Opinion: Fla. government should solve BayCare fiasco

All right already! This craziness has got to stop. We have two titans that are large enough to be immune to market forces battling to see who gets richest. Meanwhile, the patients, employers and physicians who will end up paying the bills have no voice and no bargaining power.

These people are not immune to outside regulation. The hospitals get certificates of necessity by showing that they will serve the public need and convenience, and need to be sheltered from competition. The Blues are subject to regulation by the state Department of Insurance. Bayfront, a centerpiece of BayCare, occupies public land.

A process will drag out as long as second-stringers are doing the negotiating. It is time for our elected representatives to get off their bottoms and demand a solution. Gov. Jeb Bush needs to tear himself away from the campaign and call upon the chief executives of BayCare and BlueCross to meet with him in a locked room until an agreement is reached. That's what leaders and elected representatives are supposed to do. That's the job that candidate Bush says he wants again.

So do it, Jeb. Convince us that you are looking out for us voters.
-- Frank A. McKinney, St. Petersburg

A new health plan option

After reading about 300,000 people left without recourse as BlueCross refuses to reach a compromise with BayCare hospitals, I think our national health plan should be called: DON'T GET SICK.
-- Carolyn Gold, Clearwater

Government seems unwilling to help

Re: U.S. law threatens discount drug card, Oct. 3.

Of all the mean-spirited, dog-in-the-manger attitudes, this is the worst. Tom Scully, the government's head of the Centers for Medicare and Medicaid Services, can force drug companies to stop giving low-income seniors a prescription discount and that won't add one cent to the Medicaid coffers. We can see from this attitude how hard it is going to be to get any government help with prescription costs for seniors. Because these pharmaceutical companies have decided to give seniors help with their high-priced medicines, the government is saying, "Me too, me too." If the companies don't agree to give the government the same price break we can lose our discount and the government will have gained nothing. What muddled thinking.

I wish I didn't think the government was saying, "We're not going to help and neither can anyone else," but I can't interpret it any other way.
-- Doris Whelan, St. Petersburg

It's about time

Re: Will privatization stage a comeback?, Oct. 5.

E.J. Dionne Jr. asks if someone retiring on, say, Oct. 1, 2002, might not have "lucked out" as much as someone who retired on Jan. 1, 2000.

No, but he would be one whole heck of a lot better of than someone who retired on nothing but Social Security as now structured. The key is time: If he had been putting a little into a private account for 30 years or more, he would be a lot better off than someone who hadn't, even taking the stock market swoon into account. All of these anti-privatization commentaries disregard the aspect of time, which is of course the most important aspect, and what makes it work.

Also, the Dionne piece disregarded, as they all do, the part about a private account's being able to be passed on to the heirs. And how, under some circumstances, you can pay into Social Security your whole working life, die, have no spouse or dependent children, and nobody gets any payout at all.
-- Ernest E. Lane, New Port Richey

Nullifying the nursing shortage

We've all heard about the so-called nursing shortage. Well, here is an eye-opener. After making a decision not to send the renewal fees for my Florida LPN nursing license (1999), it was then my understanding that the license would be dormant and that with some continuing education credits, I would be able to reactivate it. I dropped out of nursing.

I recently took retirement at age 62 but will have to supplement my Social Security income with part-time work. When I called the department that maintains the nursing licenses, I was told my license had become "null and void." When I asked for an explanation, I was told that when it had not been renewed for two years it becomes "null and void." When I queried how I would re-establish the license, I was told I would have to "go through the training again." How ridiculous is that?

Basic standard nursing practices do not radically change. Nurses are required to update their knowledge with CEUs (continuing education units) so that they may renew their license and keep apprised of current nursing practice and health needs. How could my education as a licensed practical nurse become "null and void," implying that everything I had learned doesn't count any more because I didn't send renewal fees for a few years? How stupid is this -- if, in fact, there is a real shortage of people willing to give nursing care to patients?

I cannot believe that the lawmakers who set down these "rules" have any sense themselves. I could understand a need for a written test, perhaps a skills test to reactivate a license. I do not understand all my years as a nurse becoming "null and void."
-- J. Durling, Clearwater

Devious plans contradict "family values'

As a resident of Florida I am embarrassed that our governor's most engaged response to the tragedy of Rilya Wilson has been that he acquired "juicy details" as to the two caregivers of the missing girl. This kind of comment is not to be taken lightly.

Gov. Jeb Bush continues to shed light on what kind of person he really is. His "devious" comments expose the core of his leadership and the vision he has for our state.

I say to Gov. Bush: How you do anything is how you do everything. The voters of Florida will determine how much they trust you in November. We deserve a leader who respects all citizens, not one who campaigns on artificial concerns and then reveals "devious plans" behind closed doors.

After school-boy escapades like these, can we even use the words Gov. Bush and "family values" in the same sentence?
-- Jose Luis Perez, St. Petersburg

Governor's gossip is shameful

Re: Trivializing a tragedy, Oct. 6.

Gov. Bush's remarks hinting at the alleged sexual orientation of Rilya Wilson's caregivers were immature, homophobic and unnecessary. The governor should apologize for such stupid remarks, but instead he insists that he did not know that a reporter was present and he thought it was a private meeting. That is an insult to the people of Florida. Is this man the governor of a major state or a gossiping teenager? Shame on him!
-- John Jagodowski, Redington Shores

Creative philanthropists

Your article on Drs. Kiran and Pallavi Patel's generous gift to the Tampa Bay Performing Arts Center really missed the mark (Cardiologist buys arts school name, Oct. 1). We are fortunate to have such generous philanthropists in our community. Their interests show no bounds.

Their major donations include the Indian Cultural Center, the University of South Florida Charter School, 70 college scholarships and other charities too numerous to mention. In India, they have built and supported five hospitals and four schools. Our community is very fortunate that the Patels decided to settle in Tampa. Their creative philanthropy is an example to all of us.
-- Martin L. Silbiger, Tampa

The complicated salmon struggle

-- I was not too surprised to discover that the St. Petersburg Times is holding forth on the art and science of salmon recovery in the Pacific Northwest. Federal tax dollars built the Federal Columbia River Power System, and any citizen in the nation has a legitimate interest in its environmental impact. The challenge of salmon recovery, however, is far more complex than the solution -- dam removal -- offered in your Sept. 28 editorial (Helping salmon survive).
Any strategy to prevent salmon extinction must account not only for the impact of the hydropower system but also the impact of hatcheries, harvest and habitat. It is far from clear that "the only solution" to avert salmon extinction is to breach the dams.
The Army Corps of Engineers has completed a comprehensive analysis of all the factors associated with dam removal. The analysis was developed in partnership with other federal, state and tribal representatives and public interest groups, and was independently peer-reviewed. The corps determined that breaching the four Lower Snake River dams would cost $267-million annually in forfeited economic benefits. In lieu of dam removal, we elected to pursue an aggressive series of operational and structural migration enhancements at an annual cost of $13-million.
For adult fish returning from the ocean to natal spawning grounds, fish ladders at the dams have always been very effective. Information on adult passage for 2001 indicates survival past each dam was about 99 percent for adults. Research shows that survival of Snake River spring Chinook juveniles migrating in-river through the hydrosystem is as high or higher in recent years than prior to construction of the Snake River dams. Survival of barged fish is about 98 percent to the point of release below Bonneville Dam.
Incidentally, the annual cost to run the juvenile fish barging program is about $3-million. The $506-million you cited for salmon recovery represents the entire regional federal budget for dam improvements, habitat restoration, and hatchery and harvest management activities. Part of the funds comes from hydropower revenue generated by the Bonneville Power Administration.
While the dams are a factor in the decline of the salmon runs, problems were apparent even before the dams. Modern development brought overfishing and a proliferation of hatcheries, followed by industry, roads, logging, mining, cattle ranching, farming, the dams and other stresses to the natural systems, all of which have played a part in salmon declines. Ocean conditions are a factor as well. Record returns of adult Chinook salmon over the past two years are attributed not only to regional efforts for restoration, but to greatly improved ocean productivity.
The people of the Northwest understand these issues, and there is a broad base of support throughout the region to seek salmon recovery while maintaining the multiple benefits of the Federal Columbia River Power System. The real relevance of this issue for the people of Florida, however, is not so much salmon as it is the choice between re-engineering and de-engineering. Can we re-engineer our waterways' infrastructure to retain their economic benefits while addressing the needs of the environment, or must we de-engineer our waterways, removing dams, levees and other man-made structures to return our rivers to a state of nature?
Floridians, who apply a significant amount of engineering to harness their own waterways in a fragile ecosystem, face the same choices as the people of the Northwest. All of us must seek the best understanding of the available facts as we make these difficult choices.
Brig. Gen. David Fastabend, commander and division engineer, Northwestern Division, U.S. Army Corps of Engineers, Portland, Ore.

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