VA Health System Is National ResourceDaniel Greenberg's...

THE BALTIMORE SUN

VA Health System Is National Resource

Daniel Greenberg's article "Another Relic of War" (Opinion * Commentary, March 24) reflects a biased and inaccurate view of the Department of Veterans Affairs' hospital system.

L Unfortunately, in some quarters, it may be viewed as gospel.

Mr. Greenberg characterizes the VA health care system as an anachronistic "second-rate system for elderly men who are down on their luck." As a writer who specializes in the politics of science and health, he should know better.

Mr. Greenberg has been recycling this sort of fact-free opinion for several years in violation of the research responsibility that goes with the power he wields as a widely published columnist.

He should visit with veterans and their doctors in VA hospitals before he writes again.

Today's VA health care system is a vital national resource that simply does not fit his biased misrepresentation.

It makes no logical sense to dismantle VA, the nation's largest health care system, when policy makers agree that most of VA's problems today stem from an on-going underfunding that has sapped VA of the strength it needs to assume its rightful position as a premier component in our health-care system. The real challenge and opportunity lies in restructuring VA so it can perform those functions at which it excels.

VA, besides being the nation's largest health care system, is also the most scrutinized, investigated and monitored.

Because VA operates under the watchful eyes of congressional committees, federal inspectors general, the Joint Commission of Accreditation of Health Care Organizations, watchdogs in the veterans service organizations and a vigilant media, any lapse in VA quality is likely to be widely publicized, leading many Americans to generalize from isolated incidents to an indictment of the entire VA system.

Often ignored is the fact that most of the VA's 171 hospitals are affiliated with over 100 of the nation's medical schools which participate in providing thousands of veterans with compassionate care every day comparable in quality to that of any private sector organization.

Mr. Greenberg has his numbers wrong, too. Specifically, his figure that one million veterans a year are admitted to VA hospitals ignores the more than 23 million outpatient visits annually.

He also states there are 25 million veterans who do not use the VA system. More accurately, between 1987 and 1992 over six million veterans received VA health care services.

Considering that only about half of the 26 million veterans, or 13 million individuals, are actually entitled to any kind of VA health care services, and that almost half of these came to VA in the last six years, one must acknowledge that VA is too big a piece of the nation's health care system to be abolished, ignored or minimized.

As for Mr. Greenberg's statement that VA services "elderly men down on their luck," yes, VA is an important safety net for medically indigent veterans. Its primary focus, however, is on those veterans with service-connected disabilities for whose care the nation has long been committed. For many VA patients there simply is no other network of facilities that can provide them with the full array of health care services they require.

Mr. Greenberg uses rhetoric to cast VA as an anachronism of a "bygone era." He only refers to World War II veterans. Are Korea and Vietnam so long ago? And what about veterans of the Cold War, Persian Gulf war and unnamed wars to come? Will there be American veterans of a war in the Balkans? One must ignore the lessons of history to expect an unbroken peace in the future.

The VA health care budget of $14.6 billion -- not $13 billion as Mr. Greenberg cited -- would not be better used to underwrite veterans' care in non-VA facilities. The fact is that VA provides more care for fewer dollars than can be bought anywhere else in the country.

Mr. Greenberg dismisses VA's value to society as "patriotic bunting." Apparently, he is unaware of the many ways VA contributes to the entire nation's health.

It is the country's single largest health manpower production resource. More than half of the nation's physicians in practice have received some part of their training in VA facilities.

VA provides outreach programs for homeless veterans and high volume programs for victims of substance abuse.

VA provides a unique setting for the large-scale clinical trials of drug therapy for such a wide diversity of diseases as tuberculosis, hypertension and AIDS, along with the transfer of newly developed medical technology to the marketplace.

Research by VA clinicians produced the cardiac pacemaker, the basic science leading to computerized axial tomography (CAT scan), the first mechanical heart transplant, the first robotic limbs, the pioneering work with nuclear medicine isotopes and the Nobel prize-winning development of radio immune assay.

The list -- the "smart" wheelchair, the laser cane, the "Seattle" prosthetic foot -- should dispel Mr. Greenberg's contention that the VA health care system is one of the "obsolete relics of war."

The VA has pioneered graduate geriatric education for physicians and excels in quality geriatric research and long-term patient care programs which could be the harbinger of how to prepare for tomorrow's graying of America.

As the nation approaches health care reform, the question should be what changes are appropriate in the VA's role -- not whether the system should be eliminated.

In fact, quite to the contrary of abolishing VA medical facilities, we should view VA's 171 hospitals, 358 ambulatory clinics and 132 nursing homes as a national resource to be assigned a component role in tomorrow's reformed universal health care system.

Donald L. Curtis, M.D.

Washington

The writer is former surgeon general of the Navy and former chief medical director of the Veterans Administration.

Rape Sentence

I am outraged by the story that appeared April 24 regarding Judge Thomas J. Bollinger's apparent support of men raping unconscious women. Judge Bollinger seems to believe that it is a woman's responsibility to thwart the "dream of a lot of males" to engage in rape.

These comments are deeply offensive not just to women but to men who, unlike the defendant in this case, do not seek sexual satisfaction by violating the trust of women young enough to be their daughters. It is possible that the facts of this case support the sentence given. Clearly, one cannot discern appropriate sentencing from a newspaper article. The problem is that the judge's comments, as reported, indicate that he finds it difficult and distasteful to uphold the law protecting women from rape by men they know. In Judge Bollinger's view, this young woman "facilitated" the rape. How is it possible that making a mistake makes you responsible for another's crime?

If Judge Bollinger walked alone late at night downtown and was mugged, should the assailant receive a lighter sentence because the judge "facilitated" the crime?

If Judge Bollinger left his car unlocked and it was stolen, can we expect leniency for the thief in his court?

And certainly, by Judge Bollinger's reasoning, any man who commits a crime when drunk is less culpable for his offenses, whatever they may be, while a woman who is drunk somehow deserves the crimes committed against her. Did this young woman exercise poor judgment? Absolutely. Fortunately, the law recognizes that poor judgment on the part of a victim does not relieve a criminal of responsibility.

The punishment for poor judgment is not rape. And as long as men like Judge Bollinger continue to believe that it is, women will continue to be exploited.

Kathleen Minke

Abingdon

I am outraged by the probation penalty the 44-year-old man received for raping an 18-year-old drunk employee. Judge Thomas Bollinger should have his robe stripped from him like that incapacitated 18-year-old had her clothes stripped from her.

I have a few questions Judge Bollinger is welcome to publicly address. What is his philosophy behind the 21-year-old legal drinking age? Also, with the legal drinking at 21, how did an 18-year-old get the alcohol to get drunk?

Since Judge Bollinger justifys his decision on the grounds that the girl became intoxicated voluntarily, then he in essence is saying she was asking for it.

This is like saying that someone who drinks himself to death by alcohol poisoning wanted to commit suicide . . .

Dale Cate

Baltimore

If a woman gets drunk and passes out on a man's bed, and the man, cleverly noticing her incapacity, forthwith breaks into her home, steals her cassette player, computer and cash, shoots her dog and trashes her apartment, would Circuit Court Judge Thomas Bollinger go just a little easy on the poor male victim of temptation?

More to the point, if a woman gets drunk and passes out on a man's bed, and the man then punches her face and blackens her eyes and knocks out her teeth and breaks her jawbone, would the Baltimore County judge award our hapless defendant, unwitting quarry of an evil seductress, probation before judgment?

Don't be surprised.

Despite rape centers and task forces and statutes, Judge Bollinger still favors the simple guideline of the unwritten code, i.e., it's okay to do it if she's drunk.

It's time to get this fraternity boy off our bench.

Beatrice S. Daly

Timonium

Santa Claus Clinton

I am writing in response to the April 14 article in The Sun about President Clinton's sharp decline in popularity after only 90 days in office.

One analyst attributed this decline to "pop cynicism."

The real reason for this unprecedented low approval rating is that the American people have now seen just how cynical a politician they have elected. Change? He is a politician's politician.

Several years ago he promised the voters of Arkansas that if they re-elected him governor, he would serve the entire term -- broken promise.

He led the American people to believe that if elected, he would not raise middle class taxes -- broken promise.

Prior to the election, Clinton said he would modify the Bush administration's Haitian refugee policy, a policy he now embraces -- another broken promise.

Having smelled the possibility of shoving his "stimulus package" down the Senate Republicans' throats, Clinton called on Senate parliamentary expert Robert Byrd of West Virginia to exercise arcane procedures to effectively deny the minority any involvement.

Galvanized by this blatant power play, and truly questioning the merit of the bill, the Senate minority turned the tables on Clinton and stalled the bill.

At the White House Easter egg hunt, Clinton had the audacity to accuse Senate Republicans of playing politics and creating gridlock.

As he gazed out into the orchestrated crowd of his aides' children, Clinton wistfully commented that the Republicans' behavior was sad and implored the minority to think of the increased funding the bill would provide for the childhood immunization program.

Of course, as Sen. Robert Dole, R-Kans., pointed out, there is in excess of $137 million currently available for the immunization program.

Furthermore, the additional funding for this program called for in the stimulus package is a minuscule part of the bill when compared to the pork projects the bill necessarily provides for in order to compensate loyal congressional Democrats who so "swiftly" and "courageously" rubber-stamped Clinton's monstrous economic package.

Most shameful, however, is Clinton's budget. Even after the middle class tax increase, many Americans remained willing to pay higher taxes based on Clinton's assurances that the budget deficit would be reduced by the tax increase. Many swallowed the bitter pill thinking, "I'd rather pay for the deficit than leave my children with its burden."

Clinton's budget, while slashing military appropriations, increases the budget deficit by $264 billion for fiscal year 1994 and, according to his own estimates, adds $1 trillion to the national debt in the next four years.

Where is the money going? Candidate Clinton is now Santa Claus Clinton.

In addition to providing municipal swimming pools and tennis courts, the federal government will operate programs to address and solve all of our societal ills.

We face new and dramatically increased taxes. A clear majority of the American people voted to limit spending and hold the line on tax increases.

Clinton's rapid and cynical reversion to Democratic pork barrel politics is proof of his lack of principles.

Timothy T. Smith

Owings Mills

First Amendment and a Match

There you go again.

All of the media are whipping up a frenzy against the authorities instead of the criminals.

The Waco band was a gang of murderous, licentious thugs who were posing a threat to the surrounding communities.

They were warned time and again and were given ample time to surrender peacefully. They lied time and again and refused.

Those who wanted to get out did, and the others could have done the same if they had wanted to. None of the authorities forced them to commit murder and suicide, just as no one forced them to join the gang in the beginning -- and don't dignify it by calling it a cult.

The people of the media always seek to glorify the criminals and vilify the authorities, and that is the reason that the law-abiding citizens are terrorized by the criminals while the criminals dominate our lives.

It is high time that the intelligent citizens band together and resolutely deal with this aggravated problem.

We cannot rely upon the career politicians for anything worthwhile. As a matter of fact we should turn them out of office -- but we must deal with the problem. It is the most important matter facing us.

Manuel M. Poliakoff

Baltimore

____________

The catastrophe that happened in Waco is the result of the right any madman to preach whatever he can find fools to listen to, and the right of any newspaper publisher or TV producer to put that nut's story out.

David Koresh used the First Amendment and a match to kill those 86 people. If the First Amendment were regulated, he could have been stopped several years ago when he used force to take control of this cult. If he knew he was not going to be on national TV or the front page, he may not have done what he did.

But the Bill of Rights should never be regulated or changed. Cults are the price we pay for the freedom of religion, and nuts trying to make headlines is the price of freedom of the press.

Unfortunately, criminals with handguns are the price we pay for the right to keep arms.

Firearms in the hands of the citizens have been a very important part of what made America what it is today. The Minutemen, feeding the family, the Alamo, to mention a few of the deeds accomplished by the people with their own guns.

The Bill of Rights is written in very easy-to-understand language, especially the Second Amendment. If the government can change the meaning of "the right of the people to keep and bear arms, shall not be infringed," it can change the meaning of any of the amendments.

David A. Titus

Mount Washington

It is easy to second-guess a situation that you have no part in, and not being involved in the Waco fiasco I was just wondering:

Were the Pilgrims, the Puritans and the Quakers cults? If that's what they were where they first lived, then they came to the United States to be religiously independent. I believe that the Davidians should have had the same opportunities.

It seems that they lived a quiet and peaceful existence, and from all reports the only time they responded is when they were threatened. I believe I would have done the same thing in their circumstance.

The powers that be could have withdrawn and waited for David " Koresh to leave and grabbed him away from the compound. This would have lessened the chance of all these people dying.

It is frightening to see armored vehicles used against American citizens. Texas looked like Budapest, Hungary, in 1956 when the Russians moved in.

The excuses that were given after the event were inadequate. The attorney general said it was because of suspected child abuse. The next day some other official said they weren't sure there was child abuse.

Even if it was child abuse, should this many people have been incinerated, including the abused children?

I am deeply grieved about this matter and find a deep feeling of sympathy for all involved.

Someone should be held accountable for this matter, and all safeguards must be enforced to see this never happens again.

Edward Mattson

Towson

As I arise from watching the horror of the tragedy taking place near Waco, I have tears in my eyes and an ache in my heart for all of those lost in this horrible miscalculation. (I use this word because I can think of no words strong enough to express my outrage at the handling of the entire situation that you could print.)

Why did the original foray take place where several persons were killed for no good reason? Why did the federal agents attack in such an utterly stupid manner? Why did they attack again when we knew that the consequences would be tragic in some manner?

What was the hurry? Yes, it had been a long wait, but no one was being hurt. We now hear that there might have been child abuse in the bunkers of the cult, and other groundless excuses for one of the most egregious mistakes made by our federal law enforcement agencies . . .

As I sit here, barely able to type through the tears brought by the thought of those innocent children, some innocent adults and the pregnant women whose children will never be born, dying in a horrible inferno I ask, "Why?"

Everyone knew that those in the compound could go nowhere, harm no one on the outside and would eventually come out on their own, if we but waited.

But no, the great powers that be, those incompetents who made these horrible decisions, caused the deaths of all of those people. Most of them were guilty of nothing more than having embraced a fanatical religion.

May God have mercy on the powers, more than they had on those trapped in the fire.

John P. Kimball

Baltimore

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