The mote in thine eye

February 02, 2004

WITH APOLOGIES to the Book of Matthew: How can the General Assembly hope to remove the mote from another's eye but fail to consider the beam in its own?

The question is not entirely metaphorical. Optometrists are once again calling on the legislature to let them perform more eye-related procedures. One of them involves an instrument called an Alger Brush, which works much like a drill and is used to remove tiny foreign objects from the cornea. The optometrists also would like to be able to use topical steroids and antiviral drugs, treat a form of glaucoma and dispense more types of prescription antibiotics.

Naturally, the state's ophthalmologists, the medical doctors who care for eyes, hate the idea. They believe optometrists are unqualified to do any of these things and could end up hurting patients.

Such turf battles are an annual rite in Annapolis, as they are in many state capitals, and the optometrists vs. ophthalmologists struggle is a long-standing one. But so are the fights between psychologists and social workers, podiatrists and orthopedic surgeons, doctors and dentists, and the list goes on. At its heart, there is always money - the winner usually makes more of it.

But the real winners in these fights are the lobbyists and the legislators, all of whom rake it in, lobbyists in fees and legislators in campaign donations. As it happens, the ophthalmologists have a heavyweight lobbyist, Bruce C. Bereano, on their side, but the optometrists aren't exactly slouching to Annapolis either. They're represented by Joel D. Rozner, who, like Mr. Bereano, usually ranks near the top when state lobbying fees are totaled.

Is this really the best way to regulate health care? When these two groups last made headlines, in 1989, it was over the use of eye drops, and the political gyrations led to a gubernatorial veto and historic legislative override. Hundreds of thousands of dollars changed hands over years of wrangling on this one issue.

Legislators should be embarrassed by the way these issues are usually handled. They are serious matters of public health and deserve study by independent experts. Let the legislature act on recommendations from people who understand these complex issues - but don't have an economic stake in the outcome.

Could such a thing happen? Probably not. Too many people are making too much money off turf wars like this. The best that can be said about it is this: In matters of ethics, a lot of lawmakers see poorly. Maybe the voters will take notice - and find the right prescription for such ills.

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