The Baltimore Sun

Expanding Medicaid still fiscally responsible

With budgets on the chopping block, one area the state should not cut is health care coverage ("'Devastating' state revenue report may mean cuts in public safety, education," Dec. 17). Here's why: As Maryland expands Medicaid coverage including preventive care, data from other states are showing that expanding health insurance can lead to costs savings down the road.

Massachusetts adopted an ambitious program in 2006 that provides incentives for business and individuals to expand health insurance coverage. Now, 440,000 more Massachusetts residents have insurance.

After two years, the state's cost for unpaid care at emergency rooms, hospitals and community health centers dropped roughly 40 percent.

Oregon provides a cautionary tale for states going the opposite direction.

In 2003, the state reduced its health coverage, leaving 50,000 fewer people on Medicaid. After these changes, the number of visits by uninsured residents to the state's emergency rooms rose from 6,682 per month in 2002 to 9,058 per month in 2004.

Many patients walking into the emergency room could have been spared considerable suffering, as well as expense, if they had received regular, preventive care.

Tough economic times translate into state budget problems, and some people are now calling call for cuts in Maryland's newly expanded Medicaid program.

But expanding health insurance, whether through state-sponsored plans or incentives for business and individuals to provide insurance, can save Maryland lives and money.

With the new Medicaid expansion program adopted in the last legislative session, our state is on a healthy, fiscally responsible road.

Dr. Dan Morhaim Vincent DeMarco, Baltimore

The writers are, respectively, a state delegate and the president of the Maryland Citizens' Health Initiative.

City alone can't solve the area's ER crisis

In the editorial "Rx for Baltimore" (Dec. 21) The Baltimore Sun once again placed the onus for solving metropolitan problems on the city.

But the use of emergency rooms to supplant primary care health care providers is not unique to the city. The fact that the city health commissioner, Dr. Joshua M. Sharfstein, does not ignore the problems in the city is merely testimony to his concern for those he serves.

Attempting to solve such problems in just one jurisdiction of an interdependent metropolitan area serves no one, and can in fact exacerbate the problems. This is true for heath care issues and for other services.

As economic and social differences between the city and its suburbs continue to disappear, we will need smart metropolitan solutions, and The Baltimore Sun should do its part to promote that kind of 21st-century thinking.

Carl Hyman, Baltimore

'Bupe' is helping addicts recover

The Baltimore Sun continues its extended attack on the drug buprenorphine with the comment, "But critics say addicts using what is known as 'bupe' may be no better off than those using methadone," in the article "Sharfstein is favorite son for FDA post" (Dec. 16).

To exactly what "critics" does this comment refer?

Buprenorphine continues to prove itself an effective and relatively benign (though imperfect, to be sure, addiction being among the most cunning, baffling and demoralizing diseases known to humanity) remedy to the horrors of heroin withdrawal.

Any medicine proved to reduce the incidence of overdose and the spread of HIV, without causing the dependency that marks methadone treatment, does make recovering addicts "better off," to my way of thinking.

Some addicts abuse "bupe." So what? Many non-addicts abuse prescription medicines.

Minor instances of misuse fail to diminish the efficacy and safety of this remarkable stepping stone to freedom from active addiction.

Joshua Bloomberg, Timonium

Suspending standards demeans the diploma

I have always believed that my high school diploma stands for my successful completion of all required high school subjects.

What, pray tell, is the value of a high school diploma if the requirements for graduation have been waived ("Test waiver would aid graduation," Dec. 18)? Catherine B. Cover, Cockeysville

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