Medical Insurers

Re “Spare These ‘Dinosaurs’ an Untimely Death,” by Melvin Kirschner, Commentary, Oct. 10:

The most charitable comment I can think of concerning Kirschner’s views is that he is somewhat confused. His assertion that insurance companies have caused physicians to become less caring, honest, accessible and effective as referrers is both specious and inaccurate. It is specious because nearly everyone in our society still holds doctors in highest regard and rightfully believes that as a whole they are honest, caring, accessible and effective, whether they work under the HMO umbrella or not. It is inaccurate because nothing about an HMO precludes a primary care doctor such as Kirschner from referring a patient to a specialist. The fact that Kirschner can’t choose which specialist the patient goes to or if he goes at all was true before HMOs were ever invented.

What Kirschner really objects to is the oversight an HMO provides physicians in the interest of controlling costs and reducing unnecessary and/or defensive medical procedures. He appears to believe that a government-run program will provide little or no oversight by comparison. If he is right, the system will explode financially as it was doing before managed care became pervasive. If he is wrong, the oversight will be provided by government bureaucrats.

Patients who move to an HMO have gained a choice, not lost one. They can still go to their general practitioner or gynecologist, whose fees are nearly always less than the deductible under indemnity plans, and pay as they always have, or they can go to the managed-care doctor and pay less.

ALAN JONES

Calabasas

The writer is an insurance broker.