It is unfortunate that, despite numerous studies praising the quality of care provided by many prepaid health-care systems, Siegel chose to perpetuate the tired old cliches that prepaid health care is typified by assembly-line medicine and financial gatekeepers more concerned with turning a profit than providing patient care.
By tarring all HMOs with the same brush, Siegel fails to mark the differences in structure, ownership and motivation among managed health-care systems.
In a group-practice HMO such as Kaiser Permanente, physician-partners are not subject to the direction of nonphysician administrators. There are no rules or policies that mandate a gatekeeping role. On the contrary, our physicians understand that prompt, appropriate medical care is also the most cost-effective care.
FRANK E. MURRAY, M.D.
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP