Word: himmelstein
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Dates: during 1990-1999
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...least one doctor has been even more outspoken about the conflict between the Hippocratic oath and the cost-controlling imperatives of the HMOs. David Himmelstein, 45, an associate professor at the Harvard Medical School and a persistent critic of for-profit HMOs, signed on a year ago with U.S. Healthcare, a $2.9 billion behemoth whose 65,000 doctors and 2.3 million members make it the largest HMO on the East Coast...
Last November, at a meeting of the National Managed Health Care Congress, Himmelstein gave a presentation during which he showed slides of, among other things, what he called the "gag clause" in his U.S. Healthcare contract. Two weeks later, he took his complaints to the Donahue show and said, "one of the HMOs that I practice in tells me I can't tell my patients if there's something wrong [with what] the HMO insists...
Three days later, U.S. Healthcare told Himmelstein his contract was being terminated. David Simon, U.S. Healthcare senior vice president, denies that Himmelstein was canned for anything he said: "Given the fact that he has expressed a lack of comfort with us, we assumed that he no longer wanted to participate and that he would have welcomed the notice that we provided...
What was the "gag clause" that drew Himmelstein's ire? In his U.S. Healthcare contract he found the following: "Physicians shall agree not to take any action or make any communication which undermines or could undermine the confidence of enrollees, potential enrollees, their employers, their unions, or the public in U.S. Healthcare or the quality of U.S. Healthcare coverage." A further proviso stipulated that "physicians shall keep the Proprietary Information and this Agreement strictly confidential." Himmelstein says he found the whole restriction "so obnoxious I crossed it out" before signing. The emended contract was accepted without complaint...
Part of the problem, say Himmelstein and others, is that doctors do not get enough training in geriatrics. Over the past several years, researchers have documented that tranquilizers such as Valium and Seconal linger an exceptionally long time in older people's bodies because their kidneys and livers work slowly at eliminating the drugs. The buildup can lead to confusion and memory loss. Unfortunately, those symptoms may be dismissed as signs of aging rather than of drug...