Medicine Should Focus On Wellness, Not Wealth

Editor, Times-Dispatch:

Your "Folly Central" editorial reflects the important issue of controlled medical services, an example being the Central Virginia Health Planning Agency's denial of the HCA application for a hospital in the West Creek medical complex.

To lower costs, competition must be allowed to expand, but this competition must come from expanded technology, not hospital beds, which are expensive and part of the "sick care system."

Fifteen hundred cardiac arrests, or heart attacks (such as Tim Russert's untimely sudden death) occur each day in the United States. The Virginia Heart Institute argues that the majority of these events could be avoided with prior identification of disease with cardiac imaging such as nuclear medicine and coronary CT angiography. Competition using technology can lower costs. Let's be concerned primarily with patients, not profits.

Charles L. Baird Jr. Richmond.

Needle Exchanges Can Reduce HIV Rates

Editor, Times-Dispatch:

In the news article, "Va. Loses HIV-Program Money," Ken Batten of the Virginia Department of Mental Health, Mental Retardation and Substance Abuse Services, stated, "One of the main routes of HIV status is use of needles . . . it was important to us that we be able to minimize the amount of needle exchange."

As a second-year medical student at VCU interested in public health, I suggest that there is an excellent way that Virginia could reduce the sharing of potentially infected needles: support syringe exchange programs (SEPs). By supplying injection drug users with sterile syringes, counseling service, and drug treatment programs referrals, SEPs reduce the rate of HIV transmission and increase enrollment in treatment programs.

Studies have shown that SEPs do not promote substance abuse. Unfortunately, in 1988, the U.S. Department of Health and Human Services (HHS) prohibited the use of federal funds to support syringe exchange programs until further research could be conducted to establish their efficacy. In 1998, HHS Secretary Donna Shalala issued a statement supporting SEPs to reduce HIV transmission. In 2000, Surgeon General David Satcher also endorsed needle exchange programs. Despite endorsements from HHS, the surgeon general, and the World Health Organization, the ban on federal funding for such programs remains in place.

Currently under Virginia law, needle exchange programs are illegal and volunteers can be charged with drug-related crimes for attempting to reduce the spread of HIV. The Virginia legislature and the Virginia Department of Health need to find a way to decriminalize these programs. Now is the time to lift the federal funding ban. HIV prevention is too important to be hindered by decades-old misconceptions. They have worked in other parts of the country and they will work in Virginia.

Jeremy Kidd. Richmond.

Restore Tax Pyramid To a Better Balance

Editor, Times-Dispatch:

The great pyramid has been turned upside-down and many of us do not seem to notice or care. Not the great pyramid of Egypt, but the tax pyramid. When taxes were first levied in this country, the base of the pyramid was resting at the local level with the smallest point at the federal level. As tax money flowed upward, the amount became less because the Founding Fathers did not want a strong federal government collecting enormous tax revenues. While the public failed to realize what was occurring, our elected officials slowly turned the pyramid around. The small tax point is now at the local level and the larger tax base is at the federal level.

We can see the result of this revenue shift. Thanks to a lack of tax revenue, the state is locked in a budget battle over transportation, something that is critical to Virginia citizens and the future of the commonwealth. It is ironic that the localities and the state that have an immediate impact on our lives have less money while the federal government is collecting a tremendous amount of tax dollars. We send thousands to Washington with calm resignation but complain loudly about local tax revenue and spending. It should be just the opposite.

If this reversal does not concern one, the next time a police officer is needed, or there is a medical emergency, try calling the federal police department or the federal rescue squad and see what response one receives. Thomas Paine wrote, "A long history of not thinking a thing wrong gives it a superficial appearance of being right." It is time to return the pyramid to its proper upright position so the state and localities can provide the important service the citizens need, require, and deserve.

Frank Williams. Richmond.

Special-Ed Vouchers Cheat the Students

Editor, Times-Dispatch:

Leslie Carbone's Commentary piece, "Grants Help Special-Needs Students; Free Public School Dollars," does not accurately portray the rest of the story.

While some disabled students' needs may be met with a $5,000 grant for a private school, the fact is that such a grant would not go far in providing for the needs of students with serious physical, intellectual, or emotional disabilities, or autism. The cost of private special education schools rivals that of Ivy League universities and then some.

Specific mandates for special education are prescribed by the federal 2004 Individuals with Disabilities in Education Act (IDEA), which Virginia accepted when it chose to receive federal special-education funding.

Disabled students' requirements may include, but are not limited to: specially trained teachers, individual assistants, speech therapy, occupational therapy, psychological services, adaptive equipment, special transportation, extended-school-year services, and life-skills instruction and vocational training for transition to employment and independent living.

A special education for students with complex disabilities that is comparable to that required by the 2004 IDEA cannot be privately purchased for $5,000. Perhaps some parents will sell out their special needs children for a quick $5,000, but the rest of us will continue to recognize our children's entitlement to every component of IDEA and the Regulations Governing Special Education Programs for Children in Virginia.

Special education is a civic responsibility. These children should not be twice wounded, once by disability and again by sub-optimization of the educational services to which they are entitled.

Elsie McKenney Gladding. Afton.

Blame the Owners, Not the Reporters

Editor, Times-Dispatch:

You regularly cite surveys revealing the liberal bias of reporters. But it is the owners, publishers, and editors who hire and train reporters, enforce professional standards, and make editorial policy. So any bias in the media must reflect the biases (or ineptitude) of publishers and editors.

In the Pew Research Center's May, 2004, survey of national media chiefs, 19 percent identified themselves as conservatives, 16 percent as liberals, and 50 percent as moderates. Yet 92 percent of them, obviously including some conservatives, affirmed that morality does not depend on belief in God and that homosexuality should be accepted by society.

That year, according to Editor and Publisher, newspaper publishers and editors (not reporters) tilted toward John Kerry over George Bush 213 to 205. More than 60 papers that endorsed Bush in 2000 switched to Kerry or abstained, while only a few went the other way.

Your analysis implies that somehow reporters are infecting their bosses with ideology. Perhaps future editorials will explain how.

Howard Grimwood. Richmond.

Intelligent Design Isn't Science

Editor, Times-Dispatch:

In response to Todd Wilson's letter, "Scientists Support Intelligent Design": I, too, welcome healthy, scientific debate on evolution. Unfortunately, intelligent design has yet to offer up a theory that is scientific in nature -- i.e., one that offers any predictions that can be looked for. Instead, its proponents launch repeated and largely discredited arguments against evolution. Evolutionary biologists engage in a vigorous debate about evolution, true, but the debate is not over whether evolution happens, but on how it happens.

Intelligent design has been demonstrated as a way of saying God did it under the disguise of scientific theory. Evolutionary theory neither denies nor promotes the idea of a god or gods. It simply offers a naturalistic explanation for what we observe today. If Wilson is truly worried about teaching science in schools, then does he suggest we teach astrology during astronomy classes, flat-Earth theory during geography lessons, or the place of chi in physiology?

Until intelligent design theories offer up a valid, testable theory backed with some evidence, they have no place in schools.

Deborah Rose. Colonial Heights.

Warner Was Bipartisan Out of Necessity Only

Editor, Times-Dispatch:

I cannot rationalize former State Sen. John Chichester's endorsement of former Gov. Mark Warner for the U.S. Senate because of Warner's bipartisanship. When Warner was governor, both chambers of the legislature were controlled by the Republicans. He had no choice but to work with Republicans to push throughout the most massive tax increase in the history of the state of Virginia.

If Warner is elected to the United States Senate, he will be in the majority party and his bipartisianship will be out the window. He can then happily go along with all the tax increases that Sen. Harry Reid and House Speaker Nancy Pelosi think are the solutions to every problem.

Flo Traywick. Lynchburg.