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Term LimitsIn your June 22 editorial "Politicians...

THE BALTIMORE SUN

Term Limits

In your June 22 editorial "Politicians as Usual" you fail to refer to the reason for the growth of the term limits movement. The reason? Congressional obstructionism. The Congress has persistently refused to set the wheels in motion for consideration of a constitutional amendment establishing term limits.

I suspect that congressional recalcitrance was a motivating factor in the Supreme Court's action in agreeing to review. I believe, too, that the review will not be confined to a narrow interpretation of the Constitution, as you suggest, but will also consider individual rights.

alph W. Miller

Baltimore

Medical Costs

With 15 years in solo private medical practice, including a day-to-day role in a hospital utilization program, I take strong exception to Dr. Usha Nellore's allegations (letter, June 25).

First, the central issue in our nation's health care crisis is unnecessary expense (or "care") -- unnecessary hospitalization, unnecessary surgery, unnecessary endoscopy and catheterization.

This finding is a consensus which the AMA, Congress, the insurance companies and hospital administrators, all acknowledge.

What motive is behind this excessive and unnecessary pattern of practice? Fifteen years of private practice have shown me it's "the bottom line." Dr. Nellore's assertion that only HMO physicians watch the bottom line is not accurate.

Every small business or sole-proprietorship watches the bottom line with the eye of an eagle, or isn't in business long. This is not intended as criticism of my medical colleagues, but rather of the third-party payers that authorize outlandish fees for invasive procedures but virtually nothing for listening to a patient, answering questions and concerns, and doing something simply and safely.

Physicians are coerced into unnecessary and excessive practice patterns by reimbursement schedules. Dr. Nellore failed to mention private practice motives.

Second, not all doctors are equal in their spending. Dr. Nellore wisely does not assert that HMO patients get well less often, or more slowly or die more frequently. Actually, the outcome of HMO care cannot be differentiated from any other care by any other means yet tested.

Dr. Nellore consistently implies that patients get less care (or less skilled care), but a huge and varied mass of hard data contradict her. The organizing principle of HMO (or "managed") care is to rid the system of incentives for excess, thereby ridding it of the excess itself.

Yes, HMOs are selective, and many doctors with "un-managed" spending patterns of practice are not welcome. This is to be expected.

Third and last: The Any Willing provider Law (AWL) is anti-competitive. How would the Orioles like "any willing ball player"? Does Johns Hopkins allow "any willing professor"?

The AWP Law is affirmative action gone berserk. Cost-conscious physicians should have the right to band together and compete head-to-head against their "un-managed" colleagues.

Let patient satisfaction and objective medical outcomes be the criteria for evaluation. I say scuttle AWP and let the competition begin. It's the patients who stand to win.

Dan H. McDougal, M.D.

Towson

Feb. 29, 2000

I greatly enjoyed Frank Roylance's essay on Cesare Emiliani's proposal for calendar reform, ("Looking Ahead Six Months to the Year 11,995," June 26).

I fear that Professor Emiliani's system makes too much sense ever to be accepted.

Be that as it may, I would point out one small error in Mr. Roylance's excellent article. In our Gregorian calendar, he says, leap years are omitted in centenary years divisible by 400.

In fact, it's the other way round: Only those centenary years which are divisible by 400 are leap years.

Accordingly, there was no leap year in 1700, 1800 or 1900. However, the much-anticipated millenary year 2000 will have a Feb. 29.

I just thought that readers who have plans for that day would like to know that Pope Gregory has not canceled it.

Bill Gavaghan

Arnold

McLean Saga

The front page article in the June 25 issue of The Sun, "McLean may retire within a week," confirms that truth is stranger than fiction. Let's see if we got this right.

Jacqueline McLean, city comptroller, is accused of being a crook and indicted for fraud and misconduct. She is represented by attorneys M. Cristina Gutierrez and Billy Murphy.

Mrs. McLean goes on unpaid leave; however, her salary is held in escrow. She suffers from depression and is hospitalized in Sheppard Pratt, paid for by her employee health benefits, which apparently she retained. Those health benefits have now expired.

A criminal trial is scheduled but delayed because of her mental state. Hearings are held which were marked by wrangling between her lawyers and Baltimore Circuit Judge Elsbeth L. Bothe. Mrs. McLean breaks down and is involuntarily committed as a state mental patient.

Five members of the City Council intercede with the judiciary on Mrs. McLean's behalf, the trial is postponed until September.

Mrs. McLean asks to retire from office with full benefits. Her lawyer, Ms. Gutierrez states that, "Retirement will settle all the outside pressures. . . ." She's got that right! With retirement would come new health benefits and a generous pension.

Mrs. McLean may or may not be entitled to retire. She may or may not have as many as 20 years of service. She may or may not be entitled to about six months pay held in escrow. But, if she retires, the comptroller job would be vacant and allow Mayor Kurt Schmoke and City Council President Mary Pat Clarke to fight over who will be the interim comptroller.

My advice: 1. Drop all charges and let Jacqueline McLean retire, give her full benefits as well as her back pay and anything else she wants. The city will save money. 2. Appoint Ms. Gutierrez as the interim comptroller. The city will save money.

L. Peterson

Bel Air

Keep Capitals and Bullets in Maryland

Your editorial "Chasing Bullets" (June 11) demonstrated a shortsighted and divisive view of Maryland that over the long run will harm Baltimore far more than it harms Prince George's and Montgomery counties. Your conclusion that few people in the Baltimore area would fight to keep the Bullets and Capitals in Maryland at the USAir Arena shows narrow-minded parochialism its worst.

Over the years, members of the General Assembly have been called upon to provide enormous amounts of money to fund everything from the Baltimore Zoo, aquarium, museums (ceramic, art, Babe Ruth, Eubie Blake, etc.) educational institutions, Orioles Park at Camden Yards, a new NFL stadium, convention centers -- the list goes on.

It wasn't easy to explain our votes for large-scale projects like the Port of Baltimore, BWI Airport, etc., because many folks in the Washington suburbs don't yet realize the economic value of such projects to the state.

That's why it was so disappointing to read your editorial that once again seemed to draw a line across the state just when the Maryland suburbs are fighting to keep the Bullets and Capitals in Maryland.

How important are these teams to our area and to the entire state of Maryland? Besides the prestige to our county, the economic spinoff, the county and state tax revenues, the convenience to those of us who love hockey and basketball -- we also will lose over 2,000 jobs if the move to the District of Columbia takes place.

The single biggest attraction in Prince George's County is the USAir Arena. The Bullets and the Capitals franchises are what makes that arena great.

When Robert Irsay was packing up the Colts in the middle of the night, in Annapolis I and Del. Joel Chasnoff led the fight to pass an emergency sports condemnation bill to help give Baltimore leverage in its fight to keep the Colts.

We need a united effort, including Baltimore, to keep these teams in Maryland and in Prince George's County where they belong. We need immediate aggressive action and support from everyone if this asset to our region and state is to be retained.

Our governor, county executive and even the Maryland press should be aggressive in formulating and selling a rational plan to Abe Pollin.

More importantly, it's time for The Sun to wake up and realize that we are Marylanders -- not just Baltimoreans or Prince Georgians -- and the loss of a major economic project to one part of the state is a loss for all.

One more thing: There are plenty of Baltimore basketball and hockey fans who come to the Largo arena just like we trudge up I-95 to see the Orioles at Camden Yards -- which we all helped pay for.

Gary R. Alexander

Fort Washington

The writer is retiring this year as a member of the Maryland House of Delegates from Prince George's County.

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