Managed care cuts have biggest impact on poorest...

Letters to the Editor

April 06, 1999

Managed care cuts have biggest impact on poorest citizens

Three years ago, the state asked its major health care systems to become involved in a newly required Medicaid managed care program called HealthChoice. Johns Hopkins Medicine, with a community provider network, formed its own Medicaid managed care organization, Priority Partners.

We did this willingly because of our time-honored commitment to take care of the community's poor. We entered the program knowing we'd probably lose money the first several years as the state program went through a shakeout and the fledgling managed care programs incurred start-up costs.

But, as we told the state then, the initial rates were too low, and it was unreasonable to expect immediate savings for taxpayers over the program's fee-for-service predecessor. After all, we are talking about caring for the sickest patients with the most complicated conditions -- people who often require extensive treatment.

Now, the state's recommendations to cut the already too-low rates still further would have a devastating impact on each managed care organization's ability to provide quality health care. This could well force Maryland-based providers, such as Priority Partners, to get out of the program as managed care companies, making way for outside national Medicaid organizations with no historic commitment to Maryland health care.

While we agree that legitimate savings can come from this program over time, it can't be done all at once.

As unfair as the proposed rate cut would be to the Medicaid managed care organizations, thoughtful people should find it deplorable that budget cuts would be made on the backs of those needing access to quality care the most -- our state's poorest citizens.

Ronald R. Peterson

Baltimore

The writer is president of the Johns Hopkins Hospital.

Classy Ripken family let us share their grief

Baltimore, the baseball world and the Ripken family lost a great friend, father, grandfather and coach when Cal Ripken Sr. died. I find touching the classy way the Ripken family allowed the public to grieve not just with them, but alongside them.

Too many times famous celebrities shun the public eye.

I think the greatest tribute to Cal Ripken Sr. is the legacy he has left behind in Vi, Cal Jr., Ellen, Billy and Fred.

Michael S. McBain

Jarrettsville

Ripkens could teach kids not to begin smoking

There is a way that the passing of Cal Ripken Sr. might serve a positive purpose.

Ripken Sr. was a smoker; he likely died at an earlier age than he would have were he not a smoker. His son, Cal Ripken Jr., is revered and idolized by the youth of America, as very few active athletes are.

Why not a national campaign featuring Cal Ripken Jr. explaining to the kids of America that tobacco robbed him and his family of many years of love and warmth they could have shared with his father?

I believe such a campaign would get through to many kids who now listen to warnings about not smoking with indifference and disbelief.

If you can't believe Cal Ripken Jr., who can you believe?

Jerry Weiner

Baltimore

Tobacco tax is just another tax

Robert V. Hess' Opinion Commentary article ("Tax Big Tobacco," March 26) on Maryland's proposed tobacco tax increase ignored several important points.

This tax increase will not be imposed on the tobacco industry, but on that portion the population that chooses to smoke.

And, since the settlement the states and the tobacco industry reached provides that the penalties the industry owes a state are reduced if the state increases its tobacco tax, this tax hike will ultimately benefit the tobacco industry.

This proposed tax increase has nothing to do with health or teen smoking, but is simply a means of raising money -- in other words, a tax. Given the state's budget surplus, this is not the time for any additional taxes.

Richard A. Fox

Westminster

Har Sinai imposes heavy burden on area

I want to express my profound disappointment over the recent approval of the Har Sinai Congregation's Walnut Avenue development plan -- an unfortunate example of county government-sanctioned sprawl in Owings Mills.

A religious institution the size of a strip mall does not belong in an residential zone with narrow, winding lanes and well and septic systems. This could not have been our lawmakers' intention. They may have envisioned the many small neighborhood churches that blend with the character of our community rather than this massive institution that will overburden our roads and water supply.

The congregation may take issue with the term "massive," but what else could you call a facility with a 1,450-seat sanctuary, a 350-seat banquet facility and a 120-child day care center (which would be the largest in Baltimore County)? Add the biweekly religious school and other daily meetings, and you have intensive usage every day of the week, which imposes an unfair burden on our community's limited resources.

What's next for Walnut Avenue, the Mormon Tabernacle Cathedral?

Donna Brooks

Owings Mills

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