WHERE IS INCENTIVE TO CONTAIN COSTS?

I read with interest Jim Kelly's observations about his hospital stay and sticker shock the moment he received his itemized bill from the hospital.

Lucky you, of the $32,000 in charges you were only responsible for $845. You then proposed a possible solution to this madness by suggesting that all should have health insurance so that no one will ever need to go bankrupt because of an illness.

The insurance industry must have your ear: Thirty million more customers. While universal coverage is probably the best way to ensure access to health care for all, without a meaningful way to contain runaway health care cost escalations we are just setting ourselves up for another budget-busting entitlement program.

Take a look at your invoice. You were billed for more than 10 items for an illness that the doctor was unable to diagnose. Just the lab costs were over $10,000. Doctors and hospitals are allowed to bill by items and procedures and not by illness — imagine the difference in the final tab between ordering a la carte rather than prix fix for dinner.

As long as the insurance industry can continue to raise rates without much resistance from consumers, there is no incentive to rein in escalating costs.

ANNE LO-SHIMAZU | Kane'ohe

CHINATOWN HOUSING

UNDERSTANDING OF HOMELESS NEEDED

Neighborhood Board Chairman Frank Lavoie has demonstrated little knowledge and understanding of the needs of homeless people with mental illness in Chinatown.

These people suffer from a disorder of the brain that is eminently treatable with medication and/or counseling. However, it is difficult for any person, while homeless, to maintain stability sufficient to move forward for treatment, employment training, etc. These people are residents of Chinatown and deserve an opportunity for safe, affordable housing that can support their recovery and improve their overall functioning.

The River Street Residence, a "Housing First" project, will provide homeless people, some of whom have mental illnesses, a permanent home and a stable environment. All necessary services, including medical and counseling, will be provided on site or will be very accessible.

In three cities, Philadelphia, San Francisco, and Denver, when a "Housing First" residence was built for the homeless, street homelessness decreased between 40 percent and 50 percent. Cities who created these permanent homes for the homeless also found a significant decrease in arrests and hospital visits and an increase in employment, thus significantly reducing taxpayer costs.

Jean Adair-Leland, Mary Pat Waterhouse and Marya Grambs | Mental Health America of Hawai'i

EMISSION RULES

REGULATIONS NEEDED TO SAVE THE PLANET

Gov. Lingle's opposition to the EPA's emission control rules shows just how short-sighted she (and 19 other governors) can be.

Their argument is a "potential" for economic harm when regulating emissions. Here's a news flash — if we don't do something about these emissions soon, there will be no economy to do harm to. Business will die along with the planet itself.

Lingle should know this. Maybe she is just protecting her political and business friends, and neglecting the Hawaiian people.

Gary Faraci | Wall Township, N.J.

INSPECTIONS

LACK OF PERSPECTIVE BY PAPER DEPLORABLE

What a thoughtless perspective was displayed in the Honolulu Advertiser editorial "Lack of inspections downright nauseating," (March 16). The writer deplores that there are nine inspectors for 9,000 food establishments. In fact it is termed "lunacy."

I think it is downright silly to assume that all government inspectors are competent and that all operators of 9,000 restaurants are somehow inept or careless. Please note that there have been no major problems for 20 years as the inspector ranks thinned from 23 to nine. Where is the celebration and congratulations to the restaurant operators for a great job? And it is a great job — obviously.

Based on fact and current circumstances, why not take a fresh look at the situation and find a cooperative way for government to work with the Hawaii Restaurant Association to get the safety and health job done. That should produce a win-win-win result along with responsibility and accountability well assigned. The public deserves no less.

Richard O. Rowland | Honolulu

HEALTH CARE

DEBATE REMINISCENT OF OTHER LEGISLATION

The current debate over the passage of the health care bill is reminiscent of two other important pieces of historic legislation that have affected every American citizen: Social Security and Medicare. The same arguments were made against both of these programs by the Republicans, and these naysayers were ultimately proven wrong because both programs have been proven over time to work very well.

The GOP has fought this kind of bill every time it comes up. It has also fought every safety bill such as seat belts and airbags in automobiles. The Congressional GOP does not want the American people to enjoy a safety net of any kind, regardless of the fact that as members of Congress, they themselves enjoy "the best health care system in the world" — at the expense of the citizen taxpayer who wishes for it in vain.

Linda Umstead | Mililani

TRUCK PASSENGERS

RIDING IN TRUCK BED MUST BE PROHIBITED

How many more must die, become injured or maimed before a law prohibiting a human being from riding in the bed of a pickup truck will be enacted?

How many have seen a youngster or oldster sitting in the bed of a pickup truck with their back leaning up against the tail gate?

Why do state lawmakers buy the plea from pickup truck owners that "it's their only mode of transportation for their family"?

I owned a Ranchero and a Datsun pickup, and at no time ever transported a human being in the bed of these vehicles because it was prohibited by law in Massachusetts.

What is the difference between using a cell phone while driving and a human being riding in the bed of a pickup truck in Hawai'i?

Answer: Talking on a cell phone is prohibited by law.

My condolences to the family of the 13-year-old boy, but the law only prohibits children under 12 from riding in the bed of a pickup truck.

Patrick Keli'inui | Honolulu