Saturday Mailbox

A single-payer system is better health choice

The Sun's editorial "Handling health costs" (March 9) notes that all the choices for reining in the cost of Medicare and Medicaid are "unpleasant."

The Sun neglects to mention the most meaningful choice available to us: to stay with the system we have right now or to adopt a single-public payer system in which the federal government would fund health care for all.

What we have now is a single-payer system funded by federal and state governments for those eligible for Medicare and Medicaid, and a private-payer system for all others.

Let us acknowledge that for those others, the most "unpleasant" choice - limiting coverage - has already been made.

Private health insurers are driven by profits. They make profits only if they pay out to medical providers less than customers pay to them.

The ideal insurance customer is one who never needs medical care.

The less health care is delivered to you, the better it is for your insurer. And if you're likely to need health care, the private insurer is better off without you.

So millions of Americans have no health insurance, or pay thousands upon thousands of dollars for the limited insurance they do have, because insurance companies figure they might get sick.

The beauty of this hybrid system for the insurance companies is that the federal government has taken on the responsibility of insuring many of the parts of the population most likely to need medical care.

What does maintaining this system cost us?

A 2003 study estimated that the average overhead of U.S. health insurance companies was 11.7 percent.

In 2006, the profit margins for Aetna and CIGNA, two of the nation's largest health insurers, were 11.3 percent and 10.7 percent, respectively.

The overhead cost of the Medicare system is 3.6 percent of its health care spending. That system makes no profits.

The U.S. pays about $7,000 per person per year for health care.

By removing the overhead and profit costs of the private system, a single-payer system could reduce that number by about 20 percent, to about $5,600 per person.

That would amount to a savings of about one-half trillion dollars from the $2.3 trillion the U.S. spent in 2007 for health care.

Why is it that no one, including The Sun, wants to talk about such plain-as-day simple facts?

Susan Rose

Columbia

State must expand fight against truancy

The editorial "Missing out on school" (March 10) calls for programs and services to address the appalling 9 percent truancy rate in Baltimore.

The editorial rightly advocates truancy intervention programs with proven success rates to help reduce unexcused absences.

And indeed, the University of Baltimore School of Law's Center for Families, Children and the Courts has developed and operated a truancy court program in selected Baltimore elementary, middle and high schools since 2004.

This program involves a partnership among the School of Law, the city school system's Office of Attendance and Truancy and the District and Circuit Courts of Baltimore.

The aim of the 10-week, voluntary program is to identify and address the root causes of a student's truant behavior. The program also offers a mentoring component, in which students learn character-building skills and develop strategies to promote academic success.

The good news is that the program works. For example, at Patterson High School, we have seen a dramatic improvement in attendance, tardiness, attitude and academic performance for 75 percent of the students in the program.

The bad news is that many more schools wish to adopt such a program but the funding does not exist to support expansion of the project.

Truancy is a complex and difficult problem - one linked to criminal behavior, substance abuse, unemployment and other social ills.

The breath of the problem in Baltimore and the dire consequences it causes for the city demand a greater response from the state, the city, the schools, the justice system, our social services agencies and our communities.

Barbara A. Babb Gloria Danziger Baltimore

The writers are, respectively, a professor of law and director of the Center for Families, Children and the Courts at the University of Baltimore School of Law and a senior fellow at the center.

Gondolas could ruin views of the harbor

Last month, I settled on a new home near the Inner Harbor. I moved there because the harbor area has won numerous awards for its design and planning. And since I have a degree in urban planning, that was important to me.

So I was shocked when I read in The Sun on Wednesday that a developer has proposed an aerial tram that would run from the Convention Center to Fells Point ("On cutting edge of urban transit," March 12).

I can think of nothing that would do more damage to Baltimore's waterfront.

The article noted that only two other cities have trams. There is a reason for this.

They are incredibly ugly. One only need look at the waterfront in New Orleans for an example of what this thing could look like.