HMO System’s Failure

* Re “Closure of Medical Group Creates Chaos,” Oct. 18.

The Family Health Care disaster makes it painfully obvious that the health maintenance organization system can never work.

The health plans with their obscene profits and often grotesque [chief executive] compensation need to be accountable for the health care of their clients. They must be held responsible if they hire mismanaging middlemen and pay them too little to provide proper care.

The middlemen (such as Family Health) should not be allowed to pay their managers unconscionable salaries and bonuses while going into debt, not paying the providers of care and then hiding behind bankruptcy laws. Legally they probably can, like so many others have, but morally I think most people would feel that the owners should go to the bank, take out some of their previous stash and pay the people they legitimately owe.

The only solution seems to be declaring HMOs illegal and going back to the doctor-patient system, with maybe some catastrophic insurance protection. But get rid of these ridiculous middlemen.

KENNETH SAUL, M.D.

Thousand Oaks