The following letter was published in The Corydon Democrat on Wednesday, Oct. 3, 2012

Good-paying jobs 'won through worker solidarity' not stealing

Rhonda Rhoads has been flooding our mailboxes with expensive full-color ads claiming she is a leader on any number of things, job creation for one. It is true she voted enthusiastically with the Republican majority to make Indiana a right-to-work — for less — state, arguing that it would bring jobs to the state.

But is it job creation to lure jobs from another state simply because workers can be paid less here? That's not job creation. It's job stealing, and, worse yet, it encourages the race to the bottom that has plagued workers wages for years. What's the value of a job that doesn't pay a living wage even if it can be lured here by a company demanding exorbitant tax favors on top of cheap wages? And what about the stress such jobs put on local services paid for with the taxes of local residents and businesses?

Rhoads apparently does not realize that the good-paying jobs of the past were won through worker solidarity, not by playing one worker against another. She claims in her mailings that right to work is working. Sure, it is, for corporate interests, which is clearly evident in how corporations and their CEOs have made out like the bandits while worker wages have been flat for over two decades.

Adding insult to injury, Rhoads claims to be a leader on such issues. It takes a lot of spin to make such a claim. She's a freshman at the state capitol, sent there after an earlier expensive advertising campaign. It'd be interesting to know what percentage of her votes differed from the positions of the state Republican leadership. Equally interesting to know would be the percentage of her campaign expenses paid by the same state Republican Party so loaded, especially this election cycle, with corporate funding.

Charles Allen
Corydon, Ind.


The following letter was published in The Courier-Journal on Sunday, Sept. 30, 2012

Doctor: 'Dismaying' number of uninsured Kentuckians

Since moving to Louisville from Boston earlier this year, I have been dismayed and embarrassed by the number of Kentuckians without health insurance.

Since 2006 when Mitt Romney signed into law a virtual twin of the Affordable Care Act, approximately 95 percent of the Massachusetts population has been insured. In my Boston practice, then, I was unaccustomed to caring for people without insurance, and my support for national coverage expansion was firm but hypothetical.

In my academic clinic at the University of Louisville, however, I am confronted daily with people in need who are unable to afford even basic services.

I recently evaluated a lovely man with a thyroid mass who is uninsured, cannot afford a biopsy, and hence awakens each morning to the disquieting thought that he may have a cancer that is growing unchecked.

That same week I saw a delightful gentleman whose wife had noticed recent mental status and personality changes. While a brain MRI would have helped direct our evaluation, this patient was uninsured and could not afford to pay for the study, so my resident and I were left to blindly treat a serious condition and to offer this man less than optimal care.

I am also certain that lack of insurance is potentially lethal. My cousin died this year from a ruptured cerebral aneurysm. She had known about her vascular malformation and had had routine follow-up with physicians, but she lost both her job and her insurance, found herself unable to pay for her blood pressure medications, and dropped dead at an auction. I have no doubt that had she been able to control her pressure, she’d still be alive.

Kentucky’s uninsured defy stereotypes, as they live largely in working households and are ethnically and racially mixed but overwhelmingly white. Kentucky’s uninsured have little meaningful access to health care, and when they seek it, they are subject to crushing medical bills and prolonged payment plans. Kentucky’s uninsured have no reasonable expectation of obtaining Medicaid, as enrollees in this program must meet rigorous financial and technical criteria. Finally, Kentucky’s uninsured are essentially unrepresented in Washington. Rand Paul supports repeal of the Affordable Care Act — a free-market approach to universal coverage — and when Mitch McConnell was asked on Fox News how he would cover the uninsured, he replied, “That is not the issue.” It most certainly is.

As a recent transplant from Massachusetts, I know that broad-based health coverage is a laudable and achievable goal, and as a physician now staffing a clinic in which 60 percent of patients are uninsured, I know that our wealthy country can do far better by its most vulnerable citizens.

Kentucky’s elected officials ought to answer to this national shame.

Rather than chanting “Repeal and Replace” into any open microphone and demonizing colleagues who have risked their political careers to offer safety and protection to the poor, they ought to visit our indigent clinics, speak to their well-meaning constituents who have no substantial access to care, and put forth a plan for universal health coverage.

Anything less is boneless and craven representation.

Anything less is leadership of an unacceptable type.

Michael Stillman, M.D.
Louisville, Ky.