Health Insurance

Your article on medical insurance rollbacks (“California Firms Enjoy Rollbacks in Medical Costs,” Oct. 17) fails to put these rollbacks in context. Health insurers, faced with the prospect of elimination by Prop. 186, are acting out of self-preservation. Yet, as the article makes clear, they are not reducing their obscene profits: They are limiting physician choice and forcing physicians to reduce their staffs. Quality of care suffers as profits grow.

Clearly the real story here is that, both nationally and in California, health insurers reduced the spiraling costs of health care only when faced with federal regulation and Prop. 186. But a short-term decrease in the rate of inflation does not translate into health care reform. Rate rollbacks do not provide coverage to 6 million uninsured Californians, they do not provide long-term care, nor will they lead to increased spending on preventive care.

When the chairman of Blue Cross of California makes more money than an entire hospital, it is clear that something is very wrong with the system. When rates are reduced at the expense of choice of provider and quality of care, it is clear that the system must be reformed. Prop. 186, feared by greedy health insurers, is that reform.

MICHAEL COHEN

San Diego