The Baltimore Sun

Medicare cuts push doctors to the brink

On behalf of the more than 2,000 members of the Maryland chapter of the American College of Physicians, I want Sun readers to know how much our members share the concerns and dismay expressed by Dr. Ronald Sroka in the article "Where the money isn't" (June 29).

We are major providers of care for Maryland's elderly and disabled citizens through Medicare, and we are shocked and angry that we face a huge cut in our reimbursement rates.

Internal medicine physicians run lean practices with high overhead costs that have been rising much more quickly than our very meager to nonexistent payment increases in the last few years.

The 10.6 percent cut in Medicare reimbursements will translate into a 20 percent to 30 percent pay cut after our rising expenses are taken into account.

Who will suffer the most?

Our patients will lose access to physicians, timely appointments, preventive services and time with their doctors. Our young doctors will not want to take care of the older and more infirm patients.

Some internists will retire early. Some will leave medicine to find other work. Some will drop out of the Medicare program entirely.

Now we need the help of our patients to make sure that Congress acts quickly to reverse this drastic cut to our ability to provide the best care for our patients.

Dr. Mary M. Newman, Lutherville

The writer is governor of the Maryland chapter of the American College of Physicians.

In a sane world, Medicare would not be planning to cut 10.6 percent from its payments for physician services, which may incite some to stop accepting Medicare patients and perhaps drop some patients they already have.

However, the program is bound by a foolish policy enacted 11 years ago by a Congress that thought it could estimate the growth of medical services for future years and limit payments to doctors accordingly.

But, of course, the Medicare population is increasing rapidly and living longer, and therefore needs more medical services.

Caring doctors can hardly keep up with the patient load, and cutting their pay cannot be justified.

Raymond S. Gill, Crownsville

Use funds for war to repair Medicare

Medicare reimbursements to physicians are going down again. As a consequence, some physicians, according to The Sun's article "Where the money isn't" (June 29), will close their practices; others will simply stop treating Medicare patients.

According to one person quoted in the article, it would cost Congress $150 billion to fix the system, but "that's money it doesn't have."

Of course, neither did Congress have the almost $1 trillion that it has appropriated for the war in Iraq.

I suggest that Congress look for Medicare funding in the same cabbage patch where it finds the apparently unlimited dollars it wastes feeding the national insecurity fomented by the terror-mongers of the Bush administration.

Russel Kacher, St. Michaels

Clark didn't scorn McCain's service

It is disappointing that many have fallen for the fit that Sen. John McCain's campaign is throwing over retired Gen. Wesley K. Clark's remarks ("Shoot this down," editorial, July 1).

But there is no moral equivalence between the Swift boat attacks on Sen. John Kerry and Mr. Clark's remarks.

The Swift boat attacks were direct attacks on Mr. Kerry's military service.

In contrast, Mr. Clark absolutely did not attack Mr. McCain's military service.

In fact, Mr. Clark honored Mr. McCain's service while noting that it alone did not provide the experience and judgment necessary to be president: "I certainly honor his service as a prisoner of war. ... But he hasn't held executive responsibility. ... He hasn't been there and ordered the bombs to fall."

It is understandable that the McCain campaign wants to focus on issues of personality instead of issues such as the economy, health care, gas prices and Iraq.

After all, the polls show that the American people trust Sen. Barack Obama more than Mr. McCain on these issues.

G. Byron Stover, Baltimore

Tired of taxes going to religious groups

Doesn't Sen. Barack Obama realize that all the pandering in the world won't get religious fundamentalists to vote for him and that the only thing his talk of expanding faith-based government-financed programs is sure to do is alienate his political base ("Obama advances faith-based plan," July 2)?

Some of us are tired of having our pockets picked for the benefit of religious groups.

As someone who sees no good coming from a possible John McCain presidency and hopes to be able to vote for Mr. Obama, I certainly hope that the senator from Illinois comes to his senses before it's too late.

Kenneth A. Stevens, Savage

No need to divide church and state

It is gratifying to see a liberal Democrat such as Sen. Barack Obama proposing to expand government funding to faith-based organizations ("Obama advances faith-based plan," July 2).

It is disappointing, however, to see Mr. Obama simultaneously advance the fiction that such funding must respect the so-called separation of church and state as a matter of constitutional law.As Mr. Obama surely knows, the phrase "separation of church and state" does not appear in the Constitution. The phrase comes from a letter written by Thomas Jefferson more than 10 years after ratification of the First Amendment, which argued for his own rather tendentious interpretation of the religion clauses of that amendment.

A better authority on the topic is the president who was serving when the First Amendment was ratified, George Washington.

Washington never believed - before or after ratification of the First Amendment - that government and religion should be kept separate from one another.

As he said in his farewell address: "Of all the dispositions and habits which lead to political prosperity, religion and morality are indispensable supports."

Mr. Obama should eschew the false talk of "separation" and instead take pride in his plan to follow in the footsteps of President Washington.

Tara Ross, Dallas

Joseph C. Smith Jr., Denver

The writers are co-authors of the book "Under God: George Washington and the Question of Church and State."

More class time won't aid learning

Having taught middle school for 17 years, I don't think that adding class time is a viable way to improve learning, particularly for average and below-average classes ("Middle school changes urged," June 25).

Keeping middle school students' attention for the allotted class time is already a major accomplishment.

Having average and below-average middle school classes report to school earlier or stay later would be a catastrophe.

Janet Hodges, Joppa

Privacy is critical in helping addicts

I read Rob Hiaasen's article "At 83, Father Martin still speaking to pain of addiction" (June 29) with great enthusiasm and pride. It captured well the many accomplishments of our co-founders and of Father Martin's Ashley treatment center since its inception 25 years ago.

However, it is important for Sun readers to understand that we have a strict privacy policy at Father Martin's Ashley.

There were names mentioned in the article as former Ashley patients that were not provided by any of our staff. Our policy is to neither confirm nor deny whether someone has been in our care.

Confidentiality is very important to Ashley, our patients and their families.

Our policies are designed to honor and respect that confidentiality without exception.

Father Mark Hushen, Havre de Grace

The writer is president and CEO of the Father Martin's Ashley treatment center.

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