CARE PACKAGES
I’ve been a senior-citizen non-group member of two HMOs over the past eight years and can verify that Dr. Jane M. Orient’s criticisms, and more that I could supply, are valid (“Clinton’s Mis-Managed Care,” Feb. 6).
The “managed care” I have encountered seems more like a slow form of genocide. My wife and I, with no influence or power, have endured poor medical care during that time.
Our prescription allowances have shrunk, and the screws have been tightened so that expensive medical tests that might run costs up for the HMO are discouraged.
I wish other seniors in bad health would band together and fight the money-hungry HMOs. Orient is telling the truth, and it’s a warning to all.
JAMES M. MECHLING
West Covina
When is someone going to stand up and call the Clinton health-care proposal what it really is: a blatantly expensive vote-buying entitlement scheme. No way can this country afford to insure 38 million people without going bankrupt.
Flawed as it is, we have the best health-care system in the world. Clinton’s system would put a layer of bureaucracy between patients and doctors and add $120 billion a year that we can’t afford to the national debt.
MICHAEL A. PACER
Glendora
A few years ago, I had a bypass operation and saw the multiple-visit racket in action. Each morning the surgeon showed up, gave me a cursory examination, told me I was doing fine and left. An hour later, my cardiologist appeared and went through the same routine. Later that afternoon, a stranger entered my room, identified himself as an associate of the surgeon and repeated the song and dance of the other two. Finally, another stranger, an associate of the cardiologist, performed an identical encore.
These visits continued for the eight days I was in the hospital. The strangers’ visits added more than $2,100 to my bill. If this goes on with all Medicare bypass patients, the Treasury of the United States is being looted to the tune of millions of dollars a year.
Orient has to understand the value of bureaucrats: They’re trying to keep the medical foxes from running off with the whole chicken coop.
MORRIS STEIN
Laguna Hills
So life for doctors ain’t what it used to be. I’ve got news for Orient: Life ain’t what it used to be for a lot of us, including aerospace engineers, teachers and realtors.
Physicians like Orient fought HMOs for years. Now their villain is not only managed care but anyone suggesting that the system needs fixing. If Orient and her cohorts are so concerned for their clientele, I suggest that they begin by posting schedules of their fees on the office wall so that patients can do comparative shopping. If they really want to keep the government out of health care, they might try applying the free enterprise system to themselves.
WINSTON BARKLEY
Temecula
As a full-time practicing internist, I sympathized with much in Orient’s article. I have learned to abhor governmental bureaucracy. I believe there must be more responsibility on the part of the patient as well as the doctor and the hospital. I find trusting, personalized care to be the most desirable and most effective.
Like Orient, I take very seriously the dictum in the Hippocratic Oath to do no harm. But unlike her, I find that the high cost of health care and the inefficient and profit-driven ways in which it is so often dispensed are clearly causing great harm to countless people. What I see people most wanting and needing is a way (or ways) in which their hard-earned dollars are spent to most benefit themselves, and that is precisely what some forms of managed care may be in the best position to bring about.
DR. HYMIE MILSTEIN
Studio City
Asking Orient to evaluate the Clinton plan is like asking Rush Limbaugh to evaluate Clinton’s first year in office. The anti-government blindfolds both wear make it impossible for them to identify facts, to analyze fairly and, in some cases, to tell the truth.
To anyone who has read the Clinton plan, it is apparent that no government-controlled, health-care cartel is called for. The plan calls for less paperwork, less government interference and less waste of doctors’ time than exist at present.
ROBERT MARGULIES
Del Mar
Orient’s clients seem to have at least some money to enjoy the health-care “freedoms” she advocates. But how about one of my patients, an elderly and recently naturalized citizen from the Philippines. Besides having heart disease, he has been recently found to have thyroid cancer. He has no money to spend on his health care. I can barely persuade him to buy aspirin for his heart disease because he needs every penny for food and shelter.
But since he is able to seek medical attention under a managed-care system, his cancer surgery and hospitalization are covered, as is his preventive health care.
If my patient moved to Tucson, Ariz., could Orient guarantee that he’d get the same care from a private-practice doctor that he got through his HMO in Long Beach?
DR. OSMUNDO R. SAGUIL
Long Beach
Orient’s claim that physicians aren’t in it for the money is ludicrous. OK, let’s pay part of the costs of medical school with tax dollars so that physicians can no longer claim they need big bucks to pay back their student loans. Then cap all physicians’ wages at no more than 50% above the average wage in their local areas.
If we cut physicians’ wages to those of other human-service providers, we’d attract a far better class of doctors, and the greedy power-trippers practicing medicine today and screaming about the Clinton plan would have to take up another line of work.
SARAH MAGEE
Sierra Madre
I and most of my colleagues in mental health provide services on a sliding-fee scale, as we were advised to do in graduate training. I would rather see 10 clients at reduced fees, if I believe I can help them, than see one patient at full fee who would work much better with another therapist but whom I must see because I am the provider for their area.
Provider alliances that restrict choice, and managed care that restricts treatment, are obstructions to health care.
MADELYNN RIGOPOULOS
Long Beach
I have practiced in Great Britain, the United States and Canada. Whatever the faults (and there are many) of national, universal coverage, I never had the slightest longing to go back to a system that forced me to worry whether a patient could afford a necessary X-ray.
It was in New York and Brooklyn that for the first and last time I saw hellholes bearing the proud name of hospital side by side with some of the best institutions in the world. Perhaps instead of alleging horrors, one should ask an average Canadian (or a Britisher, a German or a Frenchman) if he’d want to exchange his health care for the American version.
DR. L. MIRABEL
Vancouver, B.C.
What has gotten into you folks lately? First you publish a deliciously unpredictable article on drinking (“Getting Drunk,” Colman Andrews, Jan. 2), and now you sucker-punch us with an even better piece: Orient’s thrillingly mean demolition of the Clinton health-care plan.
I know of the longstanding aversion you folks at The Times have for anything that actually makes your subscribers sit up, read eagerly and say “Holy cow!” So what gives? Has someone been slipping real-journalism pills into your morning coffee?
DEBORA HOLIT
Los Angeles