Timing is everything, and this is the month when many people with subscriber-based health-care can switch their plans. I urge everyone to take the time to carefully shop around - this time, more than ever.

My mother was excited that her "golden" plan was reducing her premium by a substantial amount next year. Even though I am younger, I qualify for the same type of coverage that she has, and I almost had a heart attack when I saw how much my premium, under a different insurer, was going up next year. I contacted the competition, and was shocked to learn that benefit for benefit, the premiums and co-pays were drastically lower for virtually the same coverage options.

HMO's supposedly are getting government subsidies to keep premiums lower with the type of plan that I have, but that savings does not seem to be trickling down to us. So where is it going? My guess is that it's paying the high-priced salaries of HMO management and for TV and glossy print ads.

Subscribers are still limited in which doctors they can see, and their doctors are increasingly being restricted as to which medicines they can prescribe or which tests they can order without prior approval. HMO's have forgotten that their acronym stands for Health Maintenance Organization. Those on fixed incomes are hard pressed to maintain their health. They are being forced into deciding whether they should stop taking their medicines, put off needed doctor's visits, or have life-saving diagnostic tests or surgery. Since it's hard to pay for preventative care, their ailments get worse, and they now need reactive care, which costs everyone more in the long run.

The health-care crisis in this country has a horrible trickle-down effect on our citizens and the economy. Americans must choose between having proper health care and having food, clothing, shelter, utilities, and other necessities. Medical bills are one of the major causes of bankruptcies and home foreclosures in this country.

We have the power to change this. If you want lower premiums, lower co-pays, and freedom of choice, start flooding your HMO's phone lines, fax machines, e-mail, and snail-mail boxes and voice your displeasure. Better still, if possible, take your business elsewhere.

Most important, contact your members of Congress and demand a major change in our health-care system. Hopefully, one day America will do the right thing, so that all of us will have access to the best affordable health care in the world, and HMO's will be a relic of the past.

LINDA FULLERTON, ROCHESTER

(Fullerton is president and co-founder of the Social Security Disability Coalition.)