HMO Book’s Author Offers Another Dose

In response to Sandra Woolard’s letter concerning the article about my new book [“A Dose of Reality,” Aug. 29], she and I, at the least, are in agreement about one thing: The American health-care system “needs reformers, not critics.”

In reading my book, “The Insider’s Guide to HMOs,” she would find that its goal is clearly not just to criticize HMOs but to educate the public about how HMOs work behind the scenes.

The intent of the book is to help consumers become sophisticated and keen discriminators of the quality of their medical care. If an HMO does not provide high-quality care for its members, I want them to know it and to vote with their feet. The HMO will then need to improve or will cease to exist.

Woolard writes: “To launch one more attack [on HMOs] without offering a reasonable alternative is self-serving.” I am not interested in attacking HMOs, but I am interested in reforming HMOs and helping them evolve toward a higher quality of care.

In addition, I see no reason to offer a “reasonable alternative” to HMOs when the marketplace, in its wisdom, produced HMOs as an alternative to the agreed “fundamentally flawed,” un-managed fee-for-service medical system.

Dr. ALAN J. STEINBERG

Marina del Rey