Anecdotes from the HealthCare for Profit wars.

As seen in this column, part of a larger editorial on the problems of the healthcare system in general

I am a registered nurse. Although I have spent most of my 25-year career caring for people, I made one enormous mistake. For a brief time, I chose to work for a medical insurance company. They gave me the title, "utilization review nurse," which really meant I had control over whether people were allowed procedures, stayed in the hospital or discharged early.

Because of my discomfort with a system that left me in charge of telling a doctor by phone, some 3,000 miles away with his patient, how to practice medicine, I was far more permissive with certifications than the company liked. My phone calls were soon tapped. I was denied bonuses and raises. Harangued and threatened, I was finally booted from the insurance industry.

Meanwhile, nurses who did what they were told, who denied medical stays and who likely did harm and cost lives, were rewarded.

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The film "Sicko" reflects my experience, as Michael Moore reveals case after case of those who thought they were insured, only to find they were not. Many are excluded, denied or dropped for the flimsiest of reasons. Moore depicts something I have known for years, that there are countless ways medical insurance companies deny healthcare.

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There is one hospital experience I will never forget. On a psychiatric unit, my patient suffered the dual diagnoses of depression and alcoholism. On the second of what is usually a three-day stay, he had plus-three tremens and was suicidal. The psychiatrist came into the station and said he would be discharging him. I told the doctor the patient's condition warranted another day because the man stated he had a gun at home and would kill himself. The doctor chuckled and wrote the orders for discharge anyway, saying flippantly, "I get $1,000 for every day I save the company money, and besides, it's the weekend."

I entered a nursing note of the patient's condition and the suicide threat. The doctor was infuriated. My supervisor supported him, until she picked up the phone the next day and heard by voicemail that the patient had died from a gunshot wound en route to a hospital.