Laurie Coker could write a book on her experience as a board member of one of our public Managed Care Organizations, but she declines.  For one thing, the plot would be too predictable and unending–who would read it!  On the other hand, sometimes truth IS stranger than fiction!   The fascination of an organization with its own power (and growing it) produces not so subtle actions against some board members, providers, and community stakeholders while giving special attention and benefits to others.  Lessons learned:  1) Public systems are often politically ruled both vertically and horizontally.  This can mean a community can be trapped with a public agency that from which there is little accountability to the persons it is to serve, to their families, and to the community whose taxes are funding it.  2)  “Consumer” advocates, Recovery advocates, and other advocates who believe in social justice and hope must be guiding values of human service, must advocate at local AND STATE levels!   As the fairy tale goes, when an emperor or empress is touting new clothes that the community sees are simply not there, something simply must be done!   The buck must stop somewhere!  Yet no one seems to be able or at least willing to hold some agencies accountable.  Too much at stake politically, it seems.  Time for some crucial conversations and some change in North Carolina!