The Carlisle Mosquito Online

Friday, November 26, 1999

Opinions



Thanks from the Sidelines

Eleven years ago this fall, our little girl walked onto the Carlisle soccer field for the first time. While that seems like just yesterday, time has quickly passed and this month, I watched her play her last high school soccer game. As I watched from the sidelines, I reflected on the important role sports have played in her life and felt a wave of gratitude toward the many coaches who have worked with her along the way.

From kindergarten on, organized sports filled a void for her, as I know it did for many of her friends and teammates. When she was younger, volunteer coaches would take time away from their jobs and families, many times a week, to mold a team from a group of kids that was socially and athletically diverse. The kids on the teams rarely had the opportunity to choose their teammates, but they learned to appreciate each other's strengths and compensate for each other's weaknesses. Rarely was the focus on winning; but the kids learned to understand what it meant to win and the dedication that winning required. When they lost, or an individual was distraught about her performance, the coaches would inevitably come up with words of encouragement and help keep the focus on the positive experience of just playing the game.

Many of the kids we watched continued to play year after year and the lessons they learned weren't always easy. They learned that things aren't always fair; referees and coaches are human and make mistakes. They learned to keep their emotions in check. As they got older, the competition grew more fierce and the coaches focused more on winning. At one time or another, every player not only faced the harsh reality of her own limitations, but felt the gratification of doing something she never thought she could do.

For my daughter, the rewards of her sports experience have been enormous. For those of us on the sidelines, our reward was witnessing the role sports played in turning a little girl into a confident young woman. Most importantly though, particularly this week, it seems appropriate to extend appreciation to all the coaches who have made tremendous personal sacrifices to work with Carlisle's youth. You motivated these kids. You taught them a game they now love. You had fun with them and shared your lives. It really wasn't all about winning.



Medicare Musings

The November 14 New York Times carried a front page article headlined "Annual Spending On Medicare Dips For The First Time." Medicare spending had been growing by ten percent per year until Congress passed the Balanced Budget Act of 1997, which mandated extensive cuts in Medicare payments to doctors, hospitals and nursing homes. In the last fiscal year, Medicare spending declined by one percent. For those of us involved in the delivery of health care, this decrease comes as no surprise. The reductions mandated by the Balanced Budget Act were to occur over a five-year period, with the greatest cuts coming over the next three years.

The effects of these cuts have already been devastating. Many small hospitals, such as Symmes Hospital in Arlington, have been forced to close. Most nursing homes in the state are nearing bankruptcy. The large teaching hospitals have been especially hard hit. Medicare has been the only health insurance carrier reimbursing teaching hospitals for the cost of educating interns, residents and fellows. This reimbursement has now been drastically reduced. As a result, teaching hospitals, my own institution included, will lose tens of millions of dollars in the current fiscal year. Strong gains in the stock market over the past two years have kept the bottom line in the black for many hospitalsbut most are now predicting significant deficits for the current fiscal year because of the additional Medicare cuts.

Unfortunately, quality of care is beginning to suffer both in and out of hospitals. Nursing staffs are being reduced because of budget constraints. This at a time when the average hospital patient is much sicker than in the past and the average length of hospital stays has been greatly reduced. Most elderly patients are not discharged directly home but rather are sent to a transitional care facility or to a nursing home with rehabilitation services. The amount of home care being covered by Medicare, including physical therapy and nursing services, is being limited to control costs. The situation will only get worse as the large "baby boomer" population reaches eligibility age. Further cuts in Medicare reimbursements will accelerate this deterioration in quality of care.

The cost of prescription drugs, which is increasing at an alarming rate, is an additional new concern. Drugs now constitute a larger percentage of private health insurance payments than hospitalizations. Medicare does not pay for medications. Many senior citizens without supplementary coverage for drug expenses are now forced to choose between rent, food, heat and medications.

Health care should become a major issue in the upcoming presidential campaign. I would urge all citizens to pay close attention to what the candidates propose to do about health care in general, not just Medicare. The number of Americans without health insurance is now greater than 40 million! To me, this picture is obsceneand nothing is being done to correct it.

We must decide as a nation how to make good health care available to all citizens. This may require, horror of horrors, increasing taxes! Can Americans be convinced to pay higher taxes for the common good? I certainly hope so. If we are not willing to spend more money to provide basic health care to all our citizens then I foresee further declines in the quality of medical care. Currently, most young people entering the health care professions, my own daughter included, remain very idealistic and altruistic. If we are not able to reverse these disturbing trends, we may see a drastic change in the type of person who elects to spend their life in the health care field.

 


1999 The Carlisle Mosquito