Saturday Mailbox

SATURDAY MAILBOX

July 08, 2006

Payment cuts push care toward crisis

Dr. George H. A. Bone, the president of MedChi, the Maryland State Medical Society, hit the nail on the head in his column "Insurers' cuts to providers threaten health care" (Opinion Commentary, June 27).

Our health care system in this country is falling apart, and most patients are unaware of the drastic changes occurring on a daily basis.

But as a hospital-based physician, I see them all of the time.

Because of the low insurance payments in Maryland, we are unable to recruit young physicians in many specialties.

Training programs are having a hard time recruiting primary-care physicians at a time when baby boomers, who are getting ready to retire, will create the greatest demand for health care we have seen in generations.

We need more internists and family practitioners than ever. But young physicians do not want to enter primary-care medicine because they cannot earn a fair return on their investment of years of schooling and training.

Hospital-based specialties are being hit hard. Local anesthesiology units, for instance, cannot recruit young physicians because salaries are better and expenses are lower in other states.

Our patients and the business community need to join the fight for a better system.

Business needs to monitor CareFirst BlueCross BlueShield and UnitedHealth Group and focus on how much they are paying for actual medical care.

Patients need to write to their senators and representatives and ask for a correction in the way Medicare determines its physician payment rates.

Americans need to take action. The demise of our health care system is happening right before our eyes.

At the current rate, if and when our government finally acts, it will be too little, too late.

Dr. Andrew Greenberg

Baltimore

The writer is president of the Baltimore County Medical Association.

Medical mistakes big part of problem

The column by MedChi President Dr. George H. A. Bone presents a cogent critique of the managed-care system's dwindling physician reimbursements and their adverse effect on health care ("Insurers' cuts to providers threaten health care," Opinion Commentary, June 27).

However, the article fails to address two major factors that contribute to insurers' costs and to problems in patient care.

Medical errors and hospital-acquired infections yearly cause millions of injuries and thousands of deaths and account for tens of billions in health care expenses.

While Medicare and Medicaid are paying for the lion's share of these tragedies, commercial insurers are footing a significant part of the bill as well.

Physicians do indeed deserve to be paid well for their important services when they are competently preformed. And most of them are.

Indeed, health care workers, with their generous benefits and healthy salaries, are among the most privileged in our society. And they enjoy high esteem from most of us.

But while insurance industry greed should not be discounted and should definitely be reined in, those in the medical fields who wish to cast stones should first address the glass house in which they live - one in which so many patients needlessly suffer and die.

Michael Bennett

Baltimore

The writer is president of the Coalition for Patients' Rights.

Relocating the poor can spread blight

In Dan Rodricks' column "City woes cry out for regional solutions" (July 2), he touts a bit of social engineering that has been set in motion by U.S. District Judge Marvin J. Garbis and that most people are oblivious to.

In reference to relocating some of the city's "poorest families" to other areas, Mr. Rodricks states, "It has been done in other metropolitan areas during the past 30 years, and it has worked."

It should be noted that this practice started in Baltimore in the 1980s and early 1990s, as the city's dilapidated housing projects were imploded and their residents dispersed to more well-off neighborhoods across the city.

As someone who grew up in what had been (for the first 11 or 12 years of my life) a relatively quiet and safe Northeast Baltimore neighborhood, I saw firsthand what this flawed practice did to my community.

After a decade of mostly peaceful times, crime and blight exploded in our area.

My family's garage was broken into three times; we twice had to call the police to remove a drunken stranger from our porch; our nearest corner became an open-air drug market; my license plate was stolen, only to have the whole car stolen days later; my parents' car was struck by a woman in her car trying to run down her boyfriend; and I was "jumped" by a group of strangers after getting off the bus coming home from school.

I once pulled the car into our backyard to find a stranger urinating on our garage door.

So when I finished college and got a good job and the time came to purchase a home, Baltimore was no longer on my radar.

Harford County became my home.

And I'll tell you right now, if this flawed social engineering brings similar problems to my neighborhood again, I'll be moving once again.

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