Better health care starts with patientNot only will HMOs...

LETTERS

June 23, 1996

Better health care starts with patient

Not only will HMOs not save Medicare (Perspective, June 9), but managed care will only accelerate the deterioration of health care felt daily for others in the public and private sectors of health insurance.

In his article, Douglas J. Peddicord, a health policy analyst at the University of Maryland School of Medicine, detailed a fair assessment of what can be expected if managed care accesses Medicare enrollees. Managed care is no panacea; it's managed cost, plain and simple.

The error of our ways in cost-saving measures is in the assumption that saving money is the primary goal in the health care industry. Well, as the adage goes, you get what you pay for. If citizens in this country want to live longer and healthier lives, results start in the home and not in a doctor's office or health care insurer's statistics.

As the cry for accountability and responsibility travels through the myriad ills of our social fabric, patients had best stay focused on their role in the health care crisis. Insurers have to provide the reimbursement for services they state are available in their contracts, and physicians have to practice medical care based on Hippocratic limits and not financial incentives.

Patients have to examine choices in lifestyle that either extol or erode physical and mental well being. Tobacco, alcohol, poor dietary and exercise habits, and other misconceived choices never justify a demand for treatments and cures for years of intolerance and ignorance.

Within another two decades, the Baby Boomers reach age 65 and we had best prepare for a major shock wave if managed care metastasizes further. As Mr. Peddicord states, ''Bottom-line improvement comes at a price.'' One day that call to your insurer may be truly life or death.

Joel H. Hassman, M.D.

Eldersburg

No monopoly on Cold War

I have great respect for William Perry, our most effective secretary of defense. However, I was disturbed by one statement he reportedly made during a press conference in Germany (The Sun, June 6) that Russia should stop thinking in Cold War terms and accept NATO's planned expansion into Eastern Europe.

With a little self examination we might well discover that Russia is not alone in Cold War attitudes. How else can you explain not only our policy on NATO expansion, but U.S. military spending at near Cold War levels for unneeded and unwanted Cold War weapons systems?

Looks like a two-way street to me.

John J. Shanahan

Washington

The writer, a retired vice admiral, is director of the Center for Defense Information.

Positive school story welcomed

Thanks for your uplifting June 13 article, "Students who couldn't miss." And congratulations to Theresa Gwynn, whose perfect attendance project proves that one person can make a difference.

Be careful. If you continue printing positive copy like that, people will stop saying The Sun publishes only negative stories about the public schools in Baltimore City.

You don't want that, do you?

Magdalene B. Fennell

Baltimore

Handcuffing found wrong

Where are we heading when putting a 6-year old child in iron handcuffs is considered the right thing to do?

One wonders what treatment would have been instituted by the school authorities if the policeman had not been at the school office? Could the child have been held tightly by two adults, taken to a quiet corner, talked to calmly and been gradually soothed?

Does the school have a nurse's office? Was there no school nurse available who was trained for such eventualities?

There are medications available for such conditions, but I question why the school authorities -- teachers, principal and nurse -- were not aware of how to deal with such a situation after a whole school year had gone by.

Of course, the child needed to be restrained, soothed and shown love. I question whether cold, iron handcuffs and a policeman is the right treatment -- a traumatic experience for a child with a medical condition he cannot control nor understand, and one that often bewilders others.

Anne Stein

Baltimore

Racing industry must be competitive

The horse racing industry is not dying. On the contrary, after experiencing a horse shortage due to the tax reform act of 1986, we are finally recovering.

The last few years have shown an increase in foal production here in Maryland and last year the horse sales at Timonium set a record price for yearlings.

The Maryland horse industry as a whole also showed large profits in 1995.

Breeders from all over the country are bringing their mares here to breed to Maryland stallions.

Maryland has been the leader in horse racing and production in the mid-Atlantic region for more than 100 years.

In order to keep this lead, our purses must be better than Delaware Park's.

Delaware's purse structure continues to spiral upward. It is expected to offer $200,000 a day in purses by November 10 (Thoroughbred Times), thereby surpassing Maryland's daily purse numbers.

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