...probably much earlier. I figure it got it's start during the Clinton Healthcare Reform debacle.
One dated example:
http://www.spruance.com/medical.htm"Category: Medical
Advertisement:
Date: 7/8/00
Joke: SIGNS YOU'VE JOINED A CHEAP HMO
9. Your annual breast exam is conducted at Hooters.
8. Directions to your doctor's office include, "Take a left when you enter the trailor park."
7. The tongue depressors taste faintly of Fudgesicles.
6. The only proctologist in the plan is "Gus" from Roto-Rooter.
5. The only item used under Preventative Care coverage is"an apple a day..."
4. Your "primary care physician" is wearing the pants you gave to Goodwill last month.
3. "The patient is responsible for 200% of out of network charges" is not a typo.
2. With your last HMO, your prozac didn't come in differentcolors with little "m"s on them.
1. AND the number 1 sign you've joined a cheap HMO: You ask for Viagra; you got a popsicle stick and duct tape...."
An example that this rehashed email was just a sampling of the original, no date on entry (site running from 1998 to at least 2008):
http://www.jokecenter.com/jokes/Medical/1407.htm"Top 30 Signs You've Joined a Cheap HMO
Joke submitted by: Anonymous
Top 30 Signs You've Joined a Cheap HMO
1. Pedal-powered dialysis machines.
2. Use of antibiotics deemed an "unauthorized experimental procedure"
3. Head-wound victim in the waiting room is on the last chapter of "War and Peace"
4. You ask for Viagra. You get a popsicle stick and duct tape.
5. Annual breast exam conducted at Hooters.
6. Exam room has a tip jar.
7. You swear you saw salad tongs and a crab fork on the instrument tray just before the anesthesia kicked in.
8. "Will you be paying in eggs or pelts?"
9. Tight budget prevents acquisition of separate rectal thermometers.
10. "Take two leeches and call me in the morning"
11. The company logo features a hand squeezing a bleeding turnip.
12. Tongue depressors taste faintly of Fudgesicle.
13. Covered postnatal care consists of leaving your baby on Mia Farrow's doorstep.
14. Radiation treatment for cancer patients requires them to walk around with a postcard from Chernobyl in their pocket.
15."Pre-natal vitamin" prescription is a box of Tic-Tacs.
16. Chief Surgeon graduated from University of Benihana.
17. Directions to your doctor's office include, "take a left when you enter the trailer park"
18. Doctor listens to your heart through a paper towel tube.
19. Only item listed under Preventive Care feature of coverage is "an apple a day."
20. Only participating Physicians are Dr. Fine, Dr. Howard, Dr. Fine.
21. Only proctologist in the plan is "Gus" from Roto-Rooter.
22. Plan covers only "group" gynecological exams.
23. Preprinted prescription pads that say "Walk it off, you sissy."
24. To avoid a time consuming and expensive throat culture, the doctor just French kisses you.
25. Recycled bandages.
26. You can get your flu shot as soon as "the" hypodermic needle is dry.
27. Your "primary care physician" is wearing the pants you gave to goodwill last month.
28. 24-hour claims line is 1-800-TUF-LUCK
29. Costly MRI equipment efficiently replaced by an oversized 2-sided copier.
30. Enema? The lavatory faucet swivels to face upward."