The managed care companies are in the business of making money. Why is that a surprise. The dilemma comes when we expect they should care as much about our clientele as we do. There is some consideration being made to joining of guilds affiliated with the AFL-CIO as a means of impacting companies in the areas of legislative reform through lobbying, etc. I'm just barely familiar with this, but it seems to have some legitimacy at least as a trial. As much as we want managed care companies to empathize with our clients (and us), we must recognize that our sympathies with their financial ventures are about as absent. We do not look at each other's interests through the same lens. So, we need to get off the mark and come up with some pressures to advocate for our clients----that is if we are advocates for clients and our professions.