October 16, 2021

Dr. Erik Steele’s column is a welcome addition to your editorial pages. He is a good writer and, usually, a sound thinker. His column, “Medicine not to be bought, sold” (BDN, Dec. 16), is an outstanding exception.

Medicine has been bought and sold throughout recorded history. People who have had money, goods or services to trade have been able to buy care and pharmaceuticals (from antibiotics to newt tails) from the highest level of expertise their societies have had to offer. Those with few or no resources have suffered, died young or been helped by folk healers, wise elders and charitable institutions.

Steele blames the current state of medical economics on “American taxpayers, American businesses, American government, and American patients.” We, he asserts, are bogged down with commercial profit motives.

Are we to believe that physicians who earn much more than the average American (even accounting for costs of education and running their offices) are innocent victims of efforts to control cost? And how about for-profit hospitals, laboratories, pharmaceutical and health supplies companies? Don’t all of these have something to do with constantly rising costs of health care? What does Steele think started the whole movement toward managed care and other efforts to slow the medical money spiral?

I do not like managed care as it is widely practiced. I do not like having insurance companies stand between people and their caregivers. I do not believe health insurance for every American is what we need — we need health care, not insurance. But I am not willing to take my share of the blame for this mess while well-paid doctors take exotic vacations, drive fancy cars, live in elegant houses and moan about making less money than they used to in the old days.

Certainly many physicians and other health care givers live on more modest incomes and are generous with their healing gifts. And there are just as many of the rest of us taxpayers and patients working to find balance in the system. No matter how nice any of us are, somehow we have to pay for medical and health care; and someone will be paid for it. I believe medicine will always be bought and sold. Sharon Bray Orland

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