Health Care Crisis

* The issues raised by Ruth Rosen in “Cut Insurance Profits, Not Nurses” (Commentary, May 9) should be noted by everyone who ever expects to be a hospital patient. As the mother of a charge nurse at Alta Bates Hospital in Berkeley, I can attest to the fact that the only people who will suffer more than the nurses with the use of “multiskilled technicians” are the patients. And while the nurses can lose their jobs, the patients will lose their comfort and ultimately their lives.

The public should make known their displeasure at hospitals replacing nurses with “under-aides.” After all, they are the consumers who pay the bills, one way or another.

HELEN BAZNIK

Tustin

* Rosen makes a serious error in her analysis of the crisis in health insurance financing. Her indictments of the managed care industry and subsequent call for a socialized, single-payer health care system are akin to jumping from the frying pan into the fire.

The rationing by HMOs that she condemns will seem like the lap of luxury under government-run health care delivery.

However, there is a crisis in the way we purchase health insurance. The government has created and encouraged managed care and HMOs through a tax policy that leaves the individual with no incentive to own health insurance for himself. Instead, most Americans get their health insurance from their employer. From President Nixon’s HMO Act of 1973 to the current drive to push America’s Medicare recipients into managed care, HMOs owe more to government intervention than a free market. The managed care concept of a gatekeeper cutting costs by denying treatment raises serious ethical questions. How can a doctor function when every moment is a split-second choice between his patient’s life and the HMO’s bottom line?

While patients should not be forced or encouraged into an HMO by the state, they should be free to choose managed care if they prefer. If Rosen is truly concerned about the quality of managed care, she should advocate full tax deductibility of the cost of health insurance for individuals and tax-free medical savings accounts. In other words: Put the patient, not the state or an employer, in charge of his own health care.

SCOTT HOLLERAN

Executive Director

Americans for Free Choice in Medicine

Newport Beach