Optimal health care
must be real system
Obamacare and whatever will modify or replace it are both attacking the wrong culprit. The major problem with health care is that it’s not a system. Its efficiency and effectiveness are severely sub-optimized. We need to formulate the goals related to access, quality and cost. Then design strategies that will accomplish these critical goals.
The responsive strategies include things like triage, telehealth, self-care and a personal health record . Triage is the most important component since it maximizes the likelihood that patients will receive care at the right time and from the right source.
Let’s not forget wellness orientation, because promoting a healthy lifestyle is clearly the best way to minimize the need for care.
There are other strategies that can contribute to optimizing population health, including the outcomes analysis of clinical encounters nationwide — so that we can finally learn from experience how to more accurately diagnose, and effectively treat, the wide range of patient problems.
We should bring together the preeminent minds in this industry, to design a system that will make health care all that it can be. Then it will be much easier and far less expensive to provide full-coverage insurance for all.
JOE WEBER, PALM BEACH GARDENS
Trump health plan
I was so pleased to see the Trump health plan explained. I think it should be named the Marie Antoinette Health Plan.
The losers would be the poor (who cares about annoying poor people?), the sick (you are already sick, what do you expect the government to do?) and the elderly (we know what lies ahead for us…6 feet under).
Excellent, sir. Let them all eat cake.
PATRICIA GUSTAINUS, BOCA RATON
Mobility study fine,
but be realistic
As a transportation planner for over 30 years on New York’s Long Island — and having been involved in projects including building a public bus transportation system from scratch and working with citizen transportation groups regarding the ever-congested Hamptons and North Fork — please excuse me for a bit of cynicism when I read about the city’s mobility study.
Not that it isn’t an excellent decision and a necessary thing with top-flight people involved, but I can’t help but think of something that grandma used to say: you can’t fit five pounds in a three-pound bag.
The city’s street infrastructure is fixed and allowable building densities are relatively fixed as well. Human nature also comes into play — people don’t change their travel habits unless an alternative gives them significantly more time and flexibility.
As long as people don’t expect miracles, the fine-tuning that will result from the implementation of study recommendations will offer some relief. But don’t expect trip travel times for work and other activities to be any less.
DAN PICHNEY, WEST PALM BEACH
Our tribal instincts
may be our undoing
In his Friday column, “Enlightenment thought is once again under attack” (March 3), David Brooks wrote that anti-Enlightenment is now winning out over Enlightenment.
Where do Enlightenment and anti-Enlightenment come from? Fragile humans survived 2 million-plus years of evolution in primeval Africa by developing both a superior intellect and natural survival instincts. Enlightenment comes from that intellect. Anti-Enlightenment comes from the outdated tribal natural instincts that we are stuck with.
Anti-enlightenment tribal instincts are responsible for the racial, ethnic and religious conflicts in the less civilized parts of the world. But it also started winning with the unfolding of Europe as a result of Brexit. It certainly appears that the winning, anti-establishment presidential campaign was the result of anti-Enlightenment tribal instincts.
The unraveling of our government has started. I only hope that our form of government, a republic, can withstand it, and let Enlightenment take charge again.
MARLIN REINHART, JUPITER