Guns and Children • Medicare Cuts
Re: Guns and Children
Dear Editor:
Dr. Amethyst C. Cureg’s article “Are There Guns Where the Children Play?” in the September 2005 San Diego Physician reminds me of the Jewish saying: “The worm that lives in horse manure thinks the whole world is horse manure” (this is not meant to be disrespectful). Unfortunately, her prescription for safety is contradicted by the fact that firearms are used “more than 2,000,000 times a year for personal protection,” and recent events in New Orleans are confirming that, unfortunately, the safety of Americans cannot be completely guaranteed by law enforcement agencies and there is a place for willing, responsible, and knowledgeable citizens to be armed.
Olgard Dabbert, MD
Response:
Citizens own guns for a variety of reasons, including protecting loved ones. Whatever the motivation for gun ownership, the fact still remains that guns kill, and, in some instances, harm those whom we wanted to protect in the first place.
The thrust of the article “Are There Guns Where Children Play?” is promoting safe and responsible gun ownership, which the National Rifle Association (NRA) also espouses. The NRA emphasizes personal responsibility by stating: “In a home where guns are kept, the degree of safety a child has rests squarely on the child’s parents” [The National Rifle Association’s “Parents’ Guide to Gun Safety,” accessed October 27, 2005: www.nrahq.org/safety/eddie/infoparents.asp] I have no doubt that there are many gun owners that keep their children and loved ones from harm’s way and store their guns safely. However, there are also some who may not. Therefore, as caring physicians we should include and reinforce gun safety education as part of the patient visit and assist parents in protecting their children, loved ones, relatives and friends. The children depend on us.
Amethyst C. Cureg, MD, MPH
Re: Medicare Reimbursement, SDCMS “News You Can Use”
Dear Editor:
This week Tom Gehring broadcast another of his newsy e-mails and reminded all SDCMS members that it’s time again to contact members of Congress and urge them to stop another threatened cut in Medicare reimbursement. This time it’s 26% through 2011 with a 4.4% cut starting January 2006. I don’t remember the words of the song last time but I do know the tune is familiar.
Nearly every year the Feds threaten to reduce Medicare reimbursement. A cry is then heard throughout the land from every medical society and specialty organization pleading with their members to contact the members of Congress and urge them to stop the CMS train before it runs us over. Sometimes the cuts are reduced and sometimes delayed, but the ultimate outcome is always a reduction in reimbursement. This farce has been replayed for years. It’s a nice way for members of Congress to act sympathetic and pick up a contribution, but our protestations ultimately make no difference. The train rolls on. Why?
Because physicians have grumbled but remained in the Medicare system; despite huge reductions in reimbursement over time, there has been no reduction in access. Consequently, it should be no surprise that the Feds have no reason to stop playing this game. Moreover, there have been no negative consequences for members of Congress. Play on!
I suggest the time is long past for medical societies and specialty organizations to inform their members that they do not have to participate in Medicare. They can opt out, and they can continue to treat Medicare patients under private contracts. This is neither illegal nor unethical. Of course, there need be no mention made that opting out of Medicare will tighten access, call the bluff of the Feds, and wake up Congress, although it will. Physicians just need to know there is a viable alternative to the same old song.
Bruce E. van Dam, MD