(MONEY Magazine) – The July article "How to Size Up a Doctor Network" overlooked a critical measure of the quality of a health-care institution. Yes, the equipment and medical staff are very important, but the ancillary personnel can have as great an effect on your treatment. In an effort to become more cost-effective, some hospitals have reduced the number of trained individuals, such as registered nurses and certified respiratory therapists, and assigned their work to less skilled, less expensive employees, like nursing assistants and respiratory technicians. When evaluating a hospital in a managed-care plan, be sure there are plenty of registered nurses and certified respiratory therapists. Also, ask if the staff in each nursing unit is trained for the specialty practiced in that hospital section or if staff is moved from floor to floor on a daily basis. You want to be taken care of by specialists. Paul Werbin Norfolk

HMOs are a bargain for routine medical treatment, but they are not the best places for patients who develop rare or complex illnesses. HMOs do not pioneer new and innovative treatments, and they are simply not on the cutting edge of medical breakthroughs. Richard A. Heffern Santa Ana, Calif.

In June's "The World's Five Best Ideas," you suggest that the U.S. should adapt Canada's universal health-care system. But such a move would empower the government to run the massive insurance program for our medical system. How can we allow that, given the incompetence, inefficiency and indifference with which most government agencies operate social programs? B.E. Crawford Houston