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Concerns Over Health Care Plan

April 22, 1993

Let me begin by stating that I may not be a typical doctor. My political leanings are much more liberal than most, as evidenced by my votes for Mondale, Dukakis and Clinton. I am a medical subspecialist at a time when the emphasis is moving toward primary care. I am not a member of the American Medical Assn. and I freely admit there are many poor quality doctors practicing poor quality medicine. I am also perfectly willing to see radical changes in health care delivery even to the point of major reductions in my income.

However, I am increasingly uneasy whenever I watch news programs on the health care crisis or read about Hillary Clinton's circle of advisers. They typically include several Ph.D.s, hospital administrators, sociologists, insurance company executives, senior citizen activists, consumer group leaders, and government officials. They might include an occasional physician who represents organized medicine or is in some academic position. I worry that most of these people just don't have the right "feeling" for what is really going on in my office or at the patient's bedside.

It may be politically easy to dismiss all physicians' ideas for reform as attempts to preserve their high incomes at all costs. It may also be politically easy to cut physicians' and hospitals' fees, complain about drug company profits and tax cigarettes. I do not believe I am being elitist to suggest that we, in the full-time private practice of quality medicine, should be seen as the most qualified to help design our future health care system. We are probably the best patient advocates around. Maybe I shouldn't be so nervous. Maybe they will get it right.

Meanwhile, I'm hoping that Hillary calls.

BARRY J. ZAMOST MD

Long Beach

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