Geese preferable to suburbanites who polluteYour Aug. 6...


August 15, 1996

Geese preferable to suburbanites who pollute

Your Aug. 6 editorial about the dangers of deer and geese, "Suburban pests," has it backward. The true pests are the "Silly Suburbanites." It is the migration of these polluting people that is destroying what was home to the birds and animals long before they brought ''progress'' to the once pristine countryside.

It is far more delightful to watch a "V" of geese across the sky or deer graze in a meadow than look at an overweight suburbanite gassing up his barbecue or gunning his tractor around his quarter-acre of chemical lawn.

The genuine hazards are not the birds and animals seeking food but the ignorant people offering it. The simplest solution would be to eliminate the malls, tract houses and killer highways. In Maryland, the overpopulation of the "Stupid Suburbanite," for whom there is very little affection, is by far the most dangerous hazard.

Cooky McClung


HMOs shouldn't be profit-driven

As a doctor, the most unpleasant experience of every day is the verbal warfare with insurance carriers, HMOS and PPOs, on the payment for services I have rendered to my patients.

These companies, which for a fee are to provide financial medical coverage for their members, are less interested in quality medical care and more interested in profits, dividends and $4 million paychecks to the CEO.

I have been in unarmed combat with insurance companies for 12 years and, in my view, they are greedy, capricious, arbitrary and inflexible. An Aug. 3 article by Suzanne Wooton ("Physicians are ordered to limit referrals') reported a compelling story of how a Maryland-based HMO has directed its member-doctors to minimize referrals to specialists and to limit those specialist referrals to a single visit. One doctor quoted in the article stated the obvious: ''The quality of care issue here is horrendous."

A primary care doctor is basically restricted to two actions with any patient: referral to a specialist or prescribing medicine. The primary physician is not a specialist and if a patient needs a cardiologist, dermatologist or vascular surgeon, he is referred because the primary doctor is neither experienced nor trained in that skill.

This HMO's directive states that after the single referred visit, the specialist is to advise the primary doctor of subsequent treatment and actions. The article notes that primary care doctors may be ''uncomfortable'' performing specialty services with which they are neither familiar nor experienced. No kidding.

Isn't this like getting the plumber to wire the bathroom while he's already in the house fixing the toilet, with instructions from the electrician on the telephone? The homeowner might save money, . . . [but he also might] have to move in with his mother-in-law after the house burns down.

The HMO contends, ''We're trying to control costs while providing members with appropriate levels of care.'' The statment should have ended at the word ''costs'' and their use of the word ''appropriate'' does not inspire confidence either. . . .

The HMO mentioned in the Aug. 3 article was Mid Atlantic Medical Services Inc., a Maryland-based carrier that paid its CEO $4 million in 1995. How much quality care would $4 million provide?

Like most doctors, I followed the president's health care reform closely. Though it failed, and admittedly much of it I didn't like, an underlying premise that conventional insurance carriers would go the way of the Hula-Hoop I found appealing. Health insurance companies of all stripe should, by law, be non-profit. Their members should be looked upon as clients and customers, not cost centers. Quality health care through skilled medical treatment should be the primary goal, not black ink and multi-million-dollar salaries.

Neil B. Cohen, M.D.


U.S. firms were hooked on opium, too

A footnote to Jonathan Power's piece on the British and Chinese ''propensity'' for opium. To balance Britain's mushrooming imports of tea and silk, merchants like Dr. William Jardine bought raw opium in India and sold it to the Chinese for 10 times as much.

But they weren't the only ones. By the 1820s, according to Sterling Seagrave's ''The Soong Dynasty,'' various proper firms "such as Perkins & Co. and Russell & Co. of Boston engaged in immense opium trade by clipper ship."

In the process of addicting millions of Chinese, these Western merchants -- the founding fathers of some of the haughtiest, old-money American families -- fomented the Opium Wars, further corrupting the local governments and gaining exemption for themselves from Chinese justice. We don't have to look to Britain, let alone China, to find villains in the drug trade.

Michael Kernan


Police must be present to stop crime

I could not resist writing in response to the letter by Robert J. Casper, Aug. 9, ''An outrage in broad daylight." Can't you see that the problems lie in the inadequecy of our law enforcement policy? Too much paperwork, not enough footwork.

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