Doctor says don't reject all universal health-care proposals The Dec. 28 columns by Blue-State Greg and Red- State Dave, "If you like the post office, you'll love universal health care," are almost funny: "funny" for their inanity claiming to be humor, "almost" for the tragedy that some readers might take either diatribe seriously and reject all universal healthcare proposals out of hand. First, both writers confuse universal health care with singlepayer health care. So let's examine their arguments against that. Both compare it to the U.S. Postal Service, a "single-payer" system that competes with the private sector. My first reaction was to recall that the price of sending a letter from New Jersey to New York City via the USPS (41 cents) compares favorably to that of FedEx ($13.16). The private health insurance system takes a large bite of every dollar in premiums to pay for advertising, seven-figure executive salaries, profits for shareholders, and salaries for the legions of clerks assigned the task of deflecting claims elsewhere. Our present system is a financial drag on American businesses that provide medical benefits and a handicap on their global competitiveness. The tax increase required to support government-sponsored health care would be balanced by saving those private insurance premiums. Greg decries the high tax rates in countries with single-payer systems, citing as one example Britain's typical income tax rate of 30 percent. He is apparently unaware that most Americans pay only slightly less, 25 percent or 28 percent. What about quality? I'll just point out that the vast majority of Medicare beneficiaries are very happy with the program. So are the millions of veterans who receive their care from the VA, another federal agency. The first reimburses the private sector on a fee-for-service basis. The second owns hospitals and employs all of its workers directly. Both systems work, and some combination of them could be scaled up to serve the whole country. Greg and Dave offer no alternatives to the present non-system, which is acceptable to those with medical insurance and no prospect of ever losing it. But the rest of the population needs a new solution. Instead of devoting space to potty humor about hemorrhoids and "faceless, pro-labor government workers" with cold fingers, you could have published a more reasoned discussion of our most important domestic issue. Lawrence I. Golbe, M.D. Professor of neurology UMDNJ-Robert Wood Johnson