State regulators are not starving Maryland hospitals As...


January 16, 2000

State regulators are not starving Maryland hospitals

As chairman of the commission that regulates Maryland's hospital rates, I was surprised to read many of the statements in The Sun's editorial "Are state regulators starving Md. hospitals?" (Jan. 2)

The reason I was surprised is that so much of the editorial was inaccurate, as anyone who participated in the commission's public meetings would know.

The commission takes seriously its legislative mandate to provide efficient and effective hospitals sufficient revenue. And the current rate-setting system has been very generous to hospitals.

While rates in Maryland are only slightly above the national average, they were 12 percent below that average in 1992, and have since increased 2.5 times faster than the national average.

In response, the commission has taken cautious steps to reduce charge increases and has initiated a review of the regulatory structure. Both steps were supported by the Maryland Hospital Association.

Changes to the hospital industry nationally have impacted other states much more heavily than Maryland, primarily because of our rate-setting system.

While no longer earning the record profit levels of two years ago, Maryland hospitals remain profitable overall. This stands in sharp contrast to overall losses in D.C., Delaware, Pennsylvania, New Jersey and New York, for example.

The assertion that state-imposed rate reductions caused quality of care problems at Shady Grove Hospital is also "surprising." Those problems were because management failed to use resources wisely.

Shady Grove's profit margin is more than twice the statewide average, and it was able (as reported in the Washington Post) to afford $8 million in severance and bonuses for two departing executives.

We continue to invite the fullest possible public participation as we redesign the regulatory structure, while preserving its basic principles. Importantly, Maryland is the only state in the nation where any citizen can receive care at any hospital, regardless of his or her ability to pay.

Don Hillier


The writer is chairman of the state's Health Services Cost Review Commission.

Are we starving Maryland hospitals? That's possible but not likely.

While I don't claim any expertise on Maryland's hospital regulatory system, I do know that it makes Maryland the only state that does not send the poorly insured or uninsured to substandard, municipal charity hospitals.

We should move very carefully before we tinker with a system that we know to be of superior quality at competitive costs.

Hospitals are represented in the regulatory arena by administrators, consultants and lobbyists, whose focus is on making money. But the margins hospitals are complaining about are ones some for-profit industries find acceptable.

Consultants and administrators are not healers, they are business people. In business, the last thing to suffer is the bottom line. All else suffers first -- and in this case that means patient care.

No doubt problems exist in the quality of care, and they seem to be growing. But it would be a mistake to assume that a more profitable hospital automatically equals better care. It results in a richer hospital.

So let's not allow political will to be clouded by the Maryland Hospital Association's efforts to pretend that our families are hostage to their profits.

If we need to spend more, fine; but send it to healers, not bean counters.

Charlie Gerhardt


The writer is president of the Maryland Patient Advocacy Group.

Nursing shortage hurts quality of hospital care

In response to The Sun's editorial "Are state regulators starving Maryland hospitals?" (Jan. 2), I think state regulators have no business in the care of patients.

I was a patient in Union Memorial Hospital's coronary care unit in May, 1999. Four nurses were expected to attend to 22 critically ill patients. Although they were competent professionals, they were stretched to the breaking point.

I was fortunate during that time that my husband was able to stay and provide me with basic care, so that the nurses could attend to the more critical patients.

Regulators do indeed need to "put aside their green eyeshades" and gather data about how sub-par reimbursement rates affect patient care.

Medical care should not be the victim of "we're No. 2, we try harder."

Jacquelyn Truelove-DeSimone


Task force proposals could improve eldercare

I am writing on behalf of the Health Facilities Association of Maryland (HFAM), in response to The Sun's article on the state task force on nursing home quality of care recommendations ("Panel calls for increase in nursing home staff," Dec. 22).

We agree with many of its findings and appreciate the time and attention they gave these important issues.

The residents of nursing homes today are much sicker than in the past, and require much more care.

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