Quality Of Care

Medicare is one of the most popular and successful programs ever devised in this country. It has improved the length and quality of life for millions of our most vulnerable citizens - the elderly and disabled - while affording them dignity, choice and security in their medical care. Despite the program's success, there are problems with the quality of care Medicare beneficiaries receive. Patients complain they have to wait weeks for an appointment with a primary care physician, if they can find one. When the doctor finally sees them, it may be for only a few minutes.

WASHINGTON -- In a move that will help consumers and employers compare the quality of health plans, an industry group yesterday released a report that places the Columbia Medical Plan among the top five for "quality of care" in the country.Using data available to the public for the first time, the report measures plans' performance in dozens of ways such as the percentage of immunized children, the rate of births by Caesarean section and the percentage of doctors who are accepting new patients.

Defining the Gray Area of Medical PracticePerhaps It is coincidence, but the three articles on the front page and the Perspective section May 14 certainly point up the increasing attention- to HMOs.It is instructive to note that while HMOs, in fact if not in name, were in existence long before, the big push behind their creation today was in the 1960s and 1970s.Those leading the effort, almost a crusade, were the idealistic physicians and health economists who believed in the HMO concept, the emphases on preventive care for a fixed amount of prepaid dollars, as a more rational system for delivering both - quality and cost effective care.

She's cradling Grace, a 10-month-old baby, in her arms in a motherly embrace that spells love. That's because she loves Grace. The baby has the blackest of silky straight hair and matching long eyelashes combined with a sweet, sweet smile.The rocking chair rocks, but only slightly. Grace is cocooned in a soft white blanket.The young woman who rocks her, kisses her lightly on the head and talks gently to us while we watch -- she is not Grace's mother. She is Cathy, a primary care-giver in the infant rooms of the Downtown Baltimore Children's Centers (DBCC)

It may seem that officials at Howard County General Hospital are putting the cart before the horse with plans to reorganize departments and increase staff workloads. The effort is aimed at cutting costs at a time when the hospital is facing increased competition from health maintenance organizations, private health insurers and outpatient clinics. The changes will go into effect even though the hospital doesn't plan to hire a consulting firm thoroughly to analyze its patient care and purchasing procedures until February.

For the second consecutive year, Working Mother magazine has ranked Maryland as one of 10 states offering the nation's best child care. The judgment was based on the availability, affordability, quality and safety of care.Among Maryland's 24 localities, Howard County posts some particularly noteworthy numbers where child care is concerned.The county has the highest average care cost in the state ($94 a week), as well as the highest ratio of care slots to children under 12 with working moms (one slot for every three kids)

Maryland health officials say they have found "serious" lapses in the quality of care given to 15 patients who died last year at the John L. Deaton Specialty Hospital and Home Inc., a chronic-care hospital and nursing home on South Charles Street in Baltimore.The poor care may not have caused the patients' deaths, state authorities said yesterday. Most were elderly and already seriously ill. But, authorities said, the lapses did allow their illnesses to worsen and increased their suffering during the last days of life.

BLUE BELL, Pa. -- For months, Americans nervously watched Washington try to overhaul the nation's health care system. They should have been looking to Blue Bell instead.This southeast Pennsylvania town is the home of U.S. Healthcare, a leader in a revolution that is shattering the traditional relationship between doctor and patient.If you don't belong to U.S. Healthcare or another health maintenance organization, odds are that you will someday. Already, more than 45 million Americans, including 1.4 million Marylanders, get their health care through HMOs.

A study of doctors and clinics that care for many Medicaid patients in Maryland has found that the lowest-cost providers are not necessarily the worst, nor are the most expensive the best.When it comes to the overall health of patients, researchers at the Johns Hopkins School of Hygiene and Public Health and the state health department found that there was really no relationship between cost and quality of care.The findings suggest that policy-makers don't have to compromise care in their zeal to trim expenses -- as long as they monitor the work done by providers.

Reports on GunsThe misleading news reports in The Sun and the malicious cartoons by Kal, Mike Smith and Mike Lane gave your readers the erroneous impression that the only reason a majority of the members of the House of Representatives voted against the president's crime bill the first time was the ban on assault weapons.This was not true. There were many provisions in the bill which were found to be unacceptable. As appears in your Aug. 22 edition, the bill passed the House only after a number of appropriate amendments were made strengthening its anti-crime provisions while retaining the ban on assault weapons.

The fever for health care reform is running high in Washington, D.C., and politicians are lining up on different sides to offer treatment plans. However, no one is addressing the true driver of health care costs, or any other factors that contribute to the health care crisis. Based on my 20 years of experience in health insurance administration, here are four ways to fix the health care crisis: 1. Restore competition in the market We need to break up the BUCA monopoly (Blue Cross/Blue Shield, United Healthcare, CIGNA, and Aetna)

As the crowd filed out of Wednesday's town hall meeting, Andrea Wimmer sat in her wheelchair under a tree, holding a neon-yellow sign that said, "When Obama rations out health care based on the 'worth' of a person, I'm screwed." Two years ago, shortly after her high school graduation, Wimmer was in an auto accident that left her partly paralyzed and in need of weeks of hospitalization and therapy. Wimmer, now 20 and planning to enroll in classes at Hagerstown Community College, attended the town hall meeting along with her mother to show their opposition to the president's plan to overhaul health care.

Medicare is one of the most popular and successful programs ever devised in this country. It has improved the length and quality of life for millions of our most vulnerable citizens - the elderly and disabled - while affording them dignity, choice and security in their medical care. Despite the program's success, there are problems with the quality of care Medicare beneficiaries receive. Patients complain they have to wait weeks for an appointment with a primary care physician, if they can find one. When the doctor finally sees them, it may be for only a few minutes.

In 1993, Hillary Clinton, then the first lady, led an effort to reform the America's health care system that failed, in part because the public was excluded from secret planning sessions. Now, former Sen. Tom Daschle, who is shaping health policy proposals for President-elect Barack Obama, is hoping to do better. He is urging Americans to join in house parties this month to help develop ideas for new national policies to reduce health costs, boost the quality of care and get everyone coverage.

A report last month from the Citizens' Health Care Working Group, a nonpartisan advisory panel established by Congress, concluded that the federal government should guarantee basic and universal health care to all Americans. Such a universal system often is equated with a Canadian-style, government-run, single-payer system. But a survey of successful health care systems worldwide shows this is an incorrect assumption. For example, the World Health Organization rates France as having the No. 1 health care system in the world.

This month all across America, working parents will face the familiar challenges of summer - most important, keeping their children safe and occupied during the long school break. Schools, after all, are the major provider of care for children of working parents. And when schools close for the summer, parents must scramble. Two-thirds of American children live with two working parents or a single working parent. Yet most schools are open only 30 hours a week, 180 days a year, and they usually don't serve children under age 5. In fact, between the birth of a child and the child's 18th birthday, schools cover only one-third of the hours that a parent working full-time is at work or commuting.

Without a lot of fanfare last week, Gov. Robert L. Ehrlich Jr. took a small step toward providing low-income families better access to child care when he transferred authority for a child care subsidy program from the Department of Human Resources to the Maryland State Department of Education. As a matter of policy and practice, it's a good move. Last year, the General Assembly passed a bill, signed by Mr. Ehrlich, that took a number of child care functions out of DHR and gave them to MSDE, including licensing and monitoring child care facilities, providing incentives to improve quality of care, and maintaining and improving credentials of staff workers.

Police say stores sold tobacco to minors Two Harford County businesses were recently found in violation of the state law against selling tobacco to minors. Harford County Health Department's tobacco enforcement manager, a Harford county officer, and a 16-year-old volunteer conducted unannounced tobacco compliance checks at 13 county businesses to determine whether merchants are complying with the Maryland Youth Access Law. At Meller Food Marts, 2403 Rocks Road, the 16-year-old was asked for identification and still was sold cigarettes.

Upper Chesapeake Medical Center, with its modern brick-and-glass exterior and large windows in its open, airy lobby, feels more like an office complex than a hospital. And just as a business expands, the five-year-old Bel Air hospital is preparing for a $40 million expansion to meet the needs of a growing county population, all while pledging to maintain a high quality of care. "It was not a question of `if,' but `when' - and `when,' has come very quickly," said Lyle E. Sheldon, president and chief executive of Upper Chesapeake Health, which runs UCMC and Harford Memorial Hospital in Havre de Grace.

When Toby Adele Heller went for a physical exam July 26, 2002, the doctor found blood in her stool and recommended that a specialist evaluate her for, among other things, a tumor. Toby was profoundly retarded and could not speak for herself, so it was up to Baltimore-based Autumn Homes - paid $127,672 a year by the state to care for her in a group home - to follow through on the recommendation. They never did. Over the next 11 months, Toby would often lash out in apparent pain: screaming, pushing people, banging her head, according to records and interviews.