Damaged Care, directed by Harry Winer, is a docudrama about the unsavory health maintenance organization (HMO) industry, which began through Congressional legislation in 1973. One day, Dr. Linda Peeno (played by Laura Dern) is hired by profitmaking Humana Health Care in Louisville, Kentucky, to approve requests from physicians for extraordinary expenditures on behalf of patients. One of her earliest cases involves a man on an operating table who is in need of a heart transplant, which would cost some $500,000 to Humana. Pressure brought to bear on her by her nonmedical superiors results in a denial of the request, even though she knows that the patient will die. As she leaves Humana’s office, she walks past a sculpture that costs nearly $500,000, sad that she has caused a death just to keep her job. But not for long. She resigns and joins a nonprofit HMO, hoping for a better situation. But cost containment procedures are soon imposed, and she again resigns. The film also features a case involving Kaiser Permanente in which a baby with a 104° temperature is routed to an emergency room at a distant hospital, just to save 15 percent in costs, and the result of delayed care is quadriplegic amputation. Accordingly, Dr. Peeno begins to speak out, at first in public lectures, later on a television newsmagazine, before the House of Representatives Subcommittee on Health and the Environment, and finally in court. To demonstrate her courage, the film shows how she persists despite receiving little support from her family, including her philandering husband Doug (played by James LeGros). In one case, while at Humana, Dr. Peeno approves a voice machine for a stroke victim, Dawn Dubose (played by Suki Kaiser) then uses the device to talk by touching a pencil to a computer keyboard with her teeth; but when Dr. Peeno leaves Humana, her successor disapproves payment for the device after ten months. In the resulting lawsuit, in which she testifies as an expert witness, the jury awards $8.5 million in punitive damages (though titles tell us that on appeal the defendant agreed to a smaller settlement rather than undergoing a second lengthy jury trial). The film ends with a plea from Dr. Peeno to bring about a change in the health care system within the United States, yet only Showtime has the courage to screen the Paramount film Damaged Care, albeit without much fanfare, thus perhaps eloquently demonstrating the power of the HMO industry to suppress facts about the tragic consequences of allowing medical decisions to be made by nonphysicians. In contrast, the plot of John Q (2002), a feature film that makes a similar point, is sidetracked by a hero who takes innocent hostages instead of than focusing on the HMO scrooges whom Damaged Care portrays so vividly. MH