Regarding “Privacy concerns may take a back seat,” ModernHealthcare.com, March 21: I look forward to seeing how the questions were asked, because what Commonwealth Fund President Karen Davis reports contradicts over 20 years of polling on the subject of health privacy, including the recent PPR/Zogby poll.
Doubts privacy poll, and other letters
But even more important than what patients tell pollsters, they clearly act to protect their privacy—600,000 a year avoid early diagnosis and treatment for cancer, 2,000,000 avoid early diagnosis and treatment for mental illnesses, and millions avoid early diagnosis and treatment for sexually transmitted diseases. As a practicing psychiatrist and Freudian psychoanalyst for 35-plus years, my experience does not fit with the Commonwealth findings either. My patients are very sensitive about the wish to control which doctors see what information about them. They taught me about privacy and would speak freely only when they know the information would not be disclosed to other doctors. Yes, I am in a particularly privacy-sensitive specialty, but depression is the second most common disease in the world, and many people struggle with addictions, so we are not talking about small numbers of people who want control over their health information. Many physicians in other privacy-sensitive specialties tell the same story (reproductive health, cancer, plastic surgery).
Dr. Deborah C. PeelFounder, chairwomanPatient Privacy RightsAustin, Texas
Regarding “AMA to ONC: EHR program doesn't work for docs,” Modern Healthcare.com, March 2: We have to stop delivering healthcare through inefficient small physician practices. It is as if Americans had to do their grocery shopping at 7-Eleven stores. The electronic health-record requirements are just another pressure point on small practices, and, yes, it is getting harder and harder for them to cope. The answer isn't about adjusting EHR incentive programs, it's about restructuring how healthcare is paid for and delivered.
Philip NathansonFormer senior managerCMS, Aetna and the National Committee for Quality AssuranceHaymarket, Va.
The arrogance of Mr. Nathanson's comment causes the allegory of “The Cathedral and the Bazaar” to come to mind. Written initially in regard to computer programming and systems development (fittingly), the principles can be extended to economics, engineering and adaptive biology as well, which seems to make it particularly well-suited to the topic at hand. One of the most generalizable of its 19 tenets is: “Perfection (in design) is achieved not when there is nothing more to add, but rather when there is nothing more to take away.” Policymakers in healthcare reform would do well to learn and live by this notion; the question is whether their individual and competing self-interests will allow them to back away from the “more is better” paradigm that is failing us in more and larger ways every day.
Dr. Al DavisElmhurst, Ill.
Regarding “By the numbers—Uninsured Americans by State,” (Feb. 28, p. 34): It is interesting to note that Massachusetts has 4.4% of its population uninsured in 2009. This even after the implementation of the Massachusetts healthcare reform plan, which required all adults in the state to purchase health insurance by July 1, 2007, and imposed financial penalties of up to 50% of the cost of a health insurance plan on those who do not via income tax filings. The promise of universal coverage may just be that, a promise, one that is too easy to break and too expensive to keep.
Tom KumuraPresidentKumura & AssociatesVista, Calif.
Re: CDC announces public health accreditation program, ModernHealthcare.com, March 26: Dr. Tom Frieden at the Centers for Disease Control and Prevention just hit a public health home run with his new program to accredit public health agencies! Too often, public health agencies battle inertia of varying causes—sometimes arbitrarily political or budgetary. A nationally objective comparison, hopefully outcomes-based, will be helpful in allocation of and advocacy for scarce funding.
Stephen L. HansenSan Luis Obispo, Calif.
Re: “County health chief in Chicago resigns,” ModernHealthcare.com, March 25: I just hope that all the changes that William Foley proposed at Cook County (Ill.) Health & Hospitals System do not come to a halt. He has done a lot but more things have to happen, especially the conversion of Oak Forest (Ill.) Hospital and the cutting back of hospital beds at Stroger Hospital. The system still needs to get rid of a lot of meaningless jobs that are not needed.
Scott BeilArlington Heights, Ill.
Send us a letter
Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.