Moore A Great Muckraker and “Sicko” Great TheaterBy Ted DeCorteTake out a classified ad in an American publication and ask people to contact you if theyhave experienced any problems or challenges with their health insurance company orwith receiving healthcare in their community. That’s what Michael Moore did, and to hisamazement he received thousands of responses. Some of the most egregious of theseresponses became the basis of Mssr. Moore’s documedy “Sicko”.Everyone involved in healthcare or the selling of health insurance or interested inimproving the quality of healthcare in the United States needs to see the movie or at leastbe familiar with one major point the documedy makes: Sh*t Happens! - And some of itquite deplorable and unconscionable.An insurance company (Humana) allegedly denying treatment – and paying bonuses toemployees and physicians to deny treatment - is unacceptable. An injured uninsuredindividual having to decide which finger to have sewn back on based on the cost ofsewing one finger over the other is unacceptable. Ignoring the lingering healthcare issuesof 911 “Ground Zero” workers is unacceptable. A hospital dumping uninsured patients ata homeless shelter or free clinic is unacceptable. And other less than stellar results fromvarious healthcare entities in the United States.And Moore names names of the most nefarious healthcare “do-badders”: Tricky Dick(yes, THAT Tricky Dick), who as President supported the HMO concept of healthdelivery to REDUCE the amount of healthcare delivered. Remember Nixon recorded hisWhite House meetings and Moore plays that tape. And then Edgar Kaiser, who led TrickyDick’s charge towards LESS IS BETTER, and Hillary Clinton (yes Bill’s better half),who “sold out” to Big Pharmacy and Big Insurance.As per Humana, they have countered the allegations in “Sicko” with several pressreleases. One stated that Dr. Linda Peeno (the medical examiner featured in “Sicko”) wasa part-time consultant for several insurance companies and she did not receivecompensation for denying treatment, and that no heart transplants were denied in 1996 asDr. Peeno stated in a Congressional hearing. Another Humana press release stated that theLas Vegas patient who died because of Dr. Peeno’s alleged denial had not purchased atransplant “rider” and was not insured by Humana when he died in 1988 two years afterhis hospitalization. Neither press release addressed the allegation of “bonusing”employees or physicians for denying treatment. Google “Dr. Linda Peeno” for links toher other testimonies regarding managed healthcare, including a side note that LauraDern played “Dr. Peeno” in the little known 2002 Showtime drama “Damaged Care”.In “Sicko”, Michael Moore did NOT do two things.
1. He didn’t take out a classified ad in Canada or England or France or some other country with “nationalized” healthcare to ask people to contact him if they had experienced any problems or challenges with receiving healthcare in their community, and, 2. He never asked patients in Canada or England or France requiring extensive surgery or life-saving treatments how long it took for their “nationalized” healthcare system to approve and schedule the procedure. He only interviewed them in the waiting room or in the examination room while they were receiving care.Yet, “Sicko” is convincing in showing the viewer that the delivery of healthcare in theUnited States can be at times inequitable, unaffordable, and unattainable, but he missesthe mark in providing evidence that a “nationalized” plan would “get it right” or is evennecessary.Or course I was appalled at how the healthcare entities depicted in Moore’s storiesresponded to either the delivery or reimbursement of necessary healthcare. And no oneshould suffer through what these individuals had to endure: a child dying because ahospital refused to treat her. I don’t want to sound callous and say it can’t happen becauseit can, yet state laws require hospitals to treat and stabilize patients before transferringthem to other hospitals or releasing them. I though want to know more about this storydepicted in Moore’s movie. In fact I want to know more about many of the peoplefeatured in “Sicko”.Yes, the audiences applauds Moore’s tenacity and “balls-iness” (at least as captured onfilm) in sailing his small vessel – like the Skipper and Gilligan - first to Guantanamo Bay,and then to Cuba, to seek healthcare for his 911 “crew”. It’s the little guys against the“system”. We quietly cheer them on as the absurdity of tragic-comedic events unfolds.It’s great theater! And it works! What is needed now is for a TV journalist in the UnitedStates - please not Geraldo - to track down those wary travelers to see if their diagnosisand treatment in Cuba was a success. Did our Ground Zero workers really receiveworthwhile drugs for a fraction of the cost, or just generic “knock offs”?Whatever happened in Cuba proved a point. People in the United States of all ages arefalling through large cracks and holes within our healthcare “system” everyday, and weneed a “fix”, some say an “overhaul.” I caution those (and I was one of them during the1990s) to not throw out what IS working with what is not. That’s one problem I have withMoore’s approach. The majority of individuals who have traditional health insurancepolicies have both adequate access to healthcare and adequate healthcare benefits. Theydo NOT in many cases have catastrophic benefits; they may not always have affordablebenefits; and they may not be able to affordably or practically take what they currentlyhave with them to a new job or location.
Recently I was one of a panel of “experts” on a local NPR radio station programdiscussing the plight of the “uninsured” and “underinsured” in southern Nevada. The wifeof a local policeman gave birth to a son with a chronic birth defect. Over the course ofthis child’s first few years of life their medical bills reached $1.9 million, just shy of theirunion health and welfare plan’s $2 million lifetime benefit maximum. Governmentagencies in our State gave the family advice like “make your son the ward of the State”and “get a divorce so your wife and child can qualify for welfare.” Need I comment?Fifteen years ago my wife and I marketed a small group insurance product, albeit aschedule plan, with a $5 million lifetime benefit. During a break in the show I casuallymentioned to the others on the panel that periodically your property-casualty agent callsyou to update the replacement cost on your homeowner’s policy based on countyassessor’s records. I didn’t want to say that I know very few, if any, health insuranceconsultants or producers or insurers for that matter who do the same for their healthinsurance clients. The policemen’s self-funded health and welfare plan raised the lifetimeannual maximum to $3 million which bought this family some time before healthcarecosts could potentially lead to bankruptcy or the loss of their home.It’s this part of our healthcare “system” that I find disturbing. If you have healthinsurance, does it make any sense that you could still potentially have to seek bankruptcyor lose your life savings or lose your marriage and exhaust your financial ability to havehealthcare at all? And we do not in our healthcare “system” have a consistent andreasonable “fall back’ position for catastrophic health events.And then what about prevention? Preventive healthcare is important for children.Certainly a society that values “universal” education for our children should be able tovalue “universal” health coverage for these same children. We value it more or less forour elder population. Do we mandate it like automobile insurance? Do we require proofof a health plan to attend school? Do parents show proof of a health plan or enrollchildren in a “generic” plan at birth to get a birth certificate – like a smog check to getyour car registration? Okay, that was a bit much. Yet, who should provide and then payfor this “universal” health coverage for children, if that’s what we as a society decide isimportant? “Universal” coverage does not mean “nationalized” healthcare.But, don’t give me the “this is America and we are free to chose” - to live in misery -routine. A free market needs to provide affordable choices and when it does not, societyneeds to step up to the plate and provide alternatives. Healthcare is expensive period,thus health insurance is expensive. And 80% of healthcare dollars are spent on 20% ofthose who need it.THAT needs to be fixed in our healthcare “system.” I say “system”, because we do nothave an integrated healthcare system in America (the VA comes the closest), but a loosecoalition of private and public entities working together, and unfortunately at times at
cross purposes, to deliver an unleveled array of healthcare procedures and benefits. Therehas got to be, as Bill McKay, the Robert Redford character in “The Candidate”,expounded repeatedly, “A Better Way.”Can we make it a societal goal that everyone who needs health insurance or healthcarecan get it somewhere?Can we make it a societal goal that no one with health insurance should ever facefinancial devastation from burdensome healthcare costs?Health Insurance should be “usable” anywhere in the United States and for that matter inthe world. Forget “portability”. Health Insurance should be able to be purchased as anyother product, on a nationwide basis, not by state. States can “regulate” the consumerissues of its citizens, but “universal” health insurance products from Anthem orUnitedHealthcare or Cigna should be “usable” anywhere in the United States through avariety of provider networks, period.Health Insurance needs to be “unhinged” from the workplace. Employers wouldcontinue to provide compensation & benefits packages to attract good employees, butemployees would select from a variety of national or regional healthcare benefits that areportable and affordable.Regional high risk pools need to be established and funding provided.Yes, these changes will require a complete overhaul of our current state-driven healthinsurance system.Criticize all you want, but I will take a “universal” private market solution over a“nationalized” single-payor solution any day of the week. It just better allow everyoneaccess to affordable healthcare insurance, including “sliding scale” rates based onincome.