PROVIDENCE, R.I. -- Halloween seems as good a time as any to consider the monsters our health-care system has created. They are all around us.
You may have noticed a strange hysteria spreading through the American population. Echoing the 1955 movie classic ''Invasion of the Body Snatchers,'' HMO tycoons and hospital execs are taking control of the townspeople's bodies, seemingly while they sleep.
The citizens ask leaders in Washington to send in the troops but soon understand the true horror: The leaders have joined Them.
The objective of managed care is to control the medical lives of vast numbers of people, take their money and then slash health services to the bone. Wasting resources is not to be tolerated.
The managed-care tradition goes way back. Dr. Frankenstein, for example, made great strides in the innovative use of spare body parts. Count Dracula was something of a pioneer in blood transfusion. His success in siphoning off so much for himself has inspired generations of HMO executives.
However, even Dr. Frankenstein would have run afoul of modern HMO regulations.
The insurers want patients out of the hospital fast. You'll remember that Dr. Frankenstein tried to keep the monster under his surveillance for more than 24 hours. As we all know, the monster broke his straps and escaped without even a thought of follow-up care. His HMO, at any rate, would have been delighted.
As Dracula well knew, visitors would not make the trek up to his Castle in Transylvania without some sort of financial incentive. He lured the young Englishman, Jonathan Harker, with the promise of a lucrative real-estate deal.
"Buying hearts"
Hospitals today collect patients by promising cut-rate prices to the managed-care executives who control the bodies. Major ZTC American hospitals now battle each other to offer the cheapest cardiac care. HMO executives, the Wall Street Journal reports, ''negotiate rock-bottom contracts with the same price-focused discipline that the health plan might use in buying paper towels or office supplies.'' They refer to the strategy as ''buying hearts.''
The business can be summarized as follows: Hospitals try to get the patients in. The HMOs try to get them out.
Dracula explained all this a more refined way. ''You English have a saying which is close to my heart,'' he tells Harker, then quotes Alexander Pope. ''Welcome the coming, speed the parting guest.''
Managed care has squeezed the medical system so dry that American hospitals now seek more desirable customers from foreign lands. Middle East sheiks, Asian industrialists and Latin American billionaires can pay full freight and don't come with HMO gatekeepers. How attractive these foreign patients seem next to the bargain-basement American.
Florida hospitals now sell ''health vacations'' to rich South Americans. They include blood tests, EKGs and golf. The international-business coordinator at Tampa General Hospital recalls with pleasure a $75,000 deposit wired in advance by a foreign woman, who was waiting for a kidney transplant.
Playing both sides
Even victims of Third World wars have become financially appealing. Johns Hopkins, for example, has contracted with the Ecuadorean government to provide artificial limbs for soldiers wounded in a war with Peru. (It also tried to cut a deal with Peru.) ''Casualty patients,'' Johns Hopkins' director of international services tells the Wall Street Journal, are a promising new ''marketing niche.''
HMOs scouring Transylvania for new money-saving ideas have come across folk-medicine cures. Prescribing herbs, dispensing dietary supplements and ordering relaxation therapies may help some patients. They may not. One thing is for certain: They cost a lot less than traditional medicine.
''One HMO frankly admitted they were referring AIDS patients to this quack clinic where they were giving them dietary supplements,'' the head of the National Council Against Health Fraud recently noted. ''They said it's cheaper than AZT, and the patient won't be around as long to collect.''
Surely voters can find some undead candidates to run for Congress -- beings who have not already sold their souls to the health-care industry. We must make them listen before it is too late. The monsters are on the rampage.
Froma Harrop is a Providence Journal editorial writer and columnist.
Pub Date: 10/31/96
