HMO regulations raise many more questionsIn a March 12...

Letters

March 24, 1997

HMO regulations raise many more questions

In a March 12 letter, "HMOs seen in need of more regulations," Steve Shearer supports legislation making physician administrators in health maintenance organizations accountable for their medical policy decisions.

He references a March 5 article, "Stronger oversight of HMOs sought," that detailed current legislative efforts to micromanage health care in this state. I say such efforts are Band-Aids. We need a tourniquet.

State and federal legislation created the problem. Laws that require a licensed health care provider to accept the fee set by the insurer/HMO or Medicare, rather than bill the patient, have blurred the boundaries between medical decisions and insurance-coverage decisions.

The patient may not be billed and will only receive treatment if the insurer or HMO agrees to pay for it. Does a coverage decision thus become a medical decision? And who makes that coverage decision -- the patient's licensed medical provider or a company administrator employed by the patient's insurer/HMO? The fact that the administrator is ''licensed'' raises other questions.

Instead of exploring more mandates, the legislatures should be asking questions: What does it mean to be ''licensed'' as a provider of health care. Does such an individual's license allow medical decisions where there is no ''patient,'' just thousands of ''subscribers''? What is the state's interest (health, safety and welfare) in licensing providers? What constitutes the unlicensed practice of medicine, dentistry or physical therapy in this state? If unlicensed individuals and entities are making decisions reserved to licensed practitioners, what are we going to do about it? Are corporate administrators ''licensed'' to make medical policy decisions in the first place?

H. Richard Piet

Catonsville

Enough excuses, Mr. President

The president and his sidekick seem to deny wrongdoing every day.

He should think about something a predecessor of his once said: "The buck stops here."

William D. Townsend

Timonium

Something fishy about Howard Stern's fame

In response to the headline query in the Arts section of The Sun on March 9, "Will movie and fame spoil Howard Stern?"

I quote the famous remark by John Randolph, Jefferson's leader in the House of Representatives, about a political opponent: "He shines and stinks like rotten mackerel by moonlight."

Maurice F. Mackey Jr.

Baldwin

Why license plates are free speech matter

The recent editorial on the license plate decision was a little "over-exuberant," unlike Judge Frederic Smalkin, who followed well-established principles in deciding it.

The issuance of license plates became a free speech matter when the state made it so, and the Supreme Court recognized this 20 years ago when it described a license plate with a message on it as a "mobile billboard."

When the state establishes a space for members of the public to send messages to the world, it cannot censor the speech.

David S. Bogen

William Reynolds

Baltimore

The writers are professors of law at the University of Maryland School of Law.

Home schooling family says article was unfair

Elaine Tassy's article portraying my family's home school practices (March 16) paints a picture of a mom playing school with her children.

That couldn't be further from the truth. My husband and I, along with most home school families, are deeply committed parents who want to give our children the best education possible.

Yes, we're relaxed, but everything is in control -- unlike in some public schools. Yes, my children are reading novels that aren't exactly classics, but they're sandwiched between classics and other carefully chosen reading materials. My son read three novels in the past two months; that's more than he read during his last year of school. More important, he is developing a love for reading.

Ms. Tassy made a point of quoting my 9-year-old daughter on how many times three goes into nine. "Uh, 10? Nine?" My daughter was nervous with a reporter and photographer in front of her. Ms. Tassy didn't mention that my daughter was reported to have a sixth-grade reading level, reads about two novels a week in addition to her studies and was recommended for a special college writing program at Towson State University last year.

Sharon Mager

Pasadena

Glendening has supported university

I would like to correct an impression conveyed by the March 14 article, ''Academic building to get money before basketball arena at UM.'' The tone of the article implied that Gov. Parris Glendening had not been supportive of this project and somehow had to be convinced of its value by university officials. That is simply not true.

In recent months, interest has grown in Annapolis for immediate attention to the inadequacies of Cole Field House, and both the governor and those of us on campus recognized the need to begin the planning for a new facility. Likewise, both the governor and we were insistent that action on a new field house must not delay action on academic facilities.

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