The left in America wants to raise taxes, build new bureaucracies, and have politicians control all Americans' healthcare. Americans need to reflect on why we have been a free people; and it is not because of Washington-based politicians, bureaucrats, and lobbyists. Those responsible for bureaucratized and regulated healthcare now want to take it over because costs have been driven skyward. Throwing gasoline on a fire is a dubious strategy to control it.

Noel D. Collis, MD
Little Falls, MN

Perhaps we could give the government a trial run as a healthcare insurer by letting it handle a smaller prototype to see how it would do ["Web Poll: Would the USA be better off with a single-payer, government-run healthcare insurer?" July 20]. Oh, wait. Medicare reimbursement is going to decline 10 percent (did any of my expenses decline 10 percent last year?); our local government-run city hospital is millions of dollars in debt and on the verge of bankruptcy; and our state's Medicaid program for children is crying out for funding.

David L. Anders, MD
Peachtree City, GA

Quality, not quantity

The column in the July 6 issue about owing something to long-term patients ["From the Editor: Do loyal patients deserve more?"] brings up the subject of patients who you have little contact with, but, as fate would have it, are sometimes the recipients of far more benefit than those you see more often and over a longer period of time.

I remember caring for an infant whose parents had moved here from another country seeking better medical care. After successfully diagnosing and treating the child, the family returned home.

Be grateful for loyal, long-term patients, but the irony is that sometimes we help the most those we see the least.

Edward B. Feehan, MD
Merced, CA

Hand in my pocket

I own and run an internal medicine practice. I recently gave an HPV vaccine (for cervix cancer) to a patient with Anthem insurance. My cost in the door was $145; Anthem paid $127. Calls to the insurance company have fallen on deliberately deaf ears, with a response of "this is our fee schedule." Guess who suffers? The patient will not get the next two of the total three shots, and I am short money. Now I know how the insurance executives make their millions. Yet the myth of filthy rich doctors (oops, demoted to practitioners/providers) lives on.

Ravi Gill, MD
Louisville, KY

Drug rep visits

I was pleased to read in your Sept. 21 "Readers React" column that there are physicians who appreciate the services that pharmaceutical reps deliver ["What drug rep visits cost you," Aug. 3].

Our five providers see reps as doing them a great service. They rely on the reps to keep them informed of the latest studies, indications, and overall information about the drugs they prescribe. They also greatly appreciate the samples. Without them some of our patients would have no drugs at all. Plus, it gives the patient the chance to try a drug before spending the money on something they might not be able to take.

Our providers believe that the few minutes it takes to see reps is a small price to pay for all they do for us and our patients.

Victoria Sanders, CMPE
Practice administrator
Newport News, VA

Address correspondence to Letters Editor, Medical Economics, 123 Tice Blvd., Woodcliff Lake, NJ 07677-7664 (e-mail meletters@advanstar.com
; fax 201-690-5420). Include your address and daytime phone number. Letters may be edited for length and style. Unless you specify otherwise, we'll assume your letter is for publication. Submission of a letter or e-mail constitutes permission for Medical Economics, its licensees, and its assignees to use it in the journal's various print and electronic publications and in collections, revisions, and any other form of media.