Limits on health care choices, even now

Responding to "Canadian health care a good model" [IMHO, May 9], a friend in Ottawa waited five months for an MRI that diagnosed a "brain aneurysm," then waited 13 months to have the surgery. She's very lucky her head didn't explode waiting.

An American friend skiing in Canada broke her leg and was placed in a heavy cast from hip to toe. Her husband drove her home, where the American doctors said the cast was draconian and placed her in a Cam Walker Boot instead.

I am a multiple sclerosis patient in touch with a group similarly afflicted in Canada. The lack of neurologists there forces many to travel seven to nine hours to see one, after a typical five-month wait for an appointment. You get what you pay for.

Joyce Oehler-Ey, Holbrook
 

Many who comment on efforts to reform health care express concern that more government involvement will lead to fewer choices for patients. I would like to relate a current experience that demonstrates that private health plans are limiting patient choice right now.

I recently took care of a woman with congestive heart failure who needed bypass and valve surgery. The patient's family researched the New York State Department of Health data on cardiac surgery outcomes and selected a surgeon at a different hospital who had statistically lower death rates than the most experienced surgeon in the hospital where I cared for her (1.8 percent versus 4.1 percent). That surgeon agreed to accept the patient in transfer.

However, the patient's insurance company refused to pay for care at another hospital since the surgery she needed was available at the hospital where she was originally admitted, albeit with inferior outcomes. I have never experienced this sort of denial of choice with my patients covered by Medicare, the "government" health plan for the elderly.

Dr. David L. Brown, Stony Brook