Posts Tagged 'Movies'

Stepping on Patient Empowerment’s Toes

Very interesting conversation yesterday with a gentleman named Anthony Cirillo….

Anthony and I are kindred spirits in a couple of different ways.  We both hail from marketing backgrounds with probably 50+ years of experience between the two of us.  And we’ve both identified a passion within healthcare — me with my Every Patient’s Advocate work, and Anthony with his Anthony’s Song work which takes him to senior centers and conferences across the country.

And we both believe in patient empowerment — big time — realizing that the more patients advocate for themselves, the better their outcomes, and therefore quality of life, will be.

How did we find each other?  Anthony lives near Charlotte, North Carolina, although he’s originally from the Philadelphia area (hey Ant-knee!)  I’m in Central New York State near the Finger Lakes, and the foothills of the Adirondack Mountains.  We are quite divided geographically!   

So we found each other because our passions — our patient empowerment work — turned up in news alerts delivered to email…. and voila…. now we’re discussing ways to collaborate in our work.

So all this leads me to the title of today’s blog post…. certainly neither Anthony nor I are stepping on patient empowerment toes! So what do I mean?

If you find my blog of interest, you’ll be quite interested in Anthony’s TWO blogs.  He’s expanding on the evidence found in Sicko through a new blog he’s just started — Sickoh.  And he blogs about elder-related healthcare and health non-care in his other blog, called AnthonysSong, too.

Both his blogs seem focused on those abuses of the concept of patient empowerment.  Of real interest to me is his post on the lawsuits filed by various healthcare entities against bloggers who speak out against them.  And whereas I try to turn my blog entries into lessons and tips for patient empowerment, he turns his into advice for those healthcare administrators who have begun floundering now that patients have found a public venue for their opinions and horrible experiences — cyberspace.

Patients will benefit from it all — because cyberspace has begun to level the playing field in many ways.  And because cyberspace provides a networking platform for people like Anthony and me to meet, and compare notes, and collaborate. 

I hope you, too, use this marvelous tool to help you in your quest to be a sharp patient… and if you’re a crusader like Anthony or me, I hope you’ll contact us so we can collaborate with you, too!

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Sicko Follow-Up: Misguided Notions

I’ve had conversations with dozens of people about Sicko in the two weeks since I’ve seen it. 

Here’s what I’ve learned in my informal poll:

One thing which is less about Sicko and more about a human frailty:  that the biggest critics of any movie are the very people who have not viewed it.  So with the wave of my typing fingers (or perhaps my delete key), I’m dismissing their opinions.  Haven’t seen the movie?   Sorry.  I’m not interested in your opinion about it….

So for the purposes of this post, I learned:

1.  That many are like me, moving their opinion bar gradually to embracing the possibility of universal health.

2.  That those who don’t think universal health care is an idea that’s time has come have never had a difficult health challenge, have some form of health insurance, and they think it’s adequate.  Little do they know…. although they are reconsidering now that they’ve seen the movie.

Snippets of conversations include:

“I never have a problem with seeing my doctor.  And my appointment lasts for almost an hour sometimes.”   (Then I ask — are you spending that much time with your doctor?  or with your doctor’s staff?)  “I spend time with all of them.”  (Then I ask — have you ever had a real health challenge?  Something beyond a basic, easily treatable or short-lived medical problem?)  The answer was “no” each time.

(When I asked a teacher how much her health insurance premium is..)  “I only pay $80 a paycheck.”  (Do you have any idea how much your employer/school district is paying for it?)  “No idea.”  (What if I told you there is a good chance your $80 premium is being supplemented by a $300 or $500 payment by your district?)  “Are you kidding me?  I had no idea.”

“Why are Americans entitled to a free education, and entitled to free books through libraries, and entitled to any number of services, but they aren’t entitled to health care?  What sense does that make?  They can’t be educated or read books if they are sick.”

“Universal Healthcare isn’t really free health care.  Nothing is free.  We would need a way to pay for it somehow.”  (yes, I expect money would still be deducted from paychecks but that money wouldn’t go to private insurers, it would go to whatever the universal healthcare entity is.)  “I wonder what would happen if I lost my job or got laid off and didn’t pay those premiums anymore?”  (I expect, just like you could draw unemployment, you would continue to get your healthcare, too, because you would have paid into the system already.)

“I have a friend who lives in Canada and doesn’t like their system.  He told me he hopes the US doesn’t move to a universal approach because he comes to the US for the care he can’t get in Canada.”  (Hmmm…. I would hate to think those Americans who can’t afford health insurance now would have to forego the possibility of care just so the Canadians with enough money can cross the border for care.)

“I don’t want the government telling me what kind of care I can get.  I didn’t send my kids to public schools either.  I want more control over their education and I want control over my healthcare choices.”  (Well then, I suppose there would still be private healthcare just like their are private schools.  One thing Americans have always had is a system of choices.  I don’t see that changing at all.)

So there you go — snippets only, but certainly representative.  I don’t see the conversation slowing down at all and I hope the ’08 presidential candidates will take note.

And for those who have never had a diagnosis that provides that punch in the stomach that a very scary diagnosis provides — try to put yourself in the shoes of the 40+ million Americans who have no insurance and figure out how you would manage a horrible disease or a chronic disorder… it’s not pretty.

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Find more of my commentary about Sicko here.

Read what other bloggers have said about it here:

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Why Sicko is Only the Tip of the Iceberg

Some final points about the health insurance industry — a few steps beyond Michael Moore….

Private — even not-for-profit — health insurance companies exist in this country for only one reason — to make a profit and to line the pockets of their employees. 

Hear me out…

They are businesses FIRST, many with investors to please, and as such, that is their requirement — to make money.  No matter what the business is, no matter how they do it, their number one vision, mission, goal, is to make money for themselves and their investors.  It’s no different than a pizza vendor or the power company or the state lottery.  Making money is their only reason to exist.

What that means is that the amount of money coming IN, must at least exceed, and at best FAR exceed the amount of money going out.  Even for the so-called not-for-profit health insurance organizations, they must bring in much more money than they spend, because their executives are making six figures — and sometimes more.  It could be the organization is considered not-for-profit, but that doesn’t mean they have paychecks that are anything less than those of their colleagues across the industry.

The only way they make money is by charging their customers — we patients and our employers — more money. 

They want us to believe that their costs are skyrocketing because the hospitals and doctors and pharmacists and other providers are charging them more — BUT — that is only partially true.  In fact, they tell the providers what they will pay — not the other way around!  Are we patients getting any sicker?  As a group — no. 

And don’t forget — on top of all that profit, they must continually pay out the expenses of lobbying state and federal legislators, not to mention donating to their campaigns…. and yes, that gets more expensive, too.

So think about it this way, taking a stab at the healthcare dollar you and your employer are giving the health insurers: 

  • a percentage is being paid for executive salaries, bonuses and perks
  • a percentage is being paid for administrative costs
  • a percentage is being paid for lobbyists and campaign contributions
  • a percentage must be kept to make investors happy
  • and then, whatever little is left over actually covers a PORTION of your health care.

Frustrating, isn’t it?  What’s wrong with this picture?

Here’s another way of looking at it:  in the health insurer’s perfect scenario, we pay in and pay in and pay in for as long as we stay healthy — then as soon as we get sick, they would just as soon we die.  Once we die, then they don’t have to pay out for our care!  Especially for those with chronic diseases, or something that needs newly developed treatments or surgeries — either we are uninsurable, or if they are already stuck with us, then we are denied care.  I suppose denying us service might be the only better scenario than letting us die.  At least then they don’t feel like our blood is on their hands.

Is it any wonder they employ people (like the guy in Sicko) who do everything they can to uncover reasons not to pay out?  Is it any wonder why they refuse to pay for “experimental” treatments? 

This is not about the human thing to do.  In fact, allowing these health insurance companies to make decisions about what care they will — or will not — allow to their insurance customers is simply providing them with a license to kill.  The more of us who die early, the more money they will make.

Does all this sound a bit extreme?  Well, OK.  Then tell me what I’ve missed? 

Now do you understand why being a sharp patient is so important? 

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Read two more posts about Sicko:

A Patient Advocate’s Reaction to Sicko
What Sicko Doesn’t Tell Us

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EveryPatientsAdvocate.com
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What Sicko Doesn’t Tell Us

As I mentioned in yesterday’s post, Michael Moore’s movie Sicko provides background on how our American healthcare system has become so dysfuncational, and some of the horrifying ripple effects on the health of our nation.  What it fails to mention is one major group of ripples:  medical errors and misdiagnoses.

According to the US government’s Institute of Medicine, between 44,000 and 98,000 Americans DIE each year from medical error or misdiagnosis.  Other organizations, including HealthGrades, suggest those numbers are way too conservative, that, in fact, the numbers are much higher.  Beyond those who die, millions more are injured by these mistakes.

So it begs the question:  what differences in the rates of medical errors and misdiagnoses might we find between universal health care, such as those systems cited in Sicko in Canada, France and Great Britain, and privatized healthcare programs such as the system we use here in the United States?

I’ve poked around the internet and can’t find any numbers to speak of… I can find a few within certain diseases, but nothing that helps compare apples to apples…..

When I refer to medical errors, I’m referring to problems such as:

  • surgeries:  operations on the wrong body part, called “wrong site” surgeries, or mistakes made during the surgery, or even equipment left inside the patient.
  • drugs:  the wrong drug is prescribed, or the wrong drug is dispensed, or the wrong dosage is prescribed or dispensed, or the drug is given at the wrong time, or a dose is missed
  • other treatments:  therapies are mis-prescribed, for example, an orthopedist sends a patient for physical therapy which ends up exaserbating the problem, not helping it
  • infections:  usually facility acquired (such as in hospitals or nursing homes) — a patient is admitted for one problem, but acquires an infection while resident in the facility.  MRSA, C. Diff and necrotizing fasciitis (flesh eating bacteria) are examples

When I refer to misdiagnosis, I mean:

[A request -- if anyone can point me to real numbers among the other countries, I would really appreciate it!]

My sense is this — purely a guess, but an educated one — that the error rate in the privatized US system,  where healthcare is more about money and less about care — is higher.  That we are dying and getting sicker because of our privatized system.

Why do I think this is true? 

If you review the kinds of errors listed above, you’ll see that most are time-related.  If the professionals who made them weren’t in such a hurry, if they weren’t worried about reimbursement rates or malpractice insurance payments, if they were more inclined to spend the time that is really needed to LISTEN and communicate with patients, then those errors could, in many cases, be prevented. 

Drill it down:  who will make fewer errors?

  • a doctor who has the time necessary to listen to a patient?  — or — the doctor who knows that in minute #7, he begins losing money because the insurance company won’t reimburse him for any time beyond that?
  • a surgeon who has the time to carefully review the charts prior to a surgery, takes the time to mark which body part needs to be cut, then operates correctly — or — the one who knows s/he has only one hour to perform the surgery and move on to the next one or it will impact the hospital’s profits?

Patients — take heed — there are many many ways you are hurt by our current dysfunctional system….  not all are raised in Sicko, but at least its the start of a conversation.

… and in the meantime?  Regardless of what system provides us with health care — or no health care — we still need to advocate for ourselves in all those good practice ways I talk about on this blog, and through my columns, every day.

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Read two more posts about Sicko:

A Patient Advocate’s Reaction to Sicko
Why Sicko is only the tip of the Iceberg

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Want more tools for sharp patients?
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Or link here to empower yourself at
EveryPatientsAdvocate.com
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A Patient Advocate’s Reaction to Sicko

…. is that Michael Moore has only exposed the very tip of the dysfunctional American health care system’s iceberg.

As confessed in yesterday’s blog post, I’ve never been a fan of Michael Moore’s.  I think his previous works have been inflammatory and one sided.  Not that he doesn’t raise awareness of issues, and not that he doesn’t cause dialogue that is helpful, because he does.  Rather, because he takes facts and bloats them, and his audience walks away believing partial truths.

But for Sicko?  He is inflammatory, and if I worked for a health insurer, I’d want to hide.  And if I were an executive for a health insurance company, especially the “medical director” of a health insurance company, I would be embarrassed beyond belief. 

But as far as whether his presentation was balanced — well — his story was no more unbalanced than reality.  The reality of what healthcare in the US has become is so lopsided, that it’s falling into the deep unknown.  If it’s any indication?  I’ve never attended a movie that elicited applause, not just at the end, but in reaction to statements made during the movie, too.  And whereas many had told me I would laugh, and on occasion, I did — but — I left with tears in my eyes.

I learned a few things, which I will present to you, although I have not yet confirmed them to be absolutely true.  The scary part is, even if they are only half true, then they are still worth noting. 

For example:  one woman who used to be a health insurance sales person spoke of a 37 page document of “pre-existing conditions” which would automatically cause denial of coverage to an applicant.  Another woman described how executives in health insurance companies get paid:  the higher the rate of denial of coverage (not just in policies, but in pre-approvals for treatment), the higher the bonus.  “Payment of any claim,” she explained, “is defined as a medical loss.”

One gentleman explained his former job as a health record spy — in effect, if someone made a claim the insurance company didn’t want to pay, it was up to him to comb through the previous medical records of the patient and use anything at all — ANYTHING — to create a case for denying a claim.  Of course, the insured has no recourse.  None.  (By the way — this is a perfect reason for making sure your medical records are always correct.)

I’ve often wondered if there was a watershed moment in American history that caused the previously considered “good” system of healthcare to go awry.  Moore explains it as a Nixonian decision.  In 1971, then president Richard Nixon and his buddy Edgar Kaiser (of Kaiser Permanente fame) created a new approach to healthcare where denial of service became a profit center.

And then there is Moore’s statement that there are 4 times as many health insurance lobbyists in Washington as there are congress members.  Can you guess who is paying for those lobbyists?

The last example of what I learned (although there is really quite a big more) is that Moore visits Canada, Great Britain, France and even Cuba, and claims that in those countries, where healthcare is a given, paid for by taxes, then provided at no additional cost to its citizens, people live 3 or 4 years longer than Americans on average.  Even the Journal of the American Medical Association cited those statistics.  In England, doctors earn more by keeping their patients healthy, too.  Amazing.

So here are a few comments from your friendly patient advocate — now that I’ve had a few hours to think it over:

1.  While Moore did a good job pointing out the foibles of our system as they relate to how medical care is paid for, he didn’t even attempt to talk about medical errors, misdiagnosis, drug-related problems, etc (although he mentions pharma as being almost as evil as insurance.)

2.  As long as Washington politicians are bought and paid for by health insurance, nothing will change.  As long as health insurance companies continue rewarding their top echelons with huge paychecks and bonuses, nothing will change. 

3.  I whole heartedly agree with some of his statements as they regard the services we are all entitled to because we are citizens of America and our communities:  police, firefighters, public education, inexpensive postal services, parks, libraries.  Why isn’t healthcare on that list?  Well — for seniors who use Medicare, it is.  And what about the other 47 million of us?

For the first 50+ years of my life, I never would have believed I could even think this thought, much less type it…. and based on the research I have done, all of it prior to seeing Sicko today….. I do believe American needs to move to universal healthcare.  Don’t forget — you’re hearing this from a woman who has owned businesses, and believed in private enterprise and profit all her life….. but LIFE is the keyword here…. and because health insurance and big pharma have become so greedy, because that greed is costing lives, because the need of the masses to access better care is more important than the need of individuals to control….  yes…. I believe we need to create a healthcare model similar to our public education model. 

Do I think it will be perfect?  Heavens no.  But if it parallels public education, then many MANY more will benefit, and for those who still believe private care is important — well — we have private schools, too, right?

Of all the statements that made me really think, and there were many, this is the one I will leave you with:

“You can judge a society by how it treats its worst…. and its best.”

Society, our politicians, and our American way of medical care is failing us.  It’s time we patient stood up and made the noise necessary to invoke the change that’s needed.

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Read what others have said about Sicko:

R J Eskow in the Huffington Post

M Foust in Artvoice

The American Thinker

And to learn more about how those running for president have reacted:  The LA Times

…. and see follow up blog posts from Every Patient’s Advocate,

What Sicko Doesn’t Tell Us  and Why Sicko is Only the Tip of the Iceberg

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Want more tools for sharp patients?
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