With all of the talk in Annapolis and the discussion among "professionals" over health care issues, what often gets lost is the patient-consumer's perspective.
The patient-access bill before the General Assembly would permit HMO members to opt out of the HMO network and see the doctor of their choice if they are willing to assume some financial responsibility for this additional choice and flexibility.
While this is often framed as a battle between insurance companies and health care providers, what it is really about is the patient's interest.
Increasingly, health care options are dictated by managed care programs. While this has led to some savings, the pendulum may have swung too far toward cost controls and away from health care delivery. Instead of managed care, we are getting managed cost.
I believe there are many positive things about HMOs. For regular medical checkups and routine care, the HMO does its job in an efficient manner.
However, there is no flexibility in their design for occurrences which aren't routine. Most families encounter at least one major illness sooner or later. When this happens, all patients should be entitled, if willing to share in the cost, to go to the doctor they believe offers the best chance for helping them.
The patient access bill provides a good compromise position. It will help reclaim patient rights, while not upsetting the HMO system.
Surely the fact that a patient would have to pay is a strong disincentive to going out of the plan. And, the HMOs would only have to cover 80 percent of what they would normally pay for a service. It seems fair that patients regain the right to make important health care choices if they are willing to pay for that option.
Jonathan Power seriously mis-portrays the facts in his Feb. 23 column regarding a shipment of waste materials from facilities in France back to Japan.
It is not a shipment of plutonium at all. The cargo is, in fact, nuclear waste that has been chemically separated from reusable materials as part of the well-established Japanese policy of recycling used nuclear fuel.
The waste has been immobilized by conditioning it within solid glass blocks. Nuclear experts around the world believe this is the best and safest method of treating, transporting and storing this type of material. This shipment represents part of an integrated program among companies in Japan, Britain and France.
The international transport of such nuclear materials is nothing new. The shipping company involved is the most experienced in the world for handling this type of nuclear cargo.
Some 4,000 similar flasks have been transported by sea since the 1960s in accordance with strict international regulations and with no incident involving a breach of containment.
The ship being used was specifically designed to carry these materials, has the highest safety rating of the International Maritime Organization and has a host of enhanced safety features, including satellite navigation, a double hull to withstand collision damage, enhanced buoyancy, twin engines and propellers and additional fire fighting equipment . . .
The writers represent, respectively, British Nuclear Fuels PLC, Federation of Electric Power Companies of Japan and Cogema, Inc.
In his column of March 2, George Will uses the issue of affirmative action to indulge in an exercise in liberal-bashing. Rather than using reasoned arguments to discredit an idea, he instead resorts to name calling.
The question that needs to be discussed is whether racism and sexism in this country still exist at a level to warrant affirmative action remedies and, if so, when and where should they be applied, and what form should they take.
If affirmative action is abandoned, how does one protect minorities and women who are still victims of discrimination?
Even with all the laws and statutes against discrimination, it is often very difficult to prove without resorting to numbers and percentages. All one knows is that one didn't get the job, promotion or loan even though he/she met or exceeded all the qualifications.
When discrimination is proven, is the perpetrator simply told not to do it anymore, or should some sort of compensatory measures be required?
While it is true that in a color/gender-blind society, affirmative action would be unnecessary and unfair, we are far from reaching that goal, and opponents of affirmative action should not pretend that we have.
Furthermore, while white males are sometimes the victims, discrimination against minorities and women is still far more prevalent.
These are issues which need to be discussed openly and thoroughly on their merits without resorting to name calling and labeling.
Eric H. Brown
The March 1 editorial, "Pentagon Perplexities," contained a statement so false as to invite tough truth. Dealing briefly with anti-ballistic missile defense, it stated, "Yet there is no credible foe that could launch an intercontinental threat in the foreseeable future."
We have several credible foes. North Korea, Iran, Iraq and Libya are a few examples of well articulated hatred of the U.S.A.
Hard evidence abounds in the Department of Defense of the advanced development and imminent availability not only of nuclear, chemical and biological warheads, but also of intermediate-range missile systems.
None of this is esoteric technology any more. It is here, now, and on the market. Europe, Japan and Israel are soon to be under direct, specific threat, with the continental U.S. next and clearly within the foreseeable future as the range of delivery systems is extended.
While it is generally accepted that the threat of massive attacks from the Soviet Union and China has subsided, we are now facing a very different and in some ways more real threat from an unstable individual or regime where possible retaliation has no effect.
This threat, contrary to your editorial statement, is in the foreseeable future. It is one ICBM, or a very few at most, delivered inaccurately on some location planned to have the maximum hurt, here or on our allies, and it is possible before the end of this decade.
"We have no defense against even one ICBM fired by accident or fired deliberately by an irresponsible country," said Gen. Lawrence F. Skibbie, USA (Ret.), president of American Defense Preparedness Association (ADPA Media Alert, Feb. 10).
This fact is well known by those whose responsibility it is to defend this country, but it is not known by the large majority of our citizens. It is very scary, indeed, to realize that Americans might have to find out only when it happens.
Gerald W. Iler
Racism Lives; So Why Are White Men Angry?
There is a furor in the land. Affirmative action is under siege and attack. Affirmative action is on trial.
The word is out that white America has placed it on trial. White America cannot place affirmative action on trial without sitting also in the defendant's box. White America is on trial.
Affirmative action has brought about some progress. Yet discriminatory employment practices persist.
Discrimination and racism in the economics of business and employment in the public and private sectors are not a record that the majority can be proud of. They are now more subtle and covert. The last hired and first fired was the policy of the vast majority of employers. This policy embraced more than who was the best qualified.
Because of blatant discrimination, statistics have shown that a white high school graduate earned more than a black college graduate. Black college graduates were Pullman porters, bus boys and laborers.
One attack on affirmative action states that blacks are given preferential treatment. Where did preferential treatment originate? Ask Frederick Douglass, who was a skilled caulker of ships and could only be hired as a laborer on the ships being repaired in the ports of Baltimore.
Preferential treatment is not an invention to make blacks privileged workers. There has always been affirmative action. It means to affirm.
White males have always been affirmed through the mechanism of hiring and only training their own. There have been notable exceptions. These exceptions have been based on the fundamental fact that within a scope of ability persons can learn through education and training. Additionally, African-Americans are consumers and taxpayers.
Is the downsizing of the number of jobs of the American economy the reason that politicians perceive that they can make political hay out of affirmative action?
Distortions are the fuel that feeds political posturing. Affirmative action is not a program to hire the unqualified. It does advocate reaching out to a diverse work force of the qualified or qualifiable.
The set-aside for minority business has paved the way for some excellent minority businesses in various fields.
When we say that affirmative action should be continued, we are not saying that there is no room for improvement. There must not be complacency on the part of the African-American community. However, the development of African-Americans in occupations where they have not traditionally been is a responsibility of affirmative action.
The largest area of blacks have been in fields of social work, teaching, preaching and the social sciences.
Whites taught Frederick Douglass to read, but his was the tenacious motivation. When white America places affirmative action on trial, it must also stand in the defendant's box.
As an African-American I am astounded by the fire with which the affirmative action debate rages on.
Because this issue was (not surprisingly) brought to our national attention by the Republican-led angry white men, it may be helpful to examine the plight of these Americans to better understand why they are so angry.
White males make up approximately 33 percent of our nation's population. White males make up no less than 80 percent of every coveted employment position in America (excepting pro basketball and boxing).
If these numbers are true, and I submit that they are, white men are angry because after about 25 years of affirmative action the over-representation of white men in the American work force has been reduced to a mere 200-plus percent.
They are apparently angry because the federally-required mandate that there be diversity in the work force has prevented these white men from achieving a near 300 percent representation in that same work force.
I wonder if these white men realize that it is white women, not blacks or Hispanics, who have been the major beneficiaries of most affirmative action policies. Since these women usually marry white men, white men benefit from affirmative action, albeit indirectly, in proportions equal to or slightly less than blacks or Hispanics.
It is greed, but not merely greed, which explains this perceived right of over-representation. It is the denial, regardless of what minorities say (or prove by way of Oprah), that racism is still alive and well in our society.
But even more than that, it is the baseless superiority complex that has been a staple of many European peoples' self-assessment since the time of the great crusades.
I am convinced that if right- thinking white men (I do know more than a few) actually thought about this issue they would have to agree on the following points:
* Racism is not a relic of the past, but is in fact alive and well.
* White women are also big beneficiaries of affirmative action.
* At only 33 percent of our nation's population, white men are over-represented in our work force by at least 200 percent in every professional and most non-professional positions and therefore have nothing to be angry about.
Michael G. McFadden
Homeless Project Flunked
The Sun Feb. 23 printed an article about freshman students at University of Maryland Baltimore County working on a project to design and build shelters for the homeless. If the article is accurate, it revealed appalling defects in the engineering program there.
Having engineering students form teams to complete a project is no longer new and has become part of many engineering programs.
The problem posed may be an amusing one -- e.g., building a Rube Goldberg contraption that actually works -- which helps the students realize that humor and playfulness should always be part of an engineer's equipment.
A good problem should also require students to grasp and struggle with unstated parameters which may conflict. One of the most famous current problems is the annual competition among engineering students across the nation to build and race a solar-powered car.
By the time students working on this project have finished they will have come to know first-hand how competing requirements must be balanced in good design.
The two kinds of problems mentioned lie within "classical" engineering areas. Without derogating them, one can say they have little social significance, but they do no harm.
A project to build portable shelters for the homeless is entirely different. Socially significant? Yes!
It therefore has the potential to be an exceptional educational experience, particularly for beginning engineering students who, one hopes, will learn to help solve important problems for society.
The evidence in the article shows that none of this potential was realized. The evidence begins with the flippant names given to the created shelters. "Project POSH"? "Port-a-Home 2000"? "Compactable Chalet"?
Was any social services official or anyone in the excellent social work program at UMBC consulted? One reads from the article, "Maureen Robinson, a spokeswoman for the Baltimore County Department of Social Services, wondered where the homeless people would use the shelters. 'I'm not sure whether [it] would be legal or acceptable, even [to erect them].' "
Shouldn't these questions have been answered in any "feasibility study"?
Was any homeless person ever consulted? Apparently this was not done. "In our design we considered a homeless person might have bags with them, or a child." "It eliminates the shopping cart."
The students should not be faulted, though one might have expected more of honor students.
Certainly the instructor, and perhaps the entire Engineering College, in so far as the execution of the projects shows a prevailing insular attitude, should be ashamed.
Even as good training for engineers who must satisfy customers, the project failed. Don't build something your customer can't, or won't, use.
As a scientist, one is angered by contemporary Luddites who blame most current problems on technology; one is angered even more by engineering faculty who seem to be training (not educating) engineering students to practice the kind of engineering that gives such groups very effective arguments against technology.
UMBC prides itself on being a complete university with strong departments in addition to those in science and engineering. If the Engineering College is producing engineers with no more awareness of the world than shown here, who needs it?
Homer W. Schamp Jr.
The writer is professor emeritus and former vice-chancellor for academic affairs at UMBC.
'Obscure' Project in Western Sahara
In The Sun Feb. 24 under the headline, "House GOP cuts billions in spending," the reporter mentioned an "obscure . . . voter registration project in the Western Sahara."
The truth is, this "obscure" project will determine the future of one family in the Baltimore area, my family.
Since the Western Saharan struggle for peace and freedom in North Africa may seem distant to many Marylanders, I will take this opportunity to bring the unacknowledged war into the American light . . .
My husband is a refugee from Western Sahara. He has been separated from his family for over 20 years because of the war with Morocco. . . .
The Moroccan invasion forced thousands of Saharawis to flee their homeland and seek shelter in the harshest corner of the Sahara desert in neighboring Algeria.
Today, nearly 200,000 Saharawis are still living in refugee camps in southwestern Algeria, fighting blistering 135-degree Fahrenheit summer days . . .
Eighty percent of the refugee population are women and children. They have irrigated gardens, built hospitals, day care centers, and facilities for their government-in-exile.
They are the only refugee population in the world that has constructed schools and continue to educate their children through high school.
Although they are rated by the United Nations as the most efficiently run refugee camps on the globe, each day they strive toward their ultimate goal, returning home to Western Sahara.
We as Americans play a direct role in the prolonged suffering of the refugees and the Saharawi people imprisoned in their own country.
King Hassan II of Morocco ordered the construction of a wall longer than the Great Wall of China which rips through the entire landscape of Western Sahara, sealing in the remaining native Saharawi population and restricting all movement.
Over the 20 years of the struggle for independence, Morocco has received over $1 billion in military aid from the United States to fight this war against the Western Saharan people. The longer we remain silent, the longer Saharawis like my husband will be separated from their families, risk torture in their homeland and xTC suffer under the harsh conditions of the refugee camps.
Now the sad reality of the new Republican Congress is clear. The story reported that American support to the U.N.'s Western Saharan voter registration project has been cut from the U.S. budget.
The U.N. peace plan was designed to allow the Saharawis a chance to determine their future, choosing between independence or integration with Morocco.
Since the U.S. contribution covered the majority of the project's costs, the referendum now risks collapse. One of the reasons cited for cutting U.S. aid was that only 12,000 people out of 200,000 eligible have registered to vote. The truth is that so few have registered because of the Moroccan regime's use of manipulation and intimidation.
The Saharawis are terrified to go to the registration centers because of what they fear will happen to them or their families as a result. These human rights abuses have been documented and presented to the United Nations and the U.S. Congress . . .
But how does this relate to us, as Americans and as Baltimoreans? It relates to us as human beings who value the right to live in our own country, see our families, and express our opinions without fear of torture . . .
Shelley Wagner Beirouk