I read recently that over 30% of Americans' health care is managed using Milliman Care Guidelines and that nine of the eleven largest managed care organizations in the nation are Milliman clients. That's an awful lot of god-like power in the hands of one for-profit corporation, making life/death decisions for individuals to profit the company's bottom line.

And don't try to tell me that their decisions are impartial and in the patients' best interests.

In the 1990s the Milliman company issued guidelines recommending that mastectomies be performed on an outpatient basis, and it drew considerable criticism when it suggested that elderly patients be limited to cataract surgery in just one eye--presumably because two-eyed sight was unnecessary.

I always wondered why my mother, who had been declared legally blind, got the cataract surgery in one eye only. She was so happy to have her sight (and independent living ability) restored.

She never told me (perhaps she didn't understand it herself) why she didn't have the operation on the other eye, since she was so pleased with the results of the first operation.

Now I know. May the Universe protect us from for-profit care.