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OHSU can help change health care

Readers' Letters
by: Jim Clark, Internist Chuck Kilo examines a patient at GreenField Health in Southwest Portland. Kilo started the innovative clinic nine years ago, but left in March to become chief medical officer at Oregon Health & Science University.

Thanks to Peter Korn for his article 'Reformer joins mix at OHSU' (Feb. 25). I want to be clear as to my belief that Oregon Health and Science University is a fantastic organization. I am not joining OHSU to fix or reform it. I believe that Mr. Korn may have been projecting the reform motif, as this was not my language and I don't see myself as in this light.

That said, health care is in need of much work - our outcomes need to be measured better and improved, and the value we add to those we serve needs to be enhanced. Stated differently, the system is too expensive, doesn't meet our community's need for affordable care and can, with the right focus, produce better clinical results.

This is well documented by good scientific study in the medical literature.

OHSU has a substantial and very positive role to play in health care's transformation, but it isn't me that will make that happen - rather, it is the fantastic physicians and staff at OHSU who will increasingly work across organizational boundaries with other health care professionals and organizations to create such solutions.

I hope to do my part in facilitating and assisting with that as I serve OHSU and our community, not reform OHSU. The distinction is important.

Charles M. Kilo, MD, MPH

Northeast Portland

Insurance shouldn't pay for everything

Thank you for the revealing story on the real problems of medical care in this country (Reformer joins mix at OHSU, Feb. 25).

At what point then will members of Congress start thinking outside the 'insurance box' as a way to solve the health care crisis? Focusing on just one facet, there was a time in America when a patient paid the bill out of pocket.

Today, medical insurance covers the cost, but at fantastically inflated prices. Consider what auto insurance pays for: the big bills, such as those following a collision, not for an oil change, not for gas. But medical insurance has now been applied to goods and services that insurance should never pay for, distorting pricing, supply and demand.

If auto insurance did what medical insurance does, we could be paying $100 or more for a gallon of gas. Medical insurance should only pay for exceptional costs, never the little things. When will Congress see the truth?

Otis Nance

Southwest Portland

OHSU has no need for reform

My spouse and I have been outpatients at Oregon Health and Science University for the past three years and have seen a variety of doctors there, none of whom ordered unnecessary tests or procedures (Reformer joins mix at OHSU, Feb. 25). In fact, I found them to be somewhat conservative in their approach.

I was quite skeptical that I would receive the kind of health care at OHSU that I typically expect from doctors in other facilities, due to some old stories I had heard about shoddy treatment at OHSU. I continue to return there for care, as does my spouse and some of my neighbors, because the care has been competent, efficient and personable.

Appointments at OHSU generally take about the same waiting time as elsewhere. The physicians are well trained, thorough and caring. They are at a teaching hospital and must also take time to ensure their interns are learning in tandem with their daily appointments. Many of the patients in the waiting areas are obviously on public assistance, but are treated no differently.

This article and Dr. Kilo make general allegations of waste and overuse, but nothing is cited to support that. I have to wonder why Dr. Kilo left his own practice to promote an ideology at OHSU that may be needed in specific specialties such as obstetrics, but not necessarily in such a global way as the article asserts.

Dr. Kilo must be making a much larger salary at OHSU, and was his other practice not profitable enough for him to continue there? Maybe his cutting-edge ideas have some fallacies as well, like failing to provide physicians with a wage commensurate with their training and experience.

Ann Friday

Southwest Portland

Solar projects stay local, competitive

As a member of the board of the Northeast Coalition of Neighborhoods, and a volunteer with the Solarize Northeast project, I need to respond to some misstatements contained in Relk Forsloff's letter, 'Solarize, yes, but use local firms' (March 4).

Solarize Northeast is a community-based volume-purchasing project for solar electric panels. We seek to simplify the process of going solar by offering a pre-selected contractor, educational workshops and volume discounts. This project was started and is being managed by volunteers and neighborhood activists who are trying to do something that is good for the community, the city and the Earth.

We hope that our project and others like it will help to move solar technology from a few early adopters to acceptance by the mainstream. The overwhelming response from our community indicates that we are on the right track.

After a thoughtful, thorough and competitive process, our group selected SolarCity to carry out the installations for Solarize Northeast. Among the factors we considered in making our selection were SolarCity's experience, employment practices, capacity for a high volume of work and commitment to diversity. SolarCity also offered a very attractive package of products, guarantees and services, as well as a good (but not the lowest) price.

Mr. Forsloff's assertion that we chose to save a quick buck is insulting to the volunteers who worked diligently - considering numerous factors - to arrive at a good decision for our community.

Mr. Forsloff states that we 'have chosen to give away Oregonians' tax dollars' to SolarCity. This is inflammatory and completely false. SolarCity will receive not one dime of public money. It will instead create more than 20 new green jobs in Portland, and every person it hires for this project will be, like SolarCity's current staff here, Oregonians.

I am disappointed that Mr. Forsloff, after offering us some constructive suggestions by e-mail, has chosen to spread untruths about us. In recent weeks I have had a number of fruitful conversations with local solar installers who have thoughtful ideas about Solarize Northeast and who want to understand how they can meet the challenge of this new, consumer-friendly approach.

I believe that Solarize Northeast, and the Solarize projects that will follow it, will popularize solar technology, creating abundant opportunity for those working for a clean energy future.

David Sweet

Northeast Portland

Rose Quarter vision is skewed

Regarding the Rose Quarter redevelopment story, 'Looking past the coliseum' (March 11), the official vision of the city for redeveloping the Rose Quarter is to create a vibrant, pedestrian-oriented, mixed-use district with year-round night and day active public uses. Unfortunately, the city's actions seem to be more intent on giving money to the Blazers and preserving the parking revenue, than supporting transit-oriented development.

To jump-start the vibrant neighborhood, the city needs to reduce the size and quantity of streets and parking and add a street grid that connects across Broadway. Through this process, new city-controlled land can be offered to developers.

With views of downtown and the river, and the spectacular access to light rail and the streetcar, the 40-plus-acre Rose Quarter redevelopment should be (once the market stabilizes) prime real estate without a cash subsidy.

Dan Hoyt

Southeast Portland