Readers' Letters
by: L.E. BASKOW, In December, Douglas Carneau prepared to travel to India for two partial hip replacements and back surgery scheduled for early January. Medical tourism has been a growing business in recent years, with U.S. and Canadian tourists turning to hospitals and physicians in India, Mexico and Southeast Asia for operations that sometimes cost a third or a quarter of the billed rate at U.S. hospitals.

The article 'Insurance pays for India trip' (Dec. 31) contains some important facts that deserve clarification.

Regence encourages all of our members to thoughtfully consider - in consultation with their physician - the best course of medical treatment for their illness. This includes hospitals and surgical centers, near or far. Regence does not 'send' members to particular facilities, and members remain free to select the one that is right for them.

However, there are important differences between benefit plans that impact costs - for the member, the insurer and with self-insured plans, the employer. It's also important to note that Regence does not reimburse for travel, hotel, ground transportation or other services not covered by a member's health plan.

As with any major treatment decision, members should check their individual policies carefully before finalizing plans. As for Mr. Carneau's coverage, federal privacy laws prohibit Regence from confirming or denying any details related to his coverage, treatment or out-of-pocket expenses. We do encourage all of our members to compare price and quality information whenever possible and to use that information, together with the advice and counsel of their physician, to make the health care decision that is right for them.

Terry Olson, M.D.

Medical Director, Regence BlueCross BlueShield of Oregon

Southwest Portland

Where IS the best treatment?

Too many Americans assume they have the best health care but fail to actually know for sure (Insurance pays for India trip, Dec. 31). The lack of clear and objective outcome data provided by U.S. hospitals is startling. One example is that only the state of Pennsylvania requires hospitals to report infection rates. In contrast, many Joint Commission International-accredited facilities are often very forthcoming with their nosocomial infection rates, iatrogenic infections, hemorrhage complications, etc. Needless to say, they tend to be extremely low.

It is also not unlikely that the surgeon in India has done many more orthopedic surgeries than most U.S.-based surgeons. It is also possible that that surgeon in India went to medical school in the U.S. and simply returned to India to live and practice medicine.

Todd Madden

Sunnyvale, Calif.

Overseas surgery has its risks

I hope that the rigors of a long-seated flight back to the U.S. for Mr. Carneau did not cause any complications or increased pain from being confined to an airline seat for many long hours and that he had someone to help carry his luggage around (Insurance pays for India trip, Dec. 31). Three weeks post-op is not a really long recovery time when making a flight of that length.

Another consideration to keep in mind is that blood clots are more common when seated in planes hour after hour. The air is very dehydrated and many airborne illnesses are passed around in airplane circulation systems.

I think that Dr. Huff is correct in his analysis of the offshore medical tourism situation. Why someone with a Cadillac plan wants to do this is puzzling, to say the least.

Ann Friday

Southwest Portland

Eastport thrives with Walmart business

Anyone who thinks Walmart has hurt Eastport Plaza doesn't remember what it was like before they came (The Walmart test, Jan. 7). The mall was a ghost town. There were hardly any stores and few customers. I used to go there for one store, then that moved.

Now the whole area is built up. Lots of businesses besides Walmart are in the immediate area. Parking lots are full. Restaurants are busy. It might not have the oh-so-trendy look of Mississippi or Northwest 23rd, but it is a lively retail district.

Julie Woelfer

Northeast Portland

Walmart harms smaller business

'That's great news,' says Jim Twitchell, owner of Twitchells Furniture. 'Anything that brings more shoppers out here is helpful' (The Walmart test, Jan. 7).

That's right, Jim Twitchell - and they'll be buying their furniture from Walmart, not you. I hope you had a great nine years, because you'll be closing up shop in a year or two.

Michael Caputo

Southwest Portland

Think of those who need Walmart

Sam Adams doesn't like Walmart because they are not unionized, and his Democratic Party principles are much more important than jobs in construction and in a huge shopping center.

It is also a distinct advantage to thousands of Portland citizens who can save money by shopping at Walmart during a time when so many are hurting.

(I don't want to hear that) Walmart will hurt other stores. We have huge businesses all over the Portland area. Mayor Sam talks the talk about (creating) jobs, but will only deliver if those jobs fit all of his other one-sided views.

Either help the poor in Portland, or get out of the mayor's castle!

Barry Adams

Southwest Portland

Letter writer needs history lesson

A recent letter by Chris Hawes attributed the failure of the Pilgrims to survive well during their first year to a form of 'socialism' (Pilgrims' problem was socialism, Dec. 24).

This particular socialism was, of course, not the state bureaucratic Marxism-Leninism of the former Soviet Union, but rather a very Christian attempt to make real the opening chapters of the Book of Acts, where the members of the first church 'had all things in common.'

If the original Pilgrims had the chance - or the desire - to learn from their Indian neighbors, they may well have survived on the system of 'primitive communism' (Marx's words) that allowed most Native American tribes to live (sometimes very well) for 12 millennia on this continent - and to put their Christian ideals into practice.

The second part of the letter betrays an unconscionable ignorance of reality in the Americas before Columbus. Native Americans independently evolved forms of writing and record-keeping (codex books, stone carvings and 'quipu' knots), the most highly evolved pre-contemporary system of mathematics in the world, complex architecture, music and sophisticated agricultural science (giving us over half of the different food varieties consumed around the world today).

This hardly constitutes 'intellectual complacency.' A look at books like 'Indian Givers' and '1491' may free us of some of our own intellectual complacency in this regard, and avoid falling into the 'fantasies and nonsense' to which the letter writer refers. The tragic demise of native civilizations owes much to the lack of immunity to imported diseases (resulting in tens of millions of deaths) and to the north-south orientation of the Western continents, which hindered transference of food and other technologies - unlike the Old World, where latitudinal ecosystems spread for thousands of miles, helping the diffusion of foods and technologies and stimulating ideas that could lead to conquests, empire-building and transmission of knowledge across space and time (see Jared Diamond's 'Guns, Germs and Steel').

Eric Tschuy

Southeast Portland

Schools should discuss religion

Interesting article (Group battles holiday myths, Nov. 26, 2009). Obviously, there needs to be more research on the Thanksgiving topic. Probably the unspoken reason Thanksgiving history isn't taught in public schools is because it hinges on 'religion' - specifically, the belief in God and being thankful for all he's given us. The schools need to be allowed to discuss people's spiritual beliefs without worry that they are establishing a religious order. America is way too paranoid.

What seems also to be missing from the Native American story is that the Thanksgiving holiday we celebrate now was established by the American government after the Civil War and included thanks for events above and beyond the Native American issues.

Robert Alleger

Southeast Portland

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