Man's 24 hours on an ER gurney a symptom of our failing health care system: Letters

Man's 24 hours on an ER gurney a symptom of our failing health care system

March 10 — To the Editor:

Reading Mr. Mark Brighton’s account of his recent emergency room stay in today's Portsmouth Herald brought back the images I experienced while reading the book, "Critical Condition: How Health Care in America Became Big Business-And Bad Medicine." This excellent book by Donald Barlett and James Steele, was published in 2004, long before the arrival of the COVID-19 pandemic. If you wish to understand some of the factors that have brought us to healthcare in America today, I encourage you to read this book. It is timelier today than the day it was first published.

As one who has studied and taught health care policy and delivery since the 1970s, I understand that none of the problems we are experiencing in health care today are new or surprising.  The problems affecting our national health care “system” have been developing over decades.  The arrival of the pandemic along with RSV and influenza has simply torn the scab off that festering wound for even the casual observer to now see firsthand.

There are many factors that have contributed to the state of today’s American health care crisis. The transformation of health care into a Wall Street market-based commodity, the maldistribution of physicians by specialty, the overutilization of expensive and often unnecessary high-tech medical procedures, a reimbursement system that favors high-cost specialty care, little investment in public health and preventive services, dysfunctional mental health care, extensive drug marketing, staff shortages due to cost cutting resulting dangerous patient-staff ratios to name a few.  And as a result, we experience by far the highest cost medical care in the world, with outcomes that reflect shorter life expectancy and years of healthy living than most other industrial nations.

The solutions to this crisis are not a mystery. They are present by studying and learning from other nations who have managed to avoid or at least limit their problems, and in the process, provide quality affordable health care to all their people.  Unfortunately, politics, greed and a well- funded misinformation strategy have effectively prevented us from solving our long-term health care crisis. The health care path we are now on is unsustainable, and will eventually collapse under its own weight if we do not act to fix it, and do so quickly.  As Winston Churchill said, “You can count on America to do the right thing, after they have exhausted every other alternative.” We are running out of alternatives.

Rich DiPentima, RN, MPH

Portsmouth

Americans are misinformed about BDS's true goal: the destruction of Israel

March 12 — To the Editor:

Claiming that BDS does not support the destruction of Israel or promotes antisemitism, that all it wants to accomplish is to roll back Israel's occupation of Palestinian lands is a dishonest claim. Omar Barghouti, founder of BDS stated that his goal was to euthanize the Zionist state. I have yet to see the American BDS network condemn him for his apocalyptic goal proving that it is not a sincere movement.

Academic groups supporting BDS like Students for Justice in Palestine do not want peace, they want Israel destroyed. Well-meaning Americans whose only source of information is the Palestinian victimhood narrative are sadly misinformed particularly when it comes to antisemitism that has exploded in America due to the obsessive examination of Israel's actions not applied to any other country.

Larry Shapiro

Calgary, Alberta

Whenever Republicans want to rile up their base, all they need to do is yell: 'Woke'

March 12 — To The Editor:

Years ago, our family adopted a puppy from the SPCA.  “Lucy” turned out to be an 80-pound mutt who was the smartest dog we ever had. In addition to responding to hand signals, she knew at least a dozen words. One of them was “Squirrel!.” She hated squirrels and relished her mission to chase them out of existence.

When we got a little bored and wanted some excitement in the house, one of us would yell, “Squirrel!”  Lucy would wake from a nap, bound over to the window and leap up on the sill ready for the battle, while we laughed our heads off.

The Republicans have learned a new word, too.  Whenever they want to rille up their base to take on the hated Democrats, they yell, “Woke!” and the fight is on. That looks pretty foolish to us. However, we are not laughing. It seems a very sad and ineffective way to elect responsible leaders and govern a country.

Arlo Gambell

Rye

Column seriously misrepresents goal of anti-BDS legislation in NH

March 13 — To the Editor:

Robert Azzi's recent opinion column seriously misrepresents HB339, proposed New Hampshire legislation that opposes the so-called "Boycott, Divestment, and Sanctions" (BDS) movement. He claims the bill to be a Republican attempt "to silence the legitimate voices of Granite Staters." It's not.

Azzi further claims that HB339 prohibits state investment in "any organization or institution that opposes apartheid, opposes settler-colonialism, opposes Israeli domination over the Palestinian people, opposes persecution of an occupied people, opposes war crimes of incarceration, displacement, and annexation." That's a wildly inaccurate overstatement, totally unmoored from the bill's actual language.

BDS economically targets (only) the country of Israel. There's little doubt about the ultimate goal of BDS: eventual destruction of the Jewish state. One of the BDS co-founders, Omar Barghouti, is on record as opposing "a Jewish state in any part of Palestine."

HB339 simply prohibits any state government investment (via its retirement system portfolios and deferred compensation plans) in companies that boycott Israel. That's it.  It is a relatively mild version of "anti-BDS" legislation, laws enacted in opposition to the BDS campaign.

Azzi points his finger at Republicans in the legislature, but (as he admits) more than 30 other states have enacted anti-BDS laws, including states firmly under control of Democrats. Some of the broader anti-BDS laws are of arguable constitutionality; that's an active issue in the courts. But the Supreme Court recently refused to take up a case that challenged the Arkansas anti-BDS law, leaving that law in effect.

Paul A. Sand

Rollinsford

Hospice focuses on caring, not curing; goal is a comfortable, meaningful end of life

March 10 — To the Editor:

I’m often asked about my work in hospice, which many people misunderstand if they’re aware of it at all. Like my colleagues at Compassus, I’m passionate about my work and we continuously try to help educate patients, families and other health care professionals about the benefits of hospice.

Recently this discussion was brought to the forefront by the decision of President Jimmy Carter to enter hospice. Our thoughts are with him and his family, and we would like to help our community better understand what entering hospice care means.

Hospice is comprehensive team-based care focused on patient and family well-being. A team of health care professionals and trained volunteers work together to address symptom control, pain management, and provide emotional and spiritual support. The care plan for each patient is expressly tailored to their needs and wishes. Hospice is provided where the patient lives with regular visits from the hospice team members and on-call 24-hour access to support.

Put simply, hospice focuses on caring, not curing. The goal is to make the time a patient has left as comfortable and meaningful as possible. For some patients and families, that may end the taxing cycle of repeated, unwanted hospitalizations and emergency room visits. Others may want an improved quality of life because aggressive treatments are no longer working, or the symptoms of their disease are getting harder to manage.

Patients and families often say the wished they’d started hospice earlier, and research studies back that up. Hospice has been found to provide the greatest benefit and end-of-life patient satisfaction the earlier it is initiated. While patients are eligible for hospice when it is expected they have six months or less to live, no one actually knows how you will live. Patients can continue to receive hospice as long as they meet Medicare program’s requirements.

Hospice is not giving up. It doesn’t hasten death and it’s not for the last few days of life. As a society, we are so hesitant to talk about the end of life, but it’s such an important conversation. I encourage every family to discuss their needs and wishes in advance. Your wishes can only be honored if they are known.

Lauren Beckman, MSN RN

Director of clinical services, Compassus

Exeter

This article originally appeared on Portsmouth Herald: Man's 24 hours on ER gurney reveal failing health care system: Letters