To the Editor:

''When Even Health Insurance Is No Safeguard'' (''Being a Patient'' series, front page, Oct. 23) illustrates the sad reality of the American health care system and its high cost, financially and emotionally, to consumers.

Impoverishing working middle-class Americans with the rising cost of health insurance premiums, diminished services and higher co-pays places our nation in a state of crisis.

The needs of the insurance companies should not negate the pain and the traumas of our vulnerable citizens.

Healthy people do not realize how the health care industry has shortchanged our needs. Unfortunately, they can understand the magnitude of this problem only when confronted with a serious medical issue.

It's a disgrace that a country with our resources continues to deprive people of adequate health care and in some cases force bankruptcy on those who thought they paid for adequate coverage. 

Teri Koff 
New York, Oct. 23, 2005 

The writer, a social worker, is an elder-care specialist.