ABSTRACT
Several prominent cases have recently highlighted tension between the interests of indi viduals and those of the broader population in gaining access to health care resources. The care of Helga Wanglie, an elderly woman whose family insisted on continuing life sup port long after she had lapsed into a persistent vegetative state (PVS), cost approximately $750,000, the majority of which was paid by a Medi-gap policy purchased from a health maintenance organization (HMO).1 Similarly, Baby Κ was an anencephalic infant2 whose mother, believing that all life is precious regardless of its quality, insisted that the hospi tal where her daughter was born provide mechanical ventilation, including intensive care, whenever respiratory distress threatened her life. Over the hospital's objections, courts ruled that aggressive care must be provided.3 Much of Baby K's care was covered by her mother's HMO policy.4 In the 1993 case of Fox v. HealthNet, a jury awarded $89 million to the family of a woman whose HMO had refused, as experimental, coverage for autol ogous bone marrow transplant in treating her advanced breast cancer.5
