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Bureaucracy and Specialists in US Health Care

October 7, 1991



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.

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