Complete care (for some)

The guiding ethic of our medical system goes back nearly 2,500 years to the Hippocratic Oath, which established a standard of behavior and integrity for doctors, including the admonition that, first, they should "do no harm."

But while doctors still swear to this oath, the executives and bean-counters of HMOs do not -- and they are doing a great deal of harm. It never occurred to Hippocrates that bureaucratic behemoths called HMOs would one day exist, and that they would position themselves between doctors and patients, literally making decisions on what kind of treatment the doctor can give. And Hippocrates would be horrified to learn that these managed-care corporations make their decisions based not so much on the health of the patients as on the health of their bottom lines.

In today's system of corporatized medicine, patients are referred to as "cost units," and the job of the doctor is that of an assembly-line worker who must hold down costs by rushing these "units" through the system, providing only as much care as the corporate manual prescribes. One doctor told the New York Times that his HMO expects him to see eight patients an hour -- which means he has only seven minutes with each patient.

Another physician, Dr. Thomas Self in San Diego, is a thorough and careful children's doctor. When HMOs took over, however, Self's thoroughness got him fired. They said he spent too much time per child and did too many tests to find out what ailed them. But, according to Dr. Self, the top HMO executives did make exceptions to their usual rush-rush procedure -- when they sent their children to see him. Then they wanted him to focus on the child, not on the profit picture. "In two instances," he said, "I was told to do whatever was necessary, with no thought given to cost, by the executive whose children were being treated."

These executives seem to have taken the Hypocrite's Oath.

Jim Hightower is an author, radio commentator, public speaker and political sparkplug from Austin, Texas. For more populist commentary, visit his website.

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