Health Care: More Ways to SaveOverwhelmed, perhaps, by the complexities of the health reform bills working their way through Congress, readers seemed to welcome the chance to consider some concrete cost-saving ideas that can be put into action without waiting for legislation ("10 Ways to Cut Health-Care Costs Right Now," Cover Story, No. 23). Many offered their own suggestions. Here, then, we expand the list to include some of these solutions.
11. Restructure how we teach our future doctors. Young residents today know technology well. Yet they often don't know how to elicit the stories that can avoid the overuse of technology.
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12. Promote the use of medical savings accounts, coupled with high-deductible insurance, so that consumers have an incentive to consider cost when deciding what medical services to buy.
James Kirk, Fallbrook, Calif.
13. You left out the best place to start: tort reform to reduce the size of verdicts by runaway juries and the contingency fees of John Edwards-type trial lawyers.
Richard Rodgers, Atlanta
14. Prohibit doctors from having stakes in facilities that conduct medical tests.
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15. Overseas health providers could become like Toyota (TM) or Honda (HMC) and set up businesses in America to provide health care more efficiently.
Screen name: Hugo van Randwyck
16. Fund health-care reform by having a national sales tax on edibles and drinkables: Applying a cost to bad decisions and a savings to good decisions will result in better health and lower costs for all of us.
Screen name: Patrick C.
17. Create common goals for hospitals and doctors. Hospital-physician alignment will be the key to reform.
Joane Goodroe, Sr. VP, VHA, Irving, Tex.Markets: The Eternal Cycle of ExcessThe review of John Cassidy's book How Markets Fail ("The High Cost of Blind Faith in the Market," Business Views, Nov. 23) cites Cassidy's belief that "if further calamities are to be avoided," policymakers must embrace reality-based economics. While I agree with this advice, I also think the natural cycle of markets going to excess, regulators responding, and markets going to excess again will never be avoided. The best we can do is to create a regulatory structure that's flexible, focused, and empowered enough to deal with each new excess as it arises.
Nick Balamaci, Scarsdale, N.Y.GDP: Even Less Than Meets the Eye"The GDP Mirage" (In Depth, Nov. 9) says the current GDP estimate is overstated by 1% because it overlooks cuts in R&D, product design, and worker training. Government spending probably contributes 2% to 3% to an overstated GDP. So we can conclude that the economy actually contracted in the third quarter.
Jay McIlroy, Los AngelesWatch Out for Higher Taxes on That Roth"Should You Roth?" (Personal Business, Nov. 2) failed to explain in its hypothetical example that a worker would have to come up with several hundred thousand dollars up front to pay taxes in the conversion from a 401(k) to a Roth plan. The planner's calculation also assumed that tax rates will be lower for this worker after retirement. My guess is that tax rates will have to rise to pay America's mushrooming federal debt.
Conrad Goldberg, Dean King Graduate School, Monroe College, Bronx, N.Y.