Opinion editor's note: Strib Voices publishes letters from readers online and in print each day. To contribute, click here.

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I really appreciated Jill Burcum's column on the jaw-dropping overpayments to so-called Medicare Advantage plans ("Will Musk have the guts to take on insurers?" Strib Voices, Dec. 15). Donald Trump's unofficial budget cutters, Elon Musk and Vivek Ramaswamy, should immediately focus on eliminating those mammoth overpayments. Burcum reported that the Medicare Payment Advisory Commission (MedPAC) estimated that Medicare Advantage insurers are overpaid by 22%, far more than they need to cover their 15% overhead and make a buck without delaying and denying health care, which they do with gusto.

Sad to say, MedPAC's estimate, as shocking as it is, is way too low. MedPAC took into account only two factors that create overpayments — favorable selection and upcoding. MedPAC estimated favorable selection (enrolling healthier-than-average beneficiaries) raised payments by 9%, and upcoding (adding false or inappropriate diagnoses to patient medical records to make them look sicker) added another 13% (for a total of 22%). Four other factors — favorable deselection (sicker people leaving Medicare Advantage and returning to the original Medicare program), bonuses for scores on a worthless "quality measure," pointless bonuses for selling insurance in rural counties, and an "induced utilization" subsidy that is too complicated to explain here — raise the overpayments to about 40%. Forty percent overpayment translates into about $150 billion in excess payments in 2024. To put that sum in context, consider that the Congressional Budget Office estimates that adding dental, hearing and vision coverage to traditional Medicare would cost roughly $80 billion annually.

Kip Sullivan, Minneapolis

The writer is a member of the Health Care for All Minnesota policy committee.


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My passport will expire next autumn, and I wanted to renew it in plenty of time, knowing there have been delays in the past. I qualified for online renewal, so I submitted my paperwork and photo on Dec. 9, along with payment by credit card. The website said the standard processing time was four to six weeks. I had plenty of time, so I didn't pay extra for expedited service. Nonetheless, by Dec. 12, my new passport was in the mail to me. I don't think the process could have been more efficient.

Let's hope Musk and Ramaswamy stay away from the passport office, which is no doubt staffed by "unelected bureaucrats." Unelected bureaucrats like these are the people who, day in and day out, do the government work of serving the people. These bureaucrats work to keep our air and water clean. They maintain weather forecasting and global positioning systems. They protect consumers against predatory business practices. They actually get things done. Contrast them to our elected Congress, which is too dysfunctional to agree on much of anything.

Don't get me wrong — I'm all for elected officials setting broad agendas and goals. But to actually get things done, you need experts to carry out the details. Member of Congress and the judiciary are not those experts.

Jim Almendinger, Stillwater


MADISON SHOOTING

Columbine should've been the last

Once again, we find ourselves grappling with the heartbreak of another school shooting ("Teen kills 2 at Wisconsin school," front page, Dec. 17). Another school shooting 12 years after the Sandy Hook Elementary School tragedy, where students and staff were just days away from holiday break. Another school that will bear the tragic loss and pain of a senseless act of violence at the hands of one of its students.

I was one of the first on the scene at Columbine High School, providing rescue and triage to students and staff in the immediate aftermath of the shooting. I was appointed to co-lead the Columbine Crisis Response Team as our school community worked to pick up the pieces of that unimaginable day. I have seen firsthand the devastation school shootings leave in their wake, on survivors, families and entire communities.

Yet here we are again, and the headlines remain the same. Schools should be places of learning and safety, yet they continue to be shattered by violence. This week's tragedy, like all the others, shakes our collective sense of safety and peace.

As I process the devastating news of yet another school shooting, I am overcome by a wave of anger, sadness and an all-too-familiar grief. I am furious. Furious that students, educators and families are repeatedly forced to endure this pain. Furious that despite the countless lives lost, progress on meaningful action remains slow and uneven. And I am heartbroken because every damn shooting reopens old wounds and reminds me of what we still haven't solved.

Amid the anger and sadness, I want to remind us all of our power. Every one of us has a role in fostering a culture of connection and vigilance, in pushing for change, and in protecting the children and educators in our care. This is not a problem we can turn away from, and it's not one we should ever accept as normal.

It's time to demand better for our kids, for our schools and for every person who believes in the right to learn and live without fear.

Rick Kaufman, Bloomington

The writer is executive director of community relations and emergency management for Bloomington Public Schools.


PERSON OF THE YEAR

The choice was clear

It would appear that Time magazine, in an attempt to give Republicans and conservatives alike the middle finger, or at least an "in your face" moment, has selected Trump as their Person of the Year for 2024 ("Trump gives 'Person of the Year' interview to Time magazine," Dec. 13). Actually, they had no choice ... to do otherwise would have cemented their spot in the graveyard of failed publishers. Trump overcame overwhelming odds, a feat no other person on earth could have achieved. Think of it: He was impeached twice by a biased Speaker of the House. He was raided by a weaponized FBI. He was indicted by overzealous prosecutors, not once or twice but four times, on dozens of charges of what? Made-up crimes that Perry Mason would have seen through.

He was scourged by the media (including Time), had his fortune and his businesses tied up in knots by corrupt political foes posing as our justice system. He was awaiting sentencing on trumped-up charges and as if any of that wasn't enough bad press he was shot at, hit in the ear and, upon surviving that assassination attempt, would have been killed on the fifth green of his Palm Beach golf course had it not been for the watchful eye of a Secret Service member. His closest rival for the Time award was his opponent, who blew through $1.5 billion during her campaign. Choosing her would have definitely put the magazine out of business. So it was a business decision by Time, but the right one by any stretch of the imagination. Maybe there is hope for them after all. At least they have proved to be a capitalist operation, which is nice.

Robert Huge, Minnetonka


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The venerable Person of the Year, named by Time magazine, is Trump for 2024. Many leaders have been given the prestigious award, including recent presidents George W. Bush, Bill Clinton and Barack Obama. Also in the past, Adolf Hitler, Nikita Khrushchev, Ayatollah Khomeini and Josef Stalin (twice). It seems the award is not necessarily given to the most newsworthy, honest, humane or influential person. Trump is not even president yet, and won by a slim majority in the popular vote. His future chaotic administration will certainly follow his first. What has he contributed to society in 2024? How about someone who has entertained millions of people, influenced untold numbers of young people and donated millions of dollars to charity throughout her recently concluded Eras Tour: Taylor Swift? I guess she didn't have enough baggage to compete with the president-elect.

Robert Wetherille, Eden Prairie