Marshall Helmberger ("Iron Range: Why profits over people?" Feb. 26) brings up great points. Unfortunately, money — or people with the money — drives everything (i.e., Vikings stadium windows trump birds, fossil fuels trump sound science, proprietary information trumps public safety). Lake Vermilion is a true natural treasure, so much so that Minnesota invested in a state park for the lake near Pike Bay. Despite that investment, legislators continue to put natural resources at risk. Mining has changed considerably; nowadays, the jobs are specialized (and thus fewer), risks are minimized (in terms of safety to people and environment) and, ultimately, profits are sequestered to the company rather than the community. The state should set an example by instituting appropriate environmental protections that can promote employment opportunities to maintain a healthy environment for enjoying the bounties of an economically important Iron Range lake. Then, the mining companies that continue the legacy of the state's arguably most iconic industry can play a proactive role in environmental stewardship under which natural resource extraction and enjoyment can coexist.
Nate Cathcart, Lakeville
MEDICAL ERRORS
We need to know still more about them
While the Star Tribune is to be commended for drawing attention to the 2015 Adverse Events report data ("Taking the steps to do no harm," Feb. 26), it's not the whole story.
Hospitals have fought implementation and modification of the adverse-events reporting law since it was first passed in 2003 — even after the monumental study by the Institute of Medicine that projected 98,000 deaths per year due to medical mistakes. Adverse events in Minnesota are reported only when the hospital defines them to be serious — for example, if the patient has died or has required additional treatment for seven days or more. If low levels of staffing allow a patient to fall on the way to the bathroom or acquire an ulcer that can be treated in less time, it's not "serious."
Nurses fought to amend a subdivision of the law to require root-cause analysis to include staffing as a cause for an adverse event, but that analysis only goes back to the Minnesota Department of Health. The public will never know.
Nurses, doctors, staff, legislators and members of the public all want safe and quality patient care for every Minnesotan. However, the 2015 adverse-events report is an incomplete depiction, and patients and legislators need to dig deeper into how safe their hospitals are and could be.
Rose Roach, St. Paul
The writer is executive director of the Minnesota Nurses Association.
HEALTH INSURANCE
Is UnitedHealth overstepping its role?
The article about UnitedHealthcare setting prior authorization rules for hysterectomy procedural techniques for which it will pay is a prime example of a medical/health insurance company practicing medicine without a license ("Hysterectomies restricted," Feb. 27). UnitedHealthcare unilaterally determined that vaginal hysterectomy is the best for patients, and that laparoscopic or abdominal approaches must undergo prior authorization beginning April 6 for its subscribers.
Sure, a doctor can advise the patient that one method is better, but will UnitedHealthcare have examined or taken a history from the patient? Will it have generated a medical record? Does it know what is in the patient's welfare better than the physician?