Republican Medicare Bill

Re “House Approves Republican Bill to Overhaul Medicare,” Oct. 20:

What do you get when you rip $270 billion out of Medicare? You get Newtcare. The “new” Medicare will de-emphasize quality of care and will focus on shifting our seniors into managed care, which by the way does not cost less. The emphasis of managed care is to give nothing but minimal care, thereby increasing corporate profits. The seniors of this country have been betrayed by the people that they elected to represent them.

We seem to have money for military spending that was not asked for by the Pentagon, but we don’t have the money for our seniors. We have tax cuts for the rich at the expense of those who need help. Next election, let us remember Speaker Newt Gingrich and those who didn’t have the courage and morality to oppose him.

CHARLES STILLMAN

Huntington Beach

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* I am a bit surprised that the Senate Medicare measure, approved by the Finance Committee, requires an additional Part B premium from single beneficiaries with annual incomes above $75,000 and couples with incomes of $125,000. This means that two single people each making $70,000 would, tax wise, be better off not getting married. I thought these Republicans were going to eliminate marriage penalty laws. So why are they introducing one?

WILLIAM TOMLINSON

Frazier Park

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* Re “Republicans Betting on HMOs to Rein In Medicare Expenses,” Oct. 23:

Your article makes very clear the reasons that we should not be looking for politically expedient solutions to solve social problems. Both political parties support the move to managed care, which will destroy the traditional health care system, preventing patients from selecting their own personal health care providers.

The need to control health care costs is not disputed, but using the HMO model to accomplish this is fallacious. Although HMOs provide Medicare coverage at a 5% discount to the government, they enroll a relatively healthy Medicare population. The more seriously ill elect to continue with their traditional providers. In the traditional fee-for-service sector, this healthier population was costing Medicare only about 85% of the average per patient cost. Thus, the taxpayer, instead of paying this 85% to the private sector, is now paying 95% to the HMOs.

When HMOs discount premiums charged and retain up to 30% for administrative costs and profits, funds available for medical care are significantly reduced. This, in turn, has only two possible outcomes. Either funds will be inadequate to support our traditional system, resulting in financial collapse, or medical services will be curtailed. This reduction in services will be driven by economic issues, rather than being based on patient care needs.

A more humane and rational method of reducing services would be to exclude from our Medicare insurance pool those medical services which fail to accomplish either of the goals of health care, which are prevention of premature death, and maintaining and improving quality of life. It has been estimated that 40% of medical care rendered today does neither. If we eliminated coverage for unnecessary and inhumane care, and if we ended the diversion of a major portion of our health care dollars into the insurance industry, then Medicare could save about $700 billion in the next seven years, far more than the $270 billion called for in the Republican plan.

DON R. McCANNE MD

San Clemente