Letters to the Editors

PPOs are not "managed care"

Your Dec. 4 cover story could go a long way toward demoralizing the strong resistance to HMOs that is developing in this country. Perhaps that's the intent.

The article lumps preferred provider organizations with HMOs. This is specious at best. There's simply no similarity between discounted fee-for-service and capitated care. The latter is wrong on principle.

Karl Sandberg, MD Ola, AR

Is the AMA the ultimate political authority?

In Wayne Guglielmo's last-minute election article ["Election 2000: Will doctors desert the GOP?" Oct. 23] it's gratuitous to use the AMA's political action committee contributions as evidence of physicians' political leanings, given that the AMA now represents less than half of American physicians.

Guglielmo also assumes that most physicians favor the Dingell-Norwood Patient Bill of Rights, and that because Republicans stopped the bill, physicians want them to pay. Does he believe we doctors want a bill that brings us back to the days of indiscriminate medical spending, when every headache sufferer could get an MRI?

We don't need Dingell-Norwood. Expenditures on health care are already 14 percent of our GDP. To date, HMOs are the only force that has stopped that percentage from growing.

If Guglielmo wants us to swallow all this, he ought to show us real evidence that doctors are abandoning the GOP, in the form of contributions by physicians to the parties, or statistical surveys of doctors' votes.

Don J. Woodhouse, MDWebster City, IA djwood@netins.net

Editor's Note: The American Medical Association's data come from state medical societies, which collectively have a more sizable membership than the AMA and more accurate figures on physicians' voting preferences. The AMA's Political Action Committee (AMPAC) makes direct contributions to national candidates, but it relies on recommendations from state chapters.

Don't get clipped by hedge funds

In your article, "Investing for thrills" [Nov. 20], financial adviser Jay Freeberg warns investors that hedge funds are "unsuitable for any currently taxed accounts, so use [them] only within your retirement plan."

The problem with that advice is that hedge funds use leverage in order to increase their returns. Some or all of that money will be taxable as unrelated business income. Any money subsequently withdrawn from the plan will be taxed again, regardless of any previously paid tax. There would have to be a compelling reason to subject a tax-deferred account to current levies, especially when that would result in double taxation.

James E. Maier, CPA, PFSFIS AssociatesKnoxville, TNjmaier@fisassoc.com

Editor's Note: Hedge fund returns within an Individual Retirement Account aren't taxable as unrelated business income.

Correction

The author of the article on page 89 of our Jan. 8 issue is incorrectly listed as Jonathan A. Vanek, a pathologist. He's actually John A. Vanek, a radiologist in Oberlin, OH.

Edited by Gail Weiss,
Senior Editor

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Gail Weiss. Letters to the Editors. Medical Economics 2001;3:11.