Health care mess is hurting both doctors and patientsThe...

Letters to the Editor

September 07, 1999

Health care mess is hurting both doctors and patients

The Sun's article "Insurer may try to cut rates" (Aug. 5) noted that CareFirst BlueCross BlueShield hopes to renegotiate hospital rates with Maryland's hospitals. While the Maryland Hospital Association has petitioned the Health Services Cost Review Commission (HSCRC) to stop this, the HSCRC has taken a wait-and-see attitude.

Hospitals around the state shudder at the prospect of yet another rate decrease, as they attempt to juggle budgets to remain afloat and offer good care.

As a physician on staff at one of the larger area hospitals and in private practice for the past 13 years, I am well-placed to see the effects of rate cuts on physicians, nurses, social workers, patients and administrators.

Increasingly long hours, and less time with more and more patients, do take a toll. This is complicated by reduced staff and high rates of staff turnover.

I know friends and colleagues who have left or are leaving medicine because of its increasing toll on them and their families.

I know doctors who have been unable to collect fees for months -- and thus can't pay their own bills. They have had to take out loans or ask parents for money.

Our patients face longer waiting times -- as they and we doctors are becoming anonymous to each other.

In the past, I would have time to chat with patients, ask about families and make them comfortable during medical visits. This familiarity is being eroded.

I have patients who have not been reimbursed by insurance companies and patients who are being referred to collection agencies because insurance companies refuse to pay bills.

The situation gets worse by the day. When will this chaos and insanity end?

Dr. Kenneth L. Rothbaum, Baltimore

Shared responsibility needed in health care battle

In response to James P. Pinkerton's article "The next health care battle" (Opinion Commentary, Aug. 17), I'd suggest that he wake up and smell the gunpowder. Since the mid-1980s, the health care battle has never waned.

Mr. Pinkerton is correct that economics dictate a rise in costs and a decline in coverage. That's precisely why we should not let economics dictate health care policy. Policy should be based instead on human needs.

This is not sub-Saharan Africa; America has plenty of money. But we seem to get less bang for our health care buck than any industrial country, with the possible exception of those from the former Soviet Bloc.

We need to come to grips with a few basic principles: Quality health care will never be cheap; the more profit-takers we put in the mix, the more care will cost; and the healthy must subsidize the ill.

This last principle can be restated as "shared responsibility for the common good." Is that so un-American?

Charlie Gerhardt, Baltimore

The writer is president of the Maryland Patient Advocacy Group.

Prognosis improves for MS sufferers

As a neurologist active in the clinical care of people with multiple sclerosis, I wanted to comment on The Sun's article about Montel Williams' recent diagnosis of multiple sclerosis ("Williams will go on, despite MS diagnosis," Aug. 24).

The article suggested that multiple sclerosis "typically" produces cognitive problems and other physical limitations.

The course of multiple sclerosis is unpredictable and in some individuals it causes physical challenges and cognitive difficulties. For many people, however, the disease is much more benign and allows for a relatively normal lifestyle.

Treatments developed in the past five years have also substantially changed our ability to manage multiple sclerosis.

These treatments not only suppress the activity of multiple sclerosis and reduce the number of "flare-ups," or neurological attacks, but can actually slow the disease's progression and prevent the accumulation of neurological deficits.

Dr. Justin C. McArthur, Baltimore

The writer is a professor of neurology and epidemiology at the Johns Hopkins School of Medicine.

The Sun's brief article about Montel Williams being diagnosed with MS said: "Victims typically lose some problem-solving capacity and short-term memory. Most end up in wheelchairs or need help walking."

Many people with MS never experience either of these symptoms.

Making a general statement about various symptoms that may or may not actually occur creates stereotypes that often lead to misconceptions and prejudicial attitudes.

Kay Berney, Baltimore

Send troops to wipe out the menace of tobacco?

What if this were the news:

The Republic of China, in response to a serious escalation of tobacco-related death and illness, and a corresponding increase in medical costs, has declared nicotine an illegal drug.

All existing supplies will be confiscated. Dealers and users who persist in this trade will be jailed and tobacco crops will be eliminated.

The United States, the primary supplier of this dangerous substance, has been advised to cease production immediately if it wishes to be seen as a responsible member of the global community.

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