Bureaucracy and Specialists in US Health Care

Regarding the opinion-page article "National Health Insurance Isn't the Cure," Sept. 23: If socialized in its present form, the result for Medicare - and America - would be the institutionalization of many faults including over- bureaucratization. Last year our medical bill was about $700 billion, one quarter of which went to the bureaucracy for paperwork.The oversupply of specialists is another fault. While the majority of medical conditions are - if caught early - rather ordinary stuff, only 12 percent of MDs in the US are generalists. This will fall to 10 percent by the end of the decade. More and more specialists will be deigning to treat ordinary conditions at ever more spectacular fees. In countries with workable socialized medicine, about one-third of all MDs are generalists. In France - fully socialized - the government will pay for a trip to the specialist only if the patient is referred by his generalist. An extrinsic statistic: Americans represent 5 percent of world population, but have 70 percent of the world's lawyers. Would socialization lead to no-fault medicine? I doubt it. Philip C. Holzberger, Millbrook, N.Y.

The column states that "many Canadians come to the US for treatment." But friends of mine in Canada who live in a large city and know people at all financial levels have never heard of anyone going to the US because they couldn't get medical care in Canada. We do need national health insurance like the Canadian system. The key is that in Canada, as the article states, the government sets doctors' fees. Canadian doctors, my friends tell me, are very comfortable, but they aren't filthy rich like many US doctors are. American doctors and hospitals are worried that if we had a national health care plan like Canada's, they couldn't overcharge. Marilyn M. Yelle, Garberville, Calif.

Zionism and racism Regarding the highly informative opinion-page column "Toughness With Israel Helps US Image," Sept. 23: It would also help tremendously if president Bush would call upon his Israeli friends to stop being racist and grant citizenship, including voting rights, to Palestinians. Zionism then could no longer fairly be equated with racism. Louis Ward, Sault Ste. Marie, Mich.

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