No Altruists

Your April 1 editorial and subsequent column by Barry Rascovar portrayed non-HMO physicians as greedy money-grabbers. HMO managers and physicians presumably are splendid fellows, altruists.

This year's "any willing provider" bill before the legislature would give the HMO enrollees the option to choose their own doctors. Rather than doom HMOs, as the HMO industry and its supporters claim, this bill would keep HMOs competitive in terms of enrollee service and enrollee health care.

If an HMO gives good service and its doctors provide good care, its enrollees would not be inclined to pay money out of their own pockets to obtain care outside the HMO.

On the other hand, if an HMO gatekeeper is more concerned with the HMO's bottom line than with a patient's needs, the enrollee can go elsewhere without losing completely the value of what he has paid the HMO.

A health maintenance organization is a business. It needs to have a large enough number of enrollees to be profitable. It gets that number by serving its membership well enough to keep most of its enrollees and recruits new enrollees to replace those who leave.

It is good for profits if the sicker enrollees -- who are the most expensive to serve -- leave and are replaced by new, likely healthier people.

With such considerations in mind a gatekeeper might tend to delay and skimp on service to a seriously ill enrollee with the expectation that that enrollee will either accept the poor service or, if he can, move his enrollment to another HMO.

Joan and James Childress

Baltimore

Happy Smoker

The class action suit against the tobacco companies is an insult to anyone who smokes and anyone who died of an illness labeled as "smoking related." Do these people think smokers are idiots and have no understanding of the risks?

Personally I would rather risk dying young of one of the many diseases associated with smoking than spend one day in a nursing home. I think our founding fathers called this freedom to choose.

I know many people who have quit smoking and gone back to it. By the same token, I know many people who have gone on a diet and lost many pounds, only to gain them all back. I have known alcoholics who have quit drinking, only to go back.

Addiction is nothing more than a state of mind. When your mind is made up to change your behavior, there is usually a high success rate.

Some people fight the urge to smoke, others the urge to do drugs or alcohol and others the urge to eat. Some make it, others do not.

The most important point is that there has to be a personal desire to quit doing anything that our government has determined to be "risky behavior." It is a personal choice, and it appears that there are too many people who want to make these choices for all Americans.

In my opinion, the only thing that is going to be accomplished by the constant attacks on the tobacco industry through taxes and law suits is another black market.

To all the intolerant non-smokers, God bless you. May you live a long and healthy life and some day wake up and realize this is America, not some Third World communist country.

Tobacco has been around for thousands of years and is not going to disappear because you don't like it. But if you have your way it will probably put the final nail in the coffin of our economy.

Jean Walker

Severn

Grandma Knew

My grandmother was fond of quoting:

"We little know what a web we weave, when first we practice to deceive."

1% It certainly applies in Arkansas.

Alexander K. Barton

Sherwood Forest

Education: More than Money

In her March 27 column, Sara Engram states "in education money matters." Of course it does.

If it did not matter, would Montgomery Countians spend as much as it does to educate its children?

For all the reasons discussed by the Governor's Commission on School Funding, and all the reasons it did not have time to discuss, money does indeed matter in education.

Maryland has a constitutional obligation to provide thorough and efficient schools. It is past time for the state to get its spending priorities straight and "adequately" fund those schools.

The problem with Ms. Engram's column, however, is that it presents a one-sided view.

The governor's commission found that school funding was not the only barrier to learning, and its report included recommendations to address this finding.

It is disturbing that these recommendations received virtually no attention. The commission's report was simply reduced to the issue of should we or should we not increase school funding.

Montgomery County spends more to educate students than any other school district; yet its impoverished students perform LTC poorly on state tests. Factors other than school funding are preventing these students from learning, and those factors must be addressed.

Wealthy, educated and politically empowered parents will always obtain the education they want for their children.

It is the rest of us who have to contend with educators who argue about accountability standards and lawmakers who argue about opportunity to learn standards.

While they argue, another generation of students is passing through the public schools.

Carolyn J. Stepnitz

Conowingo

Criticizing Critics of Guns Article

In the March 26 edition of The Sun three gun lovers attacked Scott Shane's March 15 article, because he said it was their mistress that killed an innocent person, and they could not take it.

There may be some flaws in the article, but I would like to take this occasion and bring some other facts on this issue.

One writer's main point of argument was: "The real point here is not how the murder was committed, but that it was committed at all." While I agree with him on the second part of his statement, I want to challenge him that how the murder was committed does matter.

Why did the culprit choose a gun and not stabbing? Because he did not need to be too close to the victim in order to shoot. He did not need to be strong in order for the shooting to be effective. He will not be hurt by possible defensive action of the victim.

And after committing the murder, he does not need to hide a bloody knife. The gun will do the job for him, and it does it quick and clean. If the murderer had not had a gun, perhaps the victim would be alive today like you and me. But he was murdered because his attacker had a gun.

Have gun lovers ever done any kind of study to find out how many (and why) criminals choose guns over other criminal instruments to do their crimes?

Have they ever thought about the many innocent people that have died in a simple argument because the other side could not reason and resorted to using a gun?

All those innocent people could have been alive today like you and me. But they are dead because the other side had a gun.

And are they ever going to remember the many innocent young children who were caught and died in a cross-fire because criminals decided to finish their unfinished dirty business by gun?

The other letter writers argued that when the government fails to protect its citizens, law-abiding citizens should have permission to own a gun to defend themselves.

I will ask these gentlemen and many other gun lovers who may follow the same argument, how do they expect many innocent law-abiding old citizens with arthritic hands who cannot even open the cap of their medication bottle to quickly grab the gun in their hands and pull the trigger?

How do they expect thousands of innocent, law-abiding citizens who are working hard to provide a comfortable life for their families to protect themselves when they are suddenly and unexpectedly confronted with a criminal with a gun?

Do you think that criminal gives them a chance to look in their pocket or purse to find their gun (assuming they have one)? Or, do you suggest that all these innocent, law-abiding citizens must carry a gun in their hands at all times?

If the government fails to protect its innocent citizens, let's help it to achieve its goal. If it does it wrong, let's correct it. If it doesn't do it, let's replace it.

Let's do something that protects all of us at all of the times, not some of you for some time. Let's think about us and not I.

And I wonder what pleasure it would give us to play and own an instrument whose ultimate goal is to kill?

Ezatollah Keyvan-Larijani

Baltimore