Letters - The Health Insurance Labyrinth - NYTimes.com

To the Editor:

As a family physician for 47 years, I totally agree with Paul Krugman’s May 22 column, “Blue Double Cross.” Health care insurers are more bureaucratic than any government agency. They often deny choice of doctor, and refuse to pay for care.

My experience with the government programs, Medicare and Medicaid, is that the reimbursement for services may be low, but there is one uniform set of rules to follow.

Each health care insurer has a different set of rules. The reimbursement for services varies widely and the doctor sometimes doesn’t know where to send the patient for laboratory or other tests. Furthermore, the physician often doesn’t know whether the prescriptions he or she writes will be covered.

As Mr. Krugman reports, insurance companies are still bad for your health.

Melvin H. Kirschner
Granada Hills, Calif., May 22, 2009

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To the Editor:

I am a dual citizen, born and raised in Canada. After attending graduate school in the United States, I returned to Canada, first of all because of its much better health system. During my time in the United States, I heard many astonishing lies about Canadian health care.

Someone said that Canadians can’t choose their own doctors. Sorry, wrong. It’s Americans whose choice is constrained, by health maintenance organizations.

Another person said Canadian-style care is more expensive. In fact, Canadians pay far less and still get a high standard of care and are healthier and live longer than Americans.

Someone else said that Canadian health insurance involves tons of paperwork. Wrong again. Canadian medical insurance and billing is a miracle of simplicity and economy. Anyone who has ever been to an American hospital knows how much paperwork — mostly financial — is involved, and how many different bills they get from how many different parties.

Americans deserve far better than their current system, because most of them can’t simply move to a country with a rational, humane vision of health care.

James Harbeck
Toronto, May 22, 2009