Opinion editor's note: Star Tribune Opinion publishes letters from readers online and in print each day. To contribute, click here.

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The Wednesday commentary written by three union leaders was passionate, but not very helpful ("Merger would put profits ahead of health," Opinion Exchange).

Sanford Health and M Health Fairview are nonprofit institutions. They are required to channel surplus earnings back into the institution or the community. It is true that health care markets with one dominant system tend to have higher prices, but our metropolitan area has several competing entities. Competition in rural areas has already been gone for decades.

The authors mentioned high CEO salaries multiple times in their article. While the salaries do seem inflated, the salaries also reflect the market rate. Other large-system CEO salaries in Minnesota range from $1.9 million to $3.4 million per year. (Andrea Walsh at HealthPartners, on the lower end, took a voluntary 40% pay cut when the organization had to cut staff.) The salaries are determined by the often unpaid board of directors of their nonprofit organizations.

High CEO pay affects hourly hospital workers wages paradoxically. A recent study in Health Affairs revealed that hourly workers in hospitals with low CEO pay average $30 per hour while the same workers in hospitals with high CEO pay receive an average $34 per hour. Perhaps union workers are better served by highly paid leadership.

The problems the union leaders cited — increased health care costs, hospital closings and low worker wages — occurred within the current, non-merged system. The problems will get worse. Government reimbursement for health care is decreasing particularly in rural areas, COVID-19 support is being terminated, and our population continues to age with a higher demand for services. None of these important issues will be solved by maintaining the status quo, and a merger may be a viable solution for some markets. It is clear there will be more hospital closures in this decade. Pricing will have to be adjusted downward either by the market or the government. The health systems will require innovative and flexible leadership to survive those challenges.

Lee Newcomer, Wayzata

The writer is a retired physician.

With driving safety always a relevant issue, I have what I believe to be a valid concern with the auto industry producing vehicles with touch-screen driver controls as the overwhelming choice of design. Heater/AC controls, which include separate ones for temperature and fan, require the person choosing to adjust these to focus on the touch screen to activate the control, and this person is typically the driver unless there's a front-seat passenger to accomplish this step. Even if there's a passenger available to do this, the driver is naturally inclined to do this on their own.

These fan and temperature screen control "locations" require nearly pinpoint accuracy — if you're off by even a 1/4 inch, you get no response or activation, so you, typically the driver, continue to focus even closer (and longer) on the screen as opposed to the road to accomplish the task. This equates to distracted driving, period. I drive a 2014 pickup that has no such touch screen and my heater/AC controls for both temperature and fan are knobs that I can locate and adjust without ever taking my eyes off the road — they're right where my brain tells me they are. I also drive my wife's 2022 vehicle when we travel together, and it's an ongoing concern to take my eyes off the road to adjust the controls. Even with my full attention to touching the right spot on the screen, it's not easy — those controls are fussy; accuracy is required. Wintertime driving requires extra adjustments for defrosting and heating needs and preferences.

I find it hard to believe, with the recognized hazards of distracted driving, that the auto industry seems to be moving in the wrong direction, designing vehicles with a built-in need to take your eyes off the road.

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The Star Tribune Editorial Board makes a good point in "How to drive safer and save money" (Dec. 9) but quickly veers off course into ageism.

The board's good point: In Minnesota, drivers 55 and older can take a defensive driving course and receive 10% off on car insurance, but few take advantage of this. I took the class online during the COVID shutdown. It was a good refresher no matter a person's age.

Unfortunately, the editorial inaccurately lumps all drivers 55+ into one category of unsafe drivers followed by cringeworthy conjecture about what "too many older drivers believe."

The board tells readers that older drivers make up 20% of Minnesota's driving population but we are not told that they make up only 16% of the accidents, leaving 84% of accidents to be caused by younger drivers.

The Department of Public Safety also tells us: "Older drivers are generally safe drivers."

According to the department, "from 2016-2020, only 10% of elderly drivers killed were known to be drinking. For drivers 21-34 years old in the same time frame, it was 44%." Drivers aged 65 and up who died in crashes wore seat belts 70% of the time. Among drivers aged 21-34 who were killed, only 46% did.

The Department of Public Safety suggests, "We must all be sensitive to aging drivers who can no longer get behind the wheel. Older drivers forced to stop driving will feel a real lack of freedom and often suffer from depression as a result.

"Ultimately, communities need to understand this emerging issue and make plans for safe travel options for the elderly and make these options easily accessible," and affordable.

We need to also be sensitive to unreasonable and inequitable costs. An 85-year-old woman I know was told by her doctor that, because of her age, she needed a driver trainer to assess her driving. She was forced to pay $360 to keep her license, a fee few drivers of any age can afford.

It happens after every snowfall: An army of neighbors uses snowblowers and plows to clear sidewalks beyond the boundaries of their own yards. It's an incredible service, and we thank them with words, baked goods and in-kind help, but this isn't just a shout-out to those volunteers. There's an opportunity to tap into the energy of those good citizens.

Years ago the city of Minneapolis promised to clear sidewalks at intersections to encourage walking in winter and make winter sidewalks more accessible for wheelchairs. Their track record hasn't been good. Could the city mobilize these citizens to keep intersections clear and remove the piles of snow blocking sidewalks at alleys? There are many low-cost incentives to be employed: a small subsidy for fuel, a break on property taxes, an online "tip jar," recognition dinners, etc. Not only would we get the intersections cleared, but the job would be done a few hours after the snow ends instead of days or weeks later.