Monday, Aug. 03, 1998

Letters

WHAT YOUR HEALTH PLAN WON'T COVER

"The transformation of the health-care industry into an approximation of the used-car industry is socially irresponsible." SPYROS ANDREOPOULOS Stanford, Calif.

Your report on managed care was balanced and thoughtful and mercifully free of the shrillness that characterizes much of the commentary on this controversial subject [MANAGED CARE 1998, July 13]. Of course, managed care is flawed, but with an aging population and increasingly sophisticated--and expensive--technology, it is becoming almost impossible to align the ideal components of a successful health-care system: access, quality and cost containment. One solution is to make employers provide the sources for coverage but let the employee shop around for the best HMO that meets his or her needs. That way responsibility for health care will rest with the individual--and the marketplace. DAVID WOODS, President Healthcare Media International, Inc. Philadelphia

As medical care became a trillion-dollar industry, investors who had made a killing in other sectors shifted their sights to the health-care industry. Managed care is seen as the most efficient way to extract new gold. The less doctors and hospitals provide, the more money they can make. The results: record gains--hospital profits alone hit a high of $21.3 billion in 1996, up 25% from 1995--while more Americans than ever are uninsured. Most of the proposed, limited reforms will merely confine the worst abuses. What is needed is not containment but a fundamental overhaul. ROSE ANN DEMORO, Executive Director California Nurses Association San Francisco

Ten years ago, as an accommodation to my patients who were being forced into managed care by their employers, I joined several HMOs. I struggled with the problem of denials and delays for years. Finally, at a substantial loss of income, I quit them all. I am much less busy, but my remaining patients are happier, and so am I. To pay for their competitive marketing and bloated administrative overhead, the HMOs must raise premiums. It is time to get rid of HMOs. There are 41 million people in the U.S. without health insurance. We need a national, single-payer system. MELVIN H. KIRSCHNER, M.D. Van Nuys, Calif.

It's troublesome that Americans seem to think HMOs "deny their patients proper care." HMOs mostly do exactly what they are contracted to do. If people want more, they should supplement the coverage with their own money or go somewhere else. That's the American way. And if HMOs are making such obscene profits, let's go buy stock in 'em. CHARLES H. LOWRY Garden Grove, Calif.

A for-profit corporation that receives reliable revenues, employs sharp-penciled "gatekeepers" who only grudgingly dole out "care" and cannot be sued may be an investor's dream, but it is a patient's worst nightmare. EDWARD K. GARRISON Chicago

Being in an HMO has saved me more than $10,000 in the past three years. We just had a baby who cost us $10 out of pocket. We've never had a problem with quality issues or failure to pay. GEORGE EVANS Dublin, Ga.

The facts about the very sad and untimely death of Barbara Garvey were not covered in full in your story. Her medical problems began when she noticed serious bruising, well before her vacation to Hawaii, but she refused to act on her doctor's admonition to get blood work done right away. The doctor Garvey saw in Hawaii said she was stable enough to travel back to Chicago. The focus of Rush Prudential Health Plans throughout Garvey's care stayed right where it belonged, not on trying to control costs--all the care she received was covered by us--but on trying to support her doctors as they fought to save her life. We provided a nurse to fly back to Chicago with her, but unfortunately she died from the aplastic anemia. This was a terrible loss, and our sympathies are with her family. BARBARA B. HILL, President and CEO Rush Prudential Health Plans Chicago

Americans want Mayo Clinic-type medicine but don't want to pay for it; we want "someone else" to do that. We simply can't have it both ways. Either we must confront the need to ration services and procedures by the use of managed-care systems, or we must put more of our earnings into paying for our health care. R. BARRY CROOK Oakland, Calif.

THE TAILWIND STORY

The CNN and TIME story alleging that sarin nerve gas was used by U.S. forces in a secret operation in Laos known as Tailwind and your subsequent retraction of it [TO OUR READERS, July 13] left a bitter taste in my mouth. If so much contradictory information was available after the story was broadcast and published, why weren't those facts discovered beforehand?

Why weren't proper investigative techniques used to find the whole truth instead of once again attempting to embarrass the U.S. military over Vietnam? It is this type of shoddy, irresponsible and incomplete journalism that over the years has widened the gulf between the people in the U.S. military and those in the press corps. (FORMER SGT.) DANIEL A. BACHRACH U.S.M.C. Tampa, Fla.

I liked the apology that appeared in TIME because you said you had solid information that went up in smoke. I do not blame CNN and TIME; I blame the U.S. Department of Defense. Never stop digging and watching everything it does. I think it covered this up. NAME WITHHELD BY REQUEST Phoenix, Ariz.

You and CNN blew your journalistic integrity with your Tailwind nerve-gas report. Henry Luce would have cleaned house, including the top brass. Until that happens and you return to hard-news and rock-solid journalistic ethics, how can you expect us to believe anything you print? JOHN L. PERRY Knoxville, Tenn.

TIME's apology pointedly and unfortunately avoided accepting any responsibility for the story that ran in its pages. That article, we are told, was "written by the CNN journalists," not by TIME's own correspondents. But did the CNN journalists sneak into TIME's offices in the dead of night and insert the article into the magazine? Where were TIME's editors? Shouldn't the emergence of such an incredible story after so many years have encouraged TIME to do some fact checking before printing the story? Apparently not. TIME's apology suggests that it prints whatever comes over the transom and checks the facts later. JAY WEITZEL Springfield, Va.

There are still unanswered questions about Tailwind. How could such vivid, seamless reportage, quoting a number of eyewitnesses and sources, be so totally reversed, supported by quotes from other "reliable" eyewitnesses and sources? And in your apology, some sources deny that anything in the CNN-TIME story was true. One person even says, "We did not use lethal gas, and we did not kill any defectors, men, women or children." So what was a sizable contingent of heavily armed, Special Forces soldiers doing on that secret mission in Laos? Selling Girl Scout cookies? BRUCE BRASHEAR Goteborg, Sweden

SECRET CAPITALS

Steve Lopez's article on the U.S. cities that are the best at what they do was fantastic [BONUS SECTION, July 13]. Every town was treated with respect and consideration. The amusing aspects of each place were made funny, but not a joke. I want to run out right away and see each one of these places because of unique details you brought to light. I hope all your readers got as much of a kick out of the story as I did. Bravo for showcasing the bright spots of America! SHANA ROHDE Katy, Texas

The section about Dalton, Ga., the "Carpet Capital," described how the city recruited Mexican teachers in order to attract Mexican workers. I found the condescending manner of some Dalton residents outrageous. You quoted an elderly Southern gentleman as saying, "I know these [Mexican] children are here to stay--as butchers, Realtors, car salesmen, physicians." Of course, the "physicians" remark was gratuitous. This man's attitude only reflects the fact that while the Hispanic population in the U.S. may be growing, our children are destined only to service the country's middle class unless they are better educated. KAREN SILVA Miami

Elkhart, Ind., was spotlighted as the "Recreational Vehicle Capital" of the U.S. I've had to deal with the Elkhart agency enforcing child support for 14 years. Yet even in the high-tech '90s, it is not yet computerized. It's been frustrating to cope with an overloaded system bogged down by a lack of commonplace technology. Perhaps instead of funding an RV museum that no one visits, Elkhart's city fathers could better spend the town's money on modernizing an antiquated system that forces dependent children to do without and allows deadbeat dads to go free. GERRI MOTTS Marietta, Ga.

ASIA'S NEW ORDER

America has long used the ploy of playing Japan against China in its game of Asian diplomacy [WORLD, July 13]. Bill Clinton has certainly been dazzled by the allure of China as a big market for U.S. products; he seems unable to see that country's true colors. I will say this to the Americans who want to stick their nose into our economic affairs: "You have not been asked to be a backseat driver; mind your own business." TSUTOMU NAKAMURA Kamakura, Japan

We should be jubilant that Clinton was broadcast live on Chinese TV and radio. He was able to state the case for human rights very clearly in a historic forum, and his message will bear fruit over the next 10 years. China is far from perfect, but we should not look down on its human-rights record without recalling the U.S.'s own version of Tiananmen Square: Kent State, where the National Guard shot at students protesting the Vietnam War. SUSAN MANN La Jolla, Calif.

President Clinton reviewed communist troops in Tiananmen Square, an action that told the world the deeds of the Chinese government, including the murder of protesters in 1989, didn't matter to the American people. And then he sold out 21 million free people in Taiwan by adhering to the one-China policy that does not support Taiwanese independence. Taiwan has now been set up the way South Korea was in the 1950s. ROBERT A. COOPER Phoenix, Ariz.

Clinton's visit allowed 1.2 billion Chinese to see the No. 1 person of the country that makes Coca-Cola, Nike sportswear and Boeing aircraft, all of which are quite familiar to Chinese eyes. Clinton's open exchange of views with Chinese President Jiang Zemin, Peking University students and callers in Shanghai is unparalleled. The Chinese have now seen a democratically elected leader talk with the people in an open way. And they may think twice about why their own party leaders are seldom seen in public, let alone speaking in an impromptu fashion with them. XIAO-MING YU Charlottesville, Va.

China wanted Clinton's trip to improve the image of President Jiang in the eyes of the Chinese people and firm up his grip on power. This goal has apparently been achieved. But what did the U.S. gain? Not much. Now that the party is over, can we face the fact that China is a communist country? Is communism still a threat to the democratic world? To the Asian countries, Taiwan in particular, the answer is yes. The U.S., the leader of the free world, should have second thoughts about the way it treats communist China and democratic Taiwan. CHENG-MIN TSENG Port Elgin, Ont.

GETTING OFF WELFARE

It is absurd to think that the key to ending welfare is teaching folks how to dress and explaining the concept of "boss" [NATION, July 13]. The problems of poverty and unemployment in low-income neighborhoods are deeply entrenched. Quick-fix policies blind us to real solutions, such as fully funding our schools and providing jobs that pay a wage that can support a family. HUNTER CUTTING San Francisco

I don't like the glorification of participants in the welfare-to-work program. If I continue to work hard, I won't have to go on welfare--ever. Why praise people who are doing what they should have been doing all along--working! DEBORAH ANNE REDFERN Kenosha, Wis.

The more success this generation of welfare recipients has in finding jobs, the more likely it is that their children will be employed when they become adults. Since the work ethic is often learned from parents, more work and less welfare-program participation by parents will discourage children from going on welfare. The real bridge to the 21st century is jobs that teach welfare recipients the skills they need to move up the ladder to self-sufficiency. So long as the bridge isn't roadblocked by government wage and tax policies that destroy entry-level jobs, this success will be passed on to future generations. THOMAS K. DILWORTH, Research Director Employment Policies Institute Washington

REMEMBERING A PRINCESS

A memorial to Princess Diana is necessary for the many people who loved and respected her [WORLD, July 13]. She is going to be a notable figure in history. You snidely referred to the memorial site at the Spencer family home as "Dianaland"; just call it Althorp. JEANNE MCCARTIN Ossining, N.Y.

The legend of Diana is just beginning. The people of Britain are very proud of their beautiful princess, who lit up the world with her unique smile and traveled the globe bringing peace and harmony everywhere she went. FRANK A. LOPEZ Redwood City, Calif.