Glendening veto a boon to special interestsBy vetoing...

the Forum

June 16, 1995

Glendening veto a boon to special interests

By vetoing House Bill 615, Gov. Parris Glendening has handed a victory to the big-money health care industry and its executives.

The losers will be primary health care providers and the hundreds of thousands of patients enrolled in HMOs in Maryland.

For years now, HMOs have taken advantage of a legal loophole to shift legitimate costs onto subscribers.

Here's how it works: John Smith is an HMO patient, for which he or his employer pays hefty enrollment fees.

One night Mr. Smith awakens with chest pain. Fearing the worst, his wife drives him to the nearest emergency room, where he is evaluated for possible heart attack.

After blood tests and an EKG, the doctor happily tells Mr. Smith that his pain is most likely caused by severe intestinal distress, which can often mimic the symptoms of a heart attack.

The Smiths breathe a sign of relief -- until they get the word from their HMO that their bill has been denied. Why? Mr. Smith's chest pain wasn't a "true emergency."

Had he suffered a heart attack, the HMO would have been required to pay his expenses. But since it wasn't, the payment has been denied.

Was there any way to know whether it was a heart attack without the tests being run? No, the HMO admits.

Did the Smiths act unreasonably in going to the hospital? No, says the HMO.

But if they had read the fine print in their contract, they would have known the HMO doesn't have to pay for "non-emergency" care. As determined by the HMO. After the fact.

This scenario is common one in emergency rooms throughout the state. And there have been tragedies as a result: Next time, he might have a real heart attack, but John Smith will delay coming in.

House Bill 615 would have required HMOs to pay for care received by their subscribers in emergency rooms.

The HMOs worked hard to obfuscate this issue, claiming that the bill would encourage abuse of ERs. But the fact is that ERs are abused primarily by those who have no insurance.

HMO subscribers, like most patients, would much rather get care in an office or clinic setting than in crowded hospital ERs. For the most part, they use ERs appropriately, i.e., when they perceive an emergency exists.

HB 615 went through extensive hearings and debate. It passed the Maryland Senate 47-0 and the House of Delegates 130-5. So why did Governor Glendening subvert the legislative process and betray the trust of the voters of Maryland?

Hard to say, but it may have something to do with the 1998 re-election campaign and how much money it will cost.

After all, those HMO executives make seven figure incomes, and they'll remember this favor for a long time to come.

The rest of us are just penny- ante, ordinary citizens. Score another victory for special interests over the common good.

Winifred Tabor

Baltimore

Principal's transfer

I am writing in the hope that this letter may be of some help to Brehms Lane Elementary School, whose principal, Claudia Brown, may be transferred to another school.

Mrs. Brown is an excellent principal -- caring, personable, considerate and understanding as an administrator -- who works closely with the staff, faculty, children and parents. The family of Brehms Lane does not want to lose Mrs. Brown as principal.

She has worked very hard to keep Brehms Lane a safe environment.

She has worked with the Bel-Air/Edison Community Association as one of its board members, with the School Improvement Team to elevate attendance, and with partnership organizations and businesses to provide tutoring for the children.

Mrs. Brown cares deeply about the children and staff. The Brehms Lane faculty, staff, children and parents are a family. We don't want our family circle to be broken by the transfer of Mrs. Brown.

Linda Lee

Baltimore

Baby Kares

I was saddened then outraged by your article about Baltimore County social workers taking baby Brittany Kares from her parents because the couple took her to the hospital too often ("Parents regain baby girl in custody compromise," June 8).

The action taken against Anne and Michael Kares was an indignity to them motivated by arrogance.

As the article stated, there was no suspicion of abuse or neglect by the couple. On the contrary, everything indicated these parents cared for and loved their child wholeheartedly.

The expression "It takes a whole village to raise a child" is beautiful and true. What it conveys is that each member of the community must have the courage to be aunt or uncle to that child and brother or sister to its parents in order to support the family unit.

The Baltimore County social workers evidently were not moved to applaud the love and caring of these young parents; instead they saw fit to pull the family apart -- this at a time when families in general are getting so much attention and are lauded as the cornerstone of a healthy society.

I vividly remember being the young mother of a first-born child and calling the doctor a bit too often because I was unsure and sometimes frightened when I thought my baby was ill.

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