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Medicare limits hurt patients, says reader

Re: Medicare limits did not hurt patients, Oct. 17 Conclusions drawn by the Rand Corp. study and statements from Medicare officials may lead the lay person to believe that limiting Medicare payments to hospitals has not affected patient care, but health care workers know firsthand that this is not always the case.

As a registered nurse working in a nursing home, I have seen patients admitted to this setting with fevers (something that once was never done), severe breathing difficulties, near death, and still acutely ill. One paramedic, involved in the transfer of a patient from the hospital to a nursing home, termed this "the nursing home shuffle," whereby a patient, whose time had run out, financially speaking, is transported to a nursing home, in full anticipation that they will be transported back to the hospital after a certain period of time, where they will begin again, perhaps with a diagnosis, in the Medicare payment plan. This shuffling not only takes its physical and emotional toll on the already debilitated patient, but also adds to his financial debt (the cost of transport begins at around $200).

The role of nursing homes, since the advent of Medicare's Prospective Payment System (PPS), has continued to change. Once more or less a custodial facility for the elderly with nowhere else to go, they are now becoming a "step-down" unit for those released from the hospital. Rehabilitation, that is, physical, speech and occupational therapy, is available, as well as intravenous antibiotic therapy, in preparation for some patients' eventual discharge home. A dangerous situation exists, however, for those patients who "fall into the cracks" of the Medicare system _ those deemed not sick enough to be hospitalized, yet too acutely ill for the capabilities of a nursing home environment.

A major solution to this problem would be for nursing home administrators and the corporations that own so many of them to acknowledge their new role, and stop attempting to provide care with a pre-PPS mentality. Nursing home personnel need to be more highly skilled in health care delivery. Equipment needs to be updated and more available. Patient-to-staff ratio needs to be scrutinized.

This, of course, is cause for more financial concern, but dollars allocated in proper proportions would save money in the long run, promote patient well-being, and could very well save lives. These people are your mother, your grandfather, and perhaps even yourself!

Valerie Greathouse, Dunedin

While the Congress gropes around for ways and means to fund the Medicare program it seems to me their time would be equally well spent to get to the real heart of the problem. Namely the exorbitant charges of hospitals and doctors for their services. Anyone who has had the misfortune to have to be hospitalized for even a day or two knows the bill they receive is little short of obscene.

I don't know why some major cost containment legislation is not enacted but I do know that if something is not done in this regard any amount of cutting or taxing for Medicare is but an exercise in futility.

Richard L. Hencke, Belleair Bluffs

Where should line be drawn?

Re: A profile of justice?, Oct. 14. I was appalled at the St. Petersburg Times allowing such an article in defense of a drug offender. My question is, "where do we draw the line as to how much drugs constitute an arrest _ is it two marijuana cigarettes or should it be a pound of cocaine?"

The sheriff's deputy named in the article happens to be my son and he, too, is 26 years old _ the same age as Freddie Lee Williams. Why not do a correlation between a young man who is trying to uphold and defend the law, and a young man who is arrested and pleads guilty for breaking the law? It seems to me that Freddie Lee Williams had every opportunity in the world to do whatever he would like after receiving a four-year scholarship. There are hundreds of young people who would be so grateful to receive this and would go on to repay his community in productive ways. The irony of his story is that he chose to have drugs in his possession. As for the gun in the car _ should not any police officer think it serious when he finds a semi-automatic pistol and two partially filled ammunition clips in a car? After all, part of their training is to take a gun very seriously and to consider it loaded. I'm afraid that Ms. Fredricksen has sent a very strong message to young people that it is fine to do drugs and we in our homes, schools and churches are constantly urging them never to use drugs. She seems to feel that a small amount of drugs is all right; but no one ever starts out as an addicted drug person.

My son is also supporting a family _ a wife and a baby _ and an officer's pay is not nearly enough for the dangers they may have to face in their work. I am proud of my son and all the other law enforcement officers. They need our support instead of articles like this.

I would like to ask Ms. Fredricksen to think seriously if she found herself in trouble _ would she rather have a police officer at her side or a drug offender?

Today I canceled my subscription to the St. Petersburg Times. Although I have enjoyed your paper, I would not want my eighth grader to pick it up and read another article so slanted in support of someone involved in drugs and I would urge other parents to do so as well.

Mrs. Charles V. Mizell Sr., Beverly Hills

A pleasant surprise

You can't imagine what a pleasant surprise it was for me to find Mary Ann Marger's excellent article on fine crafts in the Oct. 5 Weekend. Her list of the "Top 10 things fine crafts are not" should be posted in every would-be craft workshop.

Having been a guest juror in Ormond Beach, Miami and Winter Park, I'm fairly familiar with Florida's contemporary craftspeople, who rank among the nation's finest. Marger's article added to my appreciation. Her direct but tongue-in-cheek approach and her lists made for outstanding reading without any stuffy sermons.

Garry Barker, assistant director

and marketing manager, Berea College Crafts

Berea, Ky.

History repeats

Re: the opinion page, Oct. 17

"We are taxed in our bread and our wine, in our incomes and our investments, on our land and on our property not only for base creatures who do not deserve the name of men, but for foreign nations, complaisant nations who will bow to us and accept our largesse and promise us to assist in the keeping of the peace .

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. these mendicant nations who will desert us when we show a moment of weakness or our treasury is bare, and surely it is becoming bare!

"We are taxed to maintain legions upon their soil, in the name of law and order and the Pax Romana, a document that will fall into dust when it pleases our allies and our vassals. We keep them in precarious balance only with our gold. Is the heartblood of our nation worth these? Were they bound to us with ties of love, they would not ask our gold .

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"They take our very flesh and they hate and despise us, and who shall say that we are worthy of more?

"When a government becomes powerful it is destructive, extravagant and violent; it is a usurer that takes bread from innocent mouths and deprives honorable men of their substance, for votes with which to perpetuate itself." _ Cicero, 54 B.C.

C.A. McCleskey, Largo

Looking for the wrong job

Re: A little less worry and more job please, by Jacquin Sanders, Oct. 18.

It is amazing how many men and women these days decide to have families without evaluating the consequences first. Obviously, Mrs. Yopp didn't evaluate her situation well enough before deciding to have another child. She should have known by already having one child that she would have to give up some work time to have and take care of her new child.

Waitressing is hard work and requires a lot of lifting and being on your feet for long periods of time. This puts a lot of strain on a person, not to mention the unborn child inside. Maybe she is not looking for the right kind of job. Maybe she should try answering phones or some form of desk job. This would keep her off her feet and not require any lifting.

Also, I do not feel that the owners of her prior employment were at fault for letting her go. She had already missed one month due to her pregnancy, who is to say she won't have more problems during the rest of her term? They were considering her health when they gave her a lighter work load.

I am not trying to criticize anyone, I just feel that she could find easier work, especially in her situation.

Lisa Atkinson, Clearwater

Stretching the point

Interpreting freedom of speech as guaranteed by the Constitution to mean the right to use vituperative language at will is stretching the point beyond the intent of our Founding Fathers. Knowledge of history of those times would appear to confirm this point.

In the 18th century, speaking against, criticizing or opposing one's government was forbidden; brutal punishment, imprisonment and even death could be meted to the offender. To me it is obvious freedom of speech meant the right to talk freely against the government with no fear of reprisals. This was a major deviation from customs of the day. To interpret this freedom as the right to use four-letter words anywhere at anytime is a convolution of the intent of the Constitution.

When queried by a TV reporter, a member of 2 Live Crew stated that the Constitution guaranteed he could do and say what he pleased, anytime he pleased. If many think this way, America will face many problems in the future.

George D. Lynn, Sr., Clearwater

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