Saturday Mailbox


November 22, 2003

Treat access to health care as a basic right

At the recent health care summit sponsored by the General Assembly, the core issue was that in one of the wealthiest states in the wealthiest, most technologically advanced nation in the world, the number of people without health insurance has risen to more than 600,000 (the number is about 44 million nationwide) ("Ehrlich plans limited health reform in '04," Nov. 13).

Virtually every industrialized country in the world has found a solution to this problem because they recognize two things. First, access to adequate health care is a basic human right. Second, if the society does not pay now for prevention, early detection and timely medical treatment, the citizenship will pay later.

The health summit featured only one proposal -- one five years in the making by the Maryland Citizens' Health Initiative and its grass-roots network of more than 1,000 consumer, faith-based, provider, advocacy and business groups -- that embraces these two conditions. That program, the Health Care for All plan, would build upon the strength of our private and public sectors, and proposes an affordable and fair funding mechanism.

Some argue, as The Sun's editorial "Cut costs to expand care" (Nov. 11) stated, that universal health care "already exists in Maryland because no one is turned away from an emergency room."

It is true that under Maryland's "all-payer" system, hospitals are for the most part reimbursed for uncompensated care from a pool of hundreds of millions dollars that we all contribute to via higher insurance premiums. And that's a good thing. But to imply that this represents a form of universal coverage is simply wrong.

In my work day after day, I learn firsthand about uninsured Marylanders who are treated in ERs but denied admission for needed hospitalization unless it is absolutely urgent. Those lucky enough to get admitted have their cases later turned over to aggressive collection agencies.

And what happens when patients accumulate medical debt that is absolutely beyond their means of paying off? Nationally, more than 40 percent of personal bankruptcies are the result of medical debts.

Most of us are just one job loss away from this possibility.

And, most important, an "all-payer" system that pays only for ER use and the most urgent of hospitalizations completely disregards the need of all people for appropriate, preventive and less-costly outpatient care.

Dr. William Sciarillo


The writer is president and CEO of Baltimore HealthCare Access.

Mergers underscore CareFirst's mission

Recent merger announcements by giant health insurers should reinforce the public's confidence in Maryland's decision earlier this year to reject efforts by CareFirst to sell itself to WellPoint Health Networks Inc. of California ("Two deals create giant health insurers," Oct. 28).

What a mess we'd be in if the state insurance commissioner and General Assembly had approved CareFirst's proposal. All the promises and commitments made to Maryland would now be in question because of WellPoint's recently announced merger with rival Anthem Inc.

Luckily, we dodged the bullet and retained the independence and nonprofit status of Maryland's dominant health insurer.

Numerous studies show that expanding a health plan through mergers doesn't mean better service or lower prices for consumers. As competition diminishes, charges to customers rise and satisfaction declines. Management focuses on maximizing profits for shareholders to justify the merger, not benefits to consumers.

CareFirst remains the region's largest insurer by a wide margin. It doesn't need to become a national behemoth.

And now we have a rare opportunity to reshape this company in ways that will make it even more successful -- as a regional nonprofit insurer committed to bringing high-quality, affordable health care to the citizens of Maryland, Washington and Delaware.

Calvin M. Pierson


The writer is president of the Maryland Hospital Association.

City boarding school is a good investment

Although the project will be costly, I wholeheartedly support Coppin State College President Stanley F. Battle's idea of creating a free boarding school for city students in the former Hebrew Orphan Asylum building ("A new vision for urban education," Nov. 17).

In fact, having children in grades seven through 12 attend the proposed school may not be enough. Since most brain development occurs by age 3, perhaps the boarding school idea should be extended to include an elementary school.

We have been throwing money away to improve education for the last 40 years, but instead of creating more achievers, we have been supporting policies that do not work for a large part of the school population. Why not try something new?

School achievement rests on the attitudinal and behavioral foundation students possess. If students' environment is supportive of education and promotes behavior that buttresses learning, students are almost guaranteed success.

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