A few years ago when I worked in an emergency room, we had a patient come in as a code blue--for the three people out there that don't watch medical dramas on television, that means no heartbeat, no pulse. The person was with an HMO. Even though we did not have a contract with that company, we immediately began care.

As a courtesy, I called the HMO to inform them we had one of their patients in full cardiac arrest. When I finally got through to a case manager to explain the situation, she hesitated when I asked permission to continue treatment. Finally she said, "Is that condition life threatening?"

I assure you, no one has greater contempt for some HMO's than I do, so I was excited to see the movie Damaged Care. At last someone was speaking out about the abuses and stupidity of some managed care companies.

Damaged Care, which is based on a true story, stars Laura Dern (Jurassic Park, Citizen Ruth) as Dr. Linda Peeno, a young, enthusiastic wife and mother going to work for a managed care company. As a student, she witnessed a doctor decide to remove a woman's gall bladder based on the fact that "her insurance will pay for anything." She is gung-ho to curb these abuses and sees managed care as a fabulous gatekeeper.

Then her dream job as a medical reviewer starts to go sour, as she learns that politics plays a greater part in the decisions that affect patient care than any consideration for the patients themselves. At one point, for instance, she is told to "approve everything" for a group of doctors who are renegotiating their contracts.

At the same time, however, the head of the review department talks a lot about "looking out for the company's bottom line," and pressures reviewers to deny care that is medically appropriate. When Linda is forced not to approve a much-needed heart transplant, the patient's doctor tells her bluntly, "You might just as well have walked into the hospital and pulled the plug with your own two hands."

Linda quits, accepts a position with another managed care company, and is amazed when the same pressures start turning up. Meanwhile, her personal life is falling apart with a philandering, emotionally distant husband and critical children. Eventually, she fights to get a voice machine approved for a young nurse who has suffered a severe stroke. She eventually does get the voice machine approved, but if fired soon afterward.

At loose ends, she meets Sister Mary "Rhodie" Rhodes (Diane Ladd--why do they keep putting her in these awful bit roles?) who encourages her to speak out about her experiences with damaged care. She does so, at first reluctantly, then with the fire of a true crusader.

End of movie.

Damaged Care is a movie-of-the-week sort of film that never really finds its footing, though it tries valiantly for almost two hours. The characters are shallow, hard to know and care about, as they march along like puppets to convey the writer's message. Even Laura Dern, usually one of my favorite actresses, gives a phoned-in, two-note performance with emotional reactions ranging from shocked surprised to righteous anger. Diane Lane is wasted in her role as Rhodie. James LeGros, who plays Linda's husband and could have had a meaty role, settles on adolescent churlishness for his chief emotion.

The movie is a little long. It could easily have been cut to ninety minutes without losing a thing. The script is capable, if didactic, carefully highlighting the potential for abuse in a managed care company with its eye on the almighty dollar.

All in all, Damaged Care was just about average. It didn't inspire me to throw things at the television, but neither did it inspire me to care about the characters and their fates. It's quite forgettable, actually.

But unfortunately, it's a quite forgettable movie about a very important subject. Some--although not all--Health Management Organizations (HMOs) do routinely turn down appropriate claims, forcing sick patients to either go through a lengthy appeals process or pay out of their own pockets. Some people die waiting to get the care they need. And sometimes doctors are given orders by a person who doesn't understand that a "cardiac arrest" is indeed life threatening. These are issues we should all be aware of. This just isn't the movie to inspire knowledge and action.


Recommended:
No

Viewing Format: DVD
Video Occasion: None of the Above
Suitability For Children: Suitable for Children Age 13 and Older