THE SOUL OF AN HMO

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When a coworker invited her upstairs to meet the new associate medical director, she agreed, "so that he would look at me as a person and not just a stat on a piece of paper," she testified, while serving as a witness in the Nelene Fox civil suit. As Bosworth and her colleague waited outside Ossorio's office, they overheard him speaking angrily on the phone. "How did she find out about Duke? I'm going to have to call them...Maybe Gary told her. I'm going to have to call him too."

That he was talking about her case was bad enough. But it was his voice, cold and without compassion, that chilled her. "I was just shaking," she testified. "I was so upset, I was just shaking."

At first things moved quickly for Christine deMeurers. She endured a radical mastectomy, radiation therapy and a round of chemotherapy that ended in March 1993, the month Health Net proposed five new billboards, including one that showed a young mother holding her child, with the slogan WHEN YOU'VE GOT YOUR HEALTH NET, YOU'VE GOT EVERYTHING.

In May, Christy underwent a bone scan, which showed her cancer had spread; her disease was now classified as Stage IV metastatic breast cancer. Given the standard therapies available, it was a death sentence, but her oncologist, Dr. Mahesh Gupta, warmly assured her there was hope. He recommended she consider a bone-marrow transplant and, in a breach of Health Net procedure, skipped the usual channels for making referrals and arranged a consultation with a physician he knew, Dr. Robert McMillan, an oncologist at the Scripps Clinic in La Jolla. Christy's sister, living in Colorado, had urged her to see a leading bone-marrow transplanter at the University of Colorado, Roy B. Jones, but the deMeurerses decided to play by the book. They drove to La Jolla the following Monday.

Dr. Gupta, reviewing his notes on the case, says Dr. McMillan agreed Christy was a candidate for a transplant but said she would first have to undergo several cycles of chemotherapy to demonstrate that her tumor would respond to the potent drugs used in bone-marrow therapy. In the deMeurerses' eyes, however, it was a deeply troubling encounter. Dr. McMillan declined even to describe what was involved in a bone-marrow transplant or give the family a tour of the Scripps facilities, according to Alan deMeurers and Christy's mother, Joyce Nesmith. "I believe he was told to send us away, make it as discouraging as possible," Alan says. He found the doctor's reluctance to provide even basic information "just unbelievable."

Dr. McMillan, in a written reply to questions faxed to him by TIME, stated that rules governing patient-doctor confidentiality barred him from discussing specifics of the encounter. He wrote, "At no time, either prior to her visit or following her visit, did I discuss her case with Health Net."

Whether justified or not in their fears, the deMeurerses by now had grown deeply distrustful. They were keenly aware that Christy was dying and that every day wasted was one more day in which the cancer cells in her body could divide and spread. Just hours after their appointment with Dr. McMillan, they flew to Denver; they saw Dr. Roy B. Jones the next day.