Payment cuts create a crisis for Medicare

Thank you for calling attention to the slowly growing crisis in Medicare reimbursement in The Sun's article on the situation for seniors in Colorado ("Some seniors struggle under Medicare," Nov. 7).

Internists are the largest provider of physician services to Maryland's aging population. We suffered a 5.4 percent cut in our reimbursement rate in 2002 and are facing a 4.4 percent cut in the coming year.

Yet none of our costs has gone down. We have seen great increases in our malpractice insurance rates, our vaccine costs and health insurance costs for our own staffs.

Most internal medicine practices operate with overhead costs of 50 percent to 60 percent of revenues. Therefore a 5 percent reimbursement cut amounts to a 10 percent to 12 percent reduction in physician reimbursement.

The Maryland Chapter of the American College of Physicians-American Society of Internal Medicine is well aware that Maryland senior citizens are having trouble finding physicians. We are also very well aware that many internists are unable to take new patients and many physicians are contemplating early retirement because of rate cuts.

Another cut may be the straw that breaks the camel's back.

Dr. Mary M. Newman

Lutherville

The writer is vice president for health policy and practice of the Maryland Chapter of the American College of Physicians.

More immigration won't cure city woes

The suggestion that Baltimore must attract more immigrants to offset population losses promotes a curious notion ("Immigrants seen as key to city's growth," Nov. 10).

A motorist who hits something in the road that punctures his oil pan would be a fool if he put in more oil before repairing the hole.

Perhaps the idea is that immigrants don't know better and can be persuaded to put their shoulders to the city's tax wheel in exchange for a quality of life that the folks leaving the city find unacceptable.

But if the idea is to stem city population decline, it seems reasonable instead to identify, and then correct, whatever is causing the urban flight.

Les Taylor

Baltimore

France won respect in U.N. Iraq debate

Americans owe a debt of gratitude to France for refusing to cave in to pressure from the Bush administration to give it carte blanche to attack Iraq ("U.S., France agree on Iraq resolution," Nov. 6).

Rather than demonstrating its irrelevance, the United Nations Security Council's ability to moderate the American position on Iraq has shown that it can function as an effective check on international aggression by a great power.

And now that the GOP is in control of all branches of the federal government, such external checks on American unilateralism will be all the more important -- which is why I say, "Vive la France."

Morton Winston Timonium

Gardina didn't need anyone's coattails

To many of us in Perry Hall it was a blessing to have Vince Gardina win his re-election bid ("Ports' defeat called temporary setback," Nov. 8).

Mr. Gardina didn't win because of a few mailings, but because he works to do what's best for his district. He didn't need to ride someone else's coattails. He ran on his knowledge, honesty and integrity.

Chuck Dobry

Perry Hall

Assembly must take a stand on slots

The idea that legislators, led by Del. Howard P. Rawlings, are hiding behind the idea of a referendum to approve slots is outrageous ("The odds are better for racetrack slots, but hurdles remain," Nov. 10).

Will someone please stand up and be counted?

Charles A. Adams

Ellicott City

The state's problem isn't lack of money

How dare Peter Berns blame Maryland's tax system for the budget shortfall in Maryland ("Don't blame spending for Md. shortfall," Opinion

Commentary, Nov. 8)?

Perhaps the problem isn't lack of money, but mismanagement of taxpayers' money. Marylanders are finally realizing that throwing money at schools and roads is not accomplishing anything.

Without creating real results all you have done is wasted valuable resources.

The problem is that now, when we will have to pay for legitimate spending, politicians may find it very difficult to persuade us to pay for it.

Vernon Gray

Baltimore

Why not try to live within state budget?

Thank you, Peter Berns, for finally explaining what I've felt for years: My budget deficit is not the result of overspending ("Don't blame spending for Md. shortfall," Opinion Commentary, Nov. 8).

No, my huge debt is the result of not being paid enough. Like the state, my family is not a high-spending one. But demand for services from my six children has increased over the years and income has not risen to meet demand. And despite my employer's wealth, we spend less than most families on a range of services, utilities and recreation.

I think the weeds in my garden, my dirty laundry and my teen-agers' angst are a direct result of this shortfall.

Wait a minute -- maybe, just maybe -- we should try to live within our budget? Nah, get real.

Ruth Finnegan

Columbia

Let voters choose party's candidate

If we had had a real primary election, we might have had an energized, interested Democratic base. If Lt. Gov. Kathleen Kennedy Townsend had won the primary, she would have been ready to face the Republicans. Had she lost, we would have had a candidate with strong support.

But the coronation of Ms. Townsend by party leaders and out-of-state money men deprived voters of a real choice of Democratic candidates and took the votes of the party faithful for granted.

The message to party leaders is clear: Let the voters choose the candidate, because they certainly will choose the governor.

Mac Nachlas

Baltimore

Partisan friends won't help Ehrlich

While The Sun's article "Ehrlich's friends in high places" (Nov. 12) highlights the close relationships Rep. Robert L. Ehrlich Jr. has with Republican leaders, I am interested in what he has learned from their experience.

The leaders cited in the article have had an extremely difficult time reaching consensus in Congress, and President Bush is far from having the support of congressional Democrats for his key initiatives.

Having been elected to a state with a majority of Democrats, I hope that Mr. Ehrlich can see past his partisan colleagues and work to unite Maryland, not further divide it.

Melissa Schwartz

Silver Spring