HEALTH CARE

Two ways to take on the cost drivers

The complaint about medical providers' rates (Letter of the Day, Aug. 22) underscores the need for good health insurance for everyone. The letter writer didn't say whether or not he has insurance, but if he had good coverage, his company would reduce the provider's fee and he would pay only a partial copay of the lower fee.

This is the same reduction that Obamacare has made to Medicare payments -- an important means of reducing medical costs generally, which will set the standard for the private insurance companies. It's the reduction in costs that the Republican candidates for president and vice president are cynically describing as "gutting Medicare."

JANE SIMON, MINNEAPOLIS

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I agree that paying $505 for a 10-minute visit for an insect bite, as the Letter of the Day writer did, is outrageous, but I would argue that it's not due to greed but to the inefficiency of large clinics compared to small, independent clinics. In my small office, that service would have cost about $50.

Why the difference? Lower overhead. Government regulations have created such onerous requirements for medical practices (electronic records, reports to the various regulatory agencies and alleged measurers of "quality"), and have cut payments so much, that small practices can no longer survive.

They're being bought up by behemoth clinics and hospitals that can negotiate larger payments to support their enormous overhead. They have lobbying power with the Legislature and insurance companies to get higher payments for the same services. They give ordinary care at extraordinary prices.

This is arguably the main driver of medical inflation. Small, independent practices are high-service, low-cost providers that should be cherished by citizens and governments, but they are rapidly disappearing. Is anyone out there paying attention?

DR. RICHARD J. MORRIS, WAYZATA

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STATE WORKER CONTRACT

We should cheer any boost for middle class

Concerning the Aug. 20 commentary "Unions get a great deal from Dayton": When will Republicans Mike Benson, Keith Downey and Steve Drazkowski be happy? When all current or former members of the middle class are making minimum wage and have no health care benefits?

Rather than focusing their efforts on improving the lot of working people in the private sector who may not have decent wages and benefits, these legislators choose to deploy divide-and-conquer tactics (their article) to attack state employees who happen to get good wages and benefits.

I, for one, am happy when ANY working person has decent wages and health benefits, union or nonunion, private or public. I support state employees and their unions. Perhaps it will take more private-sector union involvement to improve the lot of middle-class working people. The right-to-work, anti-union, worship-at-the-altar-of-the-free-market Republicans are not interested in the job.

RICHARD S. SMITH, MINNEAPOLIS

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SEN. AMY KLOBUCHAR

Given her popularity, she must not be all bad

I am truly amused by the recent spate of GOPers trying to discredit Sen. Amy Klobuchar. If a senator has an approval rating consistently above 60 percent, she must be doing more right than wrong. Klobuchar's support doesn't just cross party lines, it practically obliterates them.

She may not be a headline-grabbing glory seeker like U.S. Rep. Michele Bachmann, but Klobuchar's response to all constituents, regardless of party, has led to her popularity. I would further remind Minnesotans that during the recount of the 2008 Senate election, Klobuchar easily handled the job of two senators while the other seat was vacant.

Are these naysayers serious that she doesn't deserve another term? We are lucky to have Sen. Klobuchar, and she should stay in the Senate as long as she wants.

DAVID FREDERICK, COON RAPIDS

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ATHEISTS

Well, some do go to church. Here's why ...

I'm pleased that the silent-minority atheists are getting some attention lately, and I'll be glad when it's OK in this country, even politically acceptable, to not believe in supernatural beings.

One recent letter writer says it's obvious that atheists don't go to church. I'm here to report that many of us in fact do. I'm an atheist, and I attend and financially support a fantastic, active and open-minded Christian church (St. Luke Presbyterian).

Why? Because I like the people, we do good work and the preaching is great. Churches are important communities, and I look forward to the day when they care only about good works and dump the dogma.

ROD FISHER, EDEN PRAIRIE

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Voter ID

How might a younger me have been affected?

I've had a government ID (driver's license) since I was 16. The proposed voter ID amendment poses no problem for me. However, I recall that from ages 18 to 26, I lived in a number of different apartments, dormitories and Army barracks, and my driver's license seldom reflected my current address.

Under the proposed constitutional amendment, I could not have voted where I lived. (And who knows how absentee voting will work if a photo ID must be presented?) Taking time off to get a "free state ID" (how many places in each county will offer that?) or to prove residence after casting a "provisional ballot" will make voting tougher for young people. Perhaps that is the idea.

WILLIAM CRAIG, ST. MICHAEL