No Free Care
Deep in New Jersey's Pine Barrens is a unique institution: the Deborah Heart and Lung Center. It does not bill patients. Founded seventy-eight years ago as a sanitarium for poor immigrant Jews, the hospital's philosophy is that wealth shouldn't matter when it comes to access to medical care. Costs are offset by insurance, a dedicated army of volunteers who raise money up and down the East Coast, and Medicare reimbursements.

That Deborah accepts Medicare without requiring co-payments places it in jeopardy of violating a host of civil and criminal laws, reports the Wall Street Journal. The U.S. Department of Health and Human Services Inspector General's office says that federal law prevents providers from giving remuneration in exchange for Medicare business. The co-payment waiver counts as remuneration. And because Medicare is insurance—which covers potential losses—it has no obligation to pay, as no loss need be covered if the hospital gives care for free. Finally, waiving co-payments may amount to an unfair competitive practice.

Deborah has asked for a waiver. If it doesn't get one and sticks to its philosophical guns, the hospital could face prosecution and stiff fines.

How determined is the Department of Health and Human Services to let no good deed go unpunished? The future of this charitable institution may well hinge on this question.

Fair Warning
Cost-conscious health care consumers can now seek out the lowest bidder for elective surgical procedures. According to Modern Healthcare, the Medicine Online web site recently added a new feature—"Bid For Surgery." The site claims that its "patent-pending reverse auction" allows those seeking elective surgery to save time and money in shopping for a surgeon. Prospective patients post descriptions of their surgical needs, such as rhinoplasty or corrective eye surgery, and surgeons bid by listing their qualifications and giving an estimated cost.

The site urges visitors to take control of their health and claims to empower them to make informed decisions about health care providers. There is also this admonishment: "Bid For Surgery is a serious process. Please do not exploit this new and unique process by using it for recreational or entertainment reasons."

Utah's Sex Ed 411
The State of Utah is considering legislation that mandates teaching public school children that sex outside of marriage is a crime. The legislature recently passed House Bill 411, which amends state curriculum requirements "pertaining to community and personal health … and the prevention of communicable disease." The measure is now before Governor Mike Leavitt.

The legislation's sponsor, Rep. Bill Wright, said teaching about sex encourages bad behavior, the Associated Press reports. His bill limits sex education to abstinence before marriage, fidelity after marriage, personal skills that encourage individual choice of abstinence and fidelity, and consideration "that any sexual relations outside of marriage constitutes criminal conduct."

The Utah penal code, however, does not prohibit state residents from crossing the border into neighboring Nevada when they wish to fornicate legally.