The trend towards lower cost Health Maintenance Organizations has many  Americans worried. Here are the "Top Signs You've Joined a Cheap HMO"

Pedal-powered dialysis machines.

Use of antibiotics deemed an "unauthorized experimental procedure."

Head-wound victim in the waiting room is on the last chapter of "War and Peace,"

Exam room has a tip jar.

You swear you saw salad tongs and a crab fork on the instrument tray just before the anesthesia kicked in.

"Will you be paying in eggs or pelts?"

The company logo features a hand squeezing a bleeding turnip.

Tongue depressors taste faintly of Fudgesicle.

"Pre-natal vitamin" prescription is a box of Tic-Tacs.

Directions to your doctor's office include, "take a left when you enter the trailer park,"

Doctor listens to your heart through a paper towel tube.

Only item listed under Preventive Care feature of coverage is "an apple a day."

24-hour claims line is 1-800-TUF-LUCK