"This grows out of both an outrage and a need for a response at many levels to what I think is a growing decline in both the ability of patients to pursue care and doctors to provide care [because of] interventions in the form of restrictions on access and restrictions on information. I think that attack on many levels is required."

James Michel said he also hoped injecting humor into the debate would have some practical results.

"You take a story to its absurd extremes to begin to understand what the issues are," he said.

"Physicians do what's right but they're under pressure from a system that diverts attention from patient care and makes them act like insurance agents," he said.

According to James Michel, the managed health care system was "an easy target" because it already contains elements of the absurd.

Both the Michel brothers and Abrahams said HMO Black is just getting started and will continue announcing new health plans.

"We hope to dominate the health care industry by the year 2000," Abrahams said