The Boston Globe from Boston, Massachusetts • 46

1. 46 THE BOSTON GLOBE TUESDAY, MAY 4, 1993 Reggie Lewis, meet 'moral hazard' as defined by economists WARSH Continued from page 35 a videotape that clearly showed that Lewis hadn't been hit, that he simply blacked out running down the court. Yet they permitted him to start the second half, and to play until his knees turned wobbly after six minutes. After two days of tests adminis- ty of room in it for competition. But the options are narrowing rapidly.

Many of us will be in the same position of doubting the wisdom of our own doctors in the future. Few of us will be so lucky as to have a representative of a rival specialist call for us in a van with a police dog. Here's hoping that the people who are redesigning the health care system will give plenty of thought to protecting as much as possible the patient's right to appeal his or her care. mi Program for Financial Planners Celebrating Our tenth Year of Successfully training Professional Financial Planners tered at New England Baptist Hospital and studied by a team of 12 leading Boston cardiologists, a diagnosis emerged: focal cariodmyo-pathy, or damage to a small portion of the heart. The diagnosis possibly was complicated by fact that cardiomyopathy apparently sometimes can be associated with drug use.

And apparently a nearly universal consensus has developed that such was not the case with Lewis, who is regarded as being an especially straight player by those who follow the game -but the subject must have come up in discussions among the coaching staff. Lewis walked out of New England Baptist Hospital on Parker Hill Avenue at 11:30 Sunday night in a The Boston University Program for Financial Planners offers flexibility: take only one course, or complete the entire ten-course program; outstanding faculty from major financial planning Institutions In the Boston area; preparation for CFP certification examinations; ten courses from which to choose; and a Boston University Diploma In Financial Planning upon successful completion of all ten courses In the program. An equal opportunity, affirmative action institution in fe ft ft It I A the system with an eye to efficiency, because there was plenty of money to go around. Americans were entitled to "choose their own doctor," as the American Medical Association likes to put it, and doctors were entitled to choose whatever course of therapy they liked. But the centrally-planned, hier-arically ordered health plans that are the essence of a system of managed care are changing all that.

Doctors usually operate under some variation of the capitation fee, a fixed budget of money to spread around a fixed panel of patients. The doctor shares in what doesn't get spent. That's a powerful incentive to spend less on patients than formerly. In other words, in coming years health care incentives are prone more often to get out of line the other way. Instead of giving us individually too much medicine, as in the past, our doctors in the future may risk giving us too little.

Like, just possibly, the Celtics' team physician, they may have an interest in our playing even when it's not in our best interest. Now Reggie Lewis, when he walked out of the New England Baptist Hospital and into that waiting Brigham and Women's van on Sunday night, was exercising the time-honored privilege of the patient to change doctors when not satisfied with his treatment. Surely his insurance company will continue to pay his bills. In effect he was quitting his HMO he thought they were wrong, he thought they were haughty, he thought they were rude to his wife, for whatever reason. He hasn't told us yet.

But Lewis was able to do so because he was a basketball star, because the newspapers were interested, because the system still has plen I It I-II IB'. In. Catching a ride COMPUTERS Continued from Page 45 Windows, things are changing. Because there's lots more information to put on screen, there is a need for a faster bus. Video adapters, the boards that take what your PC does and send it to the screen, are falling way behind.

You see, PC processor speed since 1983 has grown from 5MHz to 50MHz. PCs that used to push 16 bits of information around at a time now push 32. Meanwhile, the ISA bus has remained stuck at 8MHz and 16 bits at a time. Even EISA works at 8.3MHz and 32 bits; MCA works at 10MHz and 32 bits. The result: bottleneck.

PCs can think a lot faster than they can talk to the screen. The slow bus is holding them up. The solution is the local bus. This new design keeps the older, slower ISA, EISA or MCA bus for disks, modems and the like, but adds another bus attached directly to the processor, running at processor speeds. The latest video boards that plug into this bus can then keep right in step.

Well, sort of. Unfortunately, there's no local bus standard yet The first local buses, which be gan appearing in 1991, were propri etary. That is, each company designed its own. That doesn't make for volume or competition, so these are fading quickly. The second local bus type is the VL-Bus or VESA-Lo lit qtr $0.20 $0.17 lit qtr ($0.02) ($0.09) Year ($0.77) ($0.41) lit qtr ($0.34) ($0.10) am Alliance Cap Mann 34c Kahler i 2 on the local bus cal Bus (Video Electronics Standards Association), from the many PC-compatible makers that make up VESA committees.

11 Now, there's a third local bus, the PCI (peripheral component interconnect) from Intel. VL-Bus is ahead, because it started sooner1? but PCI has greater abilities and comes from the company that practically owns the PC processor chip business. For now, remember these things: Macs aren't standard in their slots. Remember to ask about expandability options of any Mac you buy. Thank Apple for the flexible SCSI port while also pressing them to; standardize their bus and SIMM memory slots more.

Any portable you buy should have PCMCIA slots, preferably'' Type II or III. Push the portable makers for standard software so that PCMCIA cards for one computer will work on any other. Don't worry anymore about ISA vs. EISA vs. MCA.

Now it's local bus time. r' NEXT WEEK: VL-Bus and PCI. Phillip Robinson writes about computers. You can call him at 415 771-6256, or unite to him care Mercury News, Business Department, 750 Ridder Park Drive, San Jose, Calif. 95190.

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(Wlmington) 02 March 31 Enterra FPI Gottschalks Gulf Canada 1993 1992 Sales Net Income Per share 6 mos Sales Net Income Per share $4.6 $3.71 89,000 35,000 Idaho Power .02 .01 Indiana Energy Ivax Liberty Maletta 7.81 (833,000) (.15) 7.63 359,000 .09 Minn Mining Mfg. Momingstar Group Natl Sea Product! Nevada Power Noma GenRad Inc. (Concord) Ql April 3 1993 Revenues $42.75 Net Income 1.33 Per share .07 Hotoglc he. (WaHham) Q2 March 27 1992 $30.8 (3.2 M) (.18) Nowsco Well Pacific Telecom People Energy Precision Castparts Quaker Chemical Ramsay HMO wild scene that started after team officials and their doctors excluded his wife from an afternoon conference. Presumably instrumental in gaining his admission to Brigham and Women's Hospital was Dr.

Thomas Gray-boys, one of 12 specialists consulted by Celtics team doctor Arnold Scheller and a member of the Brigham staff. Now two points are worth emphasizing: As the captain of the Celtics, Lewis is a leader. And the Brigham, along with the Massachusetts General, is indisputably one of the two best hospitals in Boston. It occupies the absolute pinnacle of the medical community. For those interested in the annals of Boston medicine, therefore, it is worth "savoring the moment when George Kaye, the Brigham's vice president for human resources, walked into New England Baptist Hospital and was told he couldn't see Lewis.

Outside in his hospital truck was a driver and a police dog. Kaye angrily demanded to speak to the hospital's officers, but failed to reach them. After 20 minutes he was permitted to accompany Lewis' wife, Donna, to the basketball star's room. Lewis unhooked the monitors, signed a hospital release, turned his sweatshirt inside out and walked with his wife, a friend and Kaye out the backdoor and into the waiting Brigham truck. Now this is a moment that, soon- or later, threatens to happen to us all.

Who hasn't nursed the suspicion, sometime or other, that our doctor hasn't been looking after our best interests, and felt the urge to fire him? Who hasn't wanted to shout, "I want to talk to a specialist!" The trouble is that in this situation, the Celtics were fuctioning as a kind of a health maintainence organization for Lewis. HMOs arose, after all, as a way of restructuring the incentives to doctors in our health care system to make it worth their while to keep people healthy. They were viewed as a way of curbing the abuses of the fee-for-service and indemnity insurance systems that were the essential characteristics of the Blue Cross-Blue Shield world. It was a world full of moral hazard. "Moral hazard" is what economists call the situation that arises when economic agents maximize their own well-being to the detriment of others, in situations where they don't bear the full consequences (or enjoy the full benefits) of their acts.

Any insurance system is an especially fertile field for morally hazardous behavior: a person with a good fire insurance policy is less prone to install smoke detectors than he might be otherwise; a person with too good a fire insurance policy may be tempted to burn his house down in a pinch. But moral hazard works both ways. Under the old indemnity insurance system, some doctors would put patients in hospitals overnight before trimming a hangnail, and why not? They made money when the hospital made money, the patient was happy enough to get a day off, and the insurance company didn't seem to care. Nobody was managing come with this 6 Btl 1st qtr 1st qtr 2d qtr 4th qtr Year 1st qtr 3d qtr 9 mos GenRad 1st dtr 1st qtr 2d qtr lit qtr 1st qtr 2d qtr 6 mos 1st qtr 1st qtr lit qtr 1st qtr $0.55 $0.35 $1.27 $1.10 $0.24 $0.07 $0.11 $0.55 $0.40 ($0.40) $0.22 ($0.91) $1.51 $1.38 $0.13 ($0.07) AlaTenn Resour AmCapBd AmCapExch AmCapFedMtgAM AmCapFedMtgBM AmCapGlbGvSecAM AmCapGlbGvSecBM AmCap GvSecur AmCap HiYkf Inv AmCapMuniBd AmCap TaxEx HiYldM AmCap TE InsMun AmCap TeiMunSec Am Mutllnsur Ten 4A( 32( 5vW 4.45c S0.09 $0.07 $0.20 $0.02 $0.09 $0.14 $0.30 ($0.29) 1st qtr b.4 5.8C 6Vii $0.36 $0.53 $1.45 $1.29 $0.33 $0.62 $2.67 5.3( $0.10 $0.30 5 5W 4V 51 $0.41 $0.45 $0.30 $1.19 $1.08 $0.07 ($0.18) 1st qtr ($0.16) Year $1.27 1st qtr $0.88 4th qtr ($0.51) Year $0.85 Amer President Assoc Banc- Atlantic Richfld BlackRck AdvTerm BUKkRckCA20O8M BlackRckFL20O8 BlackRck IncTr BICkRck InsMn 2008 BlackRck InvQual BlackRck MuniTarg BlackRck NA BlackRck 1998TrmM BlackRck 1999Tm BlackRck NV 2008 BlackRck TirgI mi 15c $0.38 25C 1.37ttMay 6.87(5 $0.01 ($0.23) $0.36 $0.27 $0.50 $0.80 $0.08 Zdqtr 6 mos 9 mos lit dtr $0.31 7.12(5 7.18(8 7.08c 7.37(5 5.12(5 9.37(5 6.04C 6.17( 7.12(5 6.67C $0.58 $0.52 $0.10 1st qtr $0.85 $0.77 Jurprisc Mom May 6 May 14 14 Jun 15 May 14 May 28 1993 1992 $6.4 492,168 .12 Revenues Net Income Per share 6 mos Revenues Net Income Per share $6.43 (174,127) (.04) 11.9 (650,666) (.17) Servico SkyWest Stocan Forest Trail Auto 11.72 803,322 .20 Tyson Foods Union WenoVslntl Hyde Athletic Industries, htc (Peabodyl Ql April 2 Wheel Pittsburgh Wisconsin PubServ mm a New lit qtr ($0.15) KEY: n.a.-not available, n.q.-not quoted, r-restated, b-lncludes discontinued operations, k-includes extraordinary credit or charge, f-includes operating net only, -m Canadian, i-adjusted for stock dividend. lost not stated.

1993 1992 Revenues $31.23 $19.03 Net income 1.38 a 75,000 Per share .51 a .03 a-Restated to reflect adoption of of Wheel. May 14 May 28 May 14 May 28 May 14 May 28 May 14 May 28 May 14 May 28 May 14 May 28 May 14 May 28 May 14 May 28 May 14 May 28 May 14 May 28 May 14 May 28 4C May 14 May 28 l'AC May 12 May 26 10c May 11 May 24 7W(May21 Jun 4 yvit Jun 18 Jul 2 2Vit May 5 May 20 17c Jun 1 Jun 15 PerSeptto Botystams fate (Cambridge! Dividends Q2 March 31 1993 1992 Revenues $4.07 $1.11 Net income (399,000) (773,000) Per share a (.04) (.58) Cabot Oil Cash Amer Cedar Income Circle Income Circle Income Collins Ind Compan Bolivian a-approi amount per AOR 10c 3c 17 5.95C IOC 9.8c 8C Contl Mtg Eq Cotton State 0 Cousins Prop 0 Dreyfs StraMBd Douglas Lomason UtBd May 6 Jun 6 Money rates Monev rates for Monday, reported Systems Inc. Telerate Interest rate Index: Pnma Rate): Discount Rate Broker call loan rate: Federal hinds market rate: High: 3.0625 Low: 3 Dealers commercial paper: 30-180 davi: i5Mev21 Jun 4 May Jun May May Jun May May Artistic Greetings 5C May 21 Jun 1 5 Fit Iberian Fd 6( May 14 May 31 Free St ConslGId 434c May 7 Jun 28 a-appro amount per ADR Plgrm ShtTrmMulll 4VM Apr 30 May 17 Super TrCapMkt 8 May 6 May 17 Wharf Resources 5 May 10 May 14 mos Revenues 7.3 1.6 Net income (667,000) (1.8 M) Per share Average shares a 9.52 million, 1.83 million, 9.29 million, 1.83 million. STOCK XU Corp. (Wobura) Ql March 31 i-2 for THE ROLLERBOARD TRAVELSYSTEM LUGGAGE The First Choice of Aircrews Worldwide.

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