Free The Oath by John Lescroart Page A

same amount it always has, which is ten bucks, the drug copay. So we delist it.”
    “The Nokance?”
    “Right.”
    “But—this is still hypothetical now—you’re saying it’s good stuff and you don’t let your patients get it.”
    “They can get it, but we won’t pay for it. If we did, it would wipe us out. We’re dealing with extremely small margins for the survival of the company here. You’ve got to understand that. The point is that Nokance isn’t the only stuff that works. That’s what I’m trying to get through to you. The generics do the job.”
    Elliot had his own very strongly developed ideas about drug formularies. He had been suffering from multiple sclerosis for over twenty years, and on the advice of his doctors, he sometimes thought that he’d tried all the various generics in the world for his different and changing symptoms. Not invariably, but several times—at least enough to have let him develop a healthy skepticism—he’d experienced side effects or discomfort with the generics. When he’d gone back to the brand name, the problems vanished. So Ross would never sell him on the universal benefit of generic drugs.
    “So just to be clear on your position,” Elliot said, “your view is that this gatekeeping and cost cutting, from managed care to generic drugs, is essentially consistent with your Hippocratic oath, for example. Where the emphasis is first to do no harm, then to heal.”
    “Basically, yes.” Ross seemed pleased with this take on it, but Elliot knew he wouldn’t be for long. “We’re in medicine, Mr. Elliot,” he continued. “The goal is maximum wellness for the most people.”
    “And there’s no conflict between your business interests and the needs of your patients?”
    “Of course there is.” Ross was leaning back in his chair comfortably, his legs crossed. “But we try to minimize it. It’s all a matter of degree. The company needs to sustain itself so it can continue doing its work.”
    “And also make a profit, let’s not forget. You’ve got to show earnings, though—right?—to please your investors?”
    Ross smiled and spread his hands in a self-deprecating way. “Well, we’re not doing too well at that lately.”
    “So I hear.” Elliot came forward in his wheelchair, spoke in a friendly tone. “Do your investors ever express displeasure with the salaries of your officers and directors?”
    Ross blinked a few times, but if the question bothered him, he covered it quickly. “Not often. Our board members are skilled businesspeople. If the pay weren’t competitive, they’d go elsewhere. Good help is hard to find, and when you find it, you pay top dollar for it.”
    “And this good help, what does it do exactly? Run the company?”
    “That’s right.”
    “And yet you’re close to bankruptcy.” It wasn’t a question, but Elliot let it hang for a beat. “Which makes one wonder if lesser-paid help could do any worse, doesn’t it?”
     
     
     
    Fisk and Bracco may have come across as a matched pair to their fellow homicide inspectors, but they really couldn’t have been much more different from each other as human beings. And this meant they were different kinds of cops, too.
    When it got to be five o’clock, Harlen Fisk asked his partner if he’d drop him off at Tadich’s, the city’s oldest restaurant. In spite of his pregnant wife and baby boy waiting at home, he’d be meeting his aunt Kathy and several of her supporters for dinner and schmoozing well into the night. He didn’t invite Bracco to join them, and there were no hard feelings either way. The fact was, Fisk was a political animal with his eye someday in the distant future on political rewards.
    By contrast, Bracco was the son of a cop, but even so, until he got the promotion to homicide, he hadn’t clearly understood how much his father’s connection to the mayor was affecting his career, how much the regular guys resented him. And he’d never asked for special