Rural areas subsidize cities' health care costsSeveral...


January 16, 1998

Rural areas subsidize cities' health care costs

Several large health maintenance organizations -- including Blue Cross Blue Shield of Maryland -- have petitioned the U.S. Health Care Financing Administration to allow them to charge rural Medicare patients an additional $65 to $75 per month.

These HMOs say they are not being reimbursed an adequate amount of money by Medicare to cover the cost of providing care to these rural patients.

HCFA determined the reimbursement amount for HMOs was to take 95 percent of the cost of providing care under the old fee-for-service arrangement in a given area. Unfortunately, Medicare has always reimbursed rural areas less than urban centers, thus skewing the reimbursement levels in favor of cities. For example, HCFA pays $632 per member per month in Baltimore, but only $365 in Somerset County on the Eastern Shore.

Although the cost of living may be less on the Eastern Shore, I doubt the costs for professional technicians, nurses, equipment or ancillary staff is that much different. In some instances, I might have to pay a premium to attract professional staff to locate here.

Is it appropriate to expect rural America to subsidize the excessive cost of providing care in metropolitan areas? HCFA should be asking why the cost of providing care in the cities is so much greater than in rural areas.

Certainly, if one were to tax Medicare recipients by increasing their premiums, it would be more appropriate to tax urban recipients whose cost of care is so much higher.

Dr. Alex Azar


Speaking up for nonsmokers

In 1953, I proposed in a speech class that people younger than 65 should be prevented from smoking, and those older than 65 should be required to smoke excessively.

This, I maintained facetiously, was intended to keep workers healthy and productive while they were contributing to society, and get those past their productive years out of the way as fast as possible.

This bit of satire helped me earn an A, but I am appalled that Peter VanDoren, in his column "Smokers are doing society a favor" (Jan. 4), uses much the same logic to propose that smoking is economically beneficial to society.

In 1953, I had no idea that secondhand smoke was deadly, so I assumed that only smokers would be harmed. We now know this isn't the case, yet VanDoren seems to make the same erroneous assumption. I do not have the figures at hand, but I am sure that the health cost to nonsmokers is considerable, and attributable to those "persecuted innocents."

What rubbish.

J. Wayne Ruddock


Community colleges no longer 'troubled'

I am troubled by The Sun's ubiquitous references to "troubled" Baltimore County community colleges.

In the past year, four of six articles reporting on the reorganization of the community colleges refer to "troubled community colleges" or "troubled schools."

One year ago, the term "troubled community colleges" was news. The County Council had slashed $2.5 million from the 1996-1997 operating budget with nary a word of support from the board of trustees. Faculty members were enraged by a board that seemed more concerned with micromanaging the colleges than securing financial and political support.

However, significant and hopeful reforms were made in 1997. The board was injected with new blood and dynamic leadership. A healthy dialogue has started between the colleges and the trustees. The selection of Dr. Irving Pressley McPhail as the new chancellor signals the advent of creative administrative leadership.

Mike Bowler wrote about the real trouble for community colleges in his Dec. 28 Education Beat column: "Maryland community colleges took a real hit [in higher education spending by the state]. Adjusted for inflation, spending on the state's two-year schools declined 30 percent."

Without realistic financial support, all community colleges and the communities they serve will once again be troubled.

Margaret McCampbell


The writer is president of the Catonsville Community College faculty senate.

In Northern Ireland, 'parades' inflame

Churchgoers are pelted with stones as they walk to church.

Villagers and townspeople endure "parades" that celebrate the victory of an invader over their ancestors.

Discriminatory hiring practices leave more than 25 percent of an ethnic group's skilled workers unemployed.

By his Dec. 25 letter, Bill Cooke would have us believe these oppressed citizens of Northern Ireland are "Protestant Orangemen." In fact, they are Irish Catholics.

In citing the Protestant majority in Northern Ireland, Mr. Cooke overlooks how it came to be. A plantation system instituted by Queen Elizabeth I in the mid-1500s and continued by King James II in the 1600s awarded more than 90 percent of the land owned by native Irish Catholics to English and Scottish "settlers."

Through history, this "majority" has been ensured by laws barring Irish Catholics from owning land, and by the gerrymandered partition of Ireland.

What Mr. Cooke calls "parades," the marches of Protestant Orangemen through Catholic neighborhoods to commemorate the victory of an oppressor, is more correctly termed an incendiary action.

Maureen Kilcullen


Definition of heat energetically disputed

The article "Energy output of universe mapped" (Jan. 10) says: "Infrared radiation is what you feel on the bottom of your feet when you walk across a hot sandy beach in summer."

Wrong. What you feel is conductive heat from contact with the sand that had been heated by infrared (IR) radiation.

IR is what you feel on your chest as you lie on your back on that beach. IR is what you feel when you put your hand near, but not touching, any hot object.

You have demonstrated again the pervasive scientific illiteracy of our society.

Robert C. Tompkins


Pub Date: 1/16/98

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