K. R. Sethuraman
18 Why a 'cut' for what you can't do The Wolf and the Horse: A wandering wolf walked through a field of well grown
oats. Since wolves do not eat oats, he gave it no further thought until he came
across a majestic looking horse. The wolf, wanting to ingratiate itself with the
horse, said, "Look, my friend, here is a field of fine oats. I knew you would like to
eat them. I haven't touched even a single grain. Let me have the pleasure of watching you munch it all.� But the horse was unmoved and said, "If you wolves
could eat oats, my friend, you would have hardly indulged in comraderie at the expense of your belly."
Dr Abu was a physician with a busy practice in a polyclinic. Dr Babu joined there as a
surgical consultant. "Welcome aboard" said Abu, "My ward has plenty of cases who need surgery. I have kept them just for you. I would like to see your fine work on my cases.� Dr Babu grinned wryly and thought to himself, "If only you could operate, my friend, you would not have kept your cases waiting just to see my fine work." Comments Absence of such horse sense makes a referee feel obliged to the referrer, and leads to
the practice of kickbacks and 'cut-practice'. Unlike the consumer market, where
competition reduces prices, in health care, the cost to a consumer goes up. This anomaly
occurs because consumers have no direct access to health care services; they have to go
through a health care provider. When competition gets hot, the industry offers more 54
