Health care crisis on horizon


Survey after survey has shown that Americans want to be able to spend more time with their primary care doctors, and the doctors want to spend more time with their patients. Emphasizing primary care is the cheapest way to deliver health care, and results in the best health outcomes.

American medicine, with its emphasis on paying for procedures, has come out with the opposite arrangement - there are far more specialists than primary care doctors (Fewer doctors, more waiting, Aug. 7), resulting in medical care that

is both more expensive and less effective than it could be. In this system, overall, we don't get what we pay for; we pay more, and get less.

You don't like having your primary care doctor see you for just 15 minutes when you're suffering from diabetes, congestive heart failure or other ailments? Tough luck - if there aren't procedures involved, your doctor isn't going to want to spend much time with you because insurance won't pay much for the appointment.

There is, however, lots of money for the gastroenterologist who essentially has become an extremely high-paid technician, grossing more in an eight-hour day of doing one routine colonoscopy after another than an average internist earns in a 60- or 70-hour week of seeing patients.

America's increasingly expensive medical system is heading for a crisis. There are groups working on changing American health care to be less expensive and more effective, but politically that's a huge task.

Americans are seen as being so afraid of socialized medicine and so accustomed to saying 'Insurance will pay for it' that they're willing to put up with expensive health care that's not the best. Go figure.

Amy Houchen

Southwest Portland

HOV lane presents logistics woes for cops

There's one big problem regarding 'Cops crack down on fast-lane cheaters' (Aug. 7): The officers often stop the violators and issue tickets in the HOV lane. This backs up traffic in the HOV lane and the other lanes for miles. The one ticket punishes hundreds of drivers.

The emergency lane on

Interstate 5 often is not wide enough for a vehicle after you get past the North Portland Boulevard overpass. And it's nearly impossible for the officers and violator to merge into rush-hour traffic to get over

to the right side of the highway where the emergency lane is sufficient for the ticket-writing task.

There has to be a smarter way for cops to do this.

Tim Hall

Vancouver, Wash.

Lanes more trouble than they're worth

The HOV lanes on Interstate 5 do not work well ('Cops crack down on fast-lane cheaters', Aug. 7), they simply create more congestion and gum up the rest of the travel lanes with stop-and-go traffic.

Vehicles crossing over the full-service lanes from the HOV lane to use an exit ramp and vehicles crossing over to the HOV lane from an entrance ramp create a significant negative impact on the other lanes of traffic.

The HOV lanes are far more of a political mind-set statement and dictatorial restriction that cater to the special interests than they are a workable policy in this corridor.

Terry Parker

Northeast Portland

Repurpose HOV lanes for better efficiency

Forget expensive transponders to collect fees - $18 million to set up a new program is a lot of money ('Cops crack down on fast-lane cheaters', Aug. 7).

HOV lanes could become a traffic mover with a simple change: use HOV lanes for trucks, commercial traffic and cars with four or more people who are driving through the city.

Trucks take longer to start and stop; slow-moving trucks increase pollution and the time it takes a truck to get up to speed creates problems as cars dart around slow trucks.

Trucks and commercial traffic would travel through the area faster on less fuel and less pollution if they were in an HOV lane. With fewer slower trucks and commercial traffic in the other lanes, autos would travel smoother and faster.

The cost would be new signs and the willingness to make the change.

Kay Newell

North Portland