Dowling on HMO Care

It is dismaying to see yet another unbalanced HMO-bashing piece (“Medicine From the Factory Line,” Aug. 2) on your Commentary page. Once again, good old days fee-for-service medicine is presented as virtually perfect except that maybe it costs a little too much. One needs only to look through past issues of The Times or reports from the Medical Board of California to recognize the substantial amount of poor quality medical care that took place in the past. Much of that also occurred because of profit motivation and lack of appropriate peer review and supervision.

Preventive health and testing occurred less often than in HMOs. People often neglected serious medical conditions because of the cost, and often received vastly different kinds of medical care depending on their ability to pay. Although I couldn’t agree more that doctor visits shouldn’t be rushed, one doesn’t have to go to an HMO to see an overly busy physician.

Large profits and inordinate use of funds for non-medical purposes may well deserve scrutiny. However, making outrageous profits or “earnings” from health care is certainly not new, although the particular recipients may have changed. As individual doctors are not all alike, HMOs are not all alike either. There is ample room for either greed or principle everywhere.

HYMAN J. MILSTEIN MD

Studio City

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* Dr. Dowling is to be commended for her incisive, perceptive and honest interpretation of the medical debacle we are beginning to experience in California.

Will someone please explain to me how the health care crisis is supposed to be averted (avoid bankruptcy) when a Medicare recipient signs on with an HMO which collects Medicare funds for that individual who is not sick and would not have filed a Medicare claim? Is that prudent use of tax funds?

Will someone please tell me why I paid $95 for a bone density study in 1994 (not covered by Medicare) and why Medicare was billed $295 for the very same study in 1995 (now covered by Medicare)? Isn’t something wrong here?

AUDREY H. ZOOK

Corona del Mar