HMO Members Find Quality of Programs Much Superior to Traditional Health Care

In his March 26 Viewpoints column, “HMOs Are Far From DOA: Despite Their Numerous Problems, Health Maintenance Organizations Are Here to Stay,” Dr. Brant S. Mittler used scare tactics in another attempt to influence public opinion against HMOs. This time, he is “warning” that many people may be encouraged to join an HMO.

Survey after survey indicates that HMO members find the coverage, cost and quality of care preferable to the fee-for-service system. Members give their HMOs high marks for the caring attitude of the physicians, availability of appointments at short notice and the extent of their coverage.

Meanwhile, researchers continue to find the quality of care in prepaid plans as good if not better than fee-for-service practice, whether the coverage is employer-based, Medicare or Medicaid.

After his “chilling” opening statement, Mittler suggests that HMOs have failed to stem the tide of rising health-care costs. Apparently he doesn’t know that the approach to medicine introduced by HMOs saves the health system millions, perhaps billions, of dollars each year. While HMOs and indemnity insurers are subject to the same steep rises in hospital costs and salaries, HMO premium increases are consistently lower. But HMOs account for 13% of the market. They cannot be expected to cure the ills of the 87% they do not yet cover.

Mittler cites the old chestnut about younger, healthier employees joining HMOs, while older, sicker workers stay with traditional insurance and increase the costs. Sophisticated observers know this doesn’t make sense. Ask employers where their health dollars go. As studies have shown, a disproportionate number of health-care dollars go--and should go--to prenatal and neonatal care, both areas where HMOs provide top-of-the-line coverage.

More important is the HMO offering of comprehensive benefits while employers continue to cut reimbursement for services through dramatically increased co-payments and deductibles.

JAMES F. DOHERTY

Washington

The writer is president of the Group Health Assn. of America, a trade group representing health maintenance organizations and other prepaid health-care plans.