Letters

What Scares Doctors? Being the Patient Hospitalization too often means insufficient time with the doctor, errors in treatment and a big bill that adds insult to injury. Weighing in with tales of botched operations and battles for reimbursement, patients and caregivers alike offered their prescriptions for healing an ailing system too focused on the bottom line

Your story on the harrowing experiences that doctors have had as hospital patients [May 1] only scratched the surface of what is wrong with our health-care system, which is in a rapid downhill spiral. The interests of consumers and caregivers are losing out, and the winners are the publicly traded insurance companies, which make hundreds of millions in profit as they cut patient services. Why are those companies allowed to make such huge sums of money while some hospitals cannot afford to upgrade their technology or are forced to close altogether? It is time for the entire industry to undergo fundamental reform. MICHAEL PECK, M.D. Rockville, Md.

I have observed that interns lack oversight, senior clinicians lack accountability and nurses need to be reminded to double-check medication dosages. We all make mistakes because we are human. But too many physicians avoid oversight and accountability to one another to hide their fallibility. The way to make health care as error free as possible is to ensure that no decision is made in isolation. Patient safety will not improve until doctors lead the way by openly examining what they do and how they do it--and by embracing change. RICHARD BJERKE, M.D. Pittsburgh, Pa.

I received superb care at the Mayo clinic in Rochester, Minn., for a malignant brain tumor, which is now in remission. Still, I was frightened by your cover story. Have I been blessed with dumb luck, or am I being treated by one of the best hospitals? Your article probably made countless people question the wisdom of trusting the medical world, and may have also discouraged some from seeking the care they urgently need. JACK MOSER Osceola, Wis.

The problems you described can be fixed with sufficient professional and support staff. But even as hospital profits are at all-time highs, staff numbers are being cut. Why don't hospital administrators hire enough staff to provide patients with better, safer care? Money is the answer. Maintaining or increasing current nonphysician staff levels cuts into the bottom line, reducing profits for both the hospitals and doctors. When doctors whine about substandard patient care, they're refusing to recognize that hospitals are understaffed. GEORGE M. DAVIS Fuquay-Varina, N.C.

You devoted nine pages to little more than half a dozen anecdotes decrying the sorry state of American medicine. Such fear mongering does a disservice to medical professionals who struggle to make every day one for which we should be grateful. But humans are not meant to live 90-plus years, nor are we meant to violate our bodies with stainless steel, latex and pharmaceuticals in the hope of fulfilling aspirations to immortality. Some price must be paid for defying fate, nature and God. The sooner we accept that bad things will happen despite the excellent care we receive, the sooner we will appreciate that we live longer, more comfortably and, dare I say, more happily than any previous generation. TOM PALUCH, M.D. San Diego

What really ought to scare doctors, administrators, insurance executives and the general public is that there are so few nurses to protect them. Everyone points to money as the problem, but most nurses will tell you that it was a general decline in their perceived value as caregivers that began the descent into the system we have today. If you want to have a physician who can take good care of you, you need nurses who will share that duty and keep that doctor informed. JODY NICHOLS, R.N. San Marino, Calif.

While your overview of the foibles of the U.S. health-care system presented plenty of food for thought, you missed one of the main reasons for its decline. American health care is no longer about the well-being of patients. It's about making money, which means that doctors have to reduce the time they spend with each patient. Until we fix our dysfunctional health-care system, which values dollars more than lives, Americans will continue to be mistreated. TRISHA TORREY Syracuse, N.Y.

Bolten's Uphill Battle

TIME reported on new White House chief of staff Josh Bolten's "recovery plan" [May 1]. The trouble is that Bolten's campaign is designed to elevate the President's poll numbers rather than solve the ugly problems the Administration has created for the country. It is hard to imagine any American finding valid reasons to defend George W. Bush's performance. There are new revelations almost every day about questionable conduct among the President's staff and appointees. Let's hope they never again have the guts to lecture us on patriotism, integrity or family values. At a time when the world needs leaders, that crowd has disgraced public service. MARGARET RAY Pearisburg, Va.

Luckily for Bush, he can revamp his Cabinet whenever he pleases. But the American electorate--barring an impeachment--unfortunately has to wait four years to be able to replace the occupant of the Oval Office. STANLEY RICHARD OLIVAR Vista, Calif.

Best or Worst at What?

The story rating the best and worst U.S. Senators [April 24] was little more than a display of the prejudices of your editorial staff. No set, objective criteria were used to compare members of the Senate; the information reported was purely subjective. No attempt was made to analyze the work of the Senate statistically or rank all 100 Senators in any systematic way. The article amounted to a popularity contest with a very short list of judges. Your report was a disservice to your readers and called into question the veracity of your publication. ANGELA DE ROCHA DIRECTOR OF COMMUNICATIONS OFFICE OF U.S. SENATOR WAYNE ALLARD Washington

Iraq's Missing Girls

Brian Bennett's "Stolen Away" [May 1] painted a vivid picture of the abduction and sexual abuse of girls in Iraq. Someone has rightly said that war has no winners, only losers. And perhaps the biggest losers in Iraq for the moment are its girls. Sexual exploitation causes not just physical trauma; there is mental anguish as well. When disowned by their families, such girls are in danger of committing suicide or living the life of a prostitute. The Iraqi government should make it a priority to curb the evil of sex trafficking and rehabilitate its victims. SUNIL KUMAR KUMAWAT Sanganer, India

I commend Bennett for shedding light on a little-known, crucial issue. It pains me that young girls are forced to find safe haven in jails and orphanages to escape sex trafficking, and I'm horrified that this just recently became a problem, following the fall of Saddam Hussein's regime. The lack of law and order in Iraq is enabling the exploitation of those girls. MORGAN WILEY Fairway, Kans.

I was appalled to learn that Iraqi girls who are kidnapped are not always taken back by their families and are sometimes even killed. How can a society that does not value equality, freedom and justice embrace our version of democracy? Iraqis play by a completely different set of rules. Why do I, a stay-at-home mom with one year of college, realize that, when the top people in Washington do not? CASSANDRA HAGEDORN Grand Rapids, Mich.

The starkest element in this heartbreaking story about Iraqi girls being kidnapped and sold into sexual slavery was the observation by a Western official in Baghdad who monitors the status of women in Iraq that sex trafficking was virtually nonexistent under Saddam. So was the violent persecution of Iraqi Christians, and so were terrorist attacks. Was regime change really necessary? ROBERT P. WAXMAN Cairo, N.Y.

The story about Iraqi girls broke my heart. If Islam is truly a religion of justice and humanity, then change must come from the so-called street. There should be outrage in the community that matches the reaction to the Muhammad cartoons--and that outrage should be directed at the perpetrators. DON KANG Speicher, Germany

Escaping from North Korea

TIME's story about the trials of North Koreans fleeing their country made for riveting reading [May 1]. Instead of hounding desperate refugees, the Chinese government should focus on prodding Pyongyang to open up and reform. Ultimately, only improved economic conditions under a more open system in North Korea can effectively stop the flow of refugees. If China really wants to stem illegal border crossings and help the North Korean people, a great step in the right direction would be spurring its basket-case neighbor to embrace globalization rather than just providing aid to prop up the regime. If that happened, the underground railroad created by American Christians would come to a halt, a result they and other activists would warmly welcome. CHEN LIANG Singapore

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