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Paying for Health Care

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Re “Health Plans Seek to Address Consumer Ire,” April 6: The HMO health delivery system was never intended to be the Cadillac of systems. A no-frills health insurance option, it’s affordable. And, since everybody wants something for nothing, HMOs became the first choice of employers, who foot most of the health care premiums in this country. Now everyone’s complaining about what HMOs don’t deliver. You get what you pay for. Problem is, nobody wants to pay. That’s why there are PPOs and traditional fee-for-service plans still in existence.

I’m the first to agree that HMOs swung way too far in the cost-savings direction and that they definitely favor the healthier consumer. But you start adding all the “options” you want to your basic HMO plan, and just like a car, the price goes up.

COLLEEN NELSON

Santa Ana

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Individuals pay $103 an hour to a plumber to unclog a drain, yet Medi-Cal will pay a surgeon only $97.45 to treat a knife or gunshot wound in a patient’s chest. A basic manicure costs $30, but a physician’s services and expertise for stitching up a serious wound are only worth about $15, according to the state. Because the state Legislature has failed to address inadequate Medi-Cal reimbursement rates, our children, elderly and the disabled--who most often depend on Medi-Cal to cover their medical expenses--frequently cannot find a doctor who will accept new Medi-Cal patients.

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Today, California’s economy finds the state coffers at their highest levels. The California Medical Assn. asks Californians to support us in our effort to convince the Legislature and the governor to keep poor people’s access to quality medical care open. In the past 15 years, Medi-Cal increases have been so low that, when accounting for inflation, the rates have actually been decreased by 54%. It’s time to raise the rates. We want to help all patients.

GERARD FRANK, President

L.A. County Medical Assn.

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