Робин Кук - Cell

Langley and Clayton nodded their heads in agreement.

“In view of what you two have had to endure, we here would like to say that we are prepared to make it up to you if you’re willing to cooperate.”

“What the hell do you mean by ‘cooperate’?” George demanded.

“‘Cooperation’ means that you recognize the glitch for what it was. The deaths of the patients involved are regrettable, as they had no say in the decision. That’s completely contrary to informed consent. But also remember that all of those people were terminal in the very near future and facing considerable pain and suffering with the treatments available, and therefore a very low quality of life.”

George and Paula exchanged a glance of disbelief.

“And if we don’t, as you say, cooperate, what then?” George asked.

Thorn sighed audibly. “That will necessitate a prolonged stay at this rather pleasant facility with no opportunities for outside communication until it is deemed possible for Amalgamated to deal with whatever revelations and accusations you might feel appropriate. In other words, we need to cover our behinds.” He offered a crooked smile along with his attempt at humor.

“Do you think you can actually get away with keeping us locked up?” Paula asked.

“Yes, of course. If pressed, we can manufacture evidence for addiction problems that require treatment. Something in that vein,” he said with a flip of his hand.

“People will look for us!” Paula said with disbelief.

“We’ll deal with that. Although we know that neither one of you will be missed by your employers for a few days.” Thorn glanced at George. “Well, for you, George, it’s a bit longer than a few days, isn’t it? Anyway, that’s a usual source of questions apart from local family or intimate relationships, which neither of you have.”

Paula looked at George as if to say, This is crazy .

George turned to Langley. “You’ve described the glitch that killed the patients as a spontaneous creation by the algorithm. And you also stated that it has only been temporarily blocked rather than removed.”

Langley nodded in the affirmative but Thorn interrupted.

“Let me anticipate your concerns. As I mentioned earlier, Amalgamated is in direct negotiations with CMS to provide iDoc to all Medicare and Medicaid beneficiaries. Part of their due diligence is to allow the URI, or Universal Resource Initiative, to monitor the test. URI is a clandestine agency under the aegis of the IPAB, or Independent Payment Advisory Board, which is in turn mandated by the Affordable Care Act. While the URI was performing their due diligence, they detected the glitch almost the same time as we did.”

George remembered that Zee had stated that one of the high-anonymity proxy servers was located in Maryland. It was the government association that had spooked Zee.

“Among other things,” Thorn continued, “the URI has been tasked with looking into the rationing of medical care in the last months of life, particularly for Medicare.”

Paula and George’s faces reflected their horror.

Noting their reactions, Thorn said, “Some kind of limitation or rationing has to be considered to control runaway costs. Most industrialized countries already ration medical care at the end of life, but it is, on occasion, associated with favoritism if not out-and-out corruption. The fact that iDoc made an unexpected venture into a form of rationing was looked upon by the URI with interest. They like the fact that it is totally and completely nondiscriminatory. They have specifically asked us not to rectify the glitch but merely to block the global-dump command. In short, they do not want to terminate the people selected, but they want them selected, perhaps to put them on a different track, which has yet to be specified.

“So to answer your question,” Thorn went on, looking directly at George, “the glitch has not been removed, in the sense that it is still collating the data. It is still selecting people according to its logic, but not terminating them.”

George and Paula exchanged yet another glance, a bit overwhelmed by what they had been hearing.

“Listen,” Thorn continued, “as I said, Amalgamated and the rest of the health insurance industry do not need ‘death panels.’ It is the country and the world that need some rational approach to end-of-life care. Amalgamated will not promote any particular methodology. If the government wants it as part of the Medicare-iDoc package, then that is the government’s decision, not ours.”

Thorn looked down the table at Clayton, who took the cue. “Cooperation on your part will bring other benefits, George,” Clayton said. “I will have you reinstated as a fourth-year resident. The charges of HIPAA violations will be dropped immediately. I’m sure you’re aware that a number of health care professionals have been convicted of similar violations and are now in prison.”

“Likewise, the hacking charges against you will also be dropped,” Thorn added. “You will also be given stock in Amalgamated to compensate you for having the initial conceptual idea for iDoc. And you, Paula, will be given additional stock added to your already sizable holding.”

George leveled a gaze at Thorn. “That sounds like a bribe.”

“Think of it as appropriate compensation. There will be time in the future for both of you to voice your feelings about the iDoc algorithm, but only after iDoc has been given its final FDA approval and has been at least distributed nationally.

“George, your second contribution is that you have underlined our need to correct iDoc sooner rather than later, saving iDoc from a media frenzy that might have put off its adoption for years. Amalgamated owes you a vote of thanks.”

George and Paula both appeared shell-shocked.

“Now,” Thorn said, “if you don’t have any more questions, we will let you discuss the situation in private. Then you can let us know how you feel about what has been said.”

George wasn’t done. “I do have another question. Was Amalgamated responsible for my friend Zee’s death?”

MENTAL HEALTH FACILITY

HOLLYWOOD HILLS, LOS ANGELES, CALIFORNIA

MONDAY, JULY 7, 2014, 9:58 A.M.

Thank you for asking,” Thorn replied. “I meant to bring up the issue earlier, as we were certain you assumed that we were, but we weren’t, at least not directly. What happened was we hired professionals to monitor you, to find out exactly what you knew or suspected, then Zee Beauregard entered the picture. We assumed he was helping you, especially when he managed to break into our iDoc servers. When he suddenly bolted early Saturday morning, we knew we had to follow him and bring him here along with you. He was trailed as he drove north, and we would have picked him up when he stopped. Unfortunately, that was not the way things worked out. Somehow he realized that he was being followed, and he apparently panicked. He pushed his car to unsafe speeds. I was told that it was an old vehicle. We believe he just lost control of the car and hit the concrete abutment of an overpass.”

“Why did the media report that he had a stuck accelerator?”

“No idea. You’d have to ask them. We guess it was because of his vehicle’s make and age and the fact that he was traveling over a hundred miles per hour, and it was the kind of accusation that would sell papers and up TV ratings. But, again, that’s just a guess.”

“You were going to have me picked up Saturday morning?” George asked.

“I was told that that had been the plan. But unfortunately when a backup team returned to your apartment, you had been arrested for hacking. That put us in a tailspin. We were very concerned you were going to tell the police, alerting the media in the process and putting the whole iDoc program in jeopardy, after all. But then things began to look up when you got out of jail so quickly, eventually leading us to Paula’s house.”