By Michael J. Katin, MD
Recently a radio talk show host was expressing his fear that all the interesting news stories were fading, to
the point that the lead story on the evening news dealt with a proposed child care program. Similarly, those of
us who morbidly follow the gradual decline of medical practice as we know it had been wallowing in the inevitability
of the triumph of capitation schemes, outpatient DRGs, and worse.
Now, in one brief week, our spirit has been revived by two presumably unrelated events. In California, TV new
cameras were on the scene to broadcast live a gentleman's shooting himself in the head after leading police on
a freeway chase and blowing up his own truck. Unmentioned in most of the news accounts after the fact was that
this person was displaying a sign denouncing HMOs. Most subsequent coverage agonized over the fact this had made
it onto live TV, although more truthfully agonizing over their inability to rerun the event without seeming too
crass. The part about the HMOs was submerged but still at least some percentage of the audience heard about it
the first time around.
The second event was the revitalization of Newt Gingrich (see title), who suddenly decided to launch an all-out
attack on President Clinton. While stopping short of calling him a "scumbag" (the type of bag epithet
selected by Representative Dan Burton), the Speaker made it clear that he would not set any priority above bringing
Mr. Clinton to accountability.
The truth is that peaceful coexistence is getting us nowhere. Fair compromises in Northern Ireland and the West
Bank are more likely than between medical practitioners and the Medicare-Managed Care conspiracy. These two events
should show us that Independence Day is coming.
Without contracts there can be no Managed Care. Physicians should refuse to sign into any new plans and immediately
start whatever process is necessary to cancel out of those already signed. Patients willing to pay $9 cash per
Viagra pill certainly should be willing to pay for medical care outside the Medicare or HMO systems. Hospitals
that sign up for capitated programs should be boycotted. We shall fight on the beaches, we shall fight in the fields
and in the streets, we shall fight in the hills; we shall never surrender.
P.S. Feel free to go first. A few months from now, please write and let us know how you're doing. We'll be behind
you all the way (in principle) if it's successful.