July 8, 2002

CORRUPTION

FROM ENRON TO EVERYDAY ENTERTAINMENT TO YOUR LOCAL HMO

By Barbara Lewis

The unveiling of corruption that we are seeing at corporate levels with companies like Enron and WorldCom also has its counterpart in companies that affect our everyday culture and leisure activities, and most critically, our health.

For me, (perhaps for you, too) the Enron and WorldCom fiascos were not a financial jolt. I did not lose my life savings, as many Enron shareholders did. The evolving stories left me more horrified than bankrupt.

But the same kind of bad news is showing up in companies whose deeds affect many more of us, day to day. It is a sobering dose of reality to see that greed and corruption cut a wide swathe through not only our fat-cat corporations, but also through the culture we have created, and further through the institutions that supposedly have been created to guard our well-being.

First, have a look at one aspect of the music industry.

Most of us listen to music daily, whether we like it or not. We hear certain songs played over and over on the radio. Perhaps we assume that these are the "best" songs chosen by "the people," or by "experts" who know what they are doing.

Would it surprise you to know that record companies indirectly pay radio stations to play certain songs? If you cannot pay, chances are, you cannot get airplay.

Back in the 1950’s, some record companies began the practise of pay-for air-play. "Payola," as it was called, was finally made illegal.

Today's record companies side-step that problem by hiring middle-men, independent promoters, who do the deal-making with radio stations. (The amount of money that fuels this "legal payola" is said to be as much as $300 million per year.)

So it is not necessarily the best music that thrives. Certainly, the best-financed music does.

A huge coalition of musicians, retailers and record companies has recently joined with politicians headed by Senator Russ Feingold (D. Wisconsin), to call for major changes in the radio/music industry.

The music industry woes are a symptom of a culture run amok. But corruption in entertainment is not usually life-threatening. (Although, ask a good musician who has struggled for years to be heard, how it has affected his/her health...)

Fraud within the health care industry is another matter altogether.

Chances are that you are one of the 50% of Americans who are currently enrolled in a managed health care plan (an HMO, or one of the other health organizations). Chances are also good that you are one of the many who have experienced problems with getting proper care through your HMO.

Currently, there are two huge (multi-billion dollar) lawsuits going on in Miami against the HMO industry - one on behalf of doctors and the other on behalf of patients.

Patients have a variety of complaints: that HMOs give them a lot of run-around before paying legitimate medical bills; that HMOs also sometimes tell doctors how to treat their patients even to the point of giving doctors incentives to undertreat.

There is one horrific case of a man whose release from a psychiatric ward was demanded by his HMO in spite of strong disapproval from the man’s doctor. The distressed patient who had been suicidal went home and drank a half a gallon of antifreeze, which led to a coma and later, his death.

Overall, patients feel that the HMOs do not deliver the quality of health care they promise.

Doctors often claim that they are being cheated of proper payment by HMOs which use billing software that, by design, minimizes unfairly the amount of money reimbursed.

No doubt these cases will be battled in court for a long time - years, perhaps. And that will have its many costs to society as well.

Overall, I think it is a good thing that skullduggery of various sorts is being unearthed. But it paints a pretty grim picture of humanity in the year 2002, where, at all levels of society, we see how cheating, fraud, and corruption have become everyday habits of doing business.