FRONTLINE: Sick Around America (pbs)

[Justin]

I was going to post this in the Non-Spine related sub-forum, but the topic of this video directly relates to the spine patient community here. This video is excellent and discusses the insurance epidemic in America.

It is well worth the time for anyone interested in the future of healthcare in America to set aside an ~hour to watch this:

FRONTLINE: Sick Around America (pbs)

[runner]

Justin,

Thanks for the link.
My husband is going to download this for me as he has it on his computer. I couldn't access the video from the link, but I read some of the transcript and then the letters commenting on the program.
Seems like eighty percent or more mentioned single payer health care. Although the site is closed, I might just write Frontline directly. I loved the comments by the chief medical officer at WellPoint (Anthem, Blue Cross). I guess they consider ADR an unproven, incorrect treatment and I suppose they also consider other medically necessary treatments in the same light because they sure love to deny treatment. The health insurance CEOs and for-profit scheme needs to be exposed like the banking industry was exposed for its greed. After all, the health insurance companies know more than the physicians that are actually taking care of patients.

Runner

[Justin]

Originally Posted by runner

Justin,

Thanks for the link.
My husband is going to download this for me as he has it on his computer. I couldn't access the video from the link, but I read some of the transcript and then the letters commenting on the program.
Seems like eighty percent or more mentioned single payer health care. Although the site is closed, I might just write Frontline directly. I loved the comments by the chief medical officer at WellPoint (Anthem, Blue Cross). I guess they consider ADR an unproven, incorrect treatment and I suppose they also consider other medically necessary treatments in the same light because they sure love to deny treatment. The health insurance CEOs and for-profit scheme needs to be exposed like the banking industry was exposed for its greed. After all, the health insurance companies know more than the physicians that are actually taking care of patients.

Runner

You will love the video...the comments from the "big wigs" from the insurance companies, like you mentioned, is very telling.

I just checked the link and it works for me. You might have to click the small "play" button instead of the big play button on the video screen itself.

This video is incredible...healthcare in America is changing. The insurance companies are evil and need to be stopped.

[Kathy]

I haven't watched the video yet. I can't figure out how to turn the sound up on it and my kids are being too loud for me to hear.

I am fortunate enough to be able to afford self-employed coverage; but not all can. We pay, on average, $15,000 a year out of pocket for health insurance and out of pocket expenses. This is assuming that I am the only one requiring tons of care. The year I was in the wreck, we spent over $20,000; because my husband had back problems and my daughter had numerous ear infections requiring tubes. So, I definitely see why not everyone can afford care.

I do know that something needs to be done about healthcare in America. I am not sure what that something is, as I don't want a system like Canada's either. As we have seen and heard, from several of the Canadian posters on here, their system is partially broken too. Their system is goverment influenced and dr's work for the goverment, not the patient. I have also not heard of anyone having ADR in Canada. I have been told that people have been reimbursed for out of country surgery; but what about those people who don't have the money up front for surgery? Must they wait years to get approval? Months to see a dr? I write this about the Canadian system, not to bash their healthcare; but to point out that the grass is not always greener on the other side of the fence. I have heard so many Americans say how we need a system like Canada's. Which sounds great, if you haven't heard the real stories of people fighting that system.

Our system is crazy broke too. Did you know, that in the state of Texas, there is no such thing as self-employed maternity coverage? I called every insurance company under the sun looking for a policy that would cover maternity, before I was pregnant and was told that there is not such a thing. The only way you can have private maternity coverage is through an employer (because the big insurers have to offer it, because the companies must offer it to their employees as to not discriminate). So, even though I had healthcare (that my husband and I privately paid for), it would not cover either of my pregnancies.

[Justin]

Kathy, I understand where you are coming from. I'm not in favor of a system like Canada's. However, there are many countries with universal healthcare, which has many definitions by the way, that actually works.

I know this topic can be a hotly debated one, so I'll just keep my comments short and sweet.

Our current employer-based model is an utter tragedy, as is the entire for-profit model really. I have no idea why people think it's a good idea that a CEO of BC/BS of whatever state gets $20 million a year. The insurance companies make the most money when they deny claims and raise premiums. (I do realize that insurance companies generally make money by assuming risk for a lot of people, and then paying for catastrophic events that happen to a few.) The amount of overhead and the amount of administration--at least 24% (between 30-40%) of every healthcare dollar in the US is spent on administration--that is required to navigate our healthcare system is terrible.

When it comes to delivering adequate care to people in this country, one talking point is driven by greed while one is not. We've seen recently how greed works out haven't we? Not to mention that healthcare delivery is not selling iPods, maximizing profit does not necessarily mean best care, in fact I would argue that it almost has to mean inadequate care in our current system.

Of course there are downsides to every healthcare delivery system, but I'd like to remove greedy profit-driven individuals from running the show.

My biggest problem is that insurance companies have no problem insuring the healthiest individuals, but the second you're too poor, malnourished, illness stricken, unemployed, chronically ill, old or disabled, they kick you into Medicaid and Medicare. They have absolutely no problem extracting the maximum amount of profit right up until it isn't profitable, then they kick it to the taxpayers to pick up the slack.

However, I do believe a big piece of the problem is that people have the mentality that they should be taken care of regardless of their lifestyle choices--no matter how bad they may be. We have an obesity epidemic in America (as an example) and we, as a nation, must make preventive medicine a priority. We must be preemptive with our healthcare and not wait until the type II diabetic needs a kidney transplant. It's as if we need to establish some sort of incentive-based healthcare plan, so that people will actually live healthier.

Self-responsibility needs a resurgence and at the same time, I believe, people should be entitled to basic healthcare coverage.

I know I am greatly simplify an incredibly tangled issue, but I'm just trying to share a few thoughts.

PS...Kathy, it truly is a shame that your pregnancies were not covered by your insurance. It's examples like this that irk me.

[Kathy]

Justin,
I hope you didn't think I was saying that I believed in the for profit legal killing of people they are doing now.

I completely agree with everything you said.

I think that Obama's idea/plan of rewarding people with insurance and penalizing people without insurance is a good idea. The system has to have healthy people in it to work. And you and I are prime examples of young and healthy people, aside from our backs. Yet, we ended up needing major care, luckily I had insurance. My brother on the other hand, decided to buy a Mercedes and a new house and not have healthcare. He was diagnosed with cancer 15 months ago. He now is paying the price for that decision, he needs a massive tumor removed and can't afford the surgery. He took a gamble on his health and lost.

I know there are a ton of people who truly can not afford health care and we do need to take care of these people. But there are alot of people , like my brother, who can afford it and choose not to. They choose new cars, clothes, bigger houses, etc. This is where I think Obama's plan would help give these people an incentive to have health care, thus adding healthy people to the system.

I also think that the goverment needs to make laws to better govern the health insurance industry. Where insurers have to offer everybody, regardless of medical history, health insurance. For the same price and the same coverage as someone else of the same age would get. I also think that they need to not be able to charge older people as much as they do. My mom is 53 and pays $500, for just her private insurance (and not great coverage). Older people on fixed incomes can not afford these kind of rates, that just go up as they age. They need to mandate that FDA approved surgeries, drugs, procedures, whatever is covered by insurance. Now, the obvious problem with all of this is, if everyone is pulling out of the system and there are not enough healthy people in the system, it will go bankrupt. Especially if people can get insurance, regardless of health history. What would stop someone from not having it, then they get diagnosed with something, so then they get coverage. Kinda be like wrecking your car, then buying insurance to pay. Well, it wouldn't take long before no one would have coverage and just wait till they got sick. Hence the need for something requiring people to have care.

Anyway, this too is oversimplified. I don't know the answer to the problem; but do know it is a problem. There is not any oversight, it is like the Wild West, the insurers can do whatever they want. In many cases, legally killing people, by denying them life saving treatment and they are getting rich while doing it. I don't know how they sleep at night. It is disgusting how sick and crooked our system is. I think we need more people, like yourself, willing to talk about it. If we all put our heads together we can come up with something. Yeah, people are going to disagree, you can't please everyone; but it can't keep being the elephant in the room either.

Just my opinion, would love to hear what others think. This is something that NEEDS to be talked about.

[Justin]

Originally Posted by Kathy Earhart

Justin,
I hope you didn't think I was saying that I believed in the for profit legal killing of people they are doing now.

I'm really slow...I'm embarrassed to say this, but I'm not sure what you are referring to here. See, I told you I was an "idiot."

I completely agree with everything you said.

I think that Obama's idea/plan of rewarding people with insurance and penalizing people without insurance is a good idea. The system has to have healthy people in it to work. And you and I are prime examples of young and healthy people, aside from our backs. Yet, we ended up needing major care, luckily I had insurance. My brother on the other hand, decided to buy a Mercedes and a new house and not have healthcare. He was diagnosed with cancer 15 months ago. He now is paying the price for that decision, he needs a massive tumor removed and can't afford the surgery. He took a gamble on his health and lost.

K-I'm so sorry to hear about your brother. Has he had any treatment at all?

I know there are a ton of people who truly can not afford health care and we do need to take care of these people. But there are alot of people , like my brother, who can afford it and choose not to. They choose new cars, clothes, bigger houses, etc. This is where I think Obama's plan would help give these people an incentive to have health care, thus adding healthy people to the system.

Like always, I agree with you. There are people that call an ambulance to take them to the hospital because they don't want to pay for a taxi. People will come in to the Emergency Department to get a script for Motrin to save $3 bucks, while Medicaid is billed $500. What really gets me is the people that come in with new jacks, shoes, clothes, have the latest cell phone, etc. but expect that their care and treatment to be free.

I also think that the goverment needs to make laws to better govern the health insurance industry. Where insurers have to offer everybody, regardless of medical history, health insurance. For the same price and the same coverage as someone else of the same age would get. I also think that they need to not be able to charge older people as much as they do. My mom is 53 and pays $500, for just her private insurance (and not great coverage). Older people on fixed incomes can not afford these kind of rates, that just go up as they age. They need to mandate that FDA approved surgeries, drugs, procedures, whatever is covered by insurance. Now, the obvious problem with all of this is, if everyone is pulling out of the system and there are not enough healthy people in the system, it will go bankrupt. Especially if people can get insurance, regardless of health history. What would stop someone from not having it, then they get diagnosed with something, so then they get coverage. Kinda be like wrecking your car, then buying insurance to pay. Well, it wouldn't take long before no one would have coverage and just wait till they got sick. Hence the need for something requiring people to have care.

These are great points. I am pretty sure I would be uninsurable right now if I had my 2-level ADR through my insurance in 2003 (which was not possible at the time). The number 1 reason people claim bankruptcy in America is due to medical bills.

Anyway, this too is oversimplified. I don't know the answer to the problem; but do know it is a problem. There is not any oversight, it is like the Wild West, the insurers can do whatever they want. In many cases, legally killing people, by denying them life saving treatment and they are getting rich while doing it. I don't know how they sleep at night. It is disgusting how sick and crooked our system is. I think we need more people, like yourself, willing to talk about it. If we all put our heads together we can come up with something. Yeah, people are going to disagree, you can't please everyone; but it can't keep being the elephant in the room either.

Thanks for your kind words. The really great thing about Obama (my opinion, of course) is that this discussion is even happening and that he is making it a priority. He might not have all the answers and people might not like the guy, but he sure is trying to tackle all of the major issues that are on his plate right now.

We really do need to talk about this issue, even if people disagree which is a given. Dialogue is key.

A really big challenge in the near future is that the baby boomers are getting older and very few young physicians are going into geriatrics. The primary care specialties (pediatrics, internal medicine and family practice) are being hit hard with fewer and fewer medical school graduates going into these fields. Why? Income. After 4 years of undergrad, 4 years of medical school, at least 3 years of residency with at least $200k of school loan debt / plus giving up most of your 20's and or 30's.......$120k a year is not very attractive to new grads.

Graduates are picking specialties primarily on what they will make as a result of insane increases in tuition. Loan forgiveness needs to expand and school tuition needs to be regulated in some way...