Healthcare Reform Costs, Reconciliation, and Aging

From who’s to blame for high healthcare costs to the use of reconciliation in Congress.

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Healthcare Costs Controversy

It is too easy to vilify the health insurance companies as rates go up ["The White House Vs. Big Insurance," March 12]. The real culprit is the whole healthcare system, including the American people. We demand instant cures and lots of technology. When most of our healthcare dollars are spent at the end of life instead of preparing infants for the beginning of life, our costs skyrocket. When we curtail expectations of our healthcare providers and people have the right to buy insurance across state lines, only then will insurance premiums go down.


Maggie Valley, N.C. You ask who I think is at fault for the high healthcare costs. Here's my answer: the greed of doctors, hospitals, pharmaceutical companies, and all other healthcare providers. Why is so little said about this basic reason for healthcare costs?


Deerfield Beach, Fla. You did not sufficiently inform the public that insurance company profits are a small part of the cost of healthcare. You could have reminded people that the insurance companies are regulated and if the new rates aren't justified, then they would not be approved by the states. Attacking insurance companies is politics at its worst.


Stoughton, Wis. Reconciliation Redux

"What's Wrong With Washington" [March 5] stated that the president advocated "for the controversial procedure known as 'reconciliation,' which requires only a 51-vote Senate majority instead of the regular supermajority of 60 votes." The need for 60 votes is rooted in the rules of the Senate and an accident of history, not the Constitution. Until recently, filibustering, and thus the need for 60 votes to cut off debate, was a seldom-used legislative tactic. However, since the 1950s, filibusters have been used more frequently. In fact, Congress created reconciliation in legislation reforming the federal budget process partly in response to the increasing use of the tactic and fear that a minority could hold the country fiscal hostage. Both parties have made increasing use of reconciliation to pass major legislation. Presidents Reagan, Carter, Clinton, and George W. Bush used it to pass major legislation because, as the framers of the Constitution foresaw, requiring a supermajority created gridlock.


Leesburg, Va. Aging Options and Impacts

Someone is finally asking us about our thoughts on aging ["Older and Wiser—Way Older" Editor's Note, February 2010]. The United States is full of physically active oldsters engaged in organ­ized sports. I am 92 years old, work out three times a week, and swim regularly in U.S. Masters swim meets. My event times are cataloged in the U.S. Masters database of 50,000 swimmers nationwide. I think that overmedication is a serious problem for oldsters. My only meds are for diabetes. I remember your great (then controversial) article "Diabetes Diet War" [July 14, 2003] on carb counting.


Vista, Calif. You write: "If we end up with some version of universal care, as seems likely, then does that mean that everyone is entitled to all the care he or she needs or wants? Or does somebody set limits based on cost and efficacy?" Someone is already setting these limits. Just wait until your insurance company doesn't think that you need a test or an operation. Then, perhaps you'll understand limits are already there, at least limits based on cost.


Belleville, Mich.

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