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stair capable wheel chair for her child because the school had steps and was hard to retrofit. Medicaid refused the thirty grand price tag and solved the problem better with an on site engineer at the school. An easier fix, good for all similar kids to follow. That's fine. If they run out of cash, everybody loses." "Whoa," Dryfus was bolt upright in his chair, "You're saying that Medicaid is BETTER than HMO care?" Shannon and Mac together, "Yes. Absolutely." Shannon, "They're cheap, for sure, but at least, they're FAIR." Mac piped in, "They've got no axe to grind. There's just not a lot of money there. Our job is to stretch Medicaid's resources. That's a big job. It isn't a bottomless well. They pay about 7% of an 80% calculation of the going rate figured in 1984 - or something weird like that. It isn't much. Most docs won't touch it. Without additional benefactors, it couldn't possibly work. They are like a constant contributor to a charitable mechanism. They need to supervise their expenditures. It's their bureaucratic structure that screws them up, not their nature." Leaning over and getting darker, Mac went on. "Many of the HMOs are simply evil. They are the epitome of power structures. They exist to feed the top. Like a Hitler or Stalin or whatever monster that has power, the bottom feeds the top. You must read the papers. The CEO of AmeriMed Inc. took a fifty million dollar mid year bonus. That's on top of twelve million in stock options. The year isn't over. The CEOs of most of the big HMOs are bathing themselves in obnoxious wealth. We are back to the silk mills and dye factories of the twenties and thirties." Thumping his pointing index finger on the table he exposed his inner dark side, "It's the ism thing. Nazi-ism, Stalin-ism, Capital-ism, Social-ism, whatever... you lose