HEALTH CARE PIRACY ENOUGH TO MAKE YOU ILL.

Byline: Kimit Muston Local View

I remember when HMOs were supposed to reduce the skyrocketing costs of medical care. That worked out really well, didn't it? Now I read that collectively, the five largest HMOs in California - Kaiser, Blue Cross, PacifiCare, HealthNet and Blue Shield - have $3 billion in cash reserves among them.

Why would a health maintenance organization need a huge pile of cash? Do its officers sneak into the vault and roll around in it? Is it part of their CEO retirement fund? Or maybe it's to pay for counseling for all their employees they've trained to say ``no'' to sick people.

None of the above, according to Walter Zelman, mouthpiece of the California Association of Health Plans. All that cash is required because, to quote Mr. Zelman, ``things can change very quickly.''

These guys think they need insurance? What the heck kind of business do they think they're in?! Shipping? I guess they're afraid people will expect to have their medical bills paid for by their medical insurance. What a concept.

Look, you got your HMOs and your Preferred Provider Organizations, or PPOs, but when any of them talk about cost containment, they mean their costs, not yours. In order to lower their costs, they've eliminated from the health system anybody who might encourage their customers to get sick, such as doctors and nurses.

My own doctor (I'll call him Irvin to protect his true identity) was fired by my PPO because he was spending too much time with his patients. Now, let me run that by you again and see if it raises your blood pressure as much as it raised mine: my insurance company fired my doctor because he was spending too much time ... with me!

I tracked down an HMO that used Irvin despite his shameless interest in his patients' well-being, so Irvin was able to prescribe Altace to lower my blood pressure, except my new HMO drug plan won't pay for Altace but would pay for a similar drug that also worked but which made me cough. So Irvin put me on a third drug that doesn't make me cough but is more expensive and my HMO only picks up 30 percent of the cost for it and I'm now paying just what I would have paid for the Altace originally.

Which brings up the pharmaceutical companies, and I mean that as in ``brings up your lunch.'' They're still making wonder drugs, but today the wonder is why a month's supply of one of their drugs can cost $40 everywhere on the planet except here in the United States, where it's $100. I had no idea politicians were that expensive. They don't look that expensive.

I suppose if you're under 30, this doesn't seem to involve you. But I'm on the back side of 50 and, hopefully, you will be too some day, enjoying all the joys of racing through middle age, riding like a snail on your own enlarged prostate. Perhaps it will help if you think of it this way: Remember how you spent endless hours wandering through toy stores? I now spend similar amounts of time at the Costco pharmacy in Burbank.

Last Saturday the line there was backed up pretty good. The old guy holding things up looked to be in great health to me. He stood well over 6 feet tall and he had half my waistline. Maybe he'd been a stuntman or an aerobics instructor. He was picking up three prescriptions and something was wrong. He kept looking at the pills and at his receipt, and he wasn't happy. Eventually the cashier produced a printout and patiently explained to him, just loud enough for the rest of us to overhear, ``No. It's the same as you paid last month for this one. Eighty-two dollars.''

Eighty-two dollars!? A month? And that was just for one out of the three prescriptions he was buying. Who can live with bills like that? Some miracle drug. It would be a miracle if the drug companies invented a wonder drug somebody on a weekly paycheck could afford.

The Europeans have socialized medicine with long lines and the high taxes, not like our for-profit system with long lines and high costs, where the only people interested in low prices are the ones paying, and the only people interested in the best health care are the present and future patients. And in both cases, guess who that is. How come we're not running this system?