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Emergency Rooms Fail Patients

January 05, 2002

"Physician specialists increasingly refuse to drop what they are doing to care for strangers in emergency rooms" read a subhead to your Column One on Dec. 29. The article was a frightening but not surprising report on what is going wrong with health care. "Cases Reveal Lapses in Kaiser Emergency Care" (Jan. 2) reports on failures within the HMO emergency health care system. Kaiser provides fine health care to a vast number of patients statewide; you unfairly distort the rate of poor results.

My husband is a surgical specialist, my brother a cardiologist and my daughter an RN midwife. All go forth each day to deliver the best health care possible. But California's health care system places unreasonable burdens upon its providers: excessive patient loads and risk of litigation combined with inadequate compensation and resources. My husband happily moved his medical practice from L.A. to Ohio in 1995, but senses the frustration of his colleagues in California.

There is another scary element in the health care equation. Research shows that America's best medical schools are seeing a decline in both the quantity and quality of applicants. Just as the teaching profession faces public blame and looming shortages, beware of the effect of public policies upon the pool of physicians.

Betty Raskoff Kazmin

Willard, Ohio

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What's painfully clear is that cops don't arrest cops, lawyers don't sue lawyers and doctors don't report other doctors, regardless of how horrendous the negligence or malpractice. Until the white wall is broken, the quality or lack of medical care in the emergency room will be held hostage by the egos of the specialists on call. The Hippocratic oath is an oath of ethical professional behavior sworn by all physicians, not a guarantee of personal wealth or personal recognition.

Gary Parker

Long Beach

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Thankfully the on-call doctors weren't NYC firefighters or other rescue personnel. Nobody would have been rescued without a checkbook handy.

Margie Mullen

Studio City

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The reluctance of specialists to treat uninsured patients in hospital emergency rooms highlights the need for a comprehensive health plan for all Americans. The insurance lobby successfully defeated the Clinton health proposals of 1994 that would have achieved this goal, with the result that we now have some 39 million uninsured individuals in this land of plenty. The rest of the population has been herded into profit-oriented managed care plans.

One can no more expect medical specialists to render their services without hope of payment than you would expect the CEOs of HMOs to do the same. The ideal solution would be a government-run single-payer system, similar to those of Canada and the Western democracies of Europe, where reasonable health care is furnished to all citizens and physicians are not asked to render care without compensation.

Edward C. Bayan

Northridge

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The type of condemnation found in your article on Kaiser is irresponsible. Millions of people in HMOs receive perfect care, as is my continuing experience. This is similar to blaming tires for accidents when vehicle drivers were traveling at high speeds.

Charles R. Morrison

Palm Desert

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Re "Repair, Don't Merely Bandage, Health Care," Commentary, Dec. 28:

There he goes again--Jamie Court and the health-care-bashing few who don't understand that we have the best, most effective health care system in the world. When will Court and company accept that nearly 90% of us have confidence in the system he so dearly wishes to undermine?

The simple fact is that the problem is not access to the system or that HMOs are reaping excessive profits (they clearly aren't) or that administrative costs are too high (they aren't, as opposed to government). The problem is affordability of medical care. If government keeps sticking its nose into it to mandate benefits at the whim of individual groups of constituents, costs for legitimate health care concerns will surely suffer.

Let the market forces fix the system; keep Court and his health patrols out of my health care system!

Jeffrey Miles

Venice

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