I am writing primarily to thank you for publishing the beautiful tribute to Richard and Elsie Ricklefs in the April issue of the Journal (cover story, "Medicine man"). Although I do not personally know the Ricklefs, having met Dr. Ricklefs only briefly in passing some years ago, their reputation and the force of their work is well known in many circles locally. Certainly the sense I have had of them was well reflected and amplified on by the authors who managed in a short space to deal with a good many issues, both personal and political, without being superficial.
The juxtaposition of the article on the Ricklefs with the "HMO update" that followed it was very thought provoking. That article also contained a good deal of information, and as something of an insider, though hardly a "key player," I was impressed by the accuracy of Lisa Ladd-Wilson's account.
As the two articles were presented, Dr. Jose Sanchez' call to those of us in medicine to emulate Dr. Ricklefs "in some small degree," I read as a sort of introduction to the HMO update. As one of those to whom Dr. Sanchez is speaking I feel humbled and challenged by his words.
I am reminded that as we in health care -- and in fact all of us as citizens -- face the changes rapidly taking place in the organization of health care there are many pitfalls and dangers in the path. If we are to avoid the siren song of greed and expediency, we will need to find some measure of the courage and integrity with which the Ricklefs have led their lives.
Fred Adler, M.D.
Thank God for Ron Ross' article, "Fiscal Fitness." Without clear thinking like his, how could we possibly sleep at night?
Economists mirror Pontius Pilate in the way they wash their hands of American workers. Crafting their points of view in such an obtuse manner blankets the callous truth behind their credo: To hell with American workers in the name of a "free market."
Mr. Ross, please wake up and smell the coffee. Can you cite one product whose price has fallen due to a corporation's change of venue? I cannot, and I will tell you why --because multinational corporations are moving capital, i.e., their industrial output centers, to the Third World in order to increase profits, not to cut prices to the consumer.
You are correct in pointing out that competition forces companies to be more efficient. Let me state this in lay-person's terms: If one company moves to a developing country, they all gotta go, because as soon as one can show a greater profit for their stockholders, all the rest better follow suit.
As for the oh-so-fortunate Mexican worker, gee, I guess working for a dollar a day is better than eating out of a trash can, or the street, or the sewer. A thousand workers exist for each one employed, and American companies rely on this fact to enforce working conditions and a pay scale that American workers would find insulting. The Mexican worker's lot clearly is not a whole lot better than the existing alternative, Mr. Ross.
Yes, the economy is a system. It is also a machine with no feelings. That is why human beings better own up to the fact that they indeed create and operate the companies that fuel this machine.
I feel it is about time we all start remembering that workers are human beings as well. How 'bout it, R.R.?
I may be the only one left reading them, but I feel I must respond to your "Fiscal Fitness" columns that seem to be bloated with myth about what people want and do in relation to an economy. Your last two editions had features about jobs people do that no one else wants and an attempt to create community-owned hospital. Both of these stories went a long way in discrediting Ron Ross' interpretation of trans-national corporate control and "efficiency."
Myth: People are motivated by the profit incentive.
It is true most people are now forced to work to survive, but clearly money is not the prime motivator . People take pride in what they do and produce, particularly when they are in charge of it.
Myth: Competition makes for a healthy economy.
Most everything people have done to create societies and civilization has been based on cooperation. People enjoy team work and team sports and volunteerism. More recently, people have been trained to compete in everything, which creates fear, greed and domination by a few.
Myth: Global economics and big corporate efficiency benefit us all.
Some benefit, but the rest of us pay dearly with increasing poverty and planetary degradation. This "global miracle" is all based on oil which will be gone in a few decades. Then we will need to return to community and regional economics that can sustain us for centuries. There are plenty of fine examples of this happening now. Why can't they appear in a column on "Fiscal Fitness"?