Creating a better model for health careI am writing in...

Letters

December 29, 1996

Creating a better model for health care

I am writing in response to the column titled, "A better model for health care," that appeared in The Sun on Sept. 24. In his commentary, L. David Taylor addressed the rise of managed care and the dissatisfaction of health care providers with the current system.

Physicians said that treatment restrictions sometimes conflict with the trained physician's professional judgement.

Concerned that patients are not always receiving appropriate care, some physicians are attempting to form new organizations called physician organizations (POs) and physician- hospital organizations (PHOs). Ideally, PHOs and POs would give the provider the power to determine what services a patient receives while controlling spending.

Mr. Taylor suggests a health care delivery system that he predicts would satisfy the need of both the managed-care companies and the physicians. In his model, physicians who owned the organizations would establish standards for care and have freedom in treating, while their counterparts, the insurers/HMOs, would handle controlling costs.

As an occupational therapy student, I wish to respond to Mr. Taylor's plan, as I feel it would impact the delivery of occupational therapy services. While I support the union of health care providers and managed care organizations, I do not believe that physicians should be exclusively responsible for setting standards for care.

Physicians are not the only health care professionals who are given restrictions. For example, often services provided by occupational therapists are indicated much longer than they are paid for by insurance.

Also, to allow physicians to exclusively set standards of care gives them a power that could negatively impact the delivery of other health care services. Financial incentives, hypothetically, could make the treating physician less likely to refer to specialized professions.

My proposal is for a system that unites managed care organizations and health care providers. One change I would make to Mr. Taylor's plan would be to have representatives from each of the health care professions who provide services under the insurance plan contribute to the development of standards of care and be given freedom to use the skills for which they have been formally trained.

Amy Landemare

Annapolis

Students put on a great show

Something wonderful happened in Anne Arundel on Dec. 14, when some of the finest talent in young musicians gathered to present a concert. Not publicized greatly, this event was one of the most outstanding presentations of music we have ever heard.

An orchestra of some 97 young people from the sixth, seventh and eighth grades joined their talents under the direction of Chris Allen to present a musical night to remember. Concluding the evening was the All-County Senior High Orchestra, under the direction of Harry John Brown.

We praise the music teachers and departments that assist in preparing these students to play such wonderful music and excel at such a young age. Anne Arundel County schools should be proud of this achievement. The nearly 600 in attendance at Lindale/Brooklyn Middle School would agree. Bravo, students.

Robert and Signe Worsham

Millersville

Vice doesn't follow flag; prejudice follows the writer

In his Dec. 3 op-ed piece, "Vice follows the flag," Llewellyn H. Rockwell Jr. displays a shockingly narrow-minded and prejudiced view toward enlisted members of our nation's military.

In one fell swoop, he managed to twist together the facts surrounding a single incident of rape, along with several dubious assumptions, and slander millions of present and former service members in the process. Many of whom, by the way, make profound personal sacrifices (including the ultimate) in service to our country.

In support of his assertion that "the military attracts social misfits and deviants," Mr. Rockwell offers several pieces of evidence, including the rape of a young Okinawan girl by three U.S. servicemen and the public outcry which understandably followed; the existence of "an entire city of bars and prostitutes" near our previous U.S. Naval Base in Subic Bay, Philippines, and the existence of "two dozen or so nude dancing" bars near Fort Benning in Columbus, Ga.

Rape is a terrible crime, and the three soldiers responsible were rightfully prosecuted and punished under Okinawan law. But should the crimes of a few reflect on all 1.4 million people in the military? How would Mr. Rockwell respond if someone were to impugn the entire citizenry of Auburn, Ala., for isolated misdeeds committed by three local criminals? That's the type of logic upon which his reasoning is based. It just doesn't wash.

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