To the Editor:

In recent issues, some of my colleagues have suggested that patients should be more grateful of the benefits bought with the loss of freedom under managed care (see “Letters,” October 1998, and “Monitor,” June 1998). Perhaps we should all reread what the Declaration of Independence says about liberty and freedom of the individual.

Care as offered by HMOs is dictatorial and not for the benefit of the patient but rather for those executives who, in today's environment, are becoming millionaires at the expense of both the physician and the patient.

I believe that tax-deferred medical savings accounts, which give the patient the right to choose a physician and to purchase catastrophic insurance, would be of much greater benefit than managed care since they would give the patient a greater incentive to avoid known factors that contribute to poor health. At the same time, a nest egg would be available at retirement that would cover other costs as a person reaches age 65 or older.