Competition and health care costs

To the editor:

In response to the Thursday letter from Dr. William N. Evans, who criticized your recent editorial on health care reform:

I am a small business owner, a patient and a physician. Unlike Dr. Evans, I am not a specialist, but an internist (a general practitioner and family doctor). While I have nothing but respect for Dr. Evans, I do disagree with his comments.

First, regarding "stripped-down" health plans: Though I don’t pretend to speak for the Review-Journal, I believe the editorial was alluding to the many mandates each state requires all health insurance policies to cover. In Nevada, alcoholism counseling, acupuncturists, chiropractors, marriage therapy and much more must be covered. Although these professionals provide wonderful services, should a 35-year-old man have to purchase a policy that includes coverage for things he would never need or use?

I am quite certain the Review-Journal was not suggesting plans be made available that do not provide coverage for heart surgery and other typical health care services.

With regard to price transparency in health care, I believe Dr. Evans may have confused "hospital price transparency" and "everyday (outpatient) price transparency." I agree with Dr. Evans that hospital price transparency is little to no benefit to patients. But outpatient health care services — having your blood drawn, getting a chest X-ray, seeing your doctor or purchasing your medications — is very beneficial. No one would ever suggest a patient comparison shop during an emergency. But 75 percent of all health care encounters are in the outpatient setting, and a patient does have the opportunity to shop.

Health care is the only industry in which competitive forces are not applied. Has anyone asked why all four prescription heartburn medications cost more than $100 a month? Currently, our drug makers only compete to get on five to seven "insurance formularies." What if they had to compete for 75 million Americans in order to be the heartburn pill of choice?

We all are working toward the same goals — quality health care for all Americans at an affordable price. Where we differ is the path we must take to achieve our goals. I agree with Dr. Evans: In order to accomplish these goals, we are going to need constructive dialogue, avoiding rhetoric and hyperbole.

Kelly E. Van Wagner, M.D.



Tax free

To the editor:

In response to your Thursday editorial, "More class warfare," is it possible that the 55 million uninsured Americans are also among the 40 percent of American households that don’t pay any income taxes? Giving this group of Americans tax credits for getting their own insurance doesn’t add up because they already don’t pay taxes.

Sharon Holden



Power plants

To the editor:

Nevada had a net summer electrical generation capability of 8,714 megawatts in 2005. Suppose this electrical power were produced from wind energy only. Large wind turbines are available with a peak output of 2 megawatts. Because U.S. base-load capacity factor for wind turbines is less than 30 percent, about 14,500 such wind turbines are required to provide Nevada with 8.714 gigawatts. The cost for these wind turbines at $4 million per unit is $58 billion, or about $6,700 per kilowatt of base-load capacity.

A 2 megawatt wind tower has 300-foot diameter blades and reach a height of 400 feet, with a profile the size of a 40-story Las Vegas hotel. If these 14,500 wind turbines are distributed along Interstates 80 and 15, then a turbine is required every 190 feet. At this spacing, the turbine blades would intersect.

Furthermore, wind turbines extract and alter energy from the flowing wind because of turbulence, vortices and other perturbing meteorological conditions and would create an artificial mountain range over a mile wide and 80 feet high along these interstates.

What is the impact of such a major, artificial meteorological disturbance upon seasonal weather and precipitation conditions in Nevada, the driest state?

Obviously, there are no simple solutions for future electrical development such as a major dependence upon wind power. Indeed, fossil fuel, renewables (hydro, wind, solar, geothermal), nuclear and hydrogen production must all be considered.

Gary Sandquist





Open government

To the editor:

Normally your editorial opinions serve only to aggravate me. Rarely do we agree on anything. Your Saturday editorial, "A blow to openness," however, was right on the mark. Thank you for bringing this ruling to our attention.

Transparent government is essential if our republic is to be preserved. My only question is, how is it you couldn’t find a way to blame this awful decision on Nevada Sen. Harry Reid?

Or is Review- Journal Publisher Sherman Frederick going to get around to that on Sunday?

John Farrish


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