund Board (www.HopeforaHealthyOregon.com).
For good reasons, many believe that a “Medicare-for-All” should be part of fixing our derailed healthcare system. With good leadership and political will, the shortcomings of the Medicare system are correctable. Given the trend of ever-decreasing employment-based health insurance and the deceptive practices of many for-profit insurance companies, Medicare remains the only relatively safe health care safety net for current seniors and retiring baby-boomers. We can’t afford to let it fail us.
Chinh Le, Corvallis
Access to care has become worse
Recently I heard a psychiatrist say he ends up practicing general medicine again sometimes lately because he can’t find a primary care provider for some of his patients. Amazing, since for years in Oregon the problem has been finding a psychiatrist to see patients with severe mental health problems.
For years, patients with severe depression or anxiety — bad enough to limit their ability to work, ruin relationships, lose jobs — all of these have been managed by primary care physicians with little training in handling such problems. Some family doctors in our area have become effective mental health specialists in the process, to their great credit.
In the last six years, this problem of access to mental health has become steadily worse. Our public mental health system now deals only with people who have the most severe mental illnesses, such schizophrenia and the most severe versions of bipolar disorder. Even if a patient is completely disabled by symptoms, if she or he is not suicidal or psychotic, help may not be available.
But if now even primary care services are beginning to become similarly scarce, perhaps our legislators will feel more pressure to create change. When even the rich cannot find the medical care they want, even if they can pay for it, perhaps then we will create a fairer health care system. I will try not to feel bitter knowing this was not possible when only the poor and the mentally ill were so profoundly underserved.
James Phelps, M.D., Corvallis
