The people who want to abuse Rachel Carson are definitely NOT the people who really care about controlling malaria. The critics are only using the tragedy of malaria as a tool to thwart environmentalism.

DDT may not have been as dangerous as Carson made it out to be, but this does not mean we should not be aware of its dangers. Spraying the walls of a house in central Africa is one thing; dusting a soldier head to toe with the stuff to eradicate lice is quite another. If we are going to use a pesticide properly, we need to be aware of its toxicities. Carson's detractors would have us, stupidly, cast all that is known about the harm DDT can cause aside.

I hate to nitpick, but when the author said he reacted to Sandoval's death with "total devastation," I lost interest in this article.

Was the author really "totally devastated"? His life is ruined forever? He can no longer function as a human being? He requires around the clock medical care now?

It sounds like I am being a supercilious jerk, I know, but I get tired of hearing people use exaggeration to make a point. "I reacted to his death with sadness and regret" would have been a nice way of putting it, without lending me this sense that the emotions are being forced down my throat. People talk this way conversationally, but in formal writing, it makes the article sound like used-car sales copy.

Please, just tell it like it is, and save the violin crescendo.

I haven't seen this movie yet, but from what I have seen so far I can understand why Ms. Zacharek would say Moore oversimplifies.

Two examples from the film: In one scene a man severs two fingertips and is told it would cost him $12,000 to get one fixed and $60,000 for the other. He could only afford to get one finger attached. The other example, mentioned in the review, is the woman whose feverish child was refused care at an ER because the hospital was out of network.

In both cases, Moore blames the mighty HMO. He is right, but this overlooks a crucial point. In the case of the man with the severed fingers, realize that a medical doctor put that man under anasthesia, fixed one finger, and left the other alone -- not because he couldn't fix it but because he didn't want to. That strikes me as profoundly unethical. I know it costs money to fix two fingers instead of one, but it is not as if the doctor and the hospital were getting paid nothing. They got $12,000. They could have done the second one for a discount, or negotiated a two-for-one price of say, $25,000. That is how HMOs save money, by negotiating pricing. Something could have been worked out if anyone had cared to.

In the second case, the ER doctor went along with the insurance company in refusing care. Every ER doc in the United States has the latitude to administer care to a patient if he feels the patient is too unstable to be safely transferred. Here the error most definitely was not with the HMO, but with the ER doctor who underestimated the severity of the child's illness.

I do not want to absolve HMOs of anything. They are greedy, immoral organizations. On the other hand, it takes two to tango, and medical professionals, given a choice between loyalty to patients and loyalty to the signer of the check, have sided all too often with the money. Doctors and hospitals could help the situation if they aggressively advocated for their patients.

Take the man with the severed fingers again. His doctor could have (and I have seen this done) call up the administrator of the hospital and tell him that either the hospital was going to let him sew up both fingers or he was going to take his very profitable outpatient surgeries to another hospital. Ultimately doctors can lay down the law like that. More doctors need to carry out this threat before administrators will get the message that doctors are not going to deliver half-baked care in the name of cost savings.

Doctors often fail to advocate for their patients against the system. If they did, it would not solve all problems, but things would be better.

I do not absolve myself of this sin. I have bowed to the pressure of money myself.