I cannot disagree more with Dr. Richard Chudacoff's comments and approach to health care reform. Printing inflammatory comments like those of Dr. Chudacoff do not truly represent the feelings of many doctors in our community. The time is now to approach health care reform in a thoughtful and meaningful manner.

Indeed, ACOG, the American Medical Association and the American College of Surgeons, all of which I am a proud member, support the ideals of health care reform that offers universal access to health care, especially health care for women, who tend to bear the brunt much of the problems of the uninsured.

Women often do not have adequate coverage for basic prenatal services and well-woman screening services. Health care reform proposals are looking to include access for these life-saving, cost-effective and essential services. I am shocked that Dr. Chudacoff does not think that improving access for women, -- his patients -- to health care is a good thing.

Instead, your article implies that doctors are angry and "fed up" with the current system. Well, I'm sorry, no one in Washington is proposing that doctors return to a "fee for service" model, as Dr. Chudacoff implies. To best serve the public, the same public that overwhelmingly supports health care reform, we need to have an intelligent dialogue about how to help everyday citizens (my patients) better afford health coverage and end up paying less out of pocket with less worries about how they can afford their medications or the tests their doctors recommend.

The current system allows health insurance companies to spread much of the cost of health care to those who need the services -- just look at how high co-pays and deductibles have become on the typical employer-sponsored health care plan.

This is where health care reform is going to help. By offering more options (not fewer options), my patients will be able to hold on to more of their own money and pay less out of pocket for the health care they so desperately need and deserve.

In trying to unite doctors in a march on Washington, Dr. Chudacoff is showing his true colors. He is not addressing the concerns of our patients, but rather for the concerns of his own pocketbook. I think his approach is counter-productive and causing physicians to spread fear in our community, rather than engage in a meaningful discourse about how to improve health care access while still allowing physicians to earn a living and provide quality care to our patients.

Whether Dr. Chudacoff believes it or not, the federal government is the largest payer for health care in our great nation. And President Obama's number one priority at this time is to improve health care while continuing to keep key players at the table (doctors, insurers, drug companies, etc.).

If Dr. Chudacoff has his way, doctors will quickly lose their seat at the table -- and then we will be at the mercy of everyone else. That would be a repeat of the scenario that happened in the '90s, when then-first lady Hillary Clinton tried to overhaul health care and failed.

I do not see failure as an option at this time. I sure hope Dr. Chudacoff does not as well.

KEITH R. BRILL, M.D.

LAS VEGAS

No rationing, eh?

To the editor:

It's fascinating how a seemingly unrelated issue can help in our understanding of another issue.

We are assured by President Obama and his enablers that government-run health care will not involve rationing. The unrelated Aug. 20 story on UMC's illegal alien dialysis debacle, however, indicates just the opposite.

UMC doctors seem to be saying that when the illegal aliens finally come in to the emergency room, their conditions are truly life-threatening emergencies eligible for reimbursement under the state/federal Medicaid system. Charles Duarte, head of the state's Medicaid division, said state reviewers often characterize the visits as "regular chronic care," so hospitals aren't reimbursed.

Tellingly, Brian Brannman, UMC's chief operating officer, states: "Our doctors think these patients will die and they (state officials) don't." It is stunning that these differences of opinion occur about 98 percent of the time!

People, please point out this and other facts when talking with star-struck Obamaites hewing to the official line.

DAVE FAIR

LAS VEGAS

Blatant distortions

To the editor:

In his Wednesday letter to the editor, Robert Spriesterbach referred to the government creating "a new right of free health care for 47 million people, almost half of whom are here illegally." It would be difficult to pack more misinformation in one short letter.

To begin, the bills under consideration expressly and clearly prohibit undocumented immigrants from receiving federal funds to purchase health insurance from either a public or private plan. President Obama has said he would like to consider whether the children of illegal immigrants should be covered, but such a measure is not included in any bills before Congress. Here is the exact language in the bill: "Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States."

The statement that "almost half" of the uninsured "are here illegally" is equally uninformed. The facts are: There are 45.7 million people, or 15.3 percent of the U.S. population, who lack health insurance, according to the U.S. Census Bureau's Current Population Survey, which is based on 2007 data. A total of 9.7 million among the uninsured said they were "not a citizen." Foreign students and workers legally in the country as well as illegal immigrants are included in this subgroup, according to Census Bureau researchers.

Of course, some might have lied about being a citizen, and some who reported that they were not a citizen were here legally. There is no exact data available, but no reputable source provides any evidence that the percentage is anywhere close to "almost half."

No reasonable person who bothers to check the actual facts will believe the kind of wild assertions in Mr. Spriesterbach's letter, unless of course they rely solely on Fox News, radical right-wing bloggers and the Review-Journal editorial board.

DONALD R. SILVERMAN

LAS VEGAS