LETTERS: TAXES PAY OVER HALF OF HEALTH CARE

To the editorA recent letter to the editor "HMO cost cutting is a wake-up call" by Mr. Nicholson deserves some comment. The title is well chosen, but the logic I believe, is incorrect. I do not approve of HMOs because the very objective of HMO's is profit which is not limited to improving efficiency of delivery of health care, but also to inappropriate cost cutting such as withholding treatment and lowering quality of caretakers. I really do not know what Mr. Nicholson means by socialized medicine. I assume it has something to do with government involvement in health care. If this assumption is correct, then we, the people, made the decision to become socialized when we decided and passed laws that prohibited letting people die because they did not have the wherewithal to pay for medical treatment. Who should pay for this treatment? I know most people believe that the insurance companies pay for it, but this is only partly true -- a very small part. You, my friend, pay for over half of the medical care in the United States through taxation. It cannot be any other way. In 1993 the per capita health care cost in the United States was $3,191 including government help. If your family is average and without government help, you would have spent the $3,191 per person including insurance and all other medical costs. But since the $3,191 is an average, those in poor health would have spent much more. Now, just how many families could afford the $3,191 per person, much less the higher cost to the sick? Without government financing, the average insurance premium, if everyone was insured, would be $3,191 per person plus a profit for the insurance company. Do you really believe that we do not need government involvement? I challenge the logic that shifts the blame to socialized medicine. I know the present mindset in Washington is strong for HMOs and will force (but it will be denied) Medicare recipients into HMOs. My arguments against HMO's are many and too long to present here, but Mr. Nicholson's observation is a good one. The limiting of treatment is a choice of the HMO in order to make a profit. A plain market-driven decision. Medicare pays a fixed rate per enrolled Medicare recipient, at least that is the way I understand it. Just how does cutting treatment benefit Medicare and the taxpayer? As I see it, the blame is the very market forces that Mr. Nicholson seems to promote. The only fault of government is being wrong about promoting HMOs.

Mr. Nicholson seems to have something against what he calls socialized medicine. The United States has the least involvement in health care of any industrialized nation on earth but it results in financial destitution for some and insufficient treatment for others. In addition to the above financial argument setting the need for government in the financing of health care, we still close our minds to government involvement. Instead of facing reality, we prefer to call names such as liberal, socialist, communist and worse to those promoting thoughts other than a free-market system which cannot work for health care. In time, we will have more government-financed health care, but we should make sure the role of government is limited. We should insist that we the people retain control of our medical care.

I want to make a few comments about the Canadian system of health care. I am not promoting the Canadian system, but I do believe we should open our minds and get beyond name calling. It has good points which should be considered. Compared to the United States, Canada has a lower infant mortality, higher life expectancy, universally available health care, no financial destitution due to medical care, more office visits per patient and at only two-thirds of the cost of the United States. Our press, politicians and vested interests have accentuated the negatives even false negatives in order to preserve a so-called free-market system that is now, and can only be, a failure. It wouldn't be fair if I did not mention that the Canadian system has a few negatives. It has financial problems created politically. It has a shortage of some specialists. The lack of specialists is partially due to immigration to the greener pastures in the United States. It has a shortage of specialized equipment which just happens to be too abundant and costly in the United States. Let us get back to reality. We can institute a universal health care system partially financed by the government and retain fee for service, the people's choice of doctors and treatment and economic competition at the patient/provider level. Sounds better than working for an HMO, no people's choice, financial destitution for some and insufficient treatment for others. This, however, can only be accomplished if we can talk to each other with open minds. VICTOR L. BRANT

Cape Girardeau