Health: Crisis in Coverage, HMO Care

* Re “Health Care Woe: Break the Cycle,” editorial, Dec. 3: Families USA and the Health Insurance Assn. of America proposed expanding Medicaid to cover all people under age 65 living at or below 133% of the federal poverty level (approximately $18,820 for a family of three). They proposed giving states the option, with financial inducements from the federal government, of expanding either Medicaid or the state Children’s Health Insurance Program to cover adults with incomes between 133% and 200% of the federal poverty level. The tax credits that the editorial described for employers offering employee health insurance are linked to the expansion of Medicaid and S-CHIP.

Numerous studies show a connection between poor health and the lack of health insurance. With over 45 million of our citizens without health coverage, the new Congress and president should put the expansion of health care at the top of their joint agenda.

MICHAEL SEVERAL

Los Angeles

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“Big Challenges for Managed Care” (editorial, Dec. 1) properly criticizes the state Department of Managed Health Care for the modest steps it has taken in the developing health care crisis. But the editorial itself is far too modest in the corrective actions proposed.

It ignores the fact that the HMOs have been squeezing payments to doctors for several years, below the bare minimum in many instances. It recommends “weeding out the weaker ones to make sure that the stronger ones survive” without mentioning that none or only the most selfish may be left.

Medical quality ratings can be deceptive, since doctors and hospitals have obtained them by denying care to the most needy patients. This makes honest reporting of health care quality an awesome responsibility, not likely to be accomplished easily. Affordable health care choices are disappearing at an astonishing rate, and more action (likely with increased costs) must come from the state level.

BERNIE KENNER

Rancho Palos Verdes