Hollywood’s Newest Villain: HMOs

If Shakespeare were alive and writing for Hollywood today, he might paraphrase one of his most famous lines thus: “The first thing we do, let’s kill all the managed-care professionals.”

Health maintenance organizations, once seen as potential saviors in times of runaway health-care costs, are emerging as Hollywood’s latest villain du jour. Since the movies can no longer rely on stereotypical ethnic groups as easy-to-recognize bad guys, they’re turning their attention to the administrators who hold the purse-strings at these managed-care organizations.

HMOs have already begun to draw fire--and easy laughs--in the movies. Think of Helen Hunt’s diatribe against managed care in a memorable scene in last year’s “As Good as It Gets.” Check out who the heartless and greedy antagonists are in the new remake of “Dr. Dolittle.”

Which made us wonder: How might some well-known movies have been different, had their characters been prey to the bottom-line ethic of a penny-pinching HMO?

Consider:

“One Flew Over the Cuckoo’s Nest”: Randall McMurphy arrives at a state-run mental institution, where he hopes to serve easier time than a jail sentence would afford. When his rabble-rousing begins to agitate the other patients, evil Nurse Ratched checks the files and, noticing the limits of mental-health coverage in his HMO agreement, has him discharged back to prison, saying he has used up all the hospital time his plan will cover.

“Love Story”: Discovered to have leukemia, Jenny dies in Oliver’s arms when her HMO refuses to cover the cost of a bone-marrow transplant.

“RoboCop”: When police officer Murphy is nearly killed by a vicious gang, he is rushed to a hospital, where scientists try to turn him into a crime-fighting cyborg. Shortly before the procedure can be completed, however, a representative of his HMO steps in to remind them that such experimental procedures are not covered by his insurance. Murphy dies of his wounds.

“Terms of Endearment”: Emma, told she has breast cancer, receives a drive-thru mastectomy though she actually is suffering from stomach cancer. Her subsequent death is co-opted for the reelection campaign of New York Sen. Alfonse D’Amato.

“MASH”: Surgeons Hawkeye Pierce and Trapper John McIntyre work tirelessly in combat hospitals in Korea to save soldiers who have been butchered in combat. But they are forced to move to the dispensary, passing out pills and taking temperatures, when it is discovered that they have been performing surgery on uninsured patients, in violation of their HMO contracts.

“The Godfather”: Michael Corleone rushes to the hospital to be at the bedside of his badly wounded father, Vito Corleone. There, he discovers that his father has been shipped to another hospital because the health-care facility to which he was originally taken is not affiliated with his health plan.

“A Streetcar Named Desire”: Blanche DuBois, driven insane after being raped by Stanley Kowalski, utters the classic line, “I have always depended on the kindness of strangers,” as asylum attendants lead her away. Once at the mental institution, however, she is informed that she first must pony up the co-pay for a hospital stay, as well as the price of the medicine she will require.

“Camille”: Marguerite, complaining of pulmonary problems and a persistent cough, is unable to secure a referral to a specialist from her primary care physician when her HMO deems her complaint unworthy of more expensive medical exams (“We don’t recognize consumption as an illness”) and expires of tuberculosis as a result.

“Steel Magnolias”: When her diabetes leads to kidney problems, Shelby is told she will require a kidney transplant in order to survive. She dies while waiting for the HMO to make a decision on whether to cover the procedure.

“Hard Boiled”: While trying to track down the gangsters’ secret vault in a hospital, Chow Yun-Fat squares off with the facility’s health insurance administrator and, deducing correctly that he is a gangster plant, wastes him in a blaze of gunfire to the cheers of all in the vicinity.

“The English Patient”: Count Laszlo Almasy goes into shock and dies from his burns while a physician argues with an HMO clerk about whether skin grafts qualify as cosmetic surgery.

“Dances With Wolves”: Rather than have his foot amputated in a Civil War field hospital, Lt. Dunbar rises from his sickbed to make his heroic ride in front of enemy lines. Before he can reach his horse, however, he is tackled by an HMO representative, who reminds him that he has not shown them his insurance card and, hence, is still responsible for the cost of his hospital bed. He loses his foot and spends the rest of his life in a V.A. hospital.