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    Letters to the Editors

    Leaders should experience crisis in health care


    © St. Petersburg Times
    published November 23, 2002

    Re: Report to Bush: Try solutions for health care "crisis," Nov. 20.

    It is nice that the National Academy of Sciences has finally caught up with the rest of the country and found that "the U.S. health care system is in crisis," and that the president needs to do something about it. Anyone who has needed medical care in the last few years could have told him that. Of course the president and Congress might not realize it since they have health care that the taxpayers pay for.

    I believe they should be required to seek health insurance just as we do or give the rest of us the type of health care they already enjoy. If they had to deal with co-payments, referrals, authorization numbers, approved providers and portions of bills not covered by insurance they might be a little more expeditious in implementing a universal health care plan.

    But, judging by the response the president has shown in adding a prescription supplement to Medicare (a campaign promise), I doubt he will be getting very excited about health care. With a Republican Congress and president, I would not hold my breath waiting for them to help the working people of this country. They never have.
    -- Thomas R. Minyard, Palm Harbor

    Physicians are being squeezed

    Re: Care dismays insurance insider, Nov. 9, and The wrong legal approach to gain better health care, Nov. 10.

    These two articles evoked a great deal of emotion. Kris Hundley's Nov. 9 article in the Business section talking about the dismay that has occurred in the life of Erin Evans naturally evoked sympathy. It is always sad to hear of an individual encountering cancer. It is further sorrowful to see a young person have the problem and then to have problems with his or her HMO.

    The article also evoked a great amount of anger, as I remember individuals like Erin Evans who come into my office, even today, and offer me reimbursement rates from HMOs that are literally one-third of what I received 15 years ago and that are literally less than one-half of the usual customary and reasonable fee that insurance companies offered at that time. I felt a great deal of sorrow as I have memories of discussions with colleagues forced out of practice or out of Florida because of those paltry reimbursements.

    I remembered their frustrations, as each and every HMO continued to offer reimbursement rates that were less and less each year. An individual physician has no recourse but to accept those rates or else lose, in many cases, 80 to 90 percent of their patients. Certainly, in my field of obstetrics and gynecology, a large number of my patients are on HMOs and I am left with the difficult situation of accepting a horrible reimbursement or having no patients at all.

    I felt irony as I read the article about Erin Evans, thinking that perhaps a physician who could help her beat her malignancy might not be available to her because her HMO and others failed to pay the physician a decent wage.

    Ironically, Ms. Evans is now in the field of medical liability insurance, and premiums for liability insurance continue to escalate while, at the same time, we continue to receive reimbursement rates from HMOs that continue to decrease. Feelings of anger were aroused in me as I see the destruction of the field of medicine. In my specialty, which I truly love, I see the possibility where I could be forced out of practice because of these escalating rates.

    The Nov. 10 op-ed piece by Philip K. Howard, detailing how trial lawyers are forcing insurance rates up, also evoked a very visceral response. Howard's article, along with the article about Erin Evans, certainly help the average person understand how physicians are being squeezed. We go into medicine not to get rich but certainly to be compensated for the time and effort it takes to become a physician. We now find that the profession that we love is being destroyed by insurance companies and trial lawyers, and we feel frustrated because we are powerless to stop the erosion. It is up to the consumer to demand better medical care.
    -- Jesse A. Kane, M.D., Palm Harbor

    Lobby needs to be broken

    Re: Medical care in the United States: Doctor looks to heal system, Nov. 14.

    Kris Hundley's interview with Yank Coble Jr., president of the American Medical Association, was self-serving. I suggest she write more about the perks that physicians obtain from drug companies. This lobby needs to be broken, as it exerts unfair pressure on Congress to enact special laws to extend drug patents. This keeps generic drugs from entering the market in a timely manner.

    The AMA needs to understand that doctors should lower their expectations of monetary rewards and start thinking more about the people they try to heal. Too many patients are rushed out of the office so the physicians can increase revenue and enjoy a four-day work week. One of the reasons foreign doctors come to the United States is that they do not have grand monetary expectations and they are willing to work five days a week.

    Yes, tort reform is needed, but that is only one part of the problem.
    -- William Sessions, Dunedin

    Policy opens door to justice

    Re: A larger opportunity lost, editorial Nov. 16.

    I would like to clarify some of the issues associated with the Bishops Conference and some misunderstandings of the separate and distinct issues regarding service in Catholic ministry. First, the American bishops have said that any church personnel serving in ministry will be permanently removed if it is admitted or established that they have committed even a single act of sexual abuse with a minor. Second, there is no statute of limitations for such removal. Additionally, that has been the policy in the Diocese of St. Petersburg for many years and will become the law for the rest of the U.S. Conference of Catholic Bishops once approved by the Vatican.

    Whenever it is admitted or it has been established that clergy have violated this policy, an additional penalty is sought for removal from the clerical state. At ordination a priest receives the sacrament of Holy Orders, a sacrament that can only be removed by the Holy Father. This process is internal to the church and is governed by universal church law and doctrine. Just as there is a statute of limitations in civil and criminal law, there is a statute of limitations in church law. The bishops have sought and received an exemption from that statute of limitations. The policy allows exceptional cases to be presented to the Holy Father for dismissal of the priest or deacon from the clerical state even if the case would otherwise be barred. This new process is similar to laws exempting capital crimes from a statute of limitations. Based upon this reason alone, I strongly suggest that the revised norms do indeed create a "larger opportunity."

    Through the bishops' power of governance, the policy of the Diocese of St. Petersburg will be enforced for the protection of young children and vulnerable adults. Bishop Robert Lynch has always been responsive in this area and has encouraged an open process that addresses these issues for the Catholics of this diocese. The revised policy of the Diocese assures a forum for such allegations will be available.
    -- Joseph A. DiVito, Esq., St. Petersburg

    Amendments aren't anti-Catholic

    Re: A product of anti-Catholic bigotry, by George F. Will, Nov. 11.

    George Will incorrectly calls Blaine amendments -- state constitutional amendments banning government aid to religious institutions -- "residues of ugly bigotry" resulting from anti-Catholic sentiment in the 1870s. Not true.

    Long before Sen. James G. Blaine of Maine was even born, many states had provisions in their constitutions barring diversion of tax money to religious institutions. These constitutions did not mention religious schools specifically because, at the time, education was not seen as a government concern. In fact, the origin of these rules predated the first drive by the Catholic Church to receive funding for its schools by about 10 years. As public education took hold, some states started restricting funding to only public schools.

    In 1875, President Ulysses S. Grant asked Sen. Blaine to introduce a bill in the House of Representatives. It passed the House, but failed in the Senate. Just like other past and present politicians, Blaine also used religious division to help his political career, but was not an anti-Catholic. Congress did, however, pass a law requiring that every state admitted to the Union after 1876 put a provision in its constitution stating that it would maintain a public school system "free of sectarian control." Three-fourths of the states have them, including Florida, where its provision was used to strike down the voucher bills last year.

    Pro-voucher groups have marked state Blaine amendments for extinction by any means and will have plenty of help from Focus in the Family and allied religious right groups. In a recent essay, Eric W. Treen, senior counsel for the Becket Fund -- a conservative, Catholic-oriented legal group -- outlined three strategies for doing away with Blaine amendments: (1) Persuading state courts to interpret them narrowly, (2) having federal courts declare them in conflict with the First Amendment (both requiring appointing more conservative judges) and (3) persuading voters to repeal them through referendum ballots.

    Blaine opponents did succeed once in removing this protection from a state constitution, underscoring the dangers of these changes. Louisiana immediately began funneling millions in state aid to parochial schools, now regarded as some of the worst in the nation.
    -- Frank Prahl, president, Mid-Pinellas Chapter of Americans United for Separation of Church and State, Largo

    Mangrove message

    Re: County backs off mangrove proposal, Nov. 20.

    My message to all the Pinellas homeowners whining about mangroves blocking their views: If you continue cutting your mangroves lower and lower, the time will come when you will wish those same mangroves you destroyed would grow back and block your view of the environmental devastation caused by their continued destruction.

    And, to the Pinellas County Commissioners, shame on you.
    -- Debbie Fisher, St. Petersburg

    Loyalty and longevity matter

    Re: The key to our success, Nov. 16.

    You gave your readers a perfect answer to those who claim you are "out of step" -- whatever that means -- with us. Three hundred-plus employees and retirees who have been with you for more than 25 years! I'm glad I'm a Times reader. I do not know if that kind of stability and loyalty is common to other papers but it shows you've been there for the long haul unlike many detractors who came here only recently and feel they have the right to tell us natives how they did it elsewhere.

    Please don't ever let them deter you from your mission to report the news and stand up for what you know is right whether it is popular or not. That's the kind of courage and sense of responsibility that makes a paper great and you have it.
    -- Theressa Placke, Tampa

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