August 2007

Fatally flawed: 'Sicko' shows the holes in our health-care system

By Gail Binkly

Back in the 1990s, I heard one of Rush Limbaugh’s radio shows in which he took a call from a woman concerned about health care. She said her friend had full health coverage because she was married to a man with a good job; the caller, however, being a self-employed entrepreneur, couldn’t afford coverage at all since she wasn’t part of a group. This seemed unfair.

Old Rush harrumed and hawed, trying to think of some way to blame the situation on Evil Liberals, but wound up saying, “Just keep voting conservative and things will get better.”

Well, Americans have been voting conservative for more than a decade since then, yet our health-care system is worse than ever – a fact hammered home very effectively in Michael Moore’s film “Sicko.”

This riveting documentary is far more emotional and touching than many of Hollywood’s works of fiction. People at the theater where I saw it laughed, clapped and cried as Moore unwound his tales of ordinary citizens battling a corrupt, cockamamie system where decisions are truly life-or-death.

I was laughing and crying along with everyone else – but then I’m prejudiced, having come to the conclusion long ago that health insurers serve no function other than to drive medical costs upward. Certainly “insurance” is no assurance of good care or even payment.

I recently had the following surreal conversation with a representative from my own alleged insurer after I’d been told that my routine annual exam with a “preferred provider” would cost me the full amount instead of the $25 co-pay promised in my handbook.

Me: “When does [the insurance company] pay – you know, let you pay the $25 co-payment only? What kind of visit would that be? . . . It says ‘$25 copayment for office visit’ and this was an office visit.”

Representative: “Yes, ma’am, but it wasn’t just an office visit. . . See, ma’am, an office visit is just like going and seeing the doctor for like five minutes and leaving. That’s what they consider an office visit. Any time you’re in there and the doctor has to do any sort of examination, any extended evaluation of any kind, then that’s more than an office visit. . . ”

Me: “So the only time that you would pay would be if I went to see the doctor and he didn’t look at me at all.”

Representative: “Yeah, ma’am. . .”

I suffered no great harm from the denial; I appealed it and won. But the folks in Moore’s movie don’t fare as well. They’re denied life-saving care because it was deemed experimental, or because in an emergency they happened to be too far away from a hospital that was “in-network.”

Although some 50 million Americans are uninsured, “Sicko” focuses on those who are insured, serenely believing that their health-care needs will be therefore taken care of. Of course, this is largely a delusion, Moore explains. Most of us – insured or not – are just one car wreck or one chronic illness away from bankruptcy and ruin.

“Sicko” shows plenty of good Americans – not deadbeats, not illegal immigrants – whose lives are ruined because of gaps in the coverage they thought they’d paid for. We meet an older couple forced to move into one of their children’s spare rooms because medical bills eat up their savings and home. We see volunteer 9-11 rescue workers with chronic pulmonary illnesses (acquired at Ground Zero) that aren’t covered by the government. We see a woman whose insurance company retroactively denies her coverage for surgery – demanding she pay them back because she forgot to report an unrelated yeast infection as a “preexisting condition” on her application.

But these are the lucky ones. They’re alive.

And they’re in homes — not being turned out in Los Angeles’ Skid Row, like the confused, feverish old woman deposited there, barefoot and in her hospital gown, by a Kaiser Permanente hospital in 2006, or the paraplegic man left crawling in the gutter this year by workers from Hollywood Presbyterian. Both were literally dumped because they couldn’t pay their bills – a fairly common practice.

Why does our supposedly compassionate and certainly wealthy country tolerate such behavior? Moore makes it clear that the answer is greed – greed so raw and insatiable that insurers, bigcity hospitals and pharmaceutical com panies are willing to see people die rather than risk reducing their profits.

His solution is government-run, universal health care. Sure, he says, the powers-that-be have done an excellent job scaring us away from “socialized medicine,” brainwashing us to picture Communists grimly marching in lockstep when we hear the term “socialism.” (Never mind Social Security, Medicare, and Medicaid, of course!)

Then he shows us France, Canada, Great Britain – democracies where people who need care simply go to a doctor or hospital and get treated. No applications, no co-pays, no deductibles, no exemptions for preexisting conditions.

But wait! Don’t they groan under unbearable taxes? Don’t their best doctors flee here to make more money? Don’t the people get sub-standard care?

Well, no, no, and no, according to Moore. Citizens in Western nations with socialized medicine are largely happy with the system and certainly don’t want it overturned. Yes, they pay higher taxes, but they don’t have medical bills or insurance payments!

Doctors live very comfortably, though they aren’t obscenely rich. (Why do we assume the greediest doctors are the most skilled?) People do get to choose their own doctors (here, our insurance companies essentially choose them for us).

Meanwhile, the U.S. ranks No. 37 in the world in health care, according to the World Health Organization. Many countries, including tiny Communist Cuba, have lower infant-mortality rates and higher life expectancies than ours.

“You would have to be dead to be unaffected by Moore's movie,” admitted a Blue Cross executive in a recent memo bemoaning the potential “negative impact on our image” that “Sicko” could cause insurers such as his company. (The memo was passed on to Moore and is published on his web site.) The exec accuses Moore of “cultivating misperceptions” but doesn’t say anything is actually incorrect in the film.

Yet despite all its ugly wounds, our health-care systm remains like the Mark Twain adage about the weather: Everybody talks about it, but nobody does anything about it. Until people experience the system’s shortcomings themselves, until they need a cancer treatment and their insurance company turns them down, they tend to think it’s someone else’s problem — nothing too serious.

Worried that “Sicko” might change that perception, insurers are now rushing around saying most everything that’s wrong with our health-care system is because of our own “lifestyle choices.” Of course, that doesn’t explain why even thin people get multiple sclerosis, say, and then have to fight to make their insurance companies actually pay for their treatment — but never mind, it’s all our own fault.

Our political leaders realize how massive the problem is — but don’t expect them to do anything to remedy it. They have excellent, comprehensive health care, after all, and they’re busy jetting around the country, collecting campaign donations from the pharmaceutical industry and the insurance companies.

Meanwhile, working folks are forced to put jars in convenience stores begging for spare change to help pay for surgery for their kids.

Could “socialized medicine” really be worse than a system like that? See Moore’s film, and decide for yourself.