The private insurance model is highly unsuited to a program of group health care, on any scale. Insurance is by definition a risk pool to provide a remedy for some event that is generally unlikely to occur, but that would be catastrophic in money terms if it happens.

Health care is not a model of infrequent catastrophic losses, but mainly one of steady, preventive expenses to maintain health, plus the catastrophic events.

Keeping the insurance companies in the formula will simply expand the need for government micromanagement of these companies. Laws against disqualification for "pre-existing conditions" will generate a whole new legal field in the creation of subtle techniques to deny coverage, requiring more government bureaucracy to enforce the law.

Bear in mind that Medicare is a huge sop to the for-profit insurance companies, in taking the high-cost older population out of the for-profit pool. Further, Medicare Advantage is a government handout to the for-profit industry, raising our tax burden to enhance the remarkable profitability of an industry that professes to oppose government intervention. The "public option" will simply follow the outcome of the charity hospital, a dumping ground. There will be a need to micromanage the conduct of the industry to prevent the dumping of the poor and high risk into the public option; "government" will expand.

HR 3200 offers the prospect of the health-insurance industry looking like the Military-Industrial-Congressional complex, wherein health-care expenditures will be driven by the industry with no way to turn back. In the private health-care industry, we now have no effective competition; we already have the thousand-dollar hammer and the ten-thousand dollar toilet seat, with now the prospect of further subsidization by the taxpayers.

As President Obama has - perhaps inadvertently, suggested - we need to start from scratch. HR 676 is a viable measure to build a real health-care system for the United States, with a risk and resource pool to include ALL of the population, without the private intermediaries and their traditional conduct. Rather than build a new bureaucracy to regulate the subsidized insurors, it will be more efficient to take over the job and build upon the Medicare paradigm.

If we can't enact single-payer in the present situation, it would be better to let the problem fester for a few more years, perhaps to have the uninsured swell from 18 percent to 40 percent, so that the failure of the private-industry paradigm will be more clearly demonstrated.

Perhaps Representative Eric Massa said it best, to the effect that if you oppose government-based services, then let us put a toll gate at the end of your driveway, so that you pay for the use of the roads. And be sure to display the medallions upon your house to show that you have paid for fire, police, water, sewage, mail, and ambulance services - from the private sector.

RON JOHNSON, PITTSFORD