Health care mess is hurting both doctors...

THE BALTIMORE SUN

Health care mess is hurting both doctors and patients

The Sun's article "Insurer may try to cut rates" (Aug. 5) noted that CareFirst BlueCross BlueShield hopes to renegotiate hospital rates with Maryland's hospitals. While the Maryland Hospital Association has petitioned the Health Services Cost Review Commission (HSCRC) to stop this, the HSCRC has taken a wait-and-see attitude.

Hospitals around the state shudder at the prospect of yet another rate decrease, as they attempt to juggle budgets to remain afloat and offer good care.

As a physician on staff at one of the larger area hospitals and in private practice for the past 13 years, I am well-placed to see the effects of rate cuts on physicians, nurses, social workers, patients and administrators.

Increasingly long hours, and less time with more and more patients, do take a toll. This is complicated by reduced staff and high rates of staff turnover.

I know friends and colleagues who have left or are leaving medicine because of its increasing toll on them and their families.

I know doctors who have been unable to collect fees for months -- and thus can't pay their own bills. They have had to take out loans or ask parents for money.

Our patients face longer waiting times -- as they and we doctors are becoming anonymous to each other.

In the past, I would have time to chat with patients, ask about families and make them comfortable during medical visits. This familiarity is being eroded.

I have patients who have not been reimbursed by insurance companies and patients who are being referred to collection agencies because insurance companies refuse to pay bills.

The situation gets worse by the day. When will this chaos and insanity end?

Dr. Kenneth L. Rothbaum, Baltimore

Shared responsibility needed in health care battle

In response to James P. Pinkerton's article "The next health care battle" (Opinion Commentary, Aug. 17), I'd suggest that he wake up and smell the gunpowder. Since the mid-1980s, the health care battle has never waned.

Mr. Pinkerton is correct that economics dictate a rise in costs and a decline in coverage. That's precisely why we should not let economics dictate health care policy. Policy should be based instead on human needs.

This is not sub-Saharan Africa; America has plenty of money. But we seem to get less bang for our health care buck than any industrial country, with the possible exception of those from the former Soviet Bloc.

We need to come to grips with a few basic principles: Quality health care will never be cheap; the more profit-takers we put in the mix, the more care will cost; and the healthy must subsidize the ill.

This last principle can be restated as "shared responsibility for the common good." Is that so un-American?

Charlie Gerhardt, Baltimore

The writer is president of the Maryland Patient Advocacy Group.

Prognosis improves for MS sufferers

As a neurologist active in the clinical care of people with multiple sclerosis, I wanted to comment on The Sun's article about Montel Williams' recent diagnosis of multiple sclerosis ("Williams will go on, despite MS diagnosis," Aug. 24).

The article suggested that multiple sclerosis "typically" produces cognitive problems and other physical limitations.

The course of multiple sclerosis is unpredictable and in some individuals it causes physical challenges and cognitive difficulties. For many people, however, the disease is much more benign and allows for a relatively normal lifestyle.

Treatments developed in the past five years have also substantially changed our ability to manage multiple sclerosis.

These treatments not only suppress the activity of multiple sclerosis and reduce the number of "flare-ups," or neurological attacks, but can actually slow the disease's progression and prevent the accumulation of neurological deficits.

Dr. Justin C. McArthur, Baltimore

The writer is a professor of neurology and epidemiology at the Johns Hopkins School of Medicine.

The Sun's brief article about Montel Williams being diagnosed with MS said: "Victims typically lose some problem-solving capacity and short-term memory. Most end up in wheelchairs or need help walking."

Many people with MS never experience either of these symptoms.

Making a general statement about various symptoms that may or may not actually occur creates stereotypes that often lead to misconceptions and prejudicial attitudes.

Kay Berney, Baltimore

Send troops to wipe out the menace of tobacco?

What if this were the news:

The Republic of China, in response to a serious escalation of tobacco-related death and illness, and a corresponding increase in medical costs, has declared nicotine an illegal drug.

All existing supplies will be confiscated. Dealers and users who persist in this trade will be jailed and tobacco crops will be eliminated.

The United States, the primary supplier of this dangerous substance, has been advised to cease production immediately if it wishes to be seen as a responsible member of the global community.

The Chinese military has volunteered special units of its armed forces to seek out and destroy tobacco growing sites in North Carolina, Virginia, Maryland and wherever else they may be found.

Resistance to this demand will be regarded by China as an irresponsible and unfriendly act and be met with severe economic and trade sanctions.

It is suggested that farmers currently making their living producing this dangerous product convert their fields to the cultivation of snow peas.

Sig Seidenman, Owings Mills

Nurses deserve credit for the physicals, too

The Sun's article "Medically, they're ahead of the game" (Aug. 17) provided an excellent description of the sports physicals the Baltimore County Medical Association provides. The physicians who donate their time to perform these physicals should be congratulated.

However, the nurse practitioners employed by the Baltimore County Health Department provide the same physicals in the same settings. Nowhere in the article were they mentioned.

They, too, should receive recognition for the care they consistently provide the students of Baltimore County.

Jane A. Watts, Baltimore

The writer is a certified registered nurse practitioner.

Shriver Hall Concert Series offers fine chamber music

Stephen Wigler's article "Shriver Hall, back from the brink" (Aug. 22) was an excellent portrayal of a premier series which has always had a reputation for providing the best in chamber music.

Led by board President Jephta Drachman and manager of Bill Nerenberg, the Shriver Hall Concert Series has proven that foresight, knowledge and attention to detail will bring success.

I was especially pleased to read about the series' efforts to present young musicians, because our Trust's founder, Yale Gordon, specified that his annual allocation to the Shriver Hall series be used to engage a young emerging musician.

It seems Mr. Gordon was prescient in understanding that young artists will attract young audiences.

Congratulations to the Shriver Hall Concert Series and its hardworking staff for making a superb and exciting series even better.

Loraine P. Bernstein, Baltimore

The writer is assistant director and trustee of the Peggy and Yale Gordon Trust.

To our readers

The Sun welcomes letters from readers. They should be no longer than 200 words and should include the name and address of the writer, along with day and evening telephone numbers.

Send letters to Letters to the Editor, The Sun, P.O. Box 1377, Baltimore 21278-0001. Our fax number for letters is 410-332-6977. The e-mail address is letters@baltsun.com.

All letters are subject to editing.

Pub Date: 9/07/99

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