END OF THE WORLD
Under circumstances, may as well have been
I think the Mayans were right and the world did end on Dec. 21. Most of us are still alive, but what kind of world do we live in?
It is a world where global climate change creates catastrophic hurricanes like Katrina and Sandy that wreck our cities. It is a world where people in the United States throw vast quantities of food away while people in Africa and India are starving, where the super rich get richer and the struggling poor get poorer.
It is a world where the war in Afghanistan has dragged on for 11 years and a world where Syria's Bashar Assad massacres his own people by the thousands. In this world, Minnesotans are coerced into being gambling addicts to pay for a ridiculously expensive stadium where millionaires will play a kid's game while the St. Paul Chamber Orchestra and the Minnesota Orchestra are locked out.
To top it off, in this world during the Christmas season of "peace on earth, good will toward men," people react to the Sandy Hook shootings by buying more guns.
Yes, most of us are still alive but, if we don't get smarter as a species, evolution will take its course.
BILL ARTHUR, HOPKINS
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Headlight law should be easy to enforce
My wife and I make the drive up and down Interstate 35W from New Brighton to Hinckley almost every weekend. Over the past four years, we have been conducting an informal survey whenever there is precipitation. (You may know that Minnesota has a law requiring all drivers to have headlights on during any precipitation.) Based on our survey, between one or two of every 10 cars does not have on its headlights. We all know that Minnesota enforces its seat-belt law fairly strictly. But when I called the state Department of Transportation to ask about enforcement of the headlight law, I was told it was too difficult to really enforce and drivers were counted on to use good sense.
Am I not seeing things clearly? It appears to me that not only is a driver without headlights a danger to other vehicles, but what could possibly be easier to enforce? I can see every car I pass that does not have on headlights. I have never been able to tell if a driver was wearing his or her seat belt. Not wearing a seat belt endangers one person. Not having on headlights can endanger many people.
BOB GIBBS, MINNETONKA
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Preservation should be our first thought
I started reading with interest news about my old high school, John Marshall-University High, near Dinkytown. I was startled to read on (cheerily announced) that the whole building will be razed and replaced with a mixed-use, high-density housing and retail development ("Incubator building coming down," Nov. 30).
I think that this will be another terrible loss for the old, historic neighborhood, and a complete waste of resources. Such new development is not better. Then, I read in an editorial ("Union Depot reborn as transit center," Dec. 7) that the Twin Cities has done a poor job protecting historic buildings. I agree. The 90-year-old high school should be preserved and reused. This old building, and others like it, will never be seen again. Further, continued use and waste of the planet's limited resources and materials exacts a toll on the environment in the form of more and more pollution. Is it any wonder why we are facing more and more natural disasters? Extinctions? We have to think more in the long term if we want to save ourselves, not so much in short-term economic terms that will only get us further and faster down the wrong road.
JOHN O. WILD, MINNEAPOLIS
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In prostate treatment, a lesson about cost
A recent report comparing two methods of treating prostate cancer with radiation requires further comment. The new method utilizes proton beams to attack the cancer; the older traditional method utilizes standard, available radiation. The study compared 30,000 Medicare patients. The outcomes, including both adverse effects and survival from cancer, were identical. Two questions deserve amplification.
The newer proton-beam procedure required a machine costing $180 million and a Medicare charge of $32,000. The charge for the traditional method was half as much, and the method used available equipment. Why, indeed, was such a huge study required without a prior much smaller study revealing a similar result? The answer is obvious.
The manufacturing company for the proton-beam gadget did well. The therapeutic radiologists charging for the therapy did very well. Thousands of men were subjected to an expensive study because it "made sense" to the promoters, without prior evaluation. Medicare paid the increased cost.
The second question, perhaps even more pertinent, was why the treatment was given in the first place. Many studies have now demonstrated that the great majority of biopsy-proven prostate cancers are of no clinical significance, with no decrease in survival. Most of these unimportant tumors were stimulated by PSA testing, a test now condemned because it is incapable of separating the cancers that are significant from those that be ignored.
This is the essence of evidence-based medicine, in which new proposed therapies or tests should be evaluated before they become everyday clinical practice. Can you imagine how much Medicare money could be saved if the insignificant prostate cancers were never detected by PSA tests? Medicare cost inflation will never be controlled until evidence-based medicine is mandated.
DR. SEYMOUR HANDLER, EDINA