Sick, indeed
Dru and I saw "Sicko" last night. The theater was packed. I was ready for a pointed, snarky exposé on American health care and I got it. But what I didn't expect was how angry and deeply heartsick I felt at the end.
"Sicko" is about the ugliest part of the American ethos: As a nation, we allow our own people suffer and die to protect corporate profits. Not soldiers, not foreigners (although we do a bang-up job on them, too) but kids and old people and everyone in between. Imagine "The Lottery" with a denial-of-coverage statement instead of a black dot on that fateful piece of paper. Aging parents lose their homes; a father wastes away for lack of cancer treatment; a toddler dies because her mother took her to the 'wrong' hospital. And those are the people with health insurance. Indigent patients are whisked out of for-profit ERs and shoved out of cabs near homeless shelters, still wearing hospital gowns.
If ever there were an argument against letting the invisible hand of the market govern healthcare, this is it. Dead, under-treated and bankrupt patients make happy investors, although most wouldn't admit to such a direct connection. But Moore shows that insurers are actively out to kick people off their books and talks to people who have helped make that happen. That's the part that shocked me, that insurers really aren't just being obtuse or disorganized. They deliberately deny care because paying out hurts their bottom line. How could I have been so naïve?
I've been around the healthcare block. When my middle son was stillborn, my then-insurer retroactively refused to pay for my pregnancy care. It took months -- months when I should have been focused on recovering from the worst experience of my life -- of detective work and increasingly belligerent contact to get them to cough up those four thousand dollars. When a close relative suffered a stroke, I took him to the ER and had to deal with the cashier. I was devastated that this person I loved was suffering and possibly permanently damaged, and the hospital wanted its money -- now -- because there was a problem with his insurance. A friend in labor was detained by her obstetrician's office staff while en route to the delivery room because they said she owed money. It turned out to be a miscommunication with the insurance company. Uh-huh.
When I grouse, someone is always happy to pipe up and remind me how lucky I am to have health insurance at all and I should be grateful. But when Moore showed off the Canadian, British, French and Cuban health care systems, I didn't feel grateful. I felt scammed.
I'm sure their systems of care have drawbacks that Moore omits* but I'm also pretty sure that no one in England has to choose based on cost which severed finger to have reattached, as happened to one American Moore interviews. Watching a broke, chronically ill 9/11 rescuer weep when she finds her $120 medication for sale in a Cuban pharmacy for 5 cents American, I was furious. We've been told our system has to be the way it is. It doesn't. And by the measures that matter -- overall quality of health, infant mortality and longevity -- it shouldn't be the way it is. These other countries surpass us in those areas. Worse, they get to claim the moral high ground by taking care of their sick even if they're poor, which is one of those Christian ideals our politicians are always going on about.
Moore makes a good case for single-payer health coverage, but there's a lot of insurance and pharma money pouring into politics to prevent that from happening. And there are still too many people holding the "got mine, screw you" view of the world, failing to realize that we're all subsidizing healthcare anyway when hospitals raise rates to make up for indigent care in the ER. It would make more sense to pay up front for preventive care for everyone, and it would be the right thing to do. The questions "Sicko" left me with are will we do it, and if not what kind of people are we?
*Update/lagniappe: Catherine Arnst at BusinessWeek reports that American patients' wait times are as bad or worse than most other industrialized nations:
"Sicko" is about the ugliest part of the American ethos: As a nation, we allow our own people suffer and die to protect corporate profits. Not soldiers, not foreigners (although we do a bang-up job on them, too) but kids and old people and everyone in between. Imagine "The Lottery" with a denial-of-coverage statement instead of a black dot on that fateful piece of paper. Aging parents lose their homes; a father wastes away for lack of cancer treatment; a toddler dies because her mother took her to the 'wrong' hospital. And those are the people with health insurance. Indigent patients are whisked out of for-profit ERs and shoved out of cabs near homeless shelters, still wearing hospital gowns.
If ever there were an argument against letting the invisible hand of the market govern healthcare, this is it. Dead, under-treated and bankrupt patients make happy investors, although most wouldn't admit to such a direct connection. But Moore shows that insurers are actively out to kick people off their books and talks to people who have helped make that happen. That's the part that shocked me, that insurers really aren't just being obtuse or disorganized. They deliberately deny care because paying out hurts their bottom line. How could I have been so naïve?
I've been around the healthcare block. When my middle son was stillborn, my then-insurer retroactively refused to pay for my pregnancy care. It took months -- months when I should have been focused on recovering from the worst experience of my life -- of detective work and increasingly belligerent contact to get them to cough up those four thousand dollars. When a close relative suffered a stroke, I took him to the ER and had to deal with the cashier. I was devastated that this person I loved was suffering and possibly permanently damaged, and the hospital wanted its money -- now -- because there was a problem with his insurance. A friend in labor was detained by her obstetrician's office staff while en route to the delivery room because they said she owed money. It turned out to be a miscommunication with the insurance company. Uh-huh.
When I grouse, someone is always happy to pipe up and remind me how lucky I am to have health insurance at all and I should be grateful. But when Moore showed off the Canadian, British, French and Cuban health care systems, I didn't feel grateful. I felt scammed.
I'm sure their systems of care have drawbacks that Moore omits* but I'm also pretty sure that no one in England has to choose based on cost which severed finger to have reattached, as happened to one American Moore interviews. Watching a broke, chronically ill 9/11 rescuer weep when she finds her $120 medication for sale in a Cuban pharmacy for 5 cents American, I was furious. We've been told our system has to be the way it is. It doesn't. And by the measures that matter -- overall quality of health, infant mortality and longevity -- it shouldn't be the way it is. These other countries surpass us in those areas. Worse, they get to claim the moral high ground by taking care of their sick even if they're poor, which is one of those Christian ideals our politicians are always going on about.
Moore makes a good case for single-payer health coverage, but there's a lot of insurance and pharma money pouring into politics to prevent that from happening. And there are still too many people holding the "got mine, screw you" view of the world, failing to realize that we're all subsidizing healthcare anyway when hospitals raise rates to make up for indigent care in the ER. It would make more sense to pay up front for preventive care for everyone, and it would be the right thing to do. The questions "Sicko" left me with are will we do it, and if not what kind of people are we?
*Update/lagniappe: Catherine Arnst at BusinessWeek reports that American patients' wait times are as bad or worse than most other industrialized nations:
Of the countries surveyed, 81% of patients in New Zealand got a same or next-day appointment for a nonroutine visit, 71% in Britain, 69% in Germany, 66% in Australia, 47% in the U.S., and 36% in Canada. Those lengthy wait times in the U.S. explain why 26% of Americans reported going to an emergency room for a condition that could have been treated by a regular doctor if available, higher than every other country surveyed.
Arnst also highlights the area in which USA is #1 -- the percentage of patients who simply skipped getting medical care they needed because of the cost.
Labels: politics
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