Selling insurer wouldn't benefit state consumers
Now that experts suggest CareFirst was undervalued, perhaps by hundreds of millions of dollars, when the company negotiated a purchase price ("CareFirst worth more, outside analyst reports," Sept. 10), we need to answer this question: Is the sale of such an important nonprofit health insurer in the best interest of Maryland consumers?
The valuation analysis for the Maryland insurance commissioner by the Blackstone Group is just one of a series of troubling reports about the proposed sale.
The Blackstone report shows that consumers, hospitals and other health providers would be losers. For instance, WellPoint Health Networks intends to reduce CareFirst's medical expenses, because the company devotes a higher percentage of its premium dollars to medical care than most insurers.
The acquiring company, based in California, also says it will make CareFirst more profitable through "tighter financial controls" and "better underwriting discipline."
That translates to forcing customers to pay more out-of-pocket medical costs and higher premiums in an environment in which consumers and businesses already are reeling from double-digit health insurance cost increases.
Some other likely steps to achieve higher profitability include denying more claims, making it tougher for those in poor health to get insurance and lowering reimbursement rates to doctors and hospitals.
Blackstone also found that bonuses for CareFirst executives (totaling $41.3 million) became a de-facto increase in purchase price, diverting dollars from a state health care foundation. So did a proposed executive severance package (totaling $47.9 million).
Even if this report pushes up the purchase price, the proposal ought to be rejected, It harms, rather than helps, Marylanders.
We need to find ways to keep CareFirst a nonprofit insurer and return the company's focus to its historic mission: providing broad health care coverage to Marylanders (including coverage for hard-to-insure and uninsured individuals) at a reasonable price.
Calvin M. Pierson
Elkridge
The writer is president of the Maryland Hospital Association.
Chinese medicine isn't that different
I am the Johns Hopkins physician mentioned in The Sun's article "Doctors from Hopkins improve China's care" (Aug. 29). And I think the article created the misleading impression that China's health care system is inadequate and that its physicians are, by American standards, ill-trained.
After working for six weeks in China, my impression is quite to the contrary. I found the staff at Beijing's Chaoyang Hospital intelligent, well-trained and dedicated. And about 90 percent of their medical practice is the same or similar to the medicine practiced in the United States.
Until recently, the training of physicians in China has been based on an apprenticeship system, a system common in the United States in the early 20th century and still practiced in many countries today.
This system has produced some excellent physicians. However, it lacks consistency and continuity among all physicians trained.
One of the primary roles of the Johns Hopkins Center for International Emergency, Disaster and Refugee Studies' program in China is to demonstrate a new education system that will ensure all physicians are trained consistently.
A second goal is to teach the Western medical practices that are used in U.S. emergency departments.
Finally, in the case of the patient with the rapid heart rate who was mentioned in The Sun, his treatment was completely appropriate and virtually identical to that provided in the United States. All the necessary equipment and medicines were available, and the physicians were well-trained and competent to handle his medical issues.
Dr. Michael R. DiNapoli
Baltimore
The writer is a member of the Department of Emergency Medicine at Johns Hopkins Hospital.
Recruiting in D.C. to enliven Baltimore
The Sun's article "City tries to lure residents from D.C." (Sept. 15) was an insightful look into a growing trend, and we applaud the coverage.
But reporter Molly Knight was incorrect in stating that this campaign was launched by the city. It was in fact developed by Live Baltimore, created by local advertising agency Gilden Integrated and funded by the Goldseker Foundation and the Maryland Transit Authority.
As the article noted, word of mouth has been a powerful factor, but we are not just waiting for this buzz to percolate on its own. We are fueling that tide by bringing our message to the people. We host regular social events in D.C. and invite our "city living ambassadors," who are currently commuting, to talk with these prospective residents.
At a recent home-buying fair in Washington, hundreds of people commented that they had seen our ads and wanted to know if you really could buy an attractive home for $80,000.
We are receiving an average of 45 inquiries a month from D.C. residents looking for more information, and have had more than 120 of them request a real estate referral.
If Baltimore truly believes in its future, we need to put our resources into projects such as this one. Everyone benefits from the inward migration of residents and the resulting effects to the city's tax base.
We are inspired by the progressive vision of the initial funders on this project, but also well aware that if it is to continue, we need others in the city and business community to support our efforts.
Tracy Gosson
Baltimore
The writer is the executive director of the Live Baltimore Home Center.
Stop squandering mass transit funds
State officials are now saying that an increase in the gasoline tax and other transportation-related fees may be necessary because of a shortfall in revenues for state transportation projects ("Higher gasoline tax weighed to meet transportation needs," Sept. 13).
Maryland's transportation trust has suffered from the same fiscal irresponsibility as the state's general fund. Highway funds have been squandered on frivolous projects such as noise walls and traffic circles. Mass transit has been beset with the equally frivolous program of remarking the buses and light rail fleet with the "MTA Maryland" moniker and logo.
These extra expenses are compounded by reduction of the farebox recovery requirement from 50 percent to 40 percent. This means that instead of having $2 of expense for every $1 of revenue, our transit systems may now have $2.50 of expense.
Only by the most twisted application of "social cost accounting," which transit advocates use to justify their excesses, can such a level of expense be justified.
Drastic measures are needed. If every penny counts coming in, every penny must count going out. Non-road highway expenditures should be immediately suspended and funds diverted to road construction and repair.
The farebox recovery requirement should be returned to 50 percent immediately, and increased by 5 percent per year, with the dual goals of break-even operation within 10 years and eventual privatization of the system.
Gary A. Smith
Baltimore
Cost of slots exceeds income they produce
Rep. Robert L. Ehrlich Jr. is making a huge mistake with his "monkey see, monkey do" attitude on slots in Maryland ("Fate of slot machines in Maryland likely rests in gubernatorial race," Sept. 25).
The gambling industry loves this tactic, which has worked for it in other states. But Mr. Ehrlich is ignoring the research and overlooking the real statistics in favor of dollar bills flashing before his eyes.
He sees slots as a salvation for the dying racing industry and a painless revenue source for education, but he's not telling us how he plans to fund the social costs of this highly addictive activity.
A National Opinion Research Center study found that the normal rate of compulsive or pathological gambling (about 1 percent to 5 percent of population) doubles within 50 miles of a gambling facility.
And Mr. Ehrlich is ignoring studies such as a recent one by the state of Connecticut indicating that in one year, gambling brought in $372 million but cost the state $554 million in gambling-related law enforcement, detentions, adjudications, white-collar crime and regulations (a net loss of $192 million a year).
Substituting "Lady Luck" for the values of hard work, ingenuity, education and commitment is bad public policy.
And supporting an activity that victimizes and preys upon its citizens is not protecting and serving the people -- it's exploiting them.
Cheryl Michael
East New Market
The writer is a representative of NOcasiNO Dorchester.
Reflect on our role in a violent world
I was deeply moved by the Sept. 11 letter "A day of fasting, grief and reflection." The writer explained how he and his wife and some friends spent several days in fasting, prayer and reflection on how and why the events of Sept. 11 could have been "committed in the name of Islam."
The letter caused me to consider whether those of us who are non-Muslims might not engage in a similar process of self-examination.
Over the past year I have often heard the question "Why are we so hated?" but I have seldom heard an adequate answer. Too quick to place the blame on others, we have failed as a nation to look inward or to acknowledge our own responsibility.
Perhaps we should consider why we are spending millions of dollars hunting one man who quite possibly is no longer alive, or why we are pursuing a "regime change" in Iraq that will risk thousands of lives.
Do we realize the suffering that we have already inflicted in Iraq and in Afghanistan? Or that nearly 13 million people in Africa are facing starvation and we, and perhaps only we, have the means to avert this humanitarian disaster?
Of what does world leadership consist?
Sylvia Eastman
Baltimore
Daschle is right to criticize Bush
I applaud Senate Majority Leader Tom Daschle's comments urging the White House to tone down its rhetoric and apologize to the Senate and American people ("Daschle seeks Bush apology on patriotism," Sept. 26).
The Bush administration has adopted a sinister tactic of silencing its critics through accusations of unpatriotic behavior -- even though it is fundamentally patriotic to encourage healthy debate.
The Bush administration has also sought to squelch meaningful public discourse by refusing to discuss concrete reasons for its policies.
It insists on a war with Iraq without providing evidence for the need of such a war. The administration condescends to the public and manipulates the fragile emotions laid bare by the Sept. 11 attacks, rather than making plain a case and course.
But in this country we must have debates with more than one side on the important issues -- debates that rely not on emotional manipulation, but on facts laid before us by an open, honest government.
Ryan de Ryke
Pikesville
The debt we owe Pacific Islanders
I read with much interest The Sun's three-part series "Indentured in America" (Sept. 15-17). Clearly there is a basis for the Immigration and Naturalization Service to investigate and prosecute any unlawful exploitation of workers from the Marshall Islands and Micronesia.
However, I was very disappointed in the series for not offering more historical data about why we, as U.S. citizens, are interested in those Pacific Islanders, especially the natives of the Marshall Islands.
The reporters emphasized that "the Marshalls are perhaps best known as the site of U.S. weapons testing at Bikini and Enewetak." No doubt these atolls have this image. But that is not the real importance of the Marshall Islands.
As a member of a Naval assault beach party in the Pacific during World War II, I participated in the invasions of Majuro, Kwajalein and Enewetak atolls in the Marshall Islands. I remember the devastation suffered not only by our amphibious forces and the Japanese, but also by the natives who lived on these islands.
The Sun's reporters should have noted that on Jan. 31, 1944, the 5th Amphibious Forces of the U.S. Navy invaded the Marshall Islands along with the 4th Marine Division and the 7th Army Division in the first invasion of islands Japan had held before the war.
Fortunately for us, Majuro was taken without opposition that day (the Japanese abandoned it as we invaded). But it was followed by invasions of Kwajalein on Feb. 3, 1944, and Enewetak on Feb. 17, 1944, that involved ferocious battles.
Congress probably granted Marshall Islands and Micronesia natives special immigration access to the United States in recognition of their sacrifices during World War II as well as because we used their islands for weapons testing and for military bases in the Pacific.
I know we veterans of the Pacific war owe them a debt of gratitude that we, as a nation, should back up today by putting a stop to their exploitation by the "body brokers."
Samuel A. Culotta
Baltimore