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To the Editor:

Pete du Pont's recent column ("HMO DOA," CE: December 1998) begins with a faulty premise, that HMOs are about to be outlawed, stumbles through atrocious misconceptions, and somehow arrives at a conclusion all of us can embrace.

With regard to the premise, the proposed federal legislation called the "Patient's Bill of Rights," far from outlawing HMOs, actually would mandate practices that most good HMOs already espouse. That's not to say that another layer of regulation is a good idea, but it's certainly not a serious threat to managed care, which now covers the vast majority of Americans.

Now to the misconceptions: The Minneapolis experiment which Gov. du Pont so admires does incorporate some laudable principles. But his mistake is not to realize that they are already observed by the best managed health care plans. For example, Aetna U.S. Healthcare was among the pioneers of the risk-adjusted payments and doctor report cards that he advocates. Even more importantly, we (and the best of our competitors) are focused on controlling costs not by restricting access to care, but by encouraging preventive care, disease screenings, and disease management techniques, all designed to avoid more serious (and costly) illnesses by getting people care sooner, rather than later.

As to the conclusion, Gov. du Pont's call for employers, doctors, hospitals, and patients to have an active role mirrors our vision of the future, which I dare say is more ambitious than even he imagines. The true promise of managed care is to help bring standards to the largest cottage industry in the world (our health care delivery system) by using the power of outcomes research data to help health care providers adopt the best practices that will enable all Americans to receive the same quality care that only the best-cared-for get today.

Chairman, President, and Chief Executive Aetna U.S. Healthcare Hartford, CT

Pete du Pont responds:

I think Mr. Huber may have misread my column or perhaps was misled by the headline-which I didn't write. A closer reading might allay some concerns. …