Complex Health Coverage

I was not at all surprised by Bernadine Healy's column "How Crafty Insurers Deny Care" [September 29-October 6]. All holders of health insurance policies should remember that insurers are not in the business of keeping their clients healthy; they're in the business of making money. In addition, the column brings out the fact that the U.S. system of a multiplicity of third-party payers makes transparency nearly impossible. The reaction of the British medical community to the plan by the United Kingdom's National Health Service to deny coverage for new lifesaving medications shows that doctors in Great Britain can serve as advocates for patients against the insurer. Many doctors in the United States could fill this role, but similar decisions are made piecemeal by dozens, if not hundreds, of private companies that have no obligation to disclose their rationale.

John Mack Odenton , Md.