The most important factors for patients seeking health care are quality, access, cost and choice. Here in Minnesota we enjoy some of the highest-quality care in the world. Unfortunately, health care costs continue to increase at an unsustainable rate, and proposals being floated by some in Congress to move to a “Medicare for All” system would have serious impacts on health care access and consumer choice.

Government programs like Medicare control costs in several ways: by limiting the types of care patients receive, reducing consumer choice or underpaying doctors, clinics and hospitals for their costs, which can have the unintended consequence of reducing access. This is especially problematic in rural areas where providers are already struggling to keep their doors open due to an overabundance of patients on Medicare or Medicaid, both of which vastly underpay providers compared to private insurance.

As someone who works with a network of dozens of clinics and hundreds of physicians throughout Minnesota providing individualized care to patients statewide, I can tell you that a one-size-fits-all approach to health care would move us in the wrong direction. The future of health care will be customized and tailored to individual patients. New innovations are helping to reduce redundant testing, minimize readmission and reduce costs systemwide.

Instead of looking for ways to centralize health care that would reduce choice and access, Congress should be embracing the future of individualized medicine by empowering patients with more options and incentivizing providers to compete to deliver high-quality, affordable care.

Tom Lorentzen, Bloomington

The writer is CEO of the Minnesota Healthcare Network.

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The lead editorial on insulin cost reform (“Colorado’s smart insulin cost reform,” June 5) urged that policymakers should look to Colorado “for inspiration.” Later in the piece, it is stated that “there’s a cost shift,” but there is no recognition that, in fact, Colorado’s reform does not address the outrageous cost of the drug, or, more important, that cost’s underlying causes.

While this increase in the price charged for insulin is not as flagrant or egregious as was that instituted by former Turing Pharmaceuticals CEO Martin Shkreli, who raised the price of an antiparasitic and antimalarial drug by a factor of 56, it almost certainly has the same root causes: greed and a regulatory environment that encourages this kind of behavior.

Until the fundamental problems in our health care non-system are addressed effectively, the cost-shifting approach should be seen as what it is — a Band-Aid, not a cure. Until efforts are made to align the purposes and motives of all institutions and policymakers in health care to the same goal — the health of all of us — this kind of measure will be only partly successful.

John Tobin, St. Paul


Drive safely to retain the privilege

Beginning Aug. 1, drivers lingering in the left lane can now be ticketed (“New law hits slow left-lane drivers,” front page, June 5). Thank God! Too many people believe it’s their right to drive in the left lane if they are doing the posted limit. Wrong! As a driver, you have no rights as it pertains to driving: It’s a privilege, not a right. The privilege of driving has expectations that you will also observe common courtesies of the road, one of which is to move over to the right at the earliest/safest time possible. Police officers will ensure that those not abiding by the speed limit will be ticketed. Let them do their job by doing yours and moving over.

Blair Sorvari, Champlin

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As usual, in every discussion about “slower traffic move right,” I have never seen the words “speed limit.”

Here’s a scenario: I am driving in the left lane at the speed limit. The law says slower traffic must move right. Since by definition, no one is legally allowed to go faster than me, I cannot be deemed “slower.”

Do I have a responsibility to move over to help someone else break the law or prevent his road rage?

Craig M. Wiester, Minneapolis


Why won’t line run where it should?

Two recent letters about the Southwest light-rail line, “Do the math: Transit is worth the cost” (June 5) and “Not too late to reroute this decision” (June 3), both have valid points.

It is without a doubt necessary for the Twin Cities to support and provide light-rail service to a growing population. Any objective assessment of the current ridership trends would reveal that the two operating lines are solidly successful.

As a senior living in Eden Prairie, I and many like me will use the Southwest line for trips to downtown Minneapolis for various cultural events.

I do, however, share the June 3 writer’s questions about the route. Why is it deemed efficient to bypass populated areas when we have virtually a ready-made right-of-way between 36th and 28th streets in Uptown? That’s where folks are.

By the way, as we battle the construction on Interstate 35W south of downtown, was it not considered to run a line right up the middle, from Burnsville, as the smart path to an effective and efficient rail system?

Joe Carr, Eden Prairie

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The argument that total annual costs of owing and operating cars may dwarf the annual public subsidy for SWLRT and that this somehow makes the project economically “worth it” makes no sense. The economics of funding transit depend on the cost/ridership ratio for building and operating a line. The figures for SWLRT were marginal at best when the cost was $1 billion. At $2 billion and climbing, they would not even come close to being justified by traditional metrics — and no updated data has been provided.

There has never been any analysis suggesting a decrease in the total costs of car ownership when this line is built. We will pay both those costs and the subsidy. This project is about development, not transit. And the truly sad part is that while the line has been marketed as “green” to get public support, the final figures from the environmental impact statement indicate that building the line will increase, not decrease, the total carbon output of our region compared to not building it — trains require a lot of electricity and most of that comes from burning fossil fuels.

Building this line as currently planned puts the metro area on the wrong side of the most important issue of our time — climate change. Running the train where it would have served more people instead of destroying parkland would have made so much more sense in every way.

Steven Goldsmith, Minneapolis


With so much at stake, minimizing potential loss should be our focus

I don’t understand the preoccupation with certainty regarding climate change, and meteorologist Paul Douglas’ opinion at this point is not very relevant (“Paul Douglas’ climate stance is solid,” Readers Write, June 5).

In mathematical game theory, there is a concept that says in the absence of information, strategy should be based on actions that minimize the potential loss. To put it another way, if there is only a 10% chance that the gun is loaded, would you be willing to put the gun to your head and pull the trigger?

David M. Perlman, New Hope