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Sick around America

Safe-Keeper

My avatar is not a Drumpf hat
Safe-Keeper
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This thread is for the discussion on the PBS Frontline documentary Sick Around America, sequel to Sick around the World. Together they are about as long as Sicko and cover much of the same costs, but they are far more serious than Moore's entertainment flick, with a more down-to-earth approach than is his modus operandi. PBS does not permit embedding, but the film can be viewed in its entirety on their Watch Online page.

As with Rolfe's thread, this thread is not about side-subjects such as the movie's director, the NHS, or other non-related subjects. We have a hundred threads on these subjects already. Please try to discuss the documentary only.

I personally enjoyed the film, although it focused too much on personal stories, whereas I'd like a more broad, less personal approach, but then again, that's the norm for documentaries such as this one.
 
Thanks for pointing me to that film, Safekeeper. I watched it at the weekend, but I need to watch again to assess it properly. I agree it's well done, but I disagree about focussing on the individual stories being a disadvantage. It's very hard to understand the effects of abstractions, without showing people who are actually affected by them. It's also more relevant that Sicko, because it's dated March 2009 while Sicko was released in 2007.

I'd like to clarify, though. Are you including Sick Around the World in the discussion? I'd certainly find that interesting also. However, I fear that this would introduce the subject of other countries' healthcare systems, and the whole thing would degenerate into little more than tu quoque.

Your call.

I would however suggest that the House of Representatives committee report on their enquiry into recission, which is extremely relevant to Sick Around America, but was published in June 2009, too late for the film to take it into account.

That can be seen here. http://energycommerce.house.gov/Press_111/20090616/rescission_supplemental.pdf

Rolfe.
 
Hey, as I have bits copied from that report, and I am sure it is fair use and in the public domain, I'll add a few:


Insurance companies rescind coverage even when discrepancies are unintentional or caused by others. In one case reviewed by the Committee, a WellPoint subsidiary rescinded coverage for a patient in Virginia whose insurance agent entered his weight incorrectly on his application and failed to return it to him for review. The company's Associate General Counsel warned that the agent's actions were "not acceptable" and recommended against rescission, but she was overruled.
• Insurance companies rescind coverage for conditions that are unknown to policyholders. In 2004, Fortis Health, now known as Assurant, rescinded coverage for a policyholder with lymphoma, denying him chemotherapy and a life-saving stem cell transplant. The company located a CT scan taken five years earlier that identified silent gall stones and an asymptomatic abdominal aortic aneurysm, but the policyholder's doctor never informed him of these conditions. After direct intervention from the Illinois Attorney General's Office, the individual's policy was reinstated.
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Insurance companies have evaluated employee performance based on the amount of money their employees saved the company through rescissions. The Committee obtained an annual performance evaluation of the Director of Group Underwriting at WellPoint. Under "results achieved" for meeting financial "targets" and improving financial "stability," the review stated that this official obtained "Retro savings of $9,835,564" through rescissions. The official was awarded a perfect "5" for "exceptional performance."

In written testimony for today's hearing, all three insurance companies stated that the passage of comprehensive health care reform legislation, including a system where coverage is available to everyone and all Americans are required to participate, would eliminate the controversial practices of denying coverage based on preexisting conditions and rescinding policyholders for omissions in their medical records.
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Hard to disagree with the summary:

EXECUTIVE SUMMARY
Last year, the House Committee on Oversight and Government Reform initiated an investigation into problems with the individual health insurance market. This year, the Energy and Commerce Committee, and its Subcommittee on Oversight and Investigations, continued that investigation. This memorandum presents the Committee's findings.

The Committee sent document requests to 50 state insurance commissioners and three health insurance companies that provide individual health insurance policies, Assurant Health, WellPoint, Inc., and UnitedHealth Group. The Committee obtained approximately 116,000 pages of documents and interviewed numerous policyholders who had their coverage terminated,
or "rescinded," after they became ill.

The Committee's investigation demonstrates that the market for individual health insurance in the United States is fundamentally flawed. - -
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its very good i think.
especially the last part. about changing healthcare is not only UHC but also controlling cost.
 
Safe-Keeper said:
For now, no. Let's stick to America.
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Good plan. I think there was stuff in there from Obama pointing out how much of the US GDP is being sucked up by healthcare, and how it wasn't sustainable in the global economy, especially as the sum is still increasing year on year well in excess of inflation.

It seems to me that this, just as much as the problems of people being denied care because of lack of universality in the system, is why change has to happen. The opportunity was lost in the 1990s, and things are obviously worse than they were then. If the present opportunity is lost it could be very bad for the US economy, which would be bad for the world as a whole.

The lack of universality is an economic problem too, of course. I remember another film, one of Morgan Spurlock's, where he and his fiance tried to live on the minimum wage. He didn't labour the point, but it was obviously the healthcare needs they developed that stopped them making a success of it. Everything else they really needed was provided either by social programmes or by charity (the charity furniture stores were just amazing), but the healthcare provision was very problematical.

One of the Frontline cases also brought the point home. The girl with lupus. She was unable to access the treatment that would have stabilised her condition. Eventually she crashed, and $600,000 was spent keeping her in intensive care - because as we're always being told, everybody gets all the lifesaving treatment they need. However, she died. With far less than $600,000 spent on her maintenance treatment, she could have lived a productive life and contributed to society, instead of costing society $600,000 and then dying. How is this sensible?

How many people across America are trapped in poverty by inability to fund chronic healthcare needs? Actively discouraged from improving their situation, because they'll lose eligibility for Medicaid? Or simply working all hours in jobs below their abilities to pay for their next month's medication?

Unfortunately whenever this is discussed, any suggestion that there are other systems worth looking at is met by a barrage of assertions that other systems are not perfect either. Which is of course true, but hardly constructive. No other country is spending 16% of GDP to cover only 85% of the population (well, fewer, because we have to think about the proportion that will be affected by recission if they do find themselves needing care).

Do Americans really think their present system is sustainable, or even economically efficient? Are they happy for the economy to be hampered by the amount swallowed up by healthcare? Are they happy that a significant proportion of Americans can't access routine healthcare, and that many more are held in poverty by the costs? Are they so sure that none of the pitfalls described in the Frontline programme could ever happen to them, that they can safely oppose change?

Rolfe.
 
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Changed my mind about Around the World. Feel free to discuss it if it has relevance to America.
 
Do Americans really think their present system is sustainable,
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No. Insurance premiums are rising about 10% a year. It won't be that long before it's a minority of the population that can afford insurance. Reform is coming one way or another. If it comes later rather than sooner, it will be ugly. But one way or another, it's coming.
 
On the BBC today a hedge-fund manager was asked by Robert Peston about future targets, ie companies that he sees as over-valued and thus a target for short selling.

He identified the sector as being US healthcare companies because their long term position is, in his opinion, unsustainable. 16% of GDP, 10% annual cost growth/inflation against, at best, 3% economy growth/inflation.

Steve
 
Rolfe said:
Good plan. I think there was stuff in there from Obama pointing out how much of the US GDP is being sucked up by healthcare, and how it wasn't sustainable in the global economy, especially as the sum is still increasing year on year well in excess of inflation.

It seems to me that this, just as much as the problems of people being denied care because of lack of universality in the system, is why change has to happen. The opportunity was lost in the 1990s, and things are obviously worse than they were then. If the present opportunity is lost it could be very bad for the US economy, which would be bad for the world as a whole.
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Health care costs will continue outstrip inflation almost regardless of what we do. That outpacing of inflation is not even peculiar to the American medical system. And it is to be expected, because the number of services that can be provided keeps growing. We pay more now than we did twenty years ago, but we get more too. We will continue to buy more and more in medical goods and services because more and more will become available. There are only two ways to stop that anytime soon: stop innovating or start enacting drastic cuts in provided services.

Do Americans really think their present system is sustainable, or even economically efficient?
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Efficient? No. Optimal? Far from it. Sustainable? The private side of things, yes, it's quite sustainable. No evidence has been presented to the contrary. Where we run into problems with sustainability (and we're not alone in this regard) is government programs.
 
What about the increasing numbers of people finding themselves excluded from the insurance system, or having to choose dead-end jobs simply to get insurance cover?

  • These people are often prevented from contributing to the economy to their potential, because of the restrictions imposed on their economic activity by the over-riding concern of the requirement to maintain access to healthcare.
  • They may cost the economy a great deal of money when they are finally forced to present to the emergency room in extremis, when expenditure of a fraction of that amount on maintenance therapy might have kept them not only well, but contributing to the economy.
  • Ultimately, the way such emergency treatment is funded is by forcing private businesses to supply goods and services to people who will never be able to pay. Their only recourse is to hike their prices to their paying customers to offest these government-imposed losses.
Do you not think that the debate so far is concentrating far too much on the provisions for a small minority who may benefit temporarily from very expensive end-of-life care, to the detriment of people suffering from the lack of very basic, routine procedures and pharmaceuticals?

Rolfe.
 
Rolfe said:
What about the increasing numbers of people finding themselves excluded from the insurance system, or having to choose dead-end jobs simply to get insurance cover?
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That may be bad, but I don't see any evidence that it's unsustainable. There's a major difference. 40,000 people being killed every year is bad, right? But that's completely sustainable: it's roughly how many people die in car accidents in the US.
 
Ziggurat said:
That may be bad, but I don't see any evidence that it's unsustainable. There's a major difference. 40,000 people being killed every year is bad, right? But that's completely sustainable: it's roughly how many people die in car accidents in the US.
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you like beeing duped, isnt it?
 
Ziggurat said:
That may be bad, but I don't see any evidence that it's unsustainable. There's a major difference.
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Hospitals are part of "the system", and I don't see how they can continue to operate in a situation where an increasing amount of the people they [are legally mandated to] serve will not be paying them back.
Unless, I guess, it eventually became a situation where only the top 5% of the population had insurance and paid $1000 a week per person for it or something, and everyone else ended up bankrupt (in some form or fashion) over medical bills.
 
kellyb said:
Hospitals are part of "the system", and I don't see how they can continue to operate in a situation where an increasing amount of the people they [are legally mandated to] serve will not be paying them back.
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Got any hospital financial projections to back up your gut feelings? Because those can be poor guideposts.
 
Some US insurance companies are actually experimenting with sending their insured to Costa Rica, India and other foreign countries to undergo medical treatment. US hospitals are pricing themselves out of the market.
 
WildCat said:
Some US insurance companies are actually experimenting with sending their insured to Costa Rica, India and other foreign countries to undergo medical treatment. US hospitals are pricing themselves out of the market.
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Yeah, um... no. That is only possible for a small fraction of medical procedures.
 
kellyb said:
Who predicted 10 years ago that insurance would be so expensive now?
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Who predicted it wouldn't be? And that doesn't answer the question. You made a claim about hospitals, not insurance premiums.
 
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