Michael Moore the Fraud

[lI1|1!]

You must get bored a lot.

 

basically.

 

[Jim]

One of the more striking issues with US health noncare is the number of families that lose everything, even if they have insurance. And now that the banks sucessfully lobbied Congress to turn the screws on bankruptcy law the situatiion is even tighter.

 

Illness and medical bills caused half of the 1,458,000 personal bankruptcies in 2001, according to a study published by the journal Health Affairs.

 

 

• Medical Bills Leading Cause of Bankruptcy, Harvard Study Finds

 

The study estimates that medical bankruptcies affect about 2 million Americans annually -- counting debtors and their dependents, including about 700,000 children. Surprisingly, most of those bankrupted by illness had health insurance. More than three-quarters were insured at the start of the bankrupting illness.

 

[archenemy]

I must be remembering wrong, but I thought the new bankruptcy laws allow some room for medical bankruptcy.

I thought those laws were basically for people who were able to pay some of what they owed to those they owed.

 

And I think people rarely loose "everything" as some property is exempt.

[JayB]

I don't have any doubt that the statistics are accurate, but I wonder how many of the bankruptcies were the result of medical expenses that were uncovered and were simply too large for the families affected by the illness to cover with their incomes, and how many were the result of the income lost due to disability resulting from the illness. It seems as though looking at bankruptcies resulting from an illness in a child, then looking at the impact in single versus dual income families would provide some insight.

 

I'd imagine that in the absence of disability coverage, missing even one or two months of income would be potentially devastating for most families, especially young families with children and those on the lower half of the earning's distribution curve.

 

It seems like this is an important issue to sort out, as even if all medical expenses are covered, being out of work for several months on account of a disability caused by the illness could easily lead to bankruptcy.

[Jim]

During the debate of the change in bankruptcy law (under the Rep Congress) Ted Kennedy introduced an exemption for cases of medical bankruptcy. Russ Feingold introduced an amendment protecting the homes of the elderly. Dick Durbin asked for protection for armed services members and veterans. All were rejected by the Reps.

 

If you declared bankruptcy under Chapter 7 for medical reasons, which wipes out their credit for 10 years, you had chance to start over without debt. So, naturally, the banks wanted to make it harder to declare bankruptcy by forcing people to file under Chapter 13, only a partial diminution of debt, which is now the case.

 

Elizabeth Warren, a Harvard law professor, pointed out in testimony before Congress that the bill assumes everyone is in bankruptcy because they're spendthrifts. "A family driven to bankruptcy by the increased cost of caring for an elderly parent with Alzheimer's disease is treated the same as someone who maxed out his credit cards at a casino. A person who had a heart attack is treated the same as someone who had a spending spree at the shopping mall. A mother who works two jobs and who cannot manage the prescription drugs needed for a child with diabetes is treated the same as someone who charged a bunch of credit cards with only a vague intent to repay."

 

Note to JayB - true about the disability cases - now you're going to get me worried about disability insurance again.

 

[ericb]

Note to JayB - true about the disability cases - now you're going to get me worried about disability insurance again.

 

Second that bro - I have disability insurance but couldn't live on 60% of my salary very easily

[JayB]

Note to JayB - true about the disability cases - now you're going to get me worried about disability insurance again.

 

Second that bro - I have disability insurance but couldn't live on 60% of my salary very easily

 

I found some good general information on disability coverage at this site: http://www.about-disability-insurance.com/articles.html

 

Probably worth finding a book on the subject if you want to cover all of the ins and outs of DI coverage. I imagine that's what I'll do when the time comes to get policies on our own.

[lI1|1!]

CNN Analysis: 'Sicko' numbers mostly accurate; more context needed

 

 

Story Highlights

• Analysis: Numbers cited in "Sicko" are accurate for the most part

• Assertions could use more context to flesh out comparisons of health care

• Health-care experts focus more on film's errors of omission than incorrect facts

 

(CNN) -- Michael Moore's "Sicko," which opened nationwide Friday, is filled with horror stories of people who are deprived of medical service because they can't afford it or haven't been able to navigate the murky waters of managed care in the United States.

 

It compares American health care with the universal coverage systems in Canada, France, the United Kingdom and Cuba.

 

Moore covers a lot of ground. Our team investigated some of the claims put forth in his film. We found that his numbers were mostly right, but his arguments could use a little more context. As we dug deep to uncover the numbers, we found surprisingly few inaccuracies in the film. In fact, most pundits or health-care experts we spoke to spent more time on errors of omission rather than disputing the actual claims in the film.

 

Whether it's dollars spent, group coverage or Medicaid income cutoffs, health care goes hand in hand with numbers. Moore opens his film by giving these statistics, "Fifty million uninsured Americans ... 18,000 people die because they are uninsured." (Review: "Sicko" a tonic despite flaws)

 

For the most part, that's true. The latest numbers from the Centers for Disease Control and Prevention say 46.3 million, or about 16 percent of Americans, were uninsured in 2006. For the past five years, the overall count has fluctuated between 41 million and 44 million people. According to the Institute of Medicine, 18,000 people do die each year mainly because they are less likely to receive screening and preventive care for chronic diseases.

 

Moore says that the U.S. spends more of its gross domestic product on health care than any other country.

 

Again, that's true. The United States spends more than 15 percent of its GDP on health care -- no other nation even comes close to that number. France spends about 11 percent, and Canadians spend 10 percent.

 

Like Moore, we also found that more money does not equal better care. Both the French and Canadian systems rank in the Top 10 of the world's best health-care systems, according to the World Health Organization. The United States comes in at No. 37. The rankings are based on general health of the population, access, patient satisfaction and how the care's paid for.

 

So, if Americans are paying so much and they're not getting as good or as much care, where is all the money going? "Overhead for most private health insurance plans range between 10 percent to 30 percent," says health-care analyst Paul Keckley. Overhead includes profit and administrative costs.

 

"Compare that to Medicare, which only has an overhead rate of 1 percent. Medicare is an extremely efficient health-care delivery system," says Mark Meaney, a health-care ethicist for the National Institute for Patient Rights.

 

Moore spends about half his film detailing the wonders and the benefits of the government-funded universal health-care systems in Canada, France, Cuba and the United Kingdom. He shows calm, content people in waiting rooms and people getting care in hospitals hassle free. People laugh and smile as he asks about billing departments and cost of stay.

 

Not surprisingly, it's not that simple. In most other countries, there are quotas and planned waiting times. Everyone does have access to basic levels of care. That care plan is formulated by teams of government physicians and officials who determine what's to be included in the universal basic coverage and how a specific condition is treated. If you want treatment outside of that standard plan, then you have to pay for it yourself.

 

"In most developed health systems in the world, 15 percent to 20 percent of the population buys medical services outside of the system of care run by the government. They do it through supplemental insurance, or they buy services out of pocket," Keckley says.

 

The people who pay more tend to be in the upper income or have special, more complicated conditions.

 

Moore focuses on the private insurance companies and makes no mention of the U.S. government-funded health-care systems such as Medicare, Medicaid, the State Children's Health Insurance Program and the Veterans Affairs health-care systems. About 50 percent of all health-care dollars spent in the United States flows through these government systems.

 

"Sicko" also ignores a handful of good things about the American system. Believe it or not, the United States does rank highest in the patient satisfaction category. Americans do have shorter wait times than everyone but Germans when it comes to nonemergency elective surgery such as hip replacements, cataract removal or knee repair.

 

That's no surprise given the number of U.S. specialists. In U.S. medical schools, students training to become primary-care physicians have dwindled to 10 percent. The overwhelming majority choose far more profitable specialties in the medical field. In other countries, more than one out of three aspiring doctors chooses primary care in part because there's less of an income gap with specialists. In those nations, becoming a specialist means making 30 percent more than a primary-care physician. In the United States, the gap is around 300 percent, according to Keckley.

 

As Americans continue to spend $2 trillion a year on health care, everyone agrees on one point: Things need to change, and it will take more than a movie to figure out how to get there.

 

 

it's only CNN, so there's a good chance this is an oversimplified view of things, i guess.

 

[Jim]

Seems rather obvious doesn't it?

 

National health care

If you want better coverage buy supplemental just like other industrialized countries.

[Roy]

Do your home work ,my wife and I both have good insurance .

I understand we are in the 15 percent of people who are well covered . And we are blessed . But the only thing good about our heath care is you can shop .

Granted the majority can not , and that is very sad .

 

Only the rich and people with good jobs are lucky in or sad system to get good heath care.

 

I have been damn lucky!

Edited June 30, 2007 by Roy

[Roy]

My wife and I have damnn good insurance,cause we have good jobs.

 

We are by no means rich but we get much better care , and that sucks.

 

 

JMHO

Edited June 30, 2007 by Roy

[Roy]

I have been to England National Health care sucks bigtime!

 

I have no clue what the solution is . Other than throwing heathcare bastads in this country in jail. They suck!

Edited June 30, 2007 by Roy

[JackBarben]

A few thoughts:

 

The majority of the world struggles to clothe and feed themselves. We freak out because 47 million Americans might not be able to afford hip replacement surgery at 54.

 

Just about every one of us drives at least one car, has cable and television, a computer, running water, sewage, etc. The most downtrodden among us still eat and have housing. So, we're better off than just about everyone else in the world.

 

Do we really believe that health insurance will make the world a better place? Don't you think there is maybe something a little deeper, a little more substantive than what doctors could possibly do with a few extra dollars? Some people in "third world" countries lead much more fulfilling lives than we do. These people make in one year what we pay in one month for insurance.

 

I don't know, I'm just thinking that maybe we've missed the point. Maybe there is something more important than whether or not health insurance is run by the government, by free markets, or by Micheal Moore. Maybe there are bigger issues out there that we should be tackling.

 

Maybe I'm wrong.

 

 

[Roy]

GO to asia europe there are so many places as good or better than this country .I have seen them granted there are some poor countries.But it does even out more than we re led to belive.

 

And some third world places are not that bad I have climbed and seen them

 

 

JMHO

[BillA]

I put in a 26 yo male and got 92 bucks a month. Not bad.

 

Not bad my ass. $2,000+ deductible means that you get to pay $1,100 a year for insurance but you better not get sick and have to go to the doctor because you get to pay 80% of the doctor bills yourself anyway. As a 26 year old male with shit ass insurance, last year I had to go to the emergency room and get x-rays. My total bill that I had to pay came to around $900 out of pocket, including something ridiculous like $30 for one vicodin. I made around $18,000 last year, so yeah. I'm drunk right now, but Sicko is a great fucking film that everyone should see. Even Fox News agrees!

[mtn_mouse]

Maybe I'm wrong.

 

 

You're wrong.

[Dechristo]

A few thoughts:

 

The majority of the world struggles to clothe and feed themselves. We freak out because 47 million Americans might not be able to afford hip replacement surgery at 54.

 

Just about every one of us drives at least one car, has cable and television, a computer, running water, sewage, etc. The most downtrodden among us still eat and have housing. So, we're better off than just about everyone else in the world.

 

Do we really believe that health insurance will make the world a better place? Don't you think there is maybe something a little deeper, a little more substantive than what doctors could possibly do with a few extra dollars? Some people in "third world" countries lead much more fulfilling lives than we do. These people make in one year what we pay in one month for insurance.

 

I don't know, I'm just thinking that maybe we've missed the point. Maybe there is something more important than whether or not health insurance is run by the government, by free markets, or by Micheal Moore. Maybe there are bigger issues out there that we should be tackling.

 

Maybe I'm wrong.

 

 

Of course, you're both correct and wrong. It depends only on whether a majority agrees with you, or not.

[crackers]

Cost-controls, like statutory caps on liability, will be a fixture of any comprehensive single-payer system. In the case of a state-run system, the motive will be different, but the rationing will be at least, if not more severe than anything people have to endure at the hands of private insurers.

 

There's also the matter of what happens to the allocation of health care resources when the government attempts to replace the price system with planning. Even if you accept that folks in whatever health-care bureaucracy that would emerge after the advent of a single payer system have everyone's best interests at heart, the fact remains that they will be attempting to do the impossible - and the misallocation of resources that results from price controls and central planning will be at least as severe as anything that we have to contend with today, and here I'm speaking only of the health-care resources that are on the table today. The effect on innovation will be even more dramatic when central planning makes it impossible to measure, let alone respond to effective demand.

 

I'm terribly sorry Jay, but again, you've wandered off from whatever your specialty might be. It's clear it's not health care economics. It's not mine either, but I am married to one of the heavy hitters in the field, and have spent many interesting evenings reading her work.

 

* Cost controls and rationing are not "a fixture of single payer systems" in any way that reflects your use of language. I'd recommend examining Kaiser Permante California's management of doctors as an example of the standard of cost controls used in single payer systems. Doctors believe they don't need management, and they rarely keep up with advances in their field except from drug peddlers. KP ensures that their docs are informed in the best practices in their speciality, and manages them by tracking their outcomes and inputs. Interestingly, KP patients and doctors spend more time on preventive care than anywhere else in the USA as it is clearly a results effective method of controlling costs.

* The vast majority of allocation of health care resources is currently done by the government through planning that is partially research driven and partially driven by lobbying by major insurance companies. If a particular procedure will not be covered or funded by CMS or NIH, there will be little to no research or practice of the procedure in the USA. No research means none at all. The "market" does not drive health care research in the USA; as the research arm of the single largest by expense health plan in the world, CMS drives virtually all health care research.

 

If you're interested and in DC, I'd suggest that you go to some brown bag seminars and read some papers from the health policy groups at APT, Urban and Mathematica-MPR. Most of the studies are funded by CMS, and are therefore freely available. CMS also has a large body of freely available papers.

 

Somebody wrote above that docs are humans too. That is so damn true. You've got a responsibility to doctor shop, just as you try to find a good mechanic, school for your children or anything else. Remember, you're HIRING them, and they work for you...

 

Some basic questions you should at least consider asking before any invasive procedures:

1) how many times have you personally performed this procedure?

2) how many times was the procedure successful, and what is your definition of success? What was your follow up procedure? How long is your time interval of follow up?

3) how many times did the procedure fail? what were your follow up procedures and how did you correct the error that lead to the procedure failing?

 

Doctors hate it; they trained in school to think that they're gods, not humans. It's your body.

 

EDIT: Personally, I loathe Michael Moore. He has a track record of embellishment and truth bending that I find offensive and just as dangerous as the demagogery of Rush Limbaugh. While his "health care numbers" may or may not be accurate, I must question the integrity of his argument and the specific use or abuse of any statistic he might (mis)use.

 

Edited June 30, 2007 by crackers

[Fairweather]

I still don't understand why the same folks who decry the government's most benign intrusions into its citizen's privacy are the very same one's who are so willing to turn over what is probably one of the most intimate parts of a their life - their health care and the personal issues that lie therein - to the state. You don't want the government listening to Sahib's overseas phone calls, but you don't mind if a government agent (aka "doctor") sticks a gloved hand up your rectum and records what he finds in a government database? Gimme a break.

 

What I would like to see is health insurance companies punished severely - jail time for execs - for the practice of denying coverage in the hope that a patient will die before a necessary or hopeful procedure, however expensive, is performed. I would like to see HMO's held to the same care standards as open choice. I would also like to see some minimum coverage standards for children along the lines of those provided for the elderly - but with parents somehow still financially responsible for their care vis a vis community service, service in a daycare co-op, whatever.

[JayB]

Cost-controls, like statutory caps on liability, will be a fixture of any comprehensive single-payer system. In the case of a state-run system, the motive will be different, but the rationing will be at least, if not more severe than anything people have to endure at the hands of private insurers.

 

There's also the matter of what happens to the allocation of health care resources when the government attempts to replace the price system with planning. Even if you accept that folks in whatever health-care bureaucracy that would emerge after the advent of a single payer system have everyone's best interests at heart, the fact remains that they will be attempting to do the impossible - and the misallocation of resources that results from price controls and central planning will be at least as severe as anything that we have to contend with today, and here I'm speaking only of the health-care resources that are on the table today. The effect on innovation will be even more dramatic when central planning makes it impossible to measure, let alone respond to effective demand.

 

I'm terribly sorry Jay, but again, you've wandered off from whatever your specialty might be. It's clear it's not health care economics. It's not mine either, but I am married to one of the heavy hitters in the field, and have spent many interesting evenings reading her work.

 

* Cost controls and rationing are not "a fixture of single payer systems" in any way that reflects your use of language. I'd recommend examining Kaiser Permante California's management of doctors as an example of the standard of cost controls used in single payer systems. Doctors believe they don't need management, and they rarely keep up with advances in their field except from drug peddlers. KP ensures that their docs are informed in the best practices in their speciality, and manages them by tracking their outcomes and inputs. Interestingly, KP patients and doctors spend more time on preventive care than anywhere else in the USA as it is clearly a results effective method of controlling costs.

* The vast majority of allocation of health care resources is currently done by the government through planning that is partially research driven and partially driven by lobbying by major insurance companies. If a particular procedure will not be covered or funded by CMS or NIH, there will be little to no research or practice of the procedure in the USA. No research means none at all. The "market" does not drive health care research in the USA; as the research arm of the single largest by expense health plan in the world, CMS drives virtually all health care research.

 

If you're interested and in DC, I'd suggest that you go to some brown bag seminars and read some papers from the health policy groups at APT, Urban and Mathematica-MPR. Most of the studies are funded by CMS, and are therefore freely available. CMS also has a large body of freely available papers.

 

Somebody wrote above that docs are humans too. That is so damn true. You've got a responsibility to doctor shop, just as you try to find a good mechanic, school for your children or anything else. Remember, you're HIRING them, and they work for you...

 

Some basic questions you should at least consider asking before any invasive procedures:

1) how many times have you personally performed this procedure?

2) how many times was the procedure successful, and what is your definition of success? What was your follow up procedure? How long is your time interval of follow up?

3) how many times did the procedure fail? what were your follow up procedures and how did you correct the error that lead to the procedure failing?

 

Doctors hate it; they trained in school to think that they're gods, not humans. It's your body.

 

EDIT: Personally, I loathe Michael Moore. He has a track record of embellishment and truth bending that I find offensive and just as dangerous as the demagogery of Rush Limbaugh. While his "health care numbers" may or may not be accurate, I must question the integrity of his argument and the specific use or abuse of any statistic he might (mis)use.

 

The second hand condescension in your post would be more appropriate if it was based on an actual refutation of my main point.

 

There are a number of things about the market for health-care in the US that make it unique - but at the end of the day real demand for health-care is driven by phenomena that can't be managed, unless you assume that the total incidence of disease, car-wrecks, pregnancy, cuts, breaks, bruises, migraines, cough, colds, herpes, AIDs, etc can be centrally controlled by fiats issued an omniscient bureaucracy of some sort.

 

Demand will always be an independent variable. Effective demand will be a function of the afflicted party's ability and/or willingness to pay for the care that they want or need with their own resources or those furnished by another party, or some combination of both. Any single payer will have a finite pool of resources with which to satisfy these demands. Once the total costs required to satisfy total demand reach a certain threshold, the only means that the single-payer entity will have at its disposal to do so will be via price controls or rationing.

 

There is no escape from this. None. Once the price controls and rationing are in place, the only means by which the single-payer will have to coordinate supply with demand is by estimating the latter, and allocating a specific quantity of resources to fulfill it. Demand that exceeds this allocation will not be satisfied, and the end result will be denial of care, wait-listing, or both. What happens to supply, and it's responsiveness to demand, when you cap prices is equally inexorable. Ever wonder why so few doctors accept new Medicaid patients? Think it has anything to do with the cost of providing their care relative to what doctors are paid to provide it?

 

Now to move on to a couple of the micro-points embedded in your post:

 

1) How, exactly, does anything you've written above undermine the claim that cost controls at least as onerous as those imposed by private insurers will be inevitable in a single payer model? Kaiser and Medicaid use various measures to minimize outlays and this undermines my statement - how?

 

2)If a given procedure won't be covered by Medicaid or the NIH, there will be no research into or *practice* of the procedure in the USA? So cosmetic surgery and LASIK - just to take a couple of examples - aren't practiced here? Cialis and Minoxodil were brought to market at the behest of the effective demand generated by NIH research grants and Medicaid reimbursement schedules? Claiming that these factors play a significant role in shaping research priorities and effective demand is one thing, but pretending that they are the only variables at play in the medical marketplace that determine what treatments eventually make it to market is just insane.

 

3)How would the elements of the doctor-patient relationship that you dislike be improved under a single-payer system?

 

 

[cj001f]

The majority of the world struggles to clothe and feed themselves.

 

The majority of the world doesn't anymore.

[Fairweather]

 

The majority of the world doesn't anymore.

 

That's right. Thanks, in very large part, to the adoption and promotion of capitalist models world wide the past 30 or so years.

[JackBarben]

Thanks Mtn Mouse. Glad to be corrected.

[JackBarben]

I'm not sure how whether the majority agrees with me or not has anything with whether or not I'm right or wrong. I would tend to think the opposite would be the case.

[Dechristo]

Of course, we all have our own ideas of what makes the world turn, complete with inimitable categories of right and wrong.

 

Just whose categorization are you ascribing to?

 

Your own?

The cc.com membership's?

The world population's?

God's?