AFFORDABLE CARE ACT

Debating its success, (but also, still, its value)

Every few days, someone reports the number of accounts created and the number of people buying insurance on MNsure, the Minnesota health care exchange. Is the success or failure of our exchange and the Affordable Care Act to be determined by these numbers?

My former-insurance-agent-turned-navigator contacted me and strongly recommended my husband and I do not use the MNsure exchange. He recommended that we buy our insurance directly from the insurance company (getting the same great rates now offered because of the Affordable Care Act), avoiding disclosure of our income to the government.

We will be able to leave the Minnesota high-risk pool on Jan. 1 after being denied insurance coverage last year. We will have traditional insurance coverage because of the Affordable Care Act, but if we follow his recommendation, we will not be reflected in the "success" statistics. Let's be careful about how to measure success.

LAURA HAMILTON, Minneapolis

• • •

Were the Star Tribune's editorial writers ("Health reform rollout rocky but repairable," Oct. 20) really trying to compare the glitches in the Medicare Part D rollout to the train wreck of the ACA? That's like comparing a whirlwind to a tornado.

First of all, Part D is not wonderful. It's unfunded; it doesn't allow for negotiating with drug companies for lower prices, and it has a huge hole: It was passed in the middle of the night, and it's a hidden budget-breaker. Likewise, the ACA was written behind closed doors; we were told it had to be passed so that we could find out what was in it, and it too is a mess. The law should have been negotiated on C-SPAN as our president promised us it would be.

Calls now for a bipartisan effort to fix the bill are an insult. If the American people had been invited to the original party, not just to the cleanup party, we might have gotten good health care legislation. Any other spin is hogwash.

DOUG CLEMENS, Bloomington

• • •

I always appreciate others' opinions about the Affordable Care Act. But, as is the case with an Oct. 20 letter writer, they lack some facts and perspective. Yes, it will cost more to insure people who are not insured. No, it will not cost more to provide medical care to them. Currently they go to emergency rooms for their care, and that is far more expensive than even the most expensive primary care office visit.

The goal is to provide them (and everyone else) timely, lower-cost care, and that will reduce the total cost of medical care in the state and the nation. After we do that, the next large hurdle will be to rein in the cost of the small percentage of people who have chronic conditions and use hospitals as their sole or primary source of care. That will also require some tough ethical decisions about what care we provide to which populations. (I'm talking about disease states, not race, age or gender.)

Dr. DAVID WALCHER, Edina

• • •

I am a small-business owner. My private health insurance provider increased the health insurance premiums for my business by 17.4 percent, so I checked out the MNsure website. I have had absolutely no problems accessing and using the site either as an individual or as a small business. My only question is why the rate I will pay as a small business with two employees is $400 more each month than the rate for each of my employees obtaining insurance as individuals. I have called the insurance providers and MNsure and have been given no answer. I feel obligated, morally, to purchase the more expensive insurance, but it would be nice, financially, to purchase the cheaper, individual insurance. Why the big difference in rates?

ALLISON JOHNSON, Minneapolis
MINNESOTA ORCHESTRA

It's too late for state assistance

The time has passed for effective government financial intervention to save the orchestra. Former Gov. Arne Carlson soundly argues the case ("Leaders explore state aid for orchestra," Oct. 21), but unfortunately, Osmo Vänskä has resigned already. Without him, or another maestro of stature, the orchestra will not be world-class. Who would agree to take charge of such a dysfunctional organization? Sadly, it may be time to put the Minnesota Orchestra down.

Too bad that political leaders didn't recognize the danger sooner. Unless we can find a conductor of proven power, there seems little sense in short-term state funding.

JOHN MAHONEY, Excelsior
SOUTHWEST LRT

A bike trail reroute isn't quite so clear

I'm struck by how everyone seems to think that their favored alternative for the routing of the Southwest light-rail line is "the only logical" one (Short Takes, Oct. 20). I think most cyclists would accept a reroute that retains the essential characteristics of the Kenilworth Trail — relatively wide, direct, and separated from streets. The reroute identified by the project office is narrow and circuitous and has a dozen at-grade crossings.

The truth is that there are no good alternatives for this segment of the transit line. Instead of disparaging the importance of cycling by implying that one route is as good as another, we need to identify what we value most about each of the project components — the freight rail, the light rail, the neighborhood and the bike trail — and do an accounting of which alternative preserves the most of each at a reasonable cost.

ALEX BAUMAN, Minneapolis
TEAM NAMES

Let's make this really simple …

When it comes to the name of the Washington, D.C., football team, it is very simple: Would you walk up to a Native American on a street corner and say, "Hey, redskin, how's it going?" No one in their right mind would ever say that. If it's not OK on a street corner, it's not OK on a football jersey.

IRVING KELLMAN, Plymouth
Correction

The website address given for the MSP FairSkies Coalition in a Oct. 21 letter was incorrect. The correct URL is www.mspfairskies.com.