To the editor:

The report, "Utahns assail Medicare reimbursement formulas" (April 22) is only the beginning of the problem of sickness care for the aged. Utah physicians are being cheated out of adequate fees for their services, and the patient is denied worthy services.Medicare and its underling, Health Care Financing Administration (HCFA), are driving a wedge between the Medicare patient and the private practicing primary care physician. Dr. William Roper, HCFA's recent administrator, a pediatrician, who never practiced medicine, instituted a series of rules and regulations: inane, time-consuming and not cost-saving; harassing to the physician and interfering with quality geriatric sick care.

Nationwide, more and more physicians are refusing to accept new Medicare patients. The bureaucratic red-tapers are persecuting the practitioners with stupid rules and threats of fines and imprisonment.

Locally, non-physician clerks are deciding the necessity of medical care. In their arrogance, they judge the professional service as "not necessary" and inform the patient and family as such.

This is an arbitrary decision, and when this arbitrary decision is challenged, the bureaucrat admits to having made an error, after alienating the patient and family from the innocent physician.

Ill elderly patients must be acutely ill according to the formula developed by HCFA in Washington, D.C. If the patient is not ill according to HCFA's formula, the patient is denied hospitalization and the physician is criticized. HCFA demands that patients not be seen more than once a month in a nursing home; they limit house calls; they sit in judgment as to the number of office visits. HCFA decides how diseases will be diagnosed, and how diseases will be treated. All of these decisions have been made in advance by academics, bureaucrats, and administrators, but no community practicing geriatrician is involved.

This control is alleged to conserve costs of sickness care. There are those of us who are convinced that HCFA has a hidden agenda. In essence, this is to ration sickness care to the aged as developed in England in their socialized medicine program.

If American citizens do not curtail the excessive exuberances of the Medicare bureaucracy, horrible consequences for all senior citizens shall ensue.

Victor Kassel, M.D.

Salt Lake City