A new report finds over 300-thousand senior citizens in rural Iowa do NOThave access to a health maintenance organization, or H-M-O. Ron Pollack, executive director of Families U-S-A — a national consumerwatch-dog group, says his organization’s report is intended to spur debateas Congress considers re-doing Medicare. The leading alternative is to establish a competitive system among H-M-O’s to save money in the Medicareprogram.Pollack says since there are NO H-M-O’s in rural Iowa, the state’s elderlyrural residents depend on the traditional Medicare program.Pollack says Iowa’s elderly are, in essence, discriminated against becausebig city H-M-O’s which serve Medicare recipients offer prescription drugcoverage — and sometimes a health club membership.Pollack says the Medicare program pays a lower amount of money for medicalservices provided in rural areas.”Families U-S-A” released a report this morning which showed there are noH-M-Os available to rural residents in 13 states, including Iowa, Kansas,Nebraska and South Dakota. In another 14 states, rural residents had accessto only one H-M-O.