l-goldberg/dt1st/mark2nd

HMOs Not So Horrific

It is hard to philosophically argue with Scott Holleran’s closing comment that Americans should have the “right to choose and pay for one’s own health care” (“Republican Plan Addresses HMO Horror,” Sept. 28). The sad truth, however, is that millions of Americans simply aren’t in a financial position to do so, as evidenced by the more than 40 million of our fellow citizens who lack adequate health insurance. What Mr. Holleran fails to acknowledge is that that number would be significantly higher were it not for the emergence of a managed care system which he freely criticizes.

Thanks to managed care, millions of Americans today have access to a system from which they were previously, and would otherwise still be, disenfranchised. These individuals not only receive the care they need when they are ill, but are more likely to stay well. That is because managed care has dramatically increased prenatal education, lowered infant mortality rates, elevated percentages of childhood immunizations and taken the lead in promoting mammograms (national rates have jumped from 15 percent to 72 percent in the past 10 years). Impressively, all of this has been accomplished while substantially slowing the rate of growth in the cost of health care.

It may be fashionable to pontificate about “HMO horror” or to rouse the public’s ire by saying that patients “languish in pain awaiting treatment,” as Mr. Holleran claims. The truth, however, is that study after study reveals that care under managed care is at least as good as, and often superior to, the traditional fee-for-service system. Managed care has insisted upon barometers of quality measurement, health care consistency and accountability that simply didn’t exist before.

I have no objection with Mr. Holleran’s basic call for alternatives and choice in health care. But let’s first be sure that there is an accurate portrayal of options that currently exist so that these choices can be made by a well-informed and thoughtful public.

ROSS GOLDBERG

California Association of Health Plans