HMOs Taking Us in the Wrong Direction

Your March 3 [1999] editorial “Health Care Industry Wearing Blinders,” brings to light much that is transpiring today in health care delivery — from “cowardly” public relations responses at the state legislature to “cynical” radio ads by the managed care industry.

The public outcry you described and the horror story testimonials aired in WMAZ’s, All About You, managed care series — all support my contention that we are headed in the wrong direction, toward more corporate socialized medicine, to the detriment of patient care.

The rationale for managed care is cost containment and thus, must rely on a collectivist ethic of medical care and assembly line medicine.

These ethics propound that physicians place cost considerations and the interest of third-party payers above that of their individual patients.

On the other hand, the ethics and tradition of Hippocrates place a duty on physicians to put the interest of their individual patients above those of the collective, be it society, the government, or a third-party payer or network (e.g., HMO that employs them).

The solution should be, in the short term, to institute and liberalize the concept of tax free medical savings accounts (MSAs) and return to the concept of truly catastrophic, high-deductible health insurance (rather than prepaid consumption of medical care as in HMOs); tax equity, so that all insurance premiums are 100 percent tax deductible for everyone; and in the long term, return to the oath of Hippocrates and severance of health insurance from place of employment.

Miguel A. Faria, Jr., M.D.
Macon, GA

This letter to the editor was originally published in The Macon Telegraph on March 8, 1999.