Lance Klatt’s commentary for Dec. 29 (“A proposal, given state’s surplus: Take tobacco tax hikes off autopilot”) is self-serving, shortsighted, very incomplete and basically all about the money. Consider the source. He represents service stations and convenience stores. Because of lower prices in neighboring states and the presence of smuggling, he asserts that the tax “is costing Minnesota more than $41.6 million per year and generates only about $20 million per year in additional revenue.” Accurate or not, he completely overlooks the most important benefits of the tax. According to the most recent Minnesota Adult Tobacco Survey, conducted by state-funded ClearWay Minnesota and the Minnesota Department of Health, our state’s rate of smoking has decreased significantly — to 14.4 percent. Here’s the kicker: Sixty-three percent of surveyed smokers who quit report that the price increase boosted by the tax helped them quit and stay smoke-free. The resulting improvement in the quality of life for them and those around them is priceless — although the savings in medical expenses and related problems are important, too, and something Klatt conveniently ignores.

Jim Bartos, Brooklyn Park

• • •

Reading between the lines, the commentary on cigarette taxes made a familiar argument: that the profits of tobacco makers and retailers are more important than the health of Minnesota citizens and kids. I disagree with that assertion, and so do most Minnesotans, according to many polls over the years showing strong public support for tobacco taxes.

The tobacco industry and its satellites like to spread fear about smuggling, but in Minnesota we have not seen border wars, black markets or any of the other phenomena predicted by tobacco merchants. On the contrary, according to state data, every time the cigarette tax has increased, so has the corresponding revenue collected from cigarette sales.

This is true despite the most positive outcome from cigarette taxes: decreases in the smoking rate. We know from last year’s Minnesota Adult Tobacco Survey that a 2013 tax increase was a direct factor in reducing Minnesota’s smoking rate to a historic low of 14 percent. The high school smoking rate has also fallen dramatically, to just over 10 percent. Minnesota lawmakers should recognize a good thing when they see one, and ignore calls to roll back any of our state’s tobacco taxes.

David Willoughby, Minneapolis

The writer is CEO of ClearWay Minnesota.

 

BLACK LIVES MATTER

And suppose Rosa Parks hadn’t ‘trampled on’ private property?

The letter writer visiting from Washington, D.C., used the phrase “trampling on private property” to describe Black Lives Matter activists’ actions at the pre-Christmas Mall of America gathering (“Not all attention is good attention,” Readers Write, Dec. 29).

Check history. The “front of the bus” seat was the private property of the Montgomery bus company.

Check history. The lunch-counter stools at national variety stores in the South were the private property of the store.

But the solid wall of segregation, despite prior Supreme Court decisions, did not begin to crumble until Rosa Parks refused to leave her “front of the bus” seat and until Southern black students sat down at the lunch counter and refused to leave.

Sixty years after Rosa Parks’ bus ride, we still refuse equality of opportunity to blacks. Black Lives Matter.

John D. Rice, Robbinsdale

• • •

I am tired of educated, supposedly “liberal” people being critical of the Black Lives Matter movement.

The movement is shouting “Don’t kill us,” and people respond “But …”

I think of the Vietnam War protests back in my student days and how necessary they were, sometimes violent. I have been impressed by how peaceful the BLM protesters have been and would like to give them credit.

Maybe if we all listen patiently to people’s pain and hurt we can live more harmoniously. I am hopeful.

Dorit Miles, Minnetonka

 

HEALTH INSURANCE

Still waiting to be told why single-payer plan won’t work

A Dec. 29 letter speaking against the idea of a single-payer health insurance system being implemented in the U.S. said “Substitution of the government for insurance companies is sure to fail” (“Are health savings accounts, free market a durable strategy?” Readers Write).

My question for the writer is “Why?” You make that statement but give no supporting rationale. Why should the U.S., of all developed Western nations, be unique in that manner? What is so drastically different between Canada and the U.S. that single-payer can work (and work quite well, as many Canadian acquaintances have assured me over the years) there, while it would be doomed to fail here?

And just what is the actual “value added” to our health care system that is brought to the table by the insurance companies? I’d love to be illuminated on that point. Is it more efficiency or the avoidance of fraud? Well, actually, a number of studies have shown the opposite — that is, that Medicare and Medicaid spend less on administration and lose less to fraud than do private health insurance plans.

So I’m awaiting illumination on the questions of what is unique in the U.S. that would prevent single-payer from working here? And what is the essential value added of private health insurance in this country that could not be achieved by a stepped-up “Medicare for all” plan?

John Ewan, Falcon Heights

 

SEX OFFENDER PROGRAM

Editorial displayed naiveté of appeals-court process

I don’t know who wrote the Dec. 29 Star Tribune editorial and how it passed logical muster into print (“Sex offender ruling requires explanation”). But it is entirely common for intermediate federal appeals court rulings staying the effect of a lower-court ruling to, in fact, not delve into the facts of the underlying case or to justify or explain its “rationale” for the intermediate decision. Such an explanation would only be forthcoming if the appeals court had overturned the lower-court decision. The court simply and rightly set a date to hear arguments in order to further decide the case.

That is so common, that the naiveté exhibited in the editorial is overwhelmingly unbelievable. What’s going on there?

Michael Driscoll, St. Paul

 

PHYSICIANS

I’m not seeing any burnout — just calm, efficient doctors

Two reactions regarding the article on physician burnout (“Physicians are burning out, and patients must rally around them,” Dec. 30).

First, I have seen more benefits than downsides to electronic data entry. A nurse or technician enters all of the routine stuff, so physicians can simply review it and focus on the task at hand. My most senior physician brings a scribe with him to take notes so that he and I can talk without him doing note taking. Electronic records are easily shared among physicians — eliminating duplicate testing. I have never felt over- or undertested. I have never felt rushed. I’ve noticed another change in physicians over the decades. Very fit physicians. They walk the talk. I’m guessing that many reduce stress by working out.

Second, I am on Medicare and have a supplemental plan. I have found both to be very efficient. One thing about the supplemental plan and others with negotiated rates is this. The statement reads: amount billed, amount allowed by X insurance provider, provider responsibility, X insurer paid, you owe. What is it with these negotiated fees? Why is it that a provider would bill a person without insurance the full rate and get paid significantly less by an insurance company? Because they are guaranteed that payment? Maybe the person without insurance could afford to pay the negotiated rate.

If any of my physicians are feeling burned out, I’ve seen no evidence of it. Calm, well-run front offices. On time (with the exception of surgeons, who often have emergencies come up).

Mary McFetridge, New Hope