Medicare Health Plans

* Your article on the instability of the health-care system suggests that health plans and regulators may have to step in and create a new structure for managed care in the state [“Continuing Troubles at HMOs Promise a Wild Ride,” Dec. 31]. You also indicate that the Bush administration may need to increase fees for Medicare managed-care plans.

Studies by the General Accounting Office have demonstrated that the Medicare managed-care plans are already overpaid when considering their success at avoiding the enrollment of higher-cost patients.

Ironically, the financial difficulties of these plans are due primarily to the profound inefficiency of their private, market-oriented bureaucracies. The publicly administered, traditional Medicare program has been far more efficient in management of our tax-funded program.

Inviting health plans to step in with greater control will compound the problem of escalation of health-care costs. We don’t need to give the plans more tax dollars and payroll deductions. We need to move them entirely out of our health-care system and replace them with an efficient, publicly administered, universal-risk pool.

We have more than enough resources to provide comprehensive care for everyone. We need to direct these resources to the rightful beneficiaries, the patients, rather than use them to further enrich the health-plan industry that is providing no value for our investment.

DON R. McCANNE, MD

Board member, Physicians for a National Health Program

San Juan Capistrano

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