One of them is no surprise. The global cigarette giant Philip Morris, whose $8.5 billion in profits comes at the expense of the expired, recently told the Czech government that smoking is not a public health menace because the premature deaths save the country on elder care.

Philip Morris, according the Wall Street Journal, put Arthur D. Little's numbers crunchers to work. These minions, long on math and short on morals, produced a calculation that said that in 1999, ''the premature demise of smokers'' saved the Czech government between $24 million and $30 million on health care, housing, and pensions.

In another calculation, which included the care for smokers who were still hanging on and care for victims of secondhand smoke, Philip Morris claimed that ''weighing the costs and benefits,'' the Czech government came out $147 million ahead from smoking.

Philip Morris, which has a near monopoly on cigarettes in the Czech Republic, said, ''We're not trying to suggest that there would be a benefit to society from the diseases related to smoking.'' But it commissioned the study specifically to blunt charges from Czech health officials that smoking created burdensome health care costs. It went so far as to say that smoking had ''positive effects.''

In Boston, an HMO (health misanthrope organization) refused to cover a liver transplant for a woman with HIV. The woman, Belynda Dunn, does not have full-blown AIDS, but she will die within months from hepatitis C.

She has a brother willing to donate a piece of his liver. But her health misanthrope organization, the Neighborhood Health Plan, said that because of her HIV, the surgery was too ''experimental'' to cover, at $250,000. Never mind that she surely would die without the transplant. The possibility that she might cost Neighborhood Health Plan, an affiliate of Harvard Pilgrim Health Care, a quarter of a million dollars and still die is just too much risk to take.

Dunn was lucky. Being a well-known AIDS activist, her rejection gained the attention of Mayor Thomas Menino. Menino was able to instill a minor amount of shame into the health misanthrope organizations. After four months of stonewalling Dunn for actual coverage, Neighborhood Health Plan and Harvard Pilgrim agreed to donate $100,000 and $50,000, respectively. Menino said he has come up with enough other donors to create a fund that this week crossed the $325,000 mark.

It is sick that the same industry that spent $5 million last fall to defeat universal health care at the ballot box in Massachusetts would so baldly reject a dying woman. It is particularly galling for the rejection to occur in an industry where the CEOs of state giants such as Blue Cross and Blue Shield, Harvard Pilgrim, Tufts, and Fallon earned a combined $3.5 million in salary and compensation in 1998. It is a final insult that Dunn was rejected by the very HMO that claims to provide care to those who cannot afford the giants.

Last fall, the health misanthrope organizations outspent the opposition 50-1 to overcome the initial public strong support for universal health care and eke out a 52-to-48 percent victory at the polls. The money was spent for moments like this, to have the right to reject the really sick. That was nice of Menino to step in to save the day for Dunn, but health care by press conference is not in the cards for the average person.

Neighborhood Health Plan knows it too. At Menino's press conference, Neighborhood Health Plan CEO James Hooley shamelessly grandstanded as if Dunn were the recipient of his personal charity. He even referred to Dunn by her first name. ''We're happy that Belynda is going to get the care she wants.''

Happy? What fool would believe that? Like Philip Morris, Hooley dared not suggest there would be a benefit to its bottom line if Dunn had just curled up in a corner and died. But at the very same press conference, Hooley said that if another person like Dunn came to them seeking coverage, they too, would be rejected.

''Our decision was the right decision,'' Hooley said.

That can be the right decision only if your bottom line motto is ''Just Die.''

© Copyright 2001 Globe Newspaper Company

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