Los Angeles Times

Cure for a sick health system


Re “How has American healthcare gone so wrong?” Opinion, March 4

I strongly agree with Dr. Daniel J. Stone’s piece on the key challenges that our healthcare system is failing to meet. He focuses on mental health needs, out-ofcontrol drug prices, insufficie­nt hospital funding and a bloated and inefficien­t private health insurance industry.

I would also add inequitabl­e hospital funding, glaring health disparitie­s, healthcare profession­al burnout and the growing menace of profit-oriented private equity taking over U.S. healthcare.

These problems are all linked, of course. Enacting Stone’s “Medicare for all” solution, a unified system of public financing, would be a major effective step in meeting all these challenges.

Other countries have already got this, and it works well. How much longer must Americans suffer? Steve Tarzynski, MD

Santa Monica The writer is president of the California Physicians Alliance, which advocates for single-payer healthcare.

Stone extols the virtues of a single-payer system for the U.S. We already have two single-payer plans called Medicare and Medicaid (Medi-Cal in California), but with built-in inefficien­cies and costly limitation­s.

As a result, a growing number of Medicare beneficiar­ies have been turning to Medicare Advantage, while in California, Medi-Cal is being transforme­d into a multi-specialty, managedcar­e plan like Kaiser Permanente.

As for Ozempic, an injectable treatment for Type 2 diabetes, the same medication, formulated in a higher dose for managing obesity, is dispensed under the brand name Wegovy. In Britain, the list price for a month’s supply of four injection pens of Wegovy — which is not yet covered by the National Health Service — is about $88, whereas in the U.S. the same prescripti­on product sells for $1,349.

Why the vast disparity? I imagine Stone and his patients are asking the same question.

Harold N. Bass, MD Porter Ranch

Stone hits the mark with his incisive and honest critique of our American healthcare system. My attention was drawn particular­ly to primary care physicians having to step outside their scope of practice to prescribe psychoacti­ve medication­s.

I am a licensed marriage and family therapist, and I cannot relay the amount of times my clients have been unable to book appointmen­ts with psychiatri­sts due to shortages, insurance glitches, prolonged waiting periods, or because more and more psychiatri­sts are becoming fee-for-service practition­ers.

Many times, these same clients have to pay out of pocket for psychiatri­c consults, and these were the fortunate ones. Having to pay cash for a service that is covered by your insurance, and for which you pay a premium, is appalling.

Something has to change. It appears America prioritize­s wealth over mental health.

Regina Lehrer Westlake Village

Stone should have added the expenditur­es associated with patient non-compliance. The most significan­t component is substance abuse, including alcohol and drug abuse.

Rates of cigarette smoking have diminished over many years, due in part to the prohibitio­n on advertisin­g. Unfortunat­ely, it seems that alcohol advertisem­ents have replaced cigarette advertisem­ents.

Bruce R. Ellinoy Manhattan Beach The writer is a retired critical care pharmacist.

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