Dr. Dennis Shubert’s piece (BDN, March 7) provides a great launch platform for health care discussion. Dr. Shubert stresses separating needs from wants and that certainly is critical. Unfortunately, defining needs and tying costs to them is a sticky point.

For example, is it a “need” to provide the same care at the same cost for a lung cancer patient who has chosen to smoke for years or to a patient suffering serious problems due to obesity as opposed to someone who has chosen a healthy lifestyle? Should personal responsibility enter the solution? It’s impossible to see costs ever being controlled in a culture that seems to insist on total personal choice in every aspect of life.

Who best manages the procedural aspects of health care is certainly arguable, but neither public or private management will solve the real problem – us, and how we take care of ourselves. Are we willing to face and realistically deal with this? Sadly there is nothing indicating so.

Gusty Anderson

Stockholm