Re: Terry Paulson's Dec. 10 essay, "Better healthcare, part II":

This essay strongly suggests Paulson's knowledge of personal psychology — he is a Ph.D. psychologist — is considerably greater than his grasp of healthcare and our problems with its delivery and cost.

He compares individual motivation to avoid overeating when personally paying for the food to not going to the doctor when the individual, rather than his insurance, will pay the doctor's fee. The difference is that not overeating is actually good for the person, while not going to the doctor may lead to the neglect of an early sign of a life-threatening health issue. In the case of the 47 million Americans without health insurance, we know that some of them only receive medical care when their problem has become serious, with frequently disastrous results for themselves and tremendous added costs for our healthcare system.

As in his Nov. 26 essay, "Universal healthcare hurts," Paulson uses the same platitudes as the Republican Party in opposing a universal care "single-payer" solution to our healthcare delivery and cost dilemma. The same clichés with their negative connotations — such as "costly entitlements," "price control" and the like — are noted, while good concepts like "free market" and "doctor choice" are advanced with little concern for their applicability to our problem.

Certainly, our most expensive "costly entitlement" today would have to include Social Security and Medicare. Neither Paulson nor the Republican politicians apparently dares to suggest their elimination. And Medicare is a single-payer health delivery system that provides "doctor choice" and is far more efficient and less costly than the private insurance system now prevailing.

Paulson admits that even under his "universal private insurance" system, we would need a "commission to keep insurance company profit and coverage parameters reasonable." A commission means government, and that pretty much disposes of the "free market" idea and installs that bugaboo of "price control."

— William Merit True II, of Port Hueneme, spent 30 years managing healthcare delivery in both the public health field and in the private hospital sector, including, most recently, 15 years as chief executive officer of the San Gabriel Valley Medical Center before he retired.