Health Care Bureaucracies

William Schneider (Opinion, July 12) is correct that Americans fear bureaucrats, both private and government, in health care insurance. There is a simple solution to this problem without resorting to legislation: Become self-insured. By this I mean that you pay all of your health care costs yourself. There will be no middle man or accountant to tell you who you can see or how often. Of course, many people may think they cannot afford such a course and will continue to pressure government to pass laws to make insurance companies pay for all kinds of treatment. This will only tend to increase health insurance premiums.

All insurance is a “spreading of risk” in which those who do not collect pay benefits to those who have suffered a loss. All insurance policies contain sections that detail the types of losses which are covered and those which are not covered. If one does not like the coverages and exclusions, one can shop for more appropriate coverage. If your insurance will not pay the bill, you can always pay the cost yourself. Rather than mandating coverage, legislators should be considering more extensive use of medical savings accounts and making medical expenses totally deductible.

JAMES A. BAUR

Green Valley Lake

* Surely it’s time to have a more balanced look at HMOs. I joined my HMO 2 1/2 years ago. Each year I have a thorough physical, including a mammogram. Eighteen months ago I ended up in the cardiac care section. I had a private room and around-the-clock care (first-class). I have had EKGs, ultrasound, echocardiogram, angiogram and a 24-hour monitor. I have not been billed for one dime--no savings wiped out, as experienced by many patients. I receive excellent care and attention from my doctor, a wonderful lady. My prescriptions are $10 for brand name, $5 for generic.

I find it very hard to believe that, out of the millions of people with HMOs, I am the only one who is perfectly satisfied with the system.

BERYL VINCENT

Santa Monica