It works like this: Doctors quit their HMOs and close their practices, then relaunch with no more than 600 patients paying $1,500 a year. For the fee, plus a per-visit cost averaging $50 to $75, patients get same-day or next-day appointments, special phone numbers, and other services. Patients can still use private medical insurance, Medicare, or out-of-network provisions for reimbursement. "It's so much more professionally satisfying," says Robert Colton, an internist who switched after becoming fed up with shrinking HMO reimbursements and a 3,000-patient load that didn't allow time for care.
But some medical ethicists are troubled by the trend. "We're going to have a class of haves and have-nots," says John Lincourt, a bioethicist at the University of North Carolina at Charlotte. But to MDVIP, it's about choice. "We view it much the same as the choice between private school and public school," says Edward Goldman, an MDVIP investor. "Not everyone can send their kids to private school." Or to a white-glove doctor. A backlash is building against the alternative minimum tax. The AMT, triggered by such things as incentive stock options, has been whacking the middle class harder than the rich it is aimed at.
So Silicon Valley tech workers, members of Congress, and tech companies are joining the reform battle. Ad hoc group ReformAMT drew hundreds to a San Jose, (Calif.) rally and is gaining support in Congress. Zoe Lofgren (D-Calif.) sponsored a bill to reform the tax code after thousands of tech workers got hit by the AMT's extra wallop. After exercising stock options, they found themselves facing astronomical taxes on the paper value of the shares when they exercised them. But the shares had collapsed, leaving them with no money to pay the tax. "What has happened to my constituents is monstrously unfair, and in some cases ruinous," says Lofgren. Senator Joe Lieberman (D- Conn.) has introduced an "AMT fix" as well. And the 3,500-member American Electronics Assn., the largest tech-trade group, including Intel and Microsoft, is also urging reform.
With 35 million taxpayers to be hit by AMT by 2010, up from 1.4 million this year, watch for the calls to grow louder. Try telling Bill Gates that the Wireless Web is a flop. In mid-June, Microsoft (MSFT
) inked a deal with Britain's Vodafone (VOD
) to send e-mail, Word attachments, even Powerpoint streaming to pockets and purses worldwide via Vodafone's mobile network--the largest in the world. And the Microsoft-powered cell phone, the Stinger, should debut in Europe later this year (long before its U.S. rollout).
This sets up a marquee battle between Microsoft and Finland's Nokia (NOK
) for control of the mobile Web. The Finns came out on Jun. 19 with their newest Webphone for Europe, the 9210, a flip-open computer with a keyboard and color screen.
The Nokia-Microsoft battle pits Europe against the U.S., phone king against computer champ. Revenues are measly, but there is a strategy. Microsoft sees handsets orchestrating a galaxy of digital devices, all powered by its software. But if Microsoft grabs the brains of the phone, Nokia is left selling empty boxes. That grim vision stirs Helsinki's fighting spirit. For big companies, having a star at a business event is a status symbol. While many entertainers won't do corporate gigs at any price, some earn more than half their annual income at quietly staged corporate parties.Celebs and their prices:RICKY MARTIN, ROLLING STONES*
At least $3 millionAEROSMITH, BOB DYLAN**, SHANIA TWAIN, WHITNEY HOUSTON
At least $1 millionJENNIFER LOPEZ, CARLOS SANTANA
$750,000 per hourBILLY JOEL, ELTON JOHN
$500,000 per concert, or $30,000 per songJAY LENO, BILL COSBY
$300,000, plus $10,000 to fuel their private jets* PepsiCo paid $3.5 million in '98
** Concert for Applied Materials, with son Jakob, in '98
Data: The New York Post Can't stand the ringing cell phones in theaters or restaurants? In some countries, proprietors can legally install a "jammer" to interfere with cell-phone transmissions. A London movie theater does it. So do New Delhi's Parliament and the National Theater of Japan. Once you walk in, your cell phone simply won't ring. It's illegal in the U.S., though. Jammers face an $11,000 fine from the Federal Communications Commission, which bans interfering with licensed broadcast signals--which, legally, cell-phone transmissions are.
But U.S. sales of illegal jamming devices are growing anyway. Netline, a Tel Aviv manufacturer of "C-Guard" jammers, says its American client list is growing--and includes an unnamed "major entertainment company" concerned about maintaining corporate security. "We get many farfetched inquiries from Americans who want portable devices for their cars to ensure that people driving alongside them aren't distracted by a phone," says CEO Gil Israeli. "[But] we only sell to people who have a legitimate right to control a private area, not a public space."
As a legal alternative, hospitals have started passively blocking signals--especially since a Mayo Clinic study in January found that cell phones can interfere with heart- and lung-monitoring systems and other medical equipment. When installed in walls, a metal mesh--called a Faraday cage and available for 35 cents a square foot--can dilute radio signals into ineffectiveness, says Mikel Poellinger, president of the Wall & Ceiling Industries Assn. It's legal because it's not actually tampering with transmission, just erecting a barrier to it. Cost for an average-size room? About $500. The value of undisturbed silence? Priceless. How durable is synthetic carpeting? Enough to last thousands of years in a landfill. Unfortunately, upwards of 100,000 tons of it get dumped every year, leaving a big mess.
With that in mind, Cargill Dow and the National Renewable Energy Laboratory have created a new corn-based, biodegradable polymer called polylactic acid (PLA) that can be made into eco-friendly carpeting. Cargill Dow is linking with manufacturers such as Sony to use the corn plastic for product packaging and has plans for clothing and disposable cups. (No, it doesn't dissolve in water. It takes the heat and pressure of a landfill--and 45 to 60 days--for the polymer to biodegrade.)
The Energy Dept. recently named the new bio-based plastic, which can replace petroleum-based ones in most cases, Technology of the Year. It could reduce the demand for 8 billion tons of plastics annually--and slash 10 million tons of CO2 emissions--by 2020. Best of all, with petroleum pricey and corn cheap, it's cost-competitive to make. Offshore cybercasinos are luring so many bet-crazed Hong Kongers that the city's Jockey Club is in a panic. The club, which holds a gaming monopoly, has watched racing attendance fall and fears a $7 billion loss to illegal gambling this year--equal to more than half its annual take. So it's pushing the Legislative Council to plug a legal loophole that lets residents pay foreign cyberoperators with credit cards. A proposal to let the club take bets on soccer matches could also provide relief. Why the government concern? Jockey Club is Hong Kong's biggest taxpayer and charitable donor.