Thursday, August 2, 2007

Sicko

Brenda and I went to see Sicko last weekend. Sicko is, of course, Michael Moore's latest movie about America's pathetic excuse for a health care system. Moore uses dramatic techniques (some might even call them gimmicks) to draw viewers in. But the fact that he doesn't simply use a dry-as-dust recitation of the facts, doesn't mean his points aren't valid.

One thing to remember about Sicko is that it isn't about the 46 million Americans who are uninsured. No, these tragic accounts are the real-life stories of people who have insurance. These were Americans who felt secure until they discovered the various methods (talk about your gimmicks!) insurance companies use to not pay claims.

One woman was denied because her insurance company labeled her dishonest for not having revealed on her insurance application that she once had a bladder infection! Oh, they don't hunt for these things in the beginning. They go ahead and cover you and let your pay your premiums until it comes to the time when they might have to pay out big for the surgery such as in the case of the girl in Sicko, then they suddenly discover your supposed deceptiveness and use it as an excuse to deny your coverage.

Moore interviewed a man whose job it was to pore over insurance applications searching for the slightest hint of an error or inconsistency as a reason to reject a claim. He showed portions of a congressional hearing in which a doctor who worked as a screener for an insurance company told how she was encouraged to deny medical procedures on the flimsiest of grounds. One method was to declare even some relatively tried and true procedures and medications as "experimental" and therefore, not covered.

One wife in Moore's film actually worked for, and was insured through, a hospital. When her husband was diagnosed with cancer, she tried everything including begging the appeals committee, to allow the tests recommended by her husband's doctors to go forward. They refused, as they refused to approve the bone marrow transplant he required to save his life. "Nope," the insurance company said, "we consider that operation experimental". Her husband died a short while later.

Another girl featured in Sicko was in a serious accident and was rushed, unconscious, to the emergency room via ambulance. Her insurance company refused to pay the ambulance bill on the grounds that she hadn't gotten the ambulance transport "pre-approved". They did not explain how she was supposed to do that when she was unconscious.

After filming and interviewing all these people, Moore visited Canada, England and France, all of which have national health care, to talk to citizens and doctors about how they like their system. Here in this country, we are always fed horror stories about national healthcare - about the long waits and the supposedly inferior care. I'm sure he could have found dissatisfied customers but the people Moore talked to generally seemed to be perfectly happy with their health care. In fact, they thought Americans were pretty much nuts to allow themselves to be victimized by for-profit insurance companies and pandering politicians.

The doctors in these countries were also content with their rewards under universal health care. They lived in beautiful homes, drove status cars and took long expensive vacations. They all said that they would hate being dictated to by insurance companies regarding the care they were allowed to give their patients.

Toward the end of the movie, Moore highlighted a California university-associated hospital that simply puts its poor patients out on the street when their medicaid/medicare coverage said their allotted time was up. One elderly, disoriented lady was left on the sidewalk barefooted and in her hospital gown. Fortunately, a homeless shelter found her and took her in. A hospital representative didn't even deny what they did but said that they had to do something with these people and they'd found that Skid Row as the best place to leave them. Personally, I think they should leave them on the street in front of some senator's house who gets up in Congress and pontificates about the evils of socialized medicine so they can see first-hand the face of un-socialized medicine. Said senator would, of course, be covered by the best insurance plan in the country thanks to us taxpayers.

The most controversial part of Moore's film was the trip he made to Cuba with a group of people, including some emergency workers suffering from debilitating conditions as a consequence of their rescue work at the site of the twin towers. All have fought to receive the treatment they need but have been stonewalled by their insurance companies as well as the group created to distribute funds specifically meant to assist 9/11 workers.

Moore had heard from politicians in congressional hearings saying what wonderful medical care we are giving to the detainees at Guantanamo so he first took his group to Gitmo where, of course, he was denied entrance. Then he went on in to Havana where everyone in his group received thorough testing, diagnosis and treatment. (The breathing treatment that costs a former EMT over $120 in America costs a nickel in Cuba). Now, I don't doubt for a minute that both Moore and Cuba had an agenda in treating and filming the care received by the Americans but the fact of the matter is that Cuba, a tiny little raggedy-poor Communist island offers all of its people health care. In fact, Cuba ranks only one-step below us in the medical care its citizens receives. America, the richest country in the world, rates 37th.

Back when Hillary Clinton came up with a national health care plan, the insurance companies and the pharmaceutical companies kicked it into gear and spent about a gazillion advertising dollars to put the fear of God into us about how awful that would be, then they spent another gazillion lobbying our congresspeople. Their strategy worked and here we are today with millions of not covered at all and many more millions being shafted seven ways from Sunday by their insurance companies and managed care plans. Our premiums keep going up, our co-pays keep going up and our coverages keep going down. The largest percentage of the bankruptcies in the United States are caused by health care bills than any other reason.

And meanwhile, our health care situation affects other parts of our lives too. How many people keep working when they'd like to retire because they can't afford to go without health care and they can't afford private insurance until their Medicare kicks in? How many people stay in jobs they hate because they can't get health care if they leave? How many lay-offs in America have been caused because companies have fled to countries where they can escape onerous health care costs for their employees? I don't know all the answers to these questions but I know it is....lots.

In one part of Sicko, an English man asks - "why do Americans allow this to happen? They live in a democracy. They have the votes to vote themselves health care. Why don't they?"

Why don't we?