America has the world's most modern and sophisticated medical care - organized like a European village in the 14th Century. Some HMO castles would make the Sheriff of Nottingham blush. Mr. Netzley and House Speaker Bill Batchelder, R-Medina, are working on laws to require better disclosure and regulation. But patients aren't the only pawns. Some HMO doctors feel like paper-pushers in lab coats, with less time for patients, less authority, gag rules to muzzle complaints, and 40 percent less income.
Costly specialists are an endangered species.
But doctors are lucky compared to hospitals, where cost-cutting could spread a plague like the Black Death that wiped out nearly half of Europe in the 1300s. The Cincinnati area is already showing symptoms, with twice the licensed hospital beds it needs. To survive, hospitals are forming alliances for mutual protection. And public hospitals, like University Hospital in Cincinnati, are going private to cut costs and reduce regulations. Thanks to the generous state retirement plan for public employees, and unions for every worker from residents to cafeteria servers, labor costs are 35 percent higher than for non-public hospitals.