“Sicko” — Did Michael Moore Get It Right?
A Comparison of Emergency Rooms on Two Continents
December 2007 By Denny HatchIn the News
I Am Not a Health ReformCambridge, Mass. — The “mandate model” for reform rests on impeccable political logic: avoid challenging insurance firms’ stranglehold on health care. But it is economic nonsense. The reliance on private insurers makes universal coverage unaffordable. With the exception of Dennis Kucinich, the Democratic presidential hopefuls sidestep an inconvenient truth: only a single-payer system of national health care can save what we estimate is the $350 billion wasted annually on medical bureaucracy and redirect those funds to expanded coverage. Mrs. Clinton, Mr. Edwards and Mr. Obama tout cost savings through computerization and improved care management, but Congressional Budget Office studies have found no evidence for these claims.
—David U. Himmelstein and Steffie Woolhandler, professors of medicine at Harvard and the co-founders of Physicians for a National Health Program, The New York Times Op-Ed, December 15, 2007
Three weeks ago, an American woman executive in her early sixties—let’s call her Joyce—needed to see a doctor fairly late at night in the little town of Füssen, Germany. My wife, Peggy, and I went with her to the emergency room of the local hospital.
It turned out that earlier in the year, Joyce had the very same symptoms during a business trip to the Midwest and went to the emergency room of one of the biggest hospitals in Omaha.
The comparison of how Joyce was treated in these two health care facilities for exactly the same illness is eye-opening.
Kurcafe Hotel, Füssen, December 2, 2007
It was around 10:00 p.m. Peggy and I were just draining the last drink of the evening and about to head upstairs when our friend Joyce came down the stairs. Joyce had gone up to her room soon after dinner, presumably to get a good night’s sleep before the World Curling Federation meeting the next morning. Now she was fully dressed, wearing an overcoat and looking pained and confused.
Peggy sprang up and asked if everything was okay. It wasn’t. Joyce was in severe discomfort with symptoms of cystitis—the same bladder infection that struck her in Omaha seven months earlier. She wanted to see a doctor.
Peggy popped into the kitchen and found an assistant manager of the hotel, who spoke no English. Peggy said, “hospital,” and the woman came out to the front desk, opened a small map of the town and circled the hospital. “Walk, five minutes,” she said. “Drive, two minutes.”
We grabbed our coats and escorted Joyce along Sebastianstrasse. Being a Sunday night, the streets were dark and empty. We came upon a very big traffic sign entirely in German. A small Red Cross toward the bottom indicated we were headed in the right direction. Additional signs with red crosses led us to a very dark doorway with a small light over the bell, which Joyce pushed.
From the loudspeaker came a male voice speaking German. “I need to see a doctor,” Joyce said.
“OK,” was the response. Moments later, a young technician in scrubs—probably in his early 30s—opened the door, held it as we entered and led us to the clean, well-lit emergency room. It was large with a hospital bed in the middle, completely made up with white linens. “Bladder infection,” Joyce said. “Urinary infection.”
The guy nodded, asked for her passport and then produced a small plastic cup from a cupboard and pointed Joyce to the bathroom. Peggy and I retired to the waiting room where one of the publications on the coffee table was a medical journal (in German, of course) with a long feature story on aortic stents.
Joyce appeared five minutes later with two small boxes of pills—painkillers and enough sulfonamides to cure the condition. She thanked the technician, who handed back her passport and showed us to the door. We were on our way back to the hotel.
We were in the hospital for a total of 15 minutes.
Walking home, Joyce told us that the technician tested her urine sample and then took her in to see a doctor, who was out of central casting—tall, elegant with gray hair—and spoke perfect English. He noted the test results and asked her if she had ever had this before. She said yes. He asked if she were in pain. She said no, just discomfort. As he handed her the pills, he told her that the entire cost would be 15 euros (roughly US$21). Did she want to fill out forms or would she prefer to pay cash? She paid cash.
Back at the Kurcafe Hotel we saw Joyce to her room, wished her well and went off to bed.
The Next Morning
Joyce joined us in the dining room at breakfast. It had taken a while for the various pills to kick in, but she got a good night’s sleep and was fine. Whereupon she told us the harrowing tale of the same problem on a trip to Omaha the previous spring.
Feeling the symptoms coming on while changing planes at Detroit’s Metro Airport, she used her cell phone to call her colleague who was already in Omaha to alert him that she would need to get to a hospital right away, as soon as she landed.
He was at the airport to meet her in a rental car and had programmed the GPS system to get them straight to the hospital. Joyce was in pain and discomfort. As in any big city, the emergency room was crowded. Joyce gave her insurance card to the receptionist and was seen by a triage nurse, who gave her a plastic cup. She went into the women’s rest room and, with difficulty, produced the urine sample.
Then in severe pain and discomfort, she sat with her colleague in the waiting room.
Four hours later she got in to see a doctor, who noted the test results, prescribed Cipro—a painkiller—and sulfonamides. She was with the doctor for less than three minutes.
Back at the reception desk, she got her health insurance card back, signed several forms and spent five minutes getting directions to the all-night Wal-Mart pharmacy where she could get her prescription filled.
Later, she was billed $80 by an emergency physicians group in Omaha and still later received a bill for about $150 from the hospital.
German vs. American Health Care
Okay, the hospital in Füssen on a Sunday night was deserted, so Joyce did not have to wait. The scene in Omaha was very different—an early weekday evening in the crowded waiting room of a big city hospital.
But in my opinion, a four-hour wait by a patient in severe pain for a three-minute diagnosis and treatment is unconscionable.
Was part of the reason for that wait the need by the hospital staff to create a paper trail on her case in order to avoid a malpractice lawsuit?
Further, why were she and her colleague forced onto the streets of Omaha in search of an all-night pharmacy when the medication could have been dispensed by the hospital? Was this a conspiracy among the hospital, big pharma and retail drug outlets to enable each of them to get a piece of the action? Does anybody in the health care chain care about the comfort and welfare of the patient? Or is everything driven by cash?
Had Joyce been a German citizen with no insurance and shown up with cystitis at the Omaha hospital emergency room, she would have been presented with a bill for over $1,000. (According to Wellmark BlueCross and BlueShield, the average emergency room charge is $1,049. See link below.)
After “Sicko” was released at the Cannes Film Festival and in selected theaters in the United States, I saw Michael Moore grilled by a hostile interviewer. One of the adversarial statements was that American medicine is the best in the world because in every other country, patients had to endure long waits for services.
Moore’s retort was that 47 million Americans do not have health coverage. If they were added into the system, everyone would experience long waits.
Three statistics that provide a snapshot of a nation’s health care efficiency are:
* Infant Mortality Rate. According to “The World Factbook” published by the CIA, Singapore ranks highest with just 2.30 deaths per 1,000 live births, followed by Sweden (2.76), Japan (2.80), Hong Kong (2.94), Iceland (3.27) and France (3.41). The United States ranks 41st with 6.87 deaths per 1,000 live births, bracketed by South Korea (6.05) and Croatia (6.60).
* Life Expectancy at Birth. According to the same source, Andorra ranks #1 in the world with an average life expectancy of 83.52 years. This is followed by Macau (82.27), Japan (82.02), San Marino and Singapore (81.80) and Hong Kong (81.68). The U.S. (78.00) ranks 45th in the world, bracketed by Saint Helena (78.9) and Cyprus (77.98).
* Death Rate. “The World Factbook” reports that the lowest death rate occurs in the United Arab Emirates, with 2.16 deaths per 1,000 population. This is followed by the Northern Mariana Islands (2.29), Kuwait (2.39), Saudi Arabia (2.55), Jordan (2.68) and American Samoa (3.24). The United States ranks 118th in the world with 8.26 deaths per 1,000, bracketed by Cambodia (8.24) and San Marino (8.27).
Michael Moore just might be on to something.
P.S. A wonderful e-mail, received December 17:
Denny, At the holiday season we give thanks for many things, and one of them is your column. I enjoy your insight all year, and wish you and your family a wonderful 2008.
On another note, if you’re looking for a column idea, think about “stupidest marketing ideas of 2007” ... and I have a candidate. After years of being a Comcast customer, enduring frequent outages, fewer and fewer channels, and ever-rising prices, we switched to Verizon FIOS as soon as it was offered in our neighborhood.
Since we switched in the middle of a billing cycle and still owed Comcast for a couple weeks of our service, I called them to see how much money I needed to send.
After wading through the auto-attendant system, I finally had the chance to select an option to speak with a representative.
Here’s the clincher: the voice prompt said, “If you want to speak to a representative in person, the charge will be $4.95.”
I was floored. Since when do I have to pay to find out how much money to send Comcast? Clearly, this is a case of the bean counters running “customer service,” looking at this as a cost center, rather than an opportunity to touch customers, cross-sell and upsell.
Obviously, I hung up and did not pay the fee.
The crack customer win-back team from Comcast called a few days later, asking what it would take to get me to switch back.
I just started laughing and told them if they would like to know that answer, the charge will be $4.95.
They hung up.
Best regards,
Doug Morgan
P.P.S. This is the final “Business Common Sense” of 2007. I—and the entire team—wish you a joyous holiday season and a healthy, happy and prosperous New Year. See you January 8, 2008.
Takeaway Points to Consider:
* The kid brother of a friend of mine was a bright guy, but a whiner. He was not happy in his job and told me that he could make twice as much money going on his own as a consultant. When I suggested that he go for it, he shook his head and said that he would lose his benefits. I suggested that if he was doubling his income, he could buy benefits. He stayed on the job until he was fired the following year and wound up with no job and no benefits.* One of the great tragedies of American society is the health care morass. Congress—in thrall to the big money from big pharma, the insurance industry and trial lawyers (who flourish in the world of medical malpractice)—is incapable of action, certainly in my lifetime and very likely yours. All the talk about health care reform in the current presidential campaign is hot air.
* I am no expert on insurance, but for what it’s worth, when Peggy and I were running our business out of our house in Stamford, Conn., we bought high-deductible health insurance. I figured that if I broke my leg, I would pay. If I broke my back, the insurance company would pay the bulk of it. As someone pointed out, automobile insurance does not cover brake jobs and tune-ups.
* In the hotel world, the full retail cost—the amount charged for a room that you will find on the notice on the back of the door—is called the “rack rate.” This is what you pay if you walk in off the street with no reservation. People with no health insurance are charged the rack rate for medical services in order to make up for the poor who get medical care they cannot afford and who, by law, cannot be turned away.
* If the Himmelstein-Woolhandler statistic (see “In the News” or link below) is correct—that $350 billion is being “wasted annually on medical bureaucracy”—then we have a market-driven health care system that clearly favors profit over the patient and should be changed.
Web Sites Related to Today's Edition:
“I am not a health reform,” Himmelstein & Woolhandler, New York Times Op-Edhttp://tinyurl.com/3xnev6
Emergency Room Health Care Costs
http://tinyurl.com/2ehgcg
Central Intelligence Agency: “The World Factbook”
https://www.cia.gov/library/publications/the-world-factbook
World Infant Mortality Rate (deaths per 1,000 live births)
http://tinyurl.com/24s4d7
World Life Expectancy Rate (at Birth)
http://tinyurl.com/yrq7l8
World Death Rate (Deaths per 1,000 population)
http://tinyurl.com/35yaat
A Spectacular e-Christmas Card from London Direct Marketing Whiz, Drayton Bird (with sound). To turn pages, click on the bottom right or bottom left of the book.
http://www.draytonbird.net/xmas/xmas.html
Season’s Greetings from Jacquie Lawson
http://tinyurl.com/yroba4
Companies Mentioned:
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My cousin, who is a doctor and director of research for a national health care conglomerate, told me: "Our U.S. system of care is not a system and doesn't care." How true.
Four hours in a U.S. emergency room? Most Canadians would love that! The average wait in a Calgary emergency room is now 15 hours. The concept of Canadian health care is basically a myth. My husband and I are required by law to pay around $200 per month to our provincial government for health insurance, and we also have to pay for numerous services on top of that -- everything from getting our doctor to fill out a form to getting a ride in an ambulance. What's worse is that under our socialized system we do not even have access to some medical treatments available that you have in the U.S. When my father was diagnosed with prostate cancer he had to travel to California to be treated at the Loma Linda University medical center. The treatment he got doesn't exist in Canada! Instead of the cure available in the U.S. for prostate cancer, the "cures" available from Canada's medical system are barbaric treatments that leave men infertile and incontinent. The woman who mentioned going to Canada to give birth should rethink that. Recently a woman with a high risk pregnancy (multiple births) had to be flown to Montana because there weren't enough beds in Calgary hospitals. Yet our province has billions of dollars in revenue.
I thought it was bad that I'm paying $400-500 a month (for lousy coverage) as a self-employed person. Lately I'm hearing that some people with employer-provided insurance are paying close to that.
We have a mass of people with no coverage. We have $35K working stiffs who pay thousands per year for health coverage. We have people who are being denied coverage, or who are forced to pay outrageous sums, due to pre-existing conditions.
And we have GOP candidates who continue to make cynical soundbites that any attempt at reforming this ludicrous system are somehow practicing "socialism."
Health care is probably the single issue that will determine my 2008 vote. If President Hilary can slip me into the Medicare system, I'll be happy.
Try having a baby! This will be my first child and I am almost tempted to be on a trip in Europe or Canada
when I give birth! If you do have insurance in the
US watch out, the DR?s push you for every test (to be safe from a lawsuit my A$% - it is to make more money) and then their billing companies bill you incorrectly and cause you hrs of headache to get it fixed. I am still in shock at the inefficiency of medical billing and the "system." The best words to describe medicine and health in the US is "cosmic joke." Don?t get me wrong we do have the best surgeons in the world (kudos to the surgeons who saved my dad?s life twice) they would have to be, since they are getting paid a lot!
But for everyday health needs?..we are way behind the curve. I blame the FDA and their friends at the drug companies.
I often contrast my medical experiences to the time my husband and I went to Portugal and I caught a cold and terrible cough. We went to the "pharmacia" told the pharmacist what was wrong, they gave us some cough syrup (all natural mind you) and I was cured in two days. The cost was $7. Mind you when I went to the DR?s here for the terrible cough, I was prescribed antibiotics and cough medicine, total bill about $235.
To make it even more of an amazing story, I have not had that nasty cough since our trip to Portugal 6 years ago!
So, is Michael Moore right? Of course he is. Will anything get done about it? Nope. We have turned into the same country we fought against to create our own country. The only difference is we do not have an official Monarchy nor do we have Lords and Ladies. We have Big Brother Sam.
A great story to end the year with, Denny.
Two thoughts/observations:
1. I once had the pleasure of hearing Lewis Thomas (Notes of a Medicine Watcher) speak about his career and the decision to pursue medicine. He stated that income wasn't a factor because as the son of a doctor he knew that you were likely to receive a chicken in payment if you were paid at all. How many specialists would accept such terms and uncertainty today?
2. Orwell came to teach us to watch the language. In the US we don't talk about health, we talk about the healthcare system. And as you point out, that is an expensive back end that sucks dollars out of patient care and redirects part of it to the employees and shareholders of insurance and pharmaceutical companies. In the US we defend this as the wisdom of the market. And I fear we will continue to do so until there is a catastrophe.
Best wishes to all for the New Year.
Wow! I thought I was the only one who noticed the problem. All my friends are so happy with their insurance. Fact is if you need to change insurance companies as we did, it is almost impossible unless you are a teenager. We got caught in a death spiral group plan. Now we will pay twice as much for health insurance as for food...if we don't get sick.
On a side issue, how about making a law against advertising prescription medication in public media? All the drugs I'm supposed to ask my doctor about are very annoying and cost us money if, god forbid, we need the drug. After the warnings that a rare side effect might be symptoms of Ebola they should add that if you ever take this drug you will no longer be eligible to get medical insurance. Maybe a Surgeon General warning label is needed.
Denny, thank you for your great publication. Have a happy new year.
Len
What a political football! Knee jerks in all directions: Can?t trust boobish Feds, greedy insurance carriers, inscrutable hospitals. Or Harley/SUV owners who can pay for insurance but clog the ER. Poor people, immigrants, illegals drain the system when gov?t mandates their medical care, but not legal taxpayers. Pharma kites costly non-cures (with insidious side effects). Inept doctors cause pain, grief, lawsuits. Trial attorneys make it all adversarial? Humbug!
Can we at least agree?
Pain has first priority?
Medicos must provide good diagnoses & skillful treatment?
Cumbersome Medicare is a bargain when retired folks pay 1/5th as much without it?
Medical costs kite our national inflation?
Some people/programs/orgs gouge us sometimes?
We?re better off taking better care of ourselves?
Seeking less cost for care doesn?t mean we?re communists?
Only those who can/will pay are entitled to medical coverage/treatment?
Can we really agree on that last one? I?ve got mine; yours is up to you? Hey, we?re more than our ideological biases. How do we find a fair solution for all? Chasing "market forces" may be a fool?s errand, and less bureaucracy is the goal, not more.
Bite the bullet. For any solution proposed, lobbyists/political opportunists will bang the door for big government, small government, insurers, hospitals and stockholders, Harley and SUV dealers, pharma, the medical establishment and justice (in trial lawyers? clothing).
Press for compromise, or nothing gets done.
I am so tired of the "European health care is better than US" argument. I think this is the comment of anyone who has limited experience in actually living abroad and interacting with locals. I spent most of my youth in Europe - and have been aware that health care is less expensive, but it too comes with its own price: QUALITY OF CARE
This summer it took me 3 1 hour (wait plus visit) trips to a similar facility as the one described in your friend's story . After two different courses of highly expensive antibiotics I finally got a decent doctor who knew that I had strep throat (as I had translated several times before). Sure, the doctors office was cheap, but the quality of care was sorely lacking. Why is it when someone in Europe needs intensive or risky surgery they go to private physicians or come to the US. I dont disagree that our health care system has issues (how can a procedure cost $4000 but after my insurance company's deal with the hospital make it only $1000 (?) of which I only need to pay a percentage. The socialist European system has its faults too. Let's instead focus on the fact that our system is abused by those who needlessly run to a doctor or the darn emergency room when they have a hangnail, those that are in this country illegally and those that take no responsibility for their own health... thanks, but I dont want the feds near me or my body...
Regarding nuclear power, and the comments about it's safety and waste products, few Americans, including one of your commentators, knows much about it. If one had to choose between the following: 1. Sleeping every night with another person, 2. Watching TV, or 3. Sitting on the fence of Three Mile Island during the "crisis" everyone remembers... Which would you choose?
Here's the juice: The answers are in order of their danger from radiation. Potassium 40 is a naturally occurring radioactive isotope, and it's in your body right now. We get it from the food we eat (bananas, anyone?). Nuclear power IS the future. The Luddites that fight it are the biggest danger to the world, because they have forced America to continue down the path of fossil fuel dependence 30 years beyond where we could be energy independent. If we could outlaw tree-huggers, then we'd never have to turn a light out to conserve energy, or worry about our power bills, as they'd approach zero as time passes, because that's the inevitable transaction cost of a virtually renewable resource, a la nuclear fusion. For example, a fusion process using only deuterium from sea water would have fuel for 150 billion years. That's billion with a B. To put that in perspective, our Sun won't burn that long.
My daughter has been studying in Germany for many years studying Opera. She has always been treated well and had her medical needs met without any hassle. Because of my wife and I experienced career changes in midlife we lost our medical coverage for several years. At least twice I almost died of asthma attacks because I didn't have coverage and wouldn't run up a bill at the hospital I couldn't pay.
To claim that people are at fault for not having medical coverage shows an incredible lack knowing of knowledge of what is happening in our country.
I am also sick of those who want to claim we have the best medical care in the world. The story about Omaha is not sensationalized it is the norm. We pay astronimical sums for medical care and still have the nerve to attack socialized medicine claiming it costs more! Have you checked you r taxes lately and conidered what you get for them?
I've been telling a similar story myself for a couple of years with one caveat. One was the veterinarian that treated my Cocker Spaniel and the other was the Primary Care Physician that treated my daughter. The dog received much better care!
I'm with Denny on this one. My wife and I earn about $80,000 a year, and my company pays 95 percent of my health insurance. I still pay fully 25 percent of my salary toward healthcare. Because the company pays nothing toward my family's premiums, the 3 of us are on 3 different insurance plans with 3 different deductibles. It seems like every time we go to the doctor, they want to do a CAT scan or something equally expensive. Recently, I had a sleep study done at a cost of $1,800. The insurance didn't cover any of it and applied only $800 toward my deductible because that's the amount they would have paid if they had covered it. So even though I have to pay $1,800 out of pocket, I don't get the full amount applied to my deductible. That $2,000 deductible effectively becomes a $5,000 deductible. My wife has a chronic illness (Lupus), so her income is limited because she can't work the physically demanding job that she used to work (restaurant management). In Illinois, you're either disabled or not; there's no partial disability. So we suffer from increased medical expenses AND reduced income potential. It irks me when I see one of our friends, who purposefullly had a child out of wedlock and has a welfare medical card for him. Her income is a fourth of mine, but she lives just as well. Her car is newer; she pays $40 a month in a rent-controlled apartment and has no medical expenses. Sometimes it feels like it doesn't pay to get ahead.
It is unfortunate that you do not know anything about the realities of socialized coverage.
It does not work. In England where they had terrible medical coverage for 49 years and finally went on a plan which you can pay for your own health care if you want to. Sweeden and other european countries are trying hard to get off socialized medicine. Using Canada and England as examples, socialized medicine is rationed. 2500 older people in England die each year for lack of hospital beds. It takes over six months to get a knee operation which in many cases the wait makes you a cripple. People die waiting for heart operations. In fact medicine is held back because of money problems. Need Alzeimers medicine? Not available. Cancer medicine rationed or none at all. Other important medicine not availible. Smoke, overweight not allowed in hospitals. Lottery for operations. Over 55? Try and find a doctor in Canada. Medical decisions by accountants not physicians. In mnay cases they tip the scale for the patient to die rather then supply the proper treatment. Hospitals that are dirty, muggy and old. The reason is that the costs were more than 5 times what they expected and continue to rise.
Read the articles in the British, European Medical Journals as I do. You get a completely different picture.
Our problems started with the great society with the US government getting into health care and has been helped along by the more than 13 million illegal alliens that are taking the service away from US citizens. 47 million without health care is a phoney figure. Poor citizens have medicaid and older citizens have medicare. Each of these are far better than socialized medicine. There are other families that choose 2 cars, 2 television sets rather then medical coverage. You have the best medical coverage in the world right here even with all its problems. OOPS it does work in one little country. Do you know which one?
Having had a similar experience in Austria and in England, i agree that we make it too hard and too expensive. Litigation has contributed a lot, i am sure.
The 'emergency room' scenario your friend had is a wild contrast from my one time in an emergency room in Anaheim CA. Doubled over in pain from what turned out to be a ruptured cyst, i had to wait 6 hours to get attention. Why? Because all night long, people were bringing their kids in with fevers, which can't be ignored, and of course in Anaheim there were also a few gunshot wounds, requiring immediate treatment.
Here is the deal: if families were insured, they could go for preventative care or see a doctor outside of the emergency environment. But none of these people were insured. What politicians (who have GREAT health care programs for themselves) don't understand is this: people without health care cost the system MORE money than if we had universal health care. Diabetes would be caught earlier, colds might not turn into fevers as often... but the taxpayers end up paying for all of that when someone is too poor to have insurance and cannot pay once they get to emergency.
I think that every single person holding public office, especially senators and congressmen and the President and VP, should have to purchase their own health care (and possibly be denied) so that they can see what it's like to live like a real American, not a highly privileged one.
Here's the deal...Yes, the healthcare system needs revision...No, I don't want a government that can't manage Social Security to take over my health care.
This article clearly suggests the government can do it better. Can you spell socialism? As one individual wrote - if the government is controlled by the pharmaceuticals, and insurance industry, why would you put it in their hands for more of the same?
I am tired of hearing talk show hosts exclaim I am not "entitled" to health insurance. Yes, I am! I chose a company that offered the best benefits, and insurance is part of my compensation. Just because I am not on welfare, does not mean that I am not "entitled". I made myself valuable and negotiated for insurance and other benies. I am tired of people bemoaning the fact some classes of people (poor) can't get insurance. Let them get off their butts, get an education, get a job and make themselves valuable. Insurance is available to a good worker.
And, to the comments about personal poor health habits overtaxing the system?right on! Not all problems are avoidable nor all diseases deserved. But, for overeating, lazy Americans, you get what you deserve. Walk through a Wal-Mart, count the obese customers. Shocking! Watch how many are using electric carts because their fat butts cannot walk the store. Spend a Saturday night observing in an emergency room. You'll soon stop trying to be PC. It is filled with drunks and bums and the few people who really need the services wait for hours.
Somebody's got to say it! Stop whining. But most of all, do not turn my health care over to our government.
Ugh. I cannot believe that you would listen to anything Michael Moore had to say.
Denny, I have to say that this is a very biased column. Go back and read your accounts of the two visits. The Omaha visit was much more sensationalized.
Anyway, statistics are (all) easily skewed. All of the millions of Americans who cannot get health insurance could have bought it had they not waited until they were sick. That is like calling your insurance agent to get fire insurance on your house after it has caught fire.
I do agree that there needs to be some sort of reform. Unfortunately it requires politicians (and their own agendas) to do so.
For every one of your Germany stories, I hear 10 foreign healthcare stories that contradict it.
A sensationalist like Michael Moore finds stories like yours and ignores stories like the ones I hear.
Socialized medicine? Bah! Take the Medicare system, add the Department of Motor Vehicles and wrap it up in the Internal Revenue Service with an overall design from a politician and double or triple tax rates and that will be your sole medical care provider. You will pay more and get less.
No thank you.
Yes, Michael Moore is 100% right. That story pretty much says it all about our health care "system" (if you can call it that) vs. those in other developed parts of the world. But it should be no surprise, really: this country is largely based on "I've got mine, Jack" over social responsibility, so why should medicine and health be exempt?
Denny.... Michael Moore is always on to something, and always being discredited due to hostility from people with can't bear to have him question sacred cows. I had same experience in Santa Rosa CA as Joyce did in Omaha. Middle of the night, 4 hours to see someone when I was having symptoms of exceedingly high jump in blood pressure (turned out to be from licorice in food). I was misdiagnosed, sent home to find a pharmacy with a high sugar low fat diet to follow and a $1200 bill that I had to pay for myself. God Bless America!
As someone who is healthy and pretty much only needs an annual with 2-3 doctors...I'd rather pay an affordable out-of-pocket fee to the doctor. It's health insurance that is driving medical costs up.
Why are we paying tons of money each month into a service we don't use?
Doctors have said over and over again: eliminate the insurance, and doctors' prices will go down.
Everybody clings to health insurance like their life depends on it.
Moore's criticism of our system is right. His proposed solution is wrong.
He just wants to take what is already screwing up healthcare (insurance for basic affordable care) and make it more complex, bureaucratic, and costly.
If we want to talk about catastrophic coverage...ok...that makes more sense.
I also had the same condition Joyce did, two years in a row. Two years in a row I had to wait for what seemed forever, in an emergency room. I thought I would pass out from the pain! The doctor gave me a shot and a prescription. Thankfully there was a 24 hour pharmacy nearby. The fact that I had insurance did not expedite the process whatsoever.
While on my honeymoon in Costa Rica I fell horribly ill. Our room did not have a phone (my husband woke up the manager), the clinic was closed and the nearest hospital was 2 hours away. An ambulance came with a doctor and a paramedic. I got an EKG to check my heart, two IV's, medication and a presciption. When it was all over, the doctor broke out a credit card machine and asked how we wanted to pay the $300. The next day I was as good as new.
According to Sicko, The US is below Costa Rica in health care. Wow, if I ever relocate...
To the lady with fibromyalgia, my friend manages hers very well with herbs, vitamins and diet. She lost weight and feels great. Worth researching.
To the gentleman's point regarding higher taxes, you're right, taxes are very high in countries that cover health care. I would be willing to pay if it meant a better quality of live overall. As it stands my husband has to have an HMO (which we all know sucks) beacuse the premium is paid by his employer (thank goodness) I am self-employed and the only insurance I can afford with my pre-existing heart condition is a high deductible plan. Paying for the new brakes...
Danny, tell Joyce to check into what is called a TVT. It did wonders for me!
The company at which I am employed covers half my health insurance, which is through Anthem - a Blue Cross company. I pay $400.00 of the $800.00 monthly premium for families. Even $400.00 is a lot of money for someone in sales. But let's consider what it gets me.
I have a yearly deductible of $3,200.00. I must meet that deductible before Anthem pays a dollar. A recent clinic visit to bandage a badly cut finger? $215.00 for two visits totaling 15 minutes. I will continue to pay 100% of my hospital visits and prescriptions until I've spent that $3,200.00.
So of course, if I'm feeling a strange pain or notice a scary mole, I have to decide if I can afford the $100.00 to have a doctor even look at it. All the while, sending $400.00 a month to Anthem as a way of thanking them for covering me.
The system is a joke for anyone relatively healthy. This is the best my employer could offer us. Something had better change soon, or things will go from terrible to ... worse.
What about alternative healthcare models like this one from a blog-famous Brooklyn Doctor?
http://www.jayparkinsonmd.com/About.html
I'm not so sure I agree with you this time, Denny....a good friend of mine traveling in England last year got an in-grown hair, suffered an infection and died from a blood clot after surgery within 5 days. The hospital care was like a bad horror movie. Had he been in the US, I am more than sure he would still be with us - even if the bills were higher. I would pay any amount of money to have him here.
For those of you who feel they "shouldn't have to pay for other people who don't have insurance," you already are. As an earlier poster noted, people without insurance crowd into the emergency rooms. That's the most expensive form of treatment. And if they can't afford the treatment, who pays for it? You do, through your higher insurance rates.
Also, with regard to malpractice, malpractice activity in the courts has not increased at a rate that's anywhere near the hikes in malpractice insurance. In many cases, the insurance companies are jacking up your rates to cover their bad investments and then telling you it's because of malpractice.
Finally, take a look at your state's medical association and medical board and see how many doctors are actually ever punished for malpractice outside of the courts. The answer is not many. If doctors don't want to be sued, they can start by cleaning up their own ranks. But self-policing systems among professionals are not renowned for high standards.
I have Fibromyalgia, asthma, and a really bad shoulder that needs surgery, live in Texas, work for myself and cannot get health insurance. Oh they'll let me have catastrophic at a rate higher then my monthly house payment; with a $5K deductible and pre-existing condition wait.
What does this mean? I'll end up disabled (can't get care ongoing care, so I will get worse) and the regular people will be paying for it!
Why? All because of the GREED of the insurance companies and the pharma industry. Oh yeah and the politicians in bed with them.
Thanks for helping to make my life one large worry.
Ann Wilson
A great article as usual! I did want to address the comment by Jay regarding taxes in Germany. He is correct in stating that the tax rate is higher, and that tax revenue is used to subsidize healt care costs; however, that subsidy is for German citizens (and other EEC countries with reciprocal insurance arrangements). What Joyce will have paid was the "full retail price" for the services received. The point being, if that's what those services cost in Germany, why are they so much hgher in the US?
As a foreigner I can only say this... the american health care system is hilarious.
Till 3 years ago my parents used to stay in Florida during the winter. Once, my mother needed some minor surgery, stayed for two days in the hospital, got a few pills and was charged around 40,000 USD which she refused to pay.
The hospital unwilling to reconsider the bill, my father threatened to sue them for a few millions because 3 months earlier he mistakenly was diagnosed with terminal cancer and having only a few weeks to live, by a doctor of the same hospital, necessitating an emergency repatriation to Europe which, once there, was declared to be medical nonsense.
"Curiously", the bill was dropped significantly to another amount... ridiculously low this time.
I think our poor statistics have more to do with a lack of health than a lack of health care. Far too many Americans, apparently, could care less about what they do or don't do and its consequences to health. I would like to see those same statistics set against health care system utilization. By the way, Michael Moore, to look at him, is one of the reaons that we over utilize the health care system.
Thought provoking blog as usual. Though I fear anything that provokes people into thinking government might make any system more efficient. By the way, Cipro is an antibiotic, not a painkiller.
I agree, Denny. Your life and health ? and mine ? are far too important to be left to the gentle ministrations of an insurance company out to make a buck.
If you'll permit me two small cavils:
1. Cipro is an antibiotic, not a painkiller.
2. Malpractice insurance rates are a red herring. I live with a doctor. She and I socialize with doctors. While they all carry malpractice insurance, I've yet to hear one of them complain that they really fear a lawsuit. Once again, it's insurance companies, out to make a buck, that are largely to blame for malpractice insurance costs.
Malpractice rates usually go up in bad economies ? because insurance companies want to keep increasing their earnings and rates are the strongest tool they have. Meanwhile, malpractice lawyers cull the herd largely of drunks, incompetents and people willing to experiment with your life.
Would that the law permitted lawyers to go after insurance companies that kill people by denying them treatment with the same vigor!
We need a single payer system, like Medicare, for everyone.
Just for the record, Denny, you should also look at the tax rates between Germany and the US. German medicine is paid largely through taxes - and I doubt you would be happy with your tax rate doubling or tripling for health coverage.
Denny,
I had a similar waiting experience back in April when I suffered an appendicitis attack. I waited way longer than 15 minutes to have a doctor examine me, even though a ruptured appendix is potentially fatal.
My _perception_ (cause i'm no expert on this) is that waiting rooms are filled with people who don't have health insurance who are seeking treatment for non-threatening conditions since they don't have a family doctor.
I assume that universal health care would resolve this.
Enjoy your column, Denny. I was trying to verify the comment included regarding Comcast charging to talk to a billing representative. I can't find any references to it on their website, but that doesn't mean they don't do. Is this regional? Thought you may have some more info on the validity of this...
Thank you!
My research is backed by 4 out of 5 US doctors who agree with me that the World Death rate for the US is 100%, not the 8+ per 1,000 reported, and it is tied for First Place on the World Death Rate Rankings, between Canada and Mexico.
Denny,
You're onto something here. The biggest fraud perpetrated on the American people is the defining terms that are used in the political health care reform debate. It has nothing to do with health care, and everything to do with health care insurance. All these so-called "universal health care" bills does is require everybody to buy a health insurace policy. How about a law to require everybody to buy a subscription to my newsletter, call it "universal information reform." The bottom line in the health care debate is that it is about insurance. And the bottom line for insurance is profit. We need to get rid of the middlemen who are raking greedy undeserved profits from the illnesses and diseases of the American people, dispensing taxpayer-funded notions, potions and lotions at exhorbitant costs. Why can't Medicare buy drugs and dispense them the way the VA does? Why can't wasteful insurance companies be put out of business by a government that pays health care costs directly to doctors and hospitals? You've touched a nerve, Denny.
The infant mortality rate statistic (the bracketed ones) seem off to me. I was able to deduct that when you said the statistic was bracketed between two other numbers, it meant it was between the two. (One would be higher, one lower).
You write in your article:
"The United States ranks 41st with 6.87 deaths per 1,000 live births, bracketed by South Korea (6.05) and Croatia (6.60)."
I would assume that would mean the U.S. would rank in between 6.05 and 6.60 however it is at 6.87. One of these statistics is off!
Thanks! Enjoy your column!
Rebecca Hauptman
Owner
Purify Your Body, Inc.
Thanks for a _very_ illuminating story.....clearly there is a ton of misinformation (dare I say "propaganda") that influences the way we think about healthcare in the US - but nothing beats back BS like real experience. We do need to take a critical eye to all sources of info which may - and often does - have an agenda; after all, as marketers ourselves why should we forget that what we do - trying to influence others to make certain decisions - doesn't apply when we watch the "news" or read a paper? "All news is gossip", as Thoreau once so eloquently said. A healthy dose of criticism is a healthy way to process any bit of info.
Thanks for a great story.
I agree with you Denny, about the health care morass. It stinks here in America. I am hoping & praying that the next elected President will address this forewright and get congress to fix. My advocation is the following:
1. Give tax credits to everyone to be able to afford health insurance.
2. Get the damn lawyers off the physicains backs--we need tort reform.
3. Open the floodgates so that folks can shop for health insurance across state lines and just like auto and life insurance. This will lower the cost of insurance as the market will be a lot more competitive.
I am opposed to government run health care because it is just too expensive and beauracratic.
Have a wonderful Christmas Holiday.
I thought "Sicko" was an awesome film! It made me laugh and get angry at the same time. America should look at healthcare in other countries and adopt those practices. Unfortunately, it probably never happen unless citizens start a revolution.
By the way, when I used to live in Texas, there was one hospital that had a pharmacy in-house - the only hospital I have seen since. I have always wondered why more hospitals don't do that. That pharmacy was probably a godsend to patients, especially before the 24-hour Wal-Mart came to town - but even so, the pharmacy is not open 24-hours (yet) in that Wal-Mart. People in America forget that not every city has 24-hour services like major cities.
I agree: our health insurance and medical care system are a disaster, especially for small business. Individual coverage is basically unaffordable for most small business people; without dramatic change, we'll see fewer and fewer people willing to take the risks and start or operate businesses. And the politicians have no desire or willingness to make any changes: they personally have good coverage, and receive way too much money from the parties involved. Guess that's how it works when our government is owned, controlled by, and operated for the benefit of a few huge multi-national corporations with no loyal to any nation or its' people.