Sicko (the movie)

Parent Cafe
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<p>The bill was not from the doctor’s office. It was from the company that supplied the aircast. I would understand a reasonable markup. 400 % (charging $200 for $50 item) is not reasonable. I stopped into a medical supply store after the fact. I could buy it off the shelf for $60. </p>

<p><<“And I contacted the insurance company and said they were overcharged. They told me they would look in to it. I won’t hold my breath.”</p>

<p>You are not at all taking into account the doctor’s overhead in ordering, placing and billing for this item. And the overhead expenses in staffing the office, paying other types of overhead, etc. Do you go a supermarket and refuse to pay 3.99 a pound for cherries because the grocer paid 1.59?</p>

<p>Same deal. You can skip the doctor’s office and just buy the air cast online (+ shipping), and you can grow the cherries yourself.>></p>

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<p>I saw the movie this past Saturday and would like everyone to see it. I am not optimistic, however, about a change in our health care system. For more than a quarter century the Republican line has been that government is bad, that it can’t do anything right. (I’m talking about government as in civil servants, not politicians.) The result is a widespread distrust of government services on the part of many citizens, and that is much different from how people in other countries view government. That won’t change quickly or easily, and I am afraid it–and noise from the right wing media-- will sink any health care proposals. </p>

<p>My husband is more optimistic, and I am open to attempts to “optimize” me!</p>

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<p>“The bill was not from the doctor’s office. It was from the company that supplied the aircast. I would understand a reasonable markup. 400 % (charging $200 for $50 item) is not reasonable. I stopped into a medical supply store after the fact. I could buy it off the shelf for $60.”</p>

<p>That’s fine. So next time you go to the ER, see a doctor, get your x-ray, your diagnosis, your pain meds, and refuse to let them put the aircast on. Explain to them that you are trying to save your insurance or Medicaid or Medicare some money, so sign out without recommended treatment.</p>

<p>Then wait for the medical supply store to open the next day, and figure out how to use the aircast yourself. Or order it online, pay $40 extra to get it sent overnight and then put it on yourself, taking the responsibility for delaying the treatment for 48 hours. You will save your insurance company money and can feel good about lowering medical costs for your insurance company.</p>

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<p>I saw the movie last night. So I’m reviving this thread.</p>

<p>Even if I were cynical and took Michael Moore as a “propagandist,” not as a “documenter,” he makes some excellent points. And he does it with humor. The movie was enjoyable to watch. </p>

<p>What I’ve always found interesting – not just in the health care debate but in general – is America’s alleged obsession with “pulling yourself up by your bootstraps,” that individuals need to take care of themselves, that capitalism incents us to do things for ourselves. It’s a continuation of the “Wild, Wild West” mentality, when men were men and built their own houses and protected their women, back when we were settling the country.</p>

<p>All of that is true – America is, as we know, built by immigrants who, for whatever reason, didn’t like it where they were and had the gumption to leave it and start out fresh in a strange place. These “emotional origins” (to coin a phrase) do make us independent and do make us value self-reliance over “welfare” and “community.” I use the term “welfare” in a very generic sense.</p>

<p>These emotional origins also make the concept of socialism (first-cousin to Communism) as bad as Satan. </p>

<p>This is why Hilary’s book “It Takes a Village” is so maligned by the Right – because we shouldn’t rely on anyone else; we should handle things ourselves. Real Men (and Women) take care of their own. Lazy Men (and Women) rely on others to help them.</p>

<p>So to the far Right, home-schooling is to be praised. See, we can do it without help!!</p>

<p>And this is why the concept of having government-run health care is anathema too. It suggests “socialism” and “nanny government.”</p>

<p>Except for Canada, the countries Moore profiled are much older than we are. France and Britain were not formed by rugged individualists who immigrated; the “emotional origins” of those countries stem from the fact that the countries are more than a thousand years old. Maybe we need to get over this “I can do it myself!” mentality and become more mature, like the other countries.</p>

<p>I do believe we have a great opportunity with this Presidential election to elect someone who can move the health care debate forward. And I do believe that in 20 or 30 years, we’ll finally have something that relies less on employers and more on the government, and then we will have something resembling universal, free health care.</p>

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<p>The surgical practice where my wife works treats Canadian patients all the time. They don’t want to wait the 6 months for needed colon surgery. Price is usually well into the four to five figures which they have to pay upfront in cash. I also read that they are using US border hospitals to send many overflow patients in other types of cases. What would they do without having the US as the backup plan?</p>

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<p>why should surgery cost that much? that I don’t get and dont’ say insurance, that is hogwash</p>

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<p>Surgeons (2)–$5,000, operating room help $5,000, operating room cost $2000, 3 days in hospital care $10,000, tests etc $3000. It adds up. All those fancy new MRI and monitoring machines cost $$$$$$$. But it saves them from doing many unnecessary surgeries too.</p>

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<p>Who would want to have unnecessary colon surgery?</p>

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<p>VeryHappy, I think you misunderstand Barrons. The Canadian patients his wife sees are paying out of pocket for necessary colon surgeries in the US because they would have to wait for the surgery in Canada. His second post speaks, in response to CGM, about the high cost of modern medicine. He says that the very expensive MRI machines and other monitoring equipment saves people from getting unnecessary surgeries because MRIs and similar tests can show that surgery isn’t needed; without those tests, as expensive as they are, people may need to get surgical procedures that they don’t actually need. That’s the way I read it, at least. Please correct me if I’m wrong, Barrons.</p>

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<p>As already noted, wait times for elective surgeries in Canada are now SHORTER than in the U.S. And the reason for that is simple. In a single-payer health care system, the system can be impacted by public pressure. It’s not the same when the pressures are on the short-term bottom-line to “manage to care less”:</p>

<p>From Ezra Klein:</p>

<p>Here’s a fun puzzle. Fill in the blanks in the statement below:</p>

<p>In his talk, __________ conceded that “the ___ healthcare system is not timely.” He cited “recent statistics from the Institution of Healthcare Improvement… that people are waiting an average of about 70 days to try to see a provider. And in many circumstances people initially diagnosed with cancer are waiting over a month.”</p>

<p>If you said “Troy Brennan, CEO of Aetna,” and “United States,” you’d be right! If you said Canada, or Britain, you’d be wrong. The article goes on:</p>

<p>A Commonwealth Fund study of six highly industrialized countries, the U.S., and five nations with national health systems, Britain, Germany, Australia, New Zealand, and Canada, found waiting times were worse in the U.S. than in all the other countries except Canada. And, most of the Canadian data so widely reported by the U.S. media is out of date, and misleading, according to PNHP and CNA/NNOC.</p>

<p>In Canada, there are no waits for emergency surgeries, and the median time for non-emergency elective surgery has been dropping as a result of public pressure and increased funding so that it is now equal to or better than the U.S. in most areas, the organizations say. Statistics Canada’s latest figures show that median wait times for elective surgery in Canada is now three weeks.</p>

<p>“There are significant differences between the U.S. and Canada, too,” said Burger. “In Canada, no one is denied care because of cost, because their treatment or test was not ‘pre-approved’ or because they have a pre-existing condition.”</p>

<p>I would take the three-week wait anytime over the almost 9 month wait we had here. So would 85% of British Columbia residents, and more than 70% of Washington residents, including a majority of Republicans.</p>

<p>I went from “manage to care less” where we went from 8 1/2 months for the correct surgery to repair my d’s knee properly, to my wonderful single payer where I can choose any provider I wish and get scheduled according to my needs. (Hate to rub it in, but single payer, without a single insurance company involved - though not universal coverage - DOES exist in the U.S., and it is great! It exists because our state borders Canada, and we know when we see a good deal. My wife just got out of the hospital for a non-emergency prophylactic operation related to her breast cancer - we chose the specialist, we chose the anaesthesiologist, we chose the doctor to remove the Medi-Port, we chose the week of surgery. The surgeon herself was the on-call doc over weekend. Getting rid of the 18-33% “overhead” of the insurance companies buys an awful lot of medical care.)</p>

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<p>corranged is exactly right. </p>

<p>Here is the article about Can. using US hospitals I was thinking of.</p>

<p><a href=“http://www.theglobeandmail.com/servlet/ArticleNews/freeheadlines/LAC/20070724/PREGNANT24/national/National[/url]”>http://www.theglobeandmail.com/servlet/ArticleNews/freeheadlines/LAC/20070724/PREGNANT24/national/National&lt;/a&gt;&lt;/p&gt;

<p>Some others</p>

<p><a href=“http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1115892[/url]”>http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1115892&lt;/a&gt;&lt;/p&gt;

<p><a href=“http://www.cmaj.ca/cgi/content/full/174/9/1247[/url]”>http://www.cmaj.ca/cgi/content/full/174/9/1247&lt;/a&gt;&lt;/p&gt;

<p><a href=“http://communications.uwo.ca/making_headlines/coverage/070119-2.htm[/url]”>http://communications.uwo.ca/making_headlines/coverage/070119-2.htm&lt;/a&gt;&lt;/p&gt;

<p><a href=“http://www.bmj.com/cgi/content/full/328/7441/660-a[/url]”>http://www.bmj.com/cgi/content/full/328/7441/660-a&lt;/a&gt;&lt;/p&gt;

<p><a href=“http://query.nytimes.com/gst/fullpage.html?res=9400EFDE113AF935A25752C0A9669C8B63&sec=health&spon=&pagewanted=all[/url]”>http://query.nytimes.com/gst/fullpage.html?res=9400EFDE113AF935A25752C0A9669C8B63&sec=health&spon=&pagewanted=all&lt;/a&gt;&lt;/p&gt;

<p><a href=“http://www.aims.ca/healthcare.asp?typeID=3&id=333[/url]”>http://www.aims.ca/healthcare.asp?typeID=3&id=333&lt;/a&gt;&lt;/p&gt;

<p>Recent article on wait lists–still a big problem.
<a href=“http://canadaonline.about.com/od/healthcarewaittimes/a/waittimesgtees.htm[/url]”>http://canadaonline.about.com/od/healthcarewaittimes/a/waittimesgtees.htm&lt;/a&gt;&lt;/p&gt;

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<p>Why should I have to argue with some probably underpaid (compared with the CEO) of an insurance company to justify life saving cancer treatment for a chid?
How broken is our system, with its insurance CEOs raking it in:

  1. Old days: kid needed chemo, kid admitted for chemo.
  2. New days: Pre-cert kid for chemo- paper must be filled out on our end (hospital), sent, looked at by someone on insurance end, approved (maybe), not approved (MD notified, has to call and argue with insurance company- eventually some stupid medical director who is making a cushier life than if he/she were actually doing medicine).
  3. New: hospital days denied in the middle of a 10 day admission (for example) because kid wasn’t getting therapy insurance company deemed inpatient. What the ?!@#% are we supposed to do? Discharge the kid in the middle of needed treatment? And readmit?
  4. New: hospital days denied by insurance company. Attending MD notified. Attending MD argues with insurance company dweebs. Good luck. Oh, and they continually are LATE wtih payments to hospital. Saves 'em money.
    I live this every day- major children’s hospital. Provides much in the way of charity care.</p>

<p>And my personal favorite- kid needs to find an unrelated donor for a bone marrow transplant. (this costs money). Insurance will “cover” the transplant (10c on the dollar, maybe), but not the search. How, exactly are we supposed to proceed to a transplant if we don’t have a donor??</p>

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<p>Canadian wait times–pretty current info.</p>

<p><a href=“http://www.cihi.ca/cihiweb/dispPage.jsp?cw_page=media_07mar2006_e[/url]”>http://www.cihi.ca/cihiweb/dispPage.jsp?cw_page=media_07mar2006_e&lt;/a&gt;&lt;/p&gt;

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<p>To dufay: What solution do you see to these problems?</p>

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<p>Bringing up this thread since I am so tired of being ripped off. My son just had an acute medical situation. He will be fine, but I wanted to deal with as much as possible before he leaves for school. He needed 3 specialists in 3 days and it was tiring for all of us. The cost and copays for his meds were huge (this after we pay a fortune for coverage). I wasted an hour on the phone to get to why we are spending about $65 for one medication when we have and are paying for drug coverage (we have $50 deductible which should have been met from the other small fortune I spent with the pharmacist 5 days ago). We also have a $50 copay for name brand drugs (some are 35, and some 20 depending on what it is, but the max should be $50). I found out the pharmacist put a medication through our insurance, and then “backed out”, which means my copay was never applied. Also, the pharmacist claims that they gave my son the largest tubes available for various ointments. The insurance company told me that these tubes are a 7 day and 10 day supply and we are entitled to a 30 day supply for our copay if the Rx was written for the larger tube size (which MD stated he was doing). I questioned the size with both my pharmacist and insurance since the tubes are microscopic in size, IMO. I wonder who is ripping me off. I feel like I need to be money machine. It took me 20 minutes to speak with a live person for the insurance pharmacy questions that I had. To top it off, there isn’t a doctor in network for the specialty area that my son could need without a 40 minute drive in each direction once he gets to school. This is something else to consider when you choose a school far from home. We are very fortunate that he was able to get care at home before beginning school, and hopefully he won’t require additional treatment.</p>

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<p><a href=“HuffPost - Breaking News, U.S. and World News | HuffPost”>HuffPost - Breaking News, U.S. and World News | HuffPost;

<p>Speaking to the Aetna Investor’s Conference 2007, Troy Brennan let these nuggets drop:</p>

<pre><code>* The U.S. “healthcare system is not timely.”

  • Recent statistics from the Institution of Healthcare Improvement document “that people are waiting an average of about 70 days to see a provider.”
  • “In many circumstances people initially diagnosed with cancer are waiting over a month, which is intolerable.”
  • In his former stint as an administrator and head of a physicians’ organization he spent much of his time trying “to find appointments for people with doctors.”
    </code></pre>

<p>Brennan’s comments went unreported in the major media. But some reports are now beginning to break through, spurred by the debate SiCKO has spawned.</p>

<p>Business Week, no great fan of a national healthcare system, reported in late June that “as several surveys and numerous anecdotes show, waiting times in the U.S. are often as bad or worse as those in other industrialized nations – despite the fact that the U.S. spends considerably more per capita on health care than any other country.”</p>

<p>A Commonwealth Fund study of six highly industrialized countries, the U.S., and five nations with national health systems, Britain, Germany, Australia, New Zealand, and Canada, found waiting times were worse in the U.S. than in all the other countries except Canada.</p>

<p>But, there’s something else you probably don’t hear about Canada. Substantial progress is being made.</p>

<p>Most of the wait times problems derive from funding cuts by conservative national or provincial governments, or from the siphoning off of resources by private providers. But precisely because the Canadian system is publicly administered, Canadians are able to force their elected officials to fix problems, or get voted out of office.</p>

<p>Throughout Canada, there are multiple pilot programs that have succeeded in slashing wait times. “a new approach of targeting investments to reduce waiting times combined with transparent reporting of wait times is having a substantial impact on access in the Canadian system,” wrote Robert Bell, MD, of Toronto’s University Health Network, with several of his RN and physician colleagues in a letter to the Wall Street Journal Monday.</p>

<p>Statistics Canada’s latest figures show that median wait times for elective surgery in Canada is now three weeks – that’s less time than Aetna’s chief medical officer says Americans typically wait after being diagnosed with cancer.</p>

<p>Canada also has no waits for emergency surgeries. It also doesn’t have 44 million people who are uninsured because everyone has a national healthcare card guaranteeing health care from any doctor or hospital they choose. And it doesn’t burden those with insurance with rising deductibles or co-pays.</p>

<hr>

<p>That’s the news: Canadians are waiting a third less long for elective surgeries as U.S. citizens, with insurance, are waiting for surgery after a cancer diagnosis. That’s no left-wing looney saying that - the U.S. numbers come from the CEO of Aetna Insurance.</p>

<p>To be fair, we didn’t have to wait that long with our government-run single payer option here in Washington State - it was great! But I have seen what has happened to my friends with the private insurance options, and it ain’t been pretty.</p>

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<p>So…to continue Dufay’s chemo story. During my wife’s excellent treatment through our single-payor, government-run, no insurance company health care system, we watched what happened to friends with the same diagnosis in the “world’s best health care system.” The standard of care was to use chemo drugs that have been shown conclusively to result in an 11% greater chance of recurrence, and a 10% higher mortality rate. The regimen my wife used has been used in Europe for 30 years, and isn’t in the least bit experimental, with studies of thousands of people indicating its superiority. But if you try to get it from “the world’s best health care system”, you are in for some rude surprises.</p>

<p>Then there are certain classes of drugs known to cause long-term neuropathic conditions. There are alternatives, with the same degree of efficacy, that have none of those side effects. Needless to say, we now have friends with these long-term effects, who looked at us with great wonder when we told them how easy it was for us to switch. But trying to get them out of “the world’s best health care system”? Better have a good lawyer.</p>

<p>Our doc knew all of this of course. The first question out of his mouth was “which insurance”? He was very pleased with our answer. Others aren’t so lucky.</p>

<p>Now, you would think that the “world’s best health care system” might care that the standard of care they apply would result in significantly higher rates of recurrence, or long-term neuropathic conditions, all of which they might be called upon to treat. Nothing could be further from the truth. By “managing to care less”, their expectation is that, by the time these roll around, they’ll be owned by a different company anyway.</p>

<p>Hillary Clinton will get her share from both the old company and the new one.</p>

<p>P.S. I should have added that in “the best health care system in the world”, according to the headline in my newspaper today, in Hackensack, New Jersey, surrounded by my docs per square inch than virtually anywhere in the U.S., women must now book mammograms 5 or 6 months in advance, and that followup tests might take several weeks? or that the number of mammography machines in New Jersey has dropped from 504 to 375 in just three years, and that 2/3rd of training positions go unfulfilled?</p>

<p>In south India, I could get a mammogram in a week; in Canada in two. Glad I don’t live in Hackensack.</p>

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<p>Given that mammograms are usually done only every 5-10 years for most women having to book even 6 mos out is no big deal. I do that with my next regular dental appointment–don’t you?</p>

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<p>Mammos are recommended every year for women over 50.</p>

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<p>I saw this movie and thought something should be done, I really liked the movie, and I dislike mike moore</p>