In view of the problems we’re having with the cost and availability of health care in this country, ideas about the provision of that care are always welcome. However, the “concierge medicine” model presented on the front page of the Nov. 27 Maine Sunday Telegram has little to recommend it.

First of all, for primary care physicians to reduce their patient load from the current approximately 1,800 patients to 600 would necessitate a tripling of the number of such physicians to care for those patients, and that at a time when the ranks of primary care physicians are declining and many people don’t have one to start with.

Second, any scheme that promotes two-hour annual “wellness checks” is inappropriate, especially when, again, many people are unable to get any kind of medical check, wellness or otherwise.

Third, at a charge of $1,500 per patient per year, the cost to society for the one-third of physicians who are in primary care would swell to approximately the current cost for all physicians. Put another way, if, as the article states, the concierge physician keeps two-thirds of the $1,500 annual patient charge, and has 600 patients, he or she would make $600,000 per year. For a leisurely practice.

Fourth, the one-third of the $1,500 that goes to the concierge company is spent, according to the article, on “marketing and regulatory support.” Admittedly, health insurance companies are taking close to that percentage out of premiums now. But is that the best use of scarce health care dollars?

In summary, if universally applied, this concierge model would be impractical. If selectively applied, it would be unjust. Let’s stop wasting our time tinkering with a flawed system, and start changing the system to the single-payer, Medicare-for-all, developed-world kind of plan we’re going to end up with anyway.

Daniel C. Bryant, MD

Cape Elizabeth

Local agricultural markets are the wisest investments

World hunger has been personal to me since I served as a U.S. Peace Corps volunteer in Chile (1980-82) and saw hunger and malnutrition up close. I am proud that the United States is the world leader in support for international aid to fight world hunger.

Not only is food aid and investing in agricultural development the right and moral thing to do, it also alleviates suffering and helps others to stand on their own. It is also a matter of our national security. Misery and suffering lead to famine, despair, refugee migration, religious extremism and even terrorism.

The total amount of our U.S. federal budget dollars dedicated for all international aid is less than 7/10 of 1 percent. The World Food Program and other global nongovernmental organizations have learned that investing in local agriculture is a sustainable and long-term solution. For example, their program working with the government of Ghana has accomplished amazing results. There they invested in agriculture education for the small impoverished farmer, initiated school feeding programs that kept children, especially girls, in school, and used locally produced nutritious food to do it.

The U.N. World Food Program was able to avoid costly transport of food from across the globe and the associated storage issues, while boosting local agriculture markets for the poorest farmers. Through this amazing program Ghana was able to reduce its poverty rate from 51.7 percent in 1991 to 26.5 percent by 2008, and hunger was reduced from 34 percent of the population in 1980 to 9 percent in 2004.

Solutions to avoiding famine and world hunger are at hand. I urge readers to contact their members of Congress to tell them to pass a fair and reasonable federal budget that provides level funding for international aid programs.

Frank Wertheim

Kennebunk 

Penn State story reminds us to speak up against abuse

The importance of bringing the actions and, equally important, the inactions of Joe Paterno to light is to prevent others from acquiescing.

I’m sure most of us know that what happened at Penn State could happen anywhere at any time. What does it take within the framework of a person’s character to do the right thing?

Steve Solloway said it all best (“The hero who let us all down,” Nov. 11). His article reflected strong moral commitment to doing the only thing a just and fair and compassionate person will do: protect kids and see to it that the perpetrator is stopped and tried in a court of law.

Judith M. Kaplowe

Acton

Saco should preserve, not demolish, old fire station

Not being a resident of Saco, I didn’t think I had the right at first to comment on what I think is a far too premature idea of seeking demolition bids for the old Saco fire station. Then I stumbled across a video of the closing ceremonies on YouTube.

Depression-era and federal tax dollars went into the project. I think we all have a say in the matter. Might there even be a technicality here that would prevent the building’s demolition without official federal approval?

With that great arch stonework over the doors and the art deco style front on the building, I, for one, would hate to see it go. Replacing it with a parking lot would make even less sense!

Most would agree that there’s no dire need for more parking downtown. I see no harm in the building sitting it out for a while. In this economy, seven months is a drop in the proverbial bucket. We have textile mill buildings in Sanford that have been vacant for seven decades that nobody seems to mind, so I fail to see the urgent need for immediate action.

Unfortunately, we’re far too quick to destroy rather than preserve. I believe old buildings have souls, created by the generations of people that lived and worked in them.

We need to respect their architectural value, character and history, by preserving and restoring whenever possible.

Saco councilors, please don’t act too quickly. Once these buildings are gone, they will never be replaced. If you do indeed eventually vote for demolition, I hope the “Occupy Saco Fire Station” protesters are prepared to move the tents onto the property before demolition day. And when that happens, count me in!

Bill Thomas

Sanford