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Copyright 1999 Gannett Company, Inc.  

July 14, 1999, Wednesday, FINAL EDITION


LENGTH: 479 words

HEADLINE: Put patients in 'driver's seat' on medical treatment

I agree with USA TODAY reporter William M. Welch when he states
that the fundamental question in the health care debate is who
ultimately decides when a medical treatment is really necessary:
the patient's doctor or the patient's health insurance company?
(" 'Medical necessity' is crux of health debate," News, Monday).

And I consider arrogant the suggestion by Charles Kahn III, president
of the Health Insurance Association of America, that any attempt
by Congress to regulate managed care is a mistake, including trying
to control who has the final say on issues of care because "it
puts the government between the doctor and the patient."

Currently, the managed-care organizations disastrously insert
themselves between the doctor and the patient, with the result
that we now need this current national debate.

Unfortunately, Congress granted them permission to run roughshod
over the patient-physician relationship, employers and even the
government itself.

The recent "collusion" of plans for the purpose of "boycotting"
the Medicare HMO program is a blatant attempt to extract higher
"fees" with their associated higher profits, while "striking"
against providing coverage for Medicare patients. This is illustrative
of their true motivation.

Another way to "level the playing field" for our patients' benefit
would be to remove the following federal acts:

-- The McCarran-Ferguson Act, which grants anti-trust exemption
and leeway to insurers.

-- The Employee Retirement Income Security Act (ERISA), which
grants insurers federal exemption from state laws and regulations.

Passing an appropriate "Patients' Bill of Rights" is a good
beginning. Equally important is finding a way to assure coverage
for the uninsured with private insurance that is accountable to

The ultimate solution is the American Medical Association's plan
for a system which would accomplish both goals while putting the
patient in the driver's seat.

Changing the tax structure to promote individual ownership of
health insurance must be the ultimate achievement.

Michael S. Ellis, M.D.

Chalmette, La.

Costly health care reform

One thing is certain when listening to the talk about HMO reform:
Hold on to your wallet ("Why should law protect HMOs that injure
patients?" Our View, Suing for malpractice debate, Tuesday).

When the federal government gets its hands on something like this,
it has never been able to do anything that has the effect of reducing
cost and increasing operating efficiency. In fact, quite the opposite
is true.

If the American people should have the right to sue an HMO, as
our lawmakers in Washington suggest, then is it not appropriate
that we have the right to sue Congress if it's wrong about the
costs of its good intentions?

Tom McAlevey

Tulsa, Okla.

LOAD-DATE: July 14, 1999

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