Phone: 301-933-4641

Tunnel Vision
The Paul Ruskin Public Awareness Campaign

Dumbing Down with the Maryland Health Care Commission

Barbara G. McLean, Executive Director of the Maryland Health Care Commission (MHCC), returned my four calls on October 14th, 2004. I was surprised that she did, because I had been told by a spokesperson just that morning that she would not be able to speak with me, and suggested that I write her a letter.

I suggested that I would address this issue on my website and make sure the newspapers and others knew about it.

So she called. I complained about the DISCLAIMER, which you may have read about elsewhere on this website, being deleted from the 2004 Consumer Guide (Measuring the Quality of Maryland HMOs and POS Plans.) For your convenience, the DISCLAIMER follows:

“The State of Maryland cannot guarantee the completeness or accuracy of the medical or membership records upon which this information is based.”

Was its disappearance from the Guide an oversight? A mistake? Be careful what you ask.

She said they used focus groups of various educational levels and some of the people couldn’t understand the DISCLAIMER. Others were confused about what it meant in relation to the audit language. So the DISCLAIMER, which is perfect in form and true to science, was dropped.

America (Maryland, anyway) DUMBS DOWN another notch.

Since my first letter to the Commission on April 16th, 2002, and to the present day,


has ever told me they thought the DISCLAIMER was either untrue or confusing.

On October 12th my wife went online to print out the Consumer Guide for me. It loaded completely, she said, but only the first page would print. She wanted page 3 for me (she was right on the mark, as you’ll see later.) She was able to selectively print it because of her print screen ability, but all 24 pages wouldn’t run one after another. This, I’m told by an independent expert who tried it, is a PDF (whatever that is) problem; and it’s been like that for 21 days at this writing, despite the fact that I alerted them to the problem. Then again, maybe this demonstrates that they take their copyright protection very, very seriously.

This prompts me to issue my PERSONAL PUBLIC SERVICE WARNING:

“ The MHCC, which apparently no longer wants to give you any reason to question its ratings, but rather, only how to use them (see “Quality Measurement” on page 3 of the Guide) doesn’t think that YOU need a copy of the Guide, unless you order it from them.”

So that’s what I did. I spoke clearly to a live person, spelling things as I went. My zip code, I informed her, was 20895 dash 2221. In due time my copy of the Guide arrived, addressed to zip code 20746. It’s a wonder it EVER got here!


“ The MHCC, which apparently no longer wants to give you any reason to question its ratings, but rather, only how to use them (see “Quality Measurement” on page 3 of the Guide) doesn’t think that YOU need a copy of the Guide, until several days AFTER the influential columnist Tom Graham of the Washington Post has already reported those ratings to a very large audience just prior to OPEN SEASON.”

I’m referring to his article in the October 12th Health Section entitled “HMOs: Same, but More So.” Graham, who has been criticized elsewhere on this website, reports that according to the MHCC, Kaiser has pretty much belted the ball out of the HMO park (my words).

But a question arises for me in his last two paragraphs. Here is what Joyce Burton, Chief of HMO Quality and Performance at the MHCC said during the press conference, according to Graham:

“There isn’t a simple answer for why the gap is becoming larger” (between Kaiser and its peers.) “I think all the plans aim for star performer status. Kaiser is very positive with outreach and quality improvement. There are controls that Kaiser is able to implement that perhaps other plans aren’t able to monitor.”

I spoke with Joyce Burton by phone on October 13th. I brought up her positive Kaiser comments and said it sounded like she was answering a question. She was, she responded ……. a question posed by Tom Graham.

Well, now I’m discouraged. I had planned to scan in, for your edification, my original letter to the official who used to have Joyce Burton’s job. Then I was going to scan in her very intelligently edited response, which became the DISCLAIMER. And then I was going to probe the vulnerability of medical and membership records to error, omission as in my wife’s case, and fraud. But I know now that you probably wouldn’t understand any of it.

Something just occurred to me, though …….when the DISCLAIMER was adopted, the Governor of Maryland was a Democrat; now the Governor is a Republican.

And sure enough, the Guide states: “MHCC is a public regulatory commission APPOINTED BY THE GOVERNOR with the advice and consent of the Maryland Senate.”

Hmmmm …….maybe I’m the dumb one.