Insurance firms value profits more than babiesI read with...


January 28, 1996

Insurance firms value profits more than babies

I read with great interest the Jan. 23 column, "Congratulations, Mom! Here's the door," by Robert N. Sheff, president of the Blue Cross and Blue Shield of Maryland HMOs. As a practicing pediatrician I found his logic on the benefits of early postpartum discharge to be the standard line given by the insurance industry. Clearly, this 24-hour discharge policy has only one benefit -- to save money.

When I began my practice 10 years ago, I was able to evaluate my newborn patient's transition into the world over a two to three-day period.

This not only allowed me to assess the ''recuperation,'' as Dr. Sheff calls it, but also very important medical issues such as feeding, passage of stool, jaundice and the stabilization of the cardiac system. Although, as Dr. Sheff points out, a home visit is made by a nurse following discharge, I also know that these nurses' neonatal skills vary widely.

We have had two infants in the last two years who have been discharged at 24 hours only to return to our offices later that same day with critical cardiac defects. Some would say that the system worked since those patients were detected and treated. But I can tell you it was a nightmare for the parents to be sent home with a ''well'' baby only to find out hours later that it was being readmitted for cardiac surgery.

The current insurance climate has turned 24-hour discharges 180 degrees from a situation where parents and physician had to prove that the infant/mother pair was stable and had good home supports prior to early discharge. In the current situation, the physician must prove to the insurance company that there is something wrong with the infant or mother that dictates a longer stay.

Which situation do we, as a society, really desire -- a system driven by infant/mother needs or a system driven by insurance profits?

Steven Dannenfelser, M.D.


Column confirms reader's thinking

Thanks to Tom Horton for confirming in his Jan. 19 column what I had already begun to suspect: that environmental regulations are far from being the only or even the major complaint voiced by businesses in regard to Maryland's business climate.

Let's hope that all legislators read the results of the France Center's survey -- or at least Mr. Horton's summary.

Leslie Starr


House of Ruth offers help

It is important to let all disabled battered women know what their resources are in Baltimore.

I found the Jan. 21 story about Mae Hepple to be tremendously powerful. As well as being born with cerebral palsy and confined to a wheelchair by age 13, Ms. Hepple endured years of sexual abuse and neglect from a foster relative, an abusive husband and destructive relationships.

Ms Hepple left her abusive husband in 1984 and contacted the House of Ruth. Back then, our shelter for battered women and their children was a tiny row house in the city and was not equipped to handle clients who were handicapped or in wheelchairs.

In 1987, we relocated to a new shelter facility that is fully accessible for the disabled. Included in our efforts to serve all victims of abuse, we operate a TTY service for the hearing impaired.

It is tragic that Ms. Hepple was twice victimized because of our lack of resources. However, it is important to let battered women with physical disabilities know that although we could not accommodate Ms. Hepple 12 years ago, we can help disabled and abused women and children today. For more information on shelter, counseling and legal needs, victims are encouraged to call our 24-hour hotline at (410)889-7884 or our TTY at 889-0047.

Carole J. Alexander


The writer is House of Ruth executive director.

Shooting of mentally ill woman raises issues

I was saddened by the tragic death of Betty Keat, the lady who was shot by two officers responding to neighbors' complaints about alleged throwing of "Molotov cocktails".

As a colleague at Morgan State University, I was acquainted with Mrs. Keat, lived in the same neighborhood and had enjoyed frequent brief conversations with her. Although I did not know her well, I had found her to be bright, well informed and thoroughly enjoyable company.

Many issues are raised by the sequence of events that led to her death.

The first is the need for a response by a professional psychiatric team rather than the police when a person is suspected of being mentally unbalanced. Baltimore does have a mobile response team which should be available for such situations.

From my knowledge as the first president of the Maryland Chapter of the National Association for the Mentally Ill (NAMI), I am quite certain that the Baltimore Mobile Psychiatric Response Team needs additional funding and support in order to perform such a task well.

The mentally ill are not criminals and should be attended to whenever possible by medical and not by police personnel.

The second issue is one of education for the public at large regarding the symptoms, response options and treatment of the mentally ill.

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