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The Baltimore Sun

Slots referendum an effort to evade

The deficit iceberg has been looming on the horizon for some time now. As we prepare for its inevitable impact, Gov. Martin O'Malley and state House Speaker Michael E. Busch are embracing the idea of allowing the passengers on the Titanic to decide their own fate through a referendum, thereby absolving themselves of some of the responsibility for the mess likely to ensue ("Miller gives slots a boost," Nov. 6).

The reality of the state's current financial situation will undoubtedly lead to tax increases during the special session.

However, unless these come as part of a comprehensive belt-tightening program that embraces alternative funding sources (i.e., slots), we'll have accomplished nothing.

Mr. O'Malley did not create the state's budget problem. But he apparently overlooked it during the election campaign just one year ago, when he was figuratively promising a college education to every child who could push a piece of furniture to within reaching distance of a sheepskin hanging on a wall.

Today, he speaks of, among other things, closing Maryland State Police barracks to help close the budget gap.

However, the governor and members of the House of Delegates and the state Senate asked for the privilege of representing our interests and were elected to do so.

Voter referendums are a perversion of the process of representative government and a convenient way for leaders to dodge a polarizing issue.

If the special session is to be worthwhile, a compromise on slots will have to be reached before it ends.

To wait and resolve the slots issue through a referendum next year would be irresponsible and unrealistic.

Robert Winchester


Targeting slots sites is simply unfair

Across Maryland, legislators, community leaders and voters are contemplating legalizing slots. Yet simultaneously, many elected leaders, including Gov. Martin O'Malley, are trying to distance themselves from this expansion of gambling by proposing a voter referendum to decide the issue ("Miller gives slots a boost," Nov. 6).

I think legalizing slots would be bad public policy because of the well-documented economic and social ills associated with gambling. But holding a referendum on the current proposal would be still worse, because it could allow jurisdictions across Maryland to impose slots' negative impacts on five selected jurisdictions.

What could be more unfair than to allow voters from counties such as Baltimore, Howard and Montgomery to balance our collective state budget by imposing expanded gambling on legislative districts such as mine (District 21), which includes Laurel Park?

For the sake of fairness, let the vote be about allowing slots anywhere in Maryland.

Whether it's a voter referendum or a normal legislative decision, the slots bill we consider should allow slots in any commercial establishment.

Allowing slot machines in any commercially zoned area would maximize revenue for the state.

Just as important, it would allow an equitable decision by the state's electorate - a decision each legislator or voter could make facing relatively equal ramifications.

Only when we have a vote for unrestricted slot machines across Maryland can a truly equitable debate begin.

Todd Reitzel


Racing commission isn't honest broker

I'm troubled by the wild rhetoric of Maryland Racing Commission Chairman John Franzone (The industry is "in a crisis situation. ... This is like being in the gas chamber") and the unwillingness of the commission to carry out its proper regulatory and investigatory functions ("Laurel to feel cuts in winter," Oct. 24).

Instead of being a mouthpiece for the thoroughbred track owners and the horsemen's union, the commission should be bringing calm and rationality to the situation.

A dispassionate look at handle and takeout figures would show that the Laurel Park winter and summer meets are not profitable and thus should be canceled until adequate purse money becomes available.

The commission should allocate approximately 40 days of racing for the Pimlico Race Course spring meet, 40 days for Laurel Park's autumn meet and a week of racing for the State Fair in Timonium, and that is all.

This would be a proper check on the excesses of some in the Maryland horse industry who seem to think there's a constitutional right to conduct year-round racing regardless of the economic costs or to the damage to animals and human competitors.

Commissioners also should be investigating possible mismanagement that led to an alleged $3 million "shortfall" in the thoroughbred purse account ("Horsemen enjoy Laurel - at least for this meet," Sept. 5).

They should be looking into whether past promises from the industry about improvements to racing properties and promotions have been kept, and reporting on all of this to the General Assembly.

Commissioners should leave their emotions at the door and be an honest broker among racing interests and between racing interests and lawmakers.

Otherwise, they should step down.

James Mosher

Ledyard, Conn.

The writer is a former Marylander who has written about Maryland horse racing for a number of publications.

Way too much fuss over small tax hike

It amuses me to no end how some Marylanders exaggerate the tax figures to support their argument ("Raising sales tax hurts quality of life," letters, Nov.4).

While it is technically correct that the governor's proposal to raise the current 5 percent sales tax to 6 percent is a 20 percent increase, I wonder if some Marylanders would apply the same logic to their investments.

For example, let's say a group of Marylanders has a sizable portfolio of mutual funds that have earned an average return of 5 percent in recent years.

Then, by coincidence, their return in a given year goes up to 6 percent. How many people would be bragging at that year's holiday parties that their investment returns increased a whopping 20 percent?

And the argument about the sales tax being regressive is getting old.

A sales tax is not related to income. It never was. A wealthy person who buys a $20 toaster in Maryland pays a sales tax of $1, just as a low-wage earner or a student does.

That's just the way it is. If you want to pay a lesser sales tax, buy a cheaper toaster.

Or, to avoid the 20 percent sales tax increase and its regressive nature altogether, just move to Delaware, which has no sales tax.

John C. Dudek

Shrewsbury, Pa

Doctors must lead the medical teams

Physicians have always worked closely with our pharmacist colleagues to ensure patients receive the proper medications and pharmaceuticals in the proper doses at the proper times ("The pharmacist is in," editorial, Nov. 4).

Often it is only the pharmacist who knows all the medications a patient is taking because that patient is seeing a number of physicians and has not shared all that information with his or her primary-care doctor.

In these situations, we rely on the pharmacist to use his or her training and skills to review the medications to make sure that the drugs do not adversely interact.

But it is important for the patient's safety and well-being that prescribing medications be the province of physicians.

Only members of that profession have all the necessary scientific training in physiology, pathology, microbiology and pharmacology, and the needed experience in clinical practice at the bedside, to have all of the requisite skills to completely care for patients.

We can, and should, work with our pharmacist colleagues in teams - particularly teams serving the chronically ill. And we will need to consider how these teams can augment their services to patients.

But we must never lose sight of the fact that only the physician has all of the skills and knowledge needed to understand all of the complexities of an illness.

For all of our safety, the physician still will need to be the captain of that team.

Dr. Martin P. Wasserman


The writer is executive director of MedChi, the Maryland State Medical Society.

Protect public access to local pharmacies

As the executive director of the Maryland Pharmacists Association, I could not agree more with The Sun's editorial "The pharmacist is in" (Nov. 4),

We pharmacists have always been the first line of defense in health care. We want not to supplant the services that physicians offer but to supplement them. And pharmacists are truly in an ideal position to fill the gaps in our health care system.

But we are concerned that under the Deficit Reduction Act of 2005, the Department of Health and Human Services will soon issue new rules that will cut the reimbursement rate pharmacists receive for generic medications under the Medicaid prescription program.

A recent report from the Government Accountability Office estimates that the new reimbursement rates could be 36 percent below the cost of these generic drugs to the pharmacy.

We ask Congress to prevent the reduction of reimbursement rates for generic medications to a level that would cause the closing of small and rural pharmacies and the reduction of services in others.

It is important to our health care system that pharmacists remain as accessible today as they have been for more than 100 years.

Howard Schiff


Focus on improving the quality of care

Recent commentaries and letters in The Sun have advocated single-payer, universal health insurance for American citizens ("Say yes to national health care," Opinion

Commentary, Oct. 29, and "Access to health care a question of justice," letters, Nov. 4).

The authors assert that such a system would increase the quality of health care services.

The evidence provided for such claims often is that some nations with national health insurance demonstrate better performance on measures of quality such as life expectancy, immunization rates, etc.

However, I think we need to focus more on ways we provide health services than on how we pay for them.

We need to change our focus from illness treatment to illness prevention.

Patients must be encouraged by primary-care providers to maintain healthy lifestyles.

Expensive advanced technologies should be utilized infrequently, not routinely.

Expensive new medications should not be routinely prescribed until there is proof that they are more effective or safer than other treatments.

The adherence of physicians and hospitals to best-practice guidelines should be measured, and that information should be made available to consumers.

Simple procedures can be instituted to prevent hospital infections. And care services should be provided in an integrated system with all providers helping develop a treatment plan for each patient.

Although a single-payer system would increase access to care for those now uninsured, it would not ensure higher-quality services.

The health care system itself must take the lead in quality improvement.

Dr. Larry Adler


Ensure all children can see a dentist

The death of a Prince George's County 12-year-old, Deamonte Driver, as a result of a dental infection has brought new attention to long-standing concerns about access to oral health care for Maryland's poor children ("In effort to improve dental health, city screens hundreds of children," Oct. 23).

Recent reports show that 71 percent of Maryland's children on Medicaid received no dental services in the past year.

One consequence is that more than 30 percent of Maryland's elementary school children and more than 50 percent of children in Head Start programs have untreated cavities.

To overcome this long-standing crisis of oral health care for poor children, the Dental Action Committee was convened to comprehensively examine the oral health system in Maryland ("Panel urges $40 million for dental care," Aug. 30).

The committee's report called for a "dental home" (or an identified dentist) for each child in Maryland who is eligible for Medicaid.

To accomplish this vision, the committee recommended providing adequate Medicaid reimbursements to dentists, initiating a single dental vendor system that could create a unified network of dentists to serve children on Medicaid, and ensuring a statewide "safety net" of local health departments that can provide dental care for children on Medicaid.

These recommendations could create a strong statewide public-private partnership to ensure access to oral health care for a cost of about $25 million a year.

In the richest state in the nation, can Maryland officials afford to ignore the shameful lack of access to dental care for our poorest children?

I urge the governor and the state legislature to enact these recommendations now.

Elijah E. Cummings


The writer is a member of the House of Representatives.

Bill could help kids understand Earth

As a recently retired teacher with 40 years of experience in Baltimore's schools, I saw firsthand how more and more attention was devoted to helping students do well on standardized assessment tests ("Education politics," editorial, Oct. 29).

And I know this focus often comes at the expense of subjects not assessed by standardized tests.

I definitely felt that impact in my area: environmental education.

As the No Child Left Behind law became the rule, fewer students were able to enroll in environmental classes, as they were pushed instead into courses related to topics covered by assessment tests.

Field trips became less of a priority, and money to support them grew tight.

However, environmental education should not be considered merely an "optional" subject, particularly for the sorts of kids I taught for four decades - city dwellers who spent most of their time surrounded by concrete, asphalt and brick.

Too many of my kids knew little about Baltimore's incredible collection of parks.

The deteriorating conditions of the Chesapeake Bay were irrelevant to them - in large part because many of them had never been to the bay or on its beaches. Nor did they realize that their own actions were contributing to the bay's decline.

Congress is now considering a bill - the No Child Left Inside Act, sponsored by Rep. John Sarbanes of Maryland - that for the first time would provide significant federal support to environmental education.

The money could be used for the basics - teacher training and program development.

And states could tap into a new fund to develop environmental literacy plans that could make sure their students have a basic understanding of their world.

I trust Congress will include provisions of this bill when it reauthorizes the No Child Left Behind law.

Joan F. Johnson


Multiculturalism helps end bigotry

The writer of the letter "Divisive dialogues waste tax dollars" (Nov. 1) says that it is unfortunate that Americans of European heritage are not speaking out against a multicultural education program.

As an American of European heritage, I see multiculturalism in a very different way.

I spent my childhood in a military family. My father was stationed for six years in Japan, and he traveled a lot. He impressed upon my brother and me the importance of understanding, respecting and enjoying other cultures. And I am grateful for that.

I understand that it is hard to confront the role of one's race and religion in the oppression of others when one has not participated in those acts.

Yet if we do not understand that history, we will not be able to understand the perceptions of the oppressed or know what created today's injustices or be ready to help bring about a more just world.

Multicultural education is designed to create the conditions to eliminate racism and prejudice by broadening our experience of other cultures.

In so doing, it deepens our appreciation of our own heritage as it fosters values of equity and equality and steers our children toward being engaged citizens who can shape a more just world.

That is certainly what I want for my daughter and the generations to follow.

Richard Gwynallen


Work of immigrants aids the community

The writer of the letter "Letting immigrants rip off U.S. taxpayers" (Nov. 4) suggested that it is mean to "allow illegal immigrants to take U.S. taxpayers for all they can get."

Let us not overlook that immigrants, legal or not, pay taxes.

Because they consume products, they pay sales taxes.

If they work, many of them pay income taxes.

And because they pay rent, part of that goes toward property taxes, which helps pay for the local school budget.

Not only do immigrants, illegal or not, pay their own way, they are known as hard workers. Far from being parasites, their work benefits the community and government.

The real problem here is economic globalization, which exports U.S. jobs and drives immigrants here by replacing the local economies in their home countries with nearly slave-wage jobs.

It is easy to scapegoat those on the bottom. It is a lot braver to take on the corporate behemoths and their political minions.

Let's start by revoking the licenses of corporations that hurt working people both here and abroad.

Richard J. Ochs


It's time to restore nation's principles

Today, America faces a crisis. It extends far beyond President Bush's catastrophic war in Iraq. But it is not unique to our time.

Two hundred years ago, we faced a similar crisis.

Thomas Jefferson wrote in 1798, during the illegal and undeclared war with France, and after the passage of the Alien and Sedition Acts - the Patriot Act of that time: "A little patience and we shall see the reign of witches pass over, their spells dissolve, and the people, recovering their true sight, restore their government to its true principles."

The principles we hold dear are adherence to our Constitution, the rule of law and a government of checks and balances.

Mr. Bush has used the fear created by the 9/11 attacks to mount an assault on what this nation stands for - our freedoms.

Today, the super-rich billionaires keep getting richer while members of the middle class lose their homes to mortgage scams and their jobs to imports brought in by the large corporations with their god of greed.

We must all work toward bringing our nation back to its rightful path.

Stephen Kay

Severna Park

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