Health insurance for all I recently admitted an...


February 16, 2002

Health insurance for all

I recently admitted an 8-month-old boy to the hospital for failure to thrive and developmental delay.

Failure to thrive is an alarming diagnosis in an infant - at a time when he should have been growing and developing, this child was losing weight and not reaching new milestones or gaining new skills.

His insurance company approved his admission - for one day.

One day. One day to put weight on and turn his development around. This is what our health care system has come to - reducing costs by denying care, shortening hospital stays and transferring the ever-increasing cost of care to patients and their families.

Currently, the cost of health care increases about 17 percent a year, but that increase pays for less each year. And each year, access to care gets more and more difficult.

We pay about $4,000 per person for health insurance in this country, more than enough to cover everyone, but we must eliminate administrative waste, six-figure managed-care CEO salaries and needless marketing that drain money away from actual care.

Health care is a public service, not a commodity, and if we allow it to be run like a supermarket we will all suffer the cuts that come when profits drop. The bottom line should be the health of our communities, not profits.

Health care is also different from any other business in that it's always pay now or pay later: Pay for good primary care for all now or pay down the road with expensive emergency room visits and a larger burden of preventable diseases.

A simple solution is a single-payer, universal health plan that throws out the middlemen (HMOs and managed care organizations) and expands Medicare and Medicaid to cover all Americans.

Dr. John F. Irwin, Baltimore

Stop social promotion

Kudos to The Sun for its recent editorial "Hold the line on social promotion" (Jan. 24). If we expect our children to succeed in the real world, we must hold them to real-world standards and deliver a real-world education. When we don't, the results are disastrous.

When our schools turn out children with low literacy skills, we condemn the next generation of adults to a relentless cycle of poverty.

And, as director of The Learning Bank of COIL Inc., an adult literacy program in Southwest Baltimore, I see the results of social promotion on a daily basis.

I see it on the beleaguered faces of parents who sign up for classes because they are unable to understand their children's homework.

I notice how timidly a new student ventures an answer, her self-esteem eroded by her lack of knowledge.

I catch the fear in the voice of a 30-year employee who has just learned he will lose his job if he doesn't get a GED.

It wouldn't be so bad if lack of education existed in a vacuum - fixing a single problem is a reasonable challenge. But low literacy skills have been shown to have a direct correlation to crime rates, teen-age pregnancy, drug use, poverty and unemployment.

When we have to go back and re-educate an adult, we also must address all the other problems that have resulted from that person's lack of literacy skills. This is a costly proposition. Ignoring the problem is even costlier.

It's much easier and cheaper to do it right the first time.

Dolores Bramer, Baltimore

Early disposition court merits more support

The controversial Baltimore early disposition court is on the right path as a way to resolve minor criminal charges expeditiously and justly.

Since 1999, government funding to prosecutors and public defenders has resulted in resolving one out of three charges within days after arrest. State's attorneys are also finding one out of four police arrests undeserving of prosecution. That permits greater attention to more serious crime.

And representation by public defenders at bail hearings and disposition court has meant fewer clients held unnecessarily in jail awaiting trial, and greater opportunity to defend against the charges.

These are substantial improvements from the days when prosecutors did not review arrests, and defendants did not meet their public defender until the day of trial - at least one month after arrest.

It is essential to build on these successes by taking two additional steps.

First, provide further incentives. State's attorneys, public defenders and judges know that more minor cases could be resolved sooner if they could offer hesitant defendants drug treatment and job and education opportunities.

Second, offer package deals. For defendants facing more than one charge, the state should package its plea offer to cover other pending cases instead of pursuing separate prosecutions. If such an offer is rejected, the state should move the cases to trial.

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