Single-Payer Health Plan

In their article “Loophole-Free Reforms Needed” (Commentary, Sept. 14), John Garamendi anled Laura Rosenthal address details of how and why they feel that businesses should be forced out of existing employee health insurance arrangements.

It seems that before this whole thing goes any further, a time-out should be taken for a reality check. First of all, providing subsidized medical care for more people is going to cost more. Who is to pay for this: Consumers through business taxes? All workers through reduced pay scales or higher income taxes? The new recipients, much as though they had been forced to buy present-day individual coverage? Clearly, “squeezing” Medicare will not.

For another thing, who is pushing for radical change rather than repairs? In this democracy, politicians are supposed to represent the views of the majority of the citizens who care enough to vote. Of course, there are a few districts where the majority do have radical views. But, it appears that the vast majority of such constituents are concerned (read that as hysterically scared) that “government” will “wreck” (somewhat like the retirement savings plan called Social Security) their hard-won present arrangements and coverage terms. Where and by whom is this majority view being addressed?

CHARLES W. FOX

Mission Viejo

Garamendi and Rosenthal eloquently describe the ills of our current fragmented health care system run by the insurance industry. What they do not tell you is that Proposition 186 on California’s November ballot is the cure.

Prop. 186 establishes a single nonprofit, publicly funded insurance fund to pay for all medical care of legal Californians from the doctor of their choice. By getting the profit-motivated insurance industry out of our health care system, we save up to 30 cents per dollar that insurance companies currently waste on bureaucracy, paperwork, marketing and profits.

The last few years have seen more and more Californians and their families herded into HMO’s and forced to change doctors as they watch their benefits diminish and their premiums continue to rise; all the while, insurers keep making more profits--up 32% between 1992 and 1993.

Under Prop. 186, Californians and their families are assured of the following:

Highest quality medical care at the doctor and hospital of your choice without a co-payment.

The security of medical benefits that can never be taken away, even if you get so sick that you cannot work.

Paying less than you do now for better benefits--2.5% of a family’s taxable income replaces all that you must pay now in premiums, co-payment and deductibles.

Incremental reforms cannot work because they continue to rely on an insurance industry that has had 50 years to prove that it can administer our health care system effectively and has failed because it puts profits above access to care, preventive care and choice of provider.

JENNIFER REIFEL MD

Los Angeles

Proposition 186 seeks to replace private health insurance with a state-run, government controlled health care system. This initiative will place a surcharge on personal income tax of 2.5% to 5.0%. The supporters of this measure want to slap business with payroll tax increases of 4.4% to 8.9%, depending on number of employees.

On top of this, under this initiative, health care provider and hospitals can opt out of the government-run system. Many Californians could be forced to change physicians because their current physician rejects the government-run system.

Economic studies reveal that this government-run system would have more than $40 billion in budget shortfalls on top of the new taxes. In the event of shortfalls, the elected health czar would either have to cut back health services, increase co-payments and/or go to the Legislature and ask them to raise taxes--again. Imagine urgently needed health care becoming unavailable because there is no money while the Legislature debates whether to cover shortfalls. Will your hospital or physician take a California state IOU?

LAUREEN HART

Moorpark