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Most doctors can't afford lower Medicare payments

I am responding to the recent article in Viewpoints, "Should we reduce Medicare payments to doctors?" by Wayne Madsen. There is one principle error he makes, in my opinion, the common one of confusing gross income, with net income. He says reducing Medicare payments to doctors by 27 percent will produce only a "slight" decrease in earnings to family physicians, and these physicians are already overpaid at an average of $204,000 per annum.

First of all, as a family physician in Western New York, I have never made more than half that amount; so I question his figures. You can't make that kind of money in family medicine today, and stay out of trouble, because the government and the HMOs have placed too many road blocks to our productivity. The lengthy documents I have to produce today to "justify" my fee and protect me in potential litigation have cut my productivity to about half of what it was in the '70s. This is one of the facts little known today to health care "experts," such as President Obama and Hillary Clinton, who champion the electronic medical record.

Secondly, and principally, to make $100,000 my practice had to gross about $1 million. The rest went to all of the staff, machines, mortgages, property taxes and other fees I needed to pay to stay in business. If you cut my gross income by 27 percent that doesn't mean I have to take "a little reduction in income." That means I will have no income at all, after I pay these fixed expenses, and I will have to shut my doors.

Timothy Siepel, M.D.

West Valley

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Let's all make an effort to be courteous drivers

Recently I had the pleasure of driving in Europe. And I do mean pleasure! People were respectful of every other driver on the road. There was never anyone crawling up my rear bumper or flashing his lights to intimidate me. Imagine being behind a slow-moving vehicle and that driver automatically moving over so that you can pass. They don't care if you get ahead of them since they know it's not a race. It's just transportation.

I was stuck in the middle of a very busy Krakow intersection and made it out without a scratch because of the helpfulness of others. This attitude has stayed with me upon my return and now I practice this humane treatment of other drivers here in Western New York. Looking for ways to be a courteous driver has made driving a much more calm and enjoyable experience. Try it out!

Diane Terranova

Lancaster

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NFTA must help city by improving service

It is proposed that the Buffalo region receive $1 billion in incentives to leverage an additional $5 billion in investment to help rebuild the area's economic structure and provide opportunity. This is a grand idea with one large stumbling block -- public transportation.

Who is going to invest in an area where people cannot get back and forth to work? What does it say about an area when board appointees decide that the area needs little or no service? If the medical maxim is "first, do no harm," then by what maxim does the Niagara Frontier Transportation Authority operate? Council Member Darius Pridgen's thought that there should be ridership representation on the board does not go far enough. The bus and rail should be split off and independent of the airport and other properties, with a separate board made up of predominantly public transport riders.

What is really happening here is resegregation of the city from the suburbs, and the limiting of any kind of transport opportunity for all area citizens. This is a denial of access to service of the meanest kind. Based on the area's economic disability, this is also a denial of reasonable accommodation to facilitate economic, educational and mobility health.

You have to wonder what repercussions will follow the curtailment of service to and from the outer communities? Will this curtailment cause people to lose their life, lose a job, remain in poor health, break up a family or squash an education?

Based upon the past and proud history of the NFTA and its intimate involvement with the decline of the region, and lack of real concern with the riders who faithfully depend on it, for once, "do no harm."

Thomas P. Druelinger

East Aurora

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Use some state funds to expand bridge plaza

Gov. Andrew Cuomo has pledged $1 billion in incentives for job creation in Buffalo. Why wasn't some of this money utilized to build an expanded Peace Bridge Plaza? Surely this is a worthy project and it would have created construction and various other jobs that would strengthen Buffalo's economy. But officials say there are no funds available. What a joke.

In addition to the economy, these funds could have helped a very troubled and crime-infested Peace Bridge neighborhood. Property values have gone down and it is increasingly difficult to sell your house and receive a fair price for it. In my opinion, a great disservice was done to the residents in this area by legislators (particularly local Buffalo government) and neighborhood obstructionists who didn't want the plaza. They all had their own agendas.

It doesn't matter what funds are given to Buffalo. Progress is never going to be achieved in this city. Just check Buffalo's track record for projects. Governor, if you want success, try another city.

Barbara L. Battista

Buffalo

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How will Cuomo pay for all these promises?

Gov. Andrew Cuomo is as hopelessly liberal as his old man. In fact, I think he may be more liberal. His State of the State address was right out of the Democratic playbook. Most of his speech was geared to appease his base in New York City. The money he plans to spend on New York City is staggering. Then, he throws a bone to his upstate base. A billion dollars for Buffalo?

How will he pay for all of these promises? There is only one way he can do all of this. Taxes will have to be raised (or some sleight of hand with the budget or increased fees), no matter what he said in this speech. The governor previously called the flat tax proposal "unfair" and now proposes a "fair tax." By his reasoning, everyone paying exactly the same tax rate is not fair. When Democrats talk about fairness, it always means wealth redistribution.

I saw nothing in his speech about decreased spending; only increased spending. This guy wants to be president, and he'll try to do it on the backs of the taxpayers of New York State. A Democratic governor, backed by a Democratic Buffalo mayor, and a Democratic Erie County executive and Legislature is a recipe for economic disaster for the taxpaying citizens of this region. Hold on to your wallets.

Donald F. Kochersberger

Orchard Park