Student Group Parodies, Discusses HMOs

Aiming to foster discussion about current topics in health care, the undergraduate group Exploring Policy in Health Care (EPIHC) sponsored an evening of skits and talk about managed care last night in Emerson Hall 105.

EPIHC, founded last summer, is comprised of undergraduates interested in health care policy.

The event began with a mock press conference from "HMO Black," the pseudo health maintenance organization founded last summer by a group including scientists, physicians, and Marc A. Abrahams '78, editor of the satirical science journal Annals of Improbable Research.

HMO Black, which "offers health care with a smile and free parking for the first fifteen minutes," makes "health care decisions on a rational basis, often in advance," said Nicole C. Rogers '98, an EPIHC founder who played the character of the HMO research director.

At one point in the press conference, Abrahams, the "managing director," told the audience who the panel giving the conference represented. "We are the vice presidents...we are the investors."

"What about the doctors? You always forget the doctors," said Micheline Mathews-Roth, an associate professor of medicine at the Harvard Medical School and a participant in the spoof. "What about the patients?"

"The patients are grown-ups," Abrahams responded. "They can take care of themselves."

After HMO Black performed, EPIHC members presented their own skits mocking managed care.

In one a female undergrad with a huge pimple on her head and a hot date with the president of the Fly, a final club, desperately seeks the help of her HMO to schedule an appointment with her dermatologist.

She is referred to a primary care physician who promptly decides to reuse a dirty scalpel to remove the unsightly growth.

"Bleeding" from the ordeal, the student finally gets the appointment with her dermatologist--who immediately refers her to a plastic surgeon because her face is now beyond repair.

Although Rogers, EPIHC's chairperson, admitted the skits were exaggerated, one audience member called out that he had seen some "bizarre things" in his practice as a cardiac surgeon in South Carolina.

"The truth is sometimes stranger than fiction," Carl Anderson said.

Changing from the satirical to the serious, Rogers then led the audience of more than two dozen undergraduates, medical students and doctors in a discussion about managed care.

Those at the forefront of the debate about managed care had distinct views on what they see as a system in which patient care is subordinated to profit margins.

Mathews-Ross is a research scientist who studies Erythropoietic Protoporphyia, a disease involving hemoglobin formation in the blood.

The rare disease might be curable, said Mathews-Ross, with treatment of bone-marrow cells, which "is not cheap."

"Managed care may have an inhibiting effect on research, [especially] on esoteric and rare and diseases," she said.

EPIHC's Business Manager, Stu C. Dorman '99, said he agrees.

"A lot of things about [managed care] do not promote efficiency," he said.

Although last night's event was openly critical of managed health care, Rogers said the group had no predefined opinion on managed care and planned to invite an HMO executive to address the organization in the future.

The organization's next big event is Harvard's first health care policy career fair, scheduled for December 3 at the Faculty Club.

EPIHC expects at least 10 firms to participate, Rogers said.