‘Bush’s Turn to Health Care’

Sebastian Mallaby argues that Americans should trade in their current health care for a government-run system because “the only entity with a stake in lifelong wellness is the government.” He adds that health care decisions “are simply too complex” for people to make for themselves [“Bush’s Turn to Health Care,” Opinion, January 17, 2006].

Does evidence support these arguments? No.

People who develop heart disease in the United Kingdom are 36% more likely to die from it than patients in the United States, because the British National Health Service rations access to technology, new drugs, and specialists.

The U.K. keeps costs down by resorting to what Prime Minister Blair’s health-policy adviser, Simon Stevens, admits is extreme “parsimony” (“Health Affairs,” May/June 2004). Mr. Stevens has pledged to reduce waiting times for surgery to 12 weeks by 2008. Imagine most Americans putting up with such waits.

Mr. Mallaby cites shorter life expectancy in the U.S. That figure reflects life-style decisions: diet, violence, and the large number of teen and preteen girls who use drugs and get pregnant, not the quality of medical care. A fairer way to compare quality is to ask: In which country do patients who become seriously ill have the best chance of surviving? The answer is the U.S.

Mr. Mallaby’s suggestion that people aren’t smart enough to make their own health-care decisions underlies most arguments for government-run medicine. The New York Times’s columnist Paul Krugman also says that “it’s neither fair nor realistic to expect ordinary citizens to have enough medical expertise to make life or death decisions about their own treatment.”

In 1994, Americans rejected the Clinton health plan because they didn’t want government bureaucrats to limit what their own doctors could do for them. Let’s hope most Americans still feel that way.

BETSY McCAUGHEY
Chairman Committee to Reduce Infection Deaths (www.hospitalinfection.org)
Manhattan

‘Death on the Streets’

Your editorial, “Death on the Streets,” mistakenly asserts, “The Bloomberg administration, and Mayor Giuliani’s before it, have, at key intersections in midtown, erected physical barriers that channel foot traffic to safer crossing points” [January 24, 2006].

The ones I’m familiar with in Manhattan were put in place not to help pedestrians but to speed up driving so drivers wouldn’t have to wait for pedestrians crossing avenues – not that many drivers do and not that police ticket drivers for failing to yield to pedestrians in a crosswalk.

RICHARD ROSENTHAL
Rosenthal Advertising
Manhattan

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