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Nation's Health-Care Crisis

April 20, 1985

In his analysis of the nation's health-care crisis (Times,. April 7), Harry Nelson mentioned two miraculous achievements--heart transplantation and treatment of premature infants--that owe much of their success to the pioneering efforts of California physicians.

Unfortunately, Nelson merely glossed over another major California-based contribution to health-care delivery--prepaid medical plans, also known as health maintenance organizations. The sizeable interest shown in HMOs by government, industry and a cost-conscious general public is due primarily to lower monthly premiums and decreased out-of-pocket expenses than in fee-for-service plans.

In many cases, HMO membership amounts to annual savings of 30% to 40% and has the added benefit of encouraging patients to seek medical care on a preventive basis or before their illnesses get out of hand.

Several studies on the quality of care provided by HMOs, especially those done by Dr. Alain Enthoven of Stanford University, have shown equal or higher levels of care than those offered by other segments of the medical community.

Californians, including a growing number of Medi-Cal recipients and Medicare beneficiaries, are fortunate in having such HMOs as Kaiser Permanente, Maxicare and FHP to choose from. The growing acceptance of the HMO movement, both in California and elsewhere, offers hope that health-care costs can be kept under control without sacrificing quality and availability of care.

HAROLD N. BASS

Granada Hills

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