The Oath

The way it worked in San Francisco, city employees had several medical insurance options, depending on the level of health care each individual wanted. It seemed straightforward enough. People willing to spend more of their own money on their health got better choices and more options. In theory, the system worked because even the lowest-cost medical care-provided in this case by Parnassus -was adequate. But no surprise to anybody, that wasn't so.

"Couldn't Parnassus borrow enough to stay afloat?" Glitsky asked Jackman.

The DA shook his head. "They say not."

Gina Roake almost choked on her coffee. "They can get a loan, trust me," she said. "Maybe not a great rate, but a couple of mil, prime plus something, no problem."

"What I've heard," Jackman said, "their story is that they can't repay it, whatever it is. They're losing money right and left every day as it is. And, our original problem, they don't need a loan anyway if the city just pays them what it owes."

"Which it doesn't," Marlene Ash repeated. "Owe, I mean."

"Can you prove that?" Glitsky the cop wanted to see the evidence.

"I intend to," Ash said. "Go back to the original invoices."

"Grand jury." Hardy cracked a fortune cookie.

Ash nodded grimly. "That's what I'm thinking."

"How can they say they'd run up thirteen million extra dollars and never saw it coming?" Roake asked. "That's what I'd like to know."

Jackman turned to her. "Actually, that was fairly clever. They say their contract with the city covers outpatient AIDS treatment, mental health and drug abuse counseling, and physical therapy, and they've been providing it all along without being reimbursed. The key word is 'outpatient.' They're out the money, they've already provided the service, we owe it to them." He shrugged. "They distort the hell out of the contract to get to that position, but all the unions want to read their contracts to cover those services, so Parnassus has some political support."

"So it's a contract language dispute," Freeman said. "Tell them to sue you in civil court."

"We would," Jackman said, "except that we're starting to think-"

"We know," Ash interrupted.

"We're starting to think," Jackman repeated, giving his ADA a reproachful glare, "that they didn't provide the care they allege. It was all outpatient stuff, after all. The record keeping appears to be uneven, to say the least."

"Grand jury," Hardy repeated.

Jackman broke a professional smile. "I heard you the first time, Diz. Maybe. But I'm also thinking about freezing their accounts and appointing a receiver to keep 'em ru

"You're sure of that?" Freeman asked.

Jackman nodded. "They're not paying their doctors. I'm taking that as a clue. We've received a couple of dozen complaints in the last six months. So finally we wrote a letter, told them to straighten up, pay their people or maybe we'd need to get involved, and sent a copy to each of their board members, still being paid, by the way, at an average of three hundred fifty thousand dollars a year."

"A year?" Glitsky asked. "Every year?"

"A little more, I think," Jeff Elliot said.

"Every year?" The lieutenant couldn't get over it. "I'm definitely in the wrong business."

"No you're not, dear," Treya told him. "You're perfect where you are."

Hardy blew Glitsky a kiss across the table.

"Anyway," Jackman forged ahead, "the threat got their attention. In fact, if you want my opinion, that was the proximate cause of this demand for the thirteen mil."

"So what happens if we let them go bankrupt?" Glitsky asked. "How bad could it be?"

Freeman chuckled. "May I, Clarence?" he asked the DA, then proceeded without waiting for any response. "Let me count the ways, Lieutenant. The first thing that happens is that every city employee, and that includes you, loses their health insurance. So instead of paying ten dollars to see your doctor, now you're paying sixty, eighty, a hundred and fifty. That's per office visit. Full price for prescriptions. So every union in town sues the city because you're guaranteed insurance as part of your employment contract. Then the city sues Parnassus for not providing the service; then Parnassus countersues the city for not paying for the service. So now everybody in town has to go to County General for everything and there's no room for anyone this side of multiple gunshot wounds. If you only have cancer, take two aspirin and call me in the morning. Bottom line is, if it turns out to be a bad year for the flu or AIDS or earthquakes, letting Parnassus go bankrupt could bring the city right along with it." Freeman smiled around the table. Bad news always seemed to stoke him up. "Did I leave anything out?"

"That was pretty succinct, David, thank you." Jackman pushed the remains of his fortune cookie around on the table. "In any event, Parnassus must be close to broke if it's resorting to this."

"We've got to charge them with something," Ash said.

Freeman had another idea. "I like bringing an action to freeze their accounts and appoint a receiver to investigate their books and keep the business going." The old man gave the impression he wouldn't mind taking on the job himself.

Jackman shook his head. "We'd have to go a long way to proving the fraud, David. We can't just walk in and take over."

"Even if they haven't paid their doctors?" Roake asked. "I'd call that a triggering event."

"It might be," Jackman agreed. From his expression, he found the idea potentially interesting. "Well," he said, "thanks to you all for the discussion. I'm sure I'll come to some decision. Jeff," he said across the table, "you've been unusually quiet today. I seem to remember you've written Parnassus up for a few items recently. Don't you have some advice you'd like to offer on this topic?"

The reporter broke a cynical smile under his thick beard. "You've already heard it, sir. Don't get sick."

4

Though he was nearly fifty years old, Rajan Bhutan had only been a nurse for about ten years. He'd arrived with his wife in the United States in his mid-twenties. For some time, he had made do with a succession of retail jobs, selling women's shoes and men's clothes in chain stores. This was the same type of work he'd done in Calcutta, although it didn't suit his personality very well. Small of stature, moody, and somewhat introspective by nature, he had to force himself to smile and be pleasant to customers. But he was efficient, honest, intelligent. He showed up for work every day and would stay late or come in early without complaint, so while he wasn't much of a salesman, he tended to keep his jobs-his first one at Macy's Herald Square, where he stayed six years. Then at Nordstrom for five more.

His wife had augmented their income by giving piano lessons and for about ten years they had been reasonably happy in their little apartment in the Haight, the only major disappointment in their lives the fact that Chatterjee was unable to get pregnant. Then, finally, when they were both thirty-five, she thought that the miracle had occurred, but it turned out that the something growing in her womb was not a baby, but a tumor.

After Chatterjee died, Rajan no longer found smiling, or sales, to be tolerable. During the months he'd nursed his wife, though, he'd discovered that giving physical care appealed to him in some important way. Over the next four years, he used up most of his savings going to nursing school full-time, until he finally received his RN from St. Mary's, and took a full-time job at Portola.

And true to form, he stayed. The doctors and administration liked him for the same reasons his bosses in retail had always kept him on. But he had few if any friends among the nurses. Dark and brooding now to an even greater degree than he'd been before when he'd worked in sales, he made little effort to be personable. But he was good at giving care. Over time, to his shift partners he became almost invisible-competent and polite, albeit distant and with his hooded demeanor, somewhat ominous.