I know Michael Moore is prone to bias. And he has a habit of being casual with the truth. But can anyone comment on whether he has got the general "vibe" right?
 
For those that haven't seen the movie, it goes something like this;

• If you don't have health insurance, you are screwed
  
• Even if you do have health insurance you are still screwed because the health insurance companies work their arses off to make sure you can never successfully make a claim.

I realise that some of the health care systems Moore highlights (Canada, France, the UK and Cuba) have their problems. I mean, the Australian health care system is pretty bad too.
 
But really, the way things are portrayed in Sicko, you Americans are seriously fucked.

While I have not seen the movie, I can confirm that the US medical system is indeed severely fucked.  

The medical industry has become a disgustingly vampiric monster that lives to bleed cash from human misery regardless of consequence.  Going to visit the doctor should not take on Faustian overtones, where one must gamble on whether the odds that a given medical facility will actually help you get better are good enough to warrant taking on debt that could take years to pay off.  

And that's with your typical shitty health insurance.  If you've got none, well, then you're just fucked.  I've gone into an urgent care ward barely able to breathe and had them demand cash up front.  

If you've seen the show Scrubs, Bob Kelso really isn't at all off the mark of how the medical industry in the US is actually run.

The true costs of medical care are hidden behind insurance premiums and co-pays. When I swhitched insurance because of a job change, I got an invoice from a medical supply company that listed the costs of what had formerly been "free" CPAP (for sleep apnea) equipment. A fairly simple mask? $193.00. 6' hose to connect it to the machine (basically a small-diameter vacuum cleaner hose) $40.00. Little foam air filter $14.00. Much less the cost of the machine itself (the size of a shoebox) - $165.00 for a macine I've had for a year, so extrapolate that to 12 months - close to $2,000.00. For an air pump.

Insane. And nobody really KNOWS it because usually they don't SEE what the insurance companies are being billed by the medical supply companies.

If there WAS no insurance, nobody could afford medical care - but providers and suppliers have no incentive to reduce costs because nobody sees what they're charging, so nobody complains. When premiums go up, its "greedy insurance company" - right. Look at what THEY have to pay to keep your co-pay at $15 and then see if there's some connection there.

Quote from: J ArcaneWhile I have not seen the movie, I can confirm that the US medical system is indeed severely fucked.  

Yeah. I pretty much have to hope I don't get really sick, or I'm pretty much out of luck.

Yeah, it is fucked here. I known several people over tha last few years who have enough money to get by (from investments or rental properties, mostly) but work just for the insurance.

Quote from: J ArcaneWhile I have not seen the movie, I can confirm that the US medical system is indeed severely fucked.

For you and for some others.  Not for everyone.  I've never had a problem with it.  The key is to make sure that you have insurance and I have never realy had to do without it.  Being willing and able to get and hold jobs that provide insurance helps.  Making getting a job that offers insurance a priority helps.  Being married also helps, since only one person in the couple needs to hold a job with good insurance.

I'm honeslty curious.  Exactly what are people doing for a living that they can't get medical insurance?  I've never found it difficult to find a job with insurance.

Gentlemen - I've experienced both sides of this fence.  I've had jobs, including my current one, with insurance.  I've been self-employed and gone without insurance.

The differences are difficult to explain here in post format.  It is different, and money is not the only, perhaps not the major, issue.  When uninsured, you make choices differently than if you were insured; and x-ray instead of an MRI, play percentages on the analysis of some issue instead of paying $1,000 to have it done, discuss how your treatment would differ depending on the test results.  It's a very interesting view of the health system.

Now I have insurance.  And I've just gone through a fairly difficult issue.  And here was once big fucking eye opener: We got a statement from Blue Cross Blue Shield (BCBS) yesterday for one of the procedures.  The company charged $10,000 (roughly) for it.  The discount for BCBS? $7,000. That's right, right off the top, BCBS tells the provider your service is only worth $3,000 - and they are big enough the provider has to listen. then BCBS covered the rest.  Yup - what would have been a $10,000 to someone in my position just a year ago was $0 to me.

Hell, part of the reason I still have debts to pay off is from some medical shit that happened when I didn't have insurance.

Is it fair? To quote virtually every parent who ever walked and talked "Life isn't fair."  Could more be done?  I think there are ways to improve the various components. I have been, and remain, convinced that universal healthcare coverage backed by the government is not the answer. What is?  I think it will take minds greater than Mr. Moore's (which isn't really a high bar to start with) to solve - and it will be a bunch of different things, not a single solution.

As to one of TF's orginal questions: How hard it is to get an insurance carrier to cover costs depends completely on the insurance carrier. As you can see from my example above, I didn't lift a finger and BCBS took care of $10,000 of invoice in the blink of an eye...

Just as another example:

Last year, my son started school.  So, of course, he had to get his immunizations.  We were not insured. So instead of going to the doctor's office, where each shot would have been something like $100 (and he needed 4), we went to the county health services.

It was something like $10 a shot - maybe less.

This year, I have insurance. This year my daughter is starting school.  We went to the doctor. Why?  I will say the doctor did a thorough physical, whereas with the county health service it was just the shots. Other than that, the shots were exactly the same.

Take it FWIW - just my experiences.

I'll check the numbers to ensure I'm not stretching the difference.  We'll get the statement from the doctor in a few days and I'll dig up the county receipt - just to be accurate.

Quote from: Tyberious FunkEven if you do have health insurance you are still screwed because the health insurance companies work their arses off to make sure you can never successfully make a claim.

I've never had that problem.  Heck, I've even had insurance that would pay for a Christian Science Practitioner to pray for me if I was sick, and that was in the worst paying full-time job I had after graduating college.

Quote from: John MorrowI've never had that problem.  Heck, I've even had insurance that would pay for a Christian Science Practitioner to pray for me if I was sick, and that was in the worst paying full-time job I had after graduating college.

Experiences vary. I have pretty damn comprehensive insurance through my employer, which is compared to most of my friends is leaps and bounds beyond their own insurance companies-but unlike their companies, which seem to have little in the way of problems with paying for stuff my company busts its ass to make my life a hell when it comes to copays, and deductibles.

Add in my workman's comp experiences and overall I have a less than positive opinion of my insurance provider.

Now I am sure we all have separate experiences, so I am not suggesting my experience is the end all of experiences.

Yea, it varies.  I've had some where the processers were either stupid or told to reject any initial claims with anything filled out the least bit wrong in the hopes that people wouldn't refile.
 
But my current insurance is fine.  The dental coverage is only half beyond checkups and they don't pay for glasses, only exams, but they're quick and don't screw up much.  
 
For those uninsured, many qualify for medicaid/medicare, which is essentially socialized medicine for a quarter of the medical system.  The public hospital here also has a sliding scale based on income, where they just knock off part of the cost and eat the difference.  
 
There are huge structural issues but it does function for the most part.

The thing is, look at the Medicare/Medicaid/Tricare services here in the US.

They blow. Frex the only Medicaid dentists I can find are in the city, and they aren't in a part of town I'd normally frequent. Seeing lots of bars on windows (including a school!) worry me. Plus, I don't want to drive an hour one way.

Then there's fraud and bloat. Compare Medicaid to a insurance business. The overhead is huge in a government program.

And I can't bitch enough about Tricare/Champus (the military insurance). Mom is always fighting them.

When the movie came out, we had the usual spate of letters to the editor in the local paper. One stuck with me. The author wrote that he was on a panel comparing health care in the US, Canada, Great Britain, Australia, and New Zeland. They used, IIRC, eleven indices to judge care.

Their findings:

Each country placed first in at least one index, some more than one. Each country placed last in at least one index, some more than one. Care was roughly comparable from country to country. The main differences between the other countries and the US were: 1. The US had, at that time, 40 million people uninsured. It has since risen to 44 million. 2. Care in the US cost, on average, twice as much per capita.

So far, my own coverage has been up to snuff. Co-pays haven't been too much to bear, and no one has gotten pissy about referrals. My girlfriend is a medical assistant. When she worked at a pediatric office, some days she spent most of her time on the phone trying to get referrals for patients. This meant delays in patient care, since she was not available to prep the exam room, take pulse, temp, BP, etc. Depending on who does the study, this cost is sometimes counted, sometimes not.

Part of the problem is each company has different rules as to what is covered or not. Because of the mismatch, doctors' offices don't know ahead of time what will be covered or not. This means that, by some estimates, up to %30 of our healthcare costs are just for administrative overhead. As I understand, Italy, France and Germany have government- business councils to set rules and standards to avoid such conflicts.

The fraud aspect is quite a problem. I've seen overbilling for simple procedures, billing for procedures never performed, and relabelling procedures so they sound more severe than they really are, so as to allow billing at higher rates. I don't know the overall figure, but a Congressional investigation some years ago estimated $20-40 billion in fraud in psychiatry alone.

I could go on, but my blood pressure is going up...

What were the indices?  One thing I learned when I was a departmental director was that you could make any "study" say what you want if you managed the measures ahead of time.

So if you wanted it to look like you needed this system or that function, you focused on measurements that showed that, perhaps allowing a few through to seem balanced.

Quote from: James J SkachWhat were the indices?  One thing I learned when I was a departmental director was that you could make any "study" say what you want if you managed the measures ahead of time.

So if you wanted it to look like you needed this system or that function, you focused on measurements that showed that, perhaps allowing a few through to seem balanced.

I've been searching the Baltimore Sun's online archives, but can't find the letter. The author didn't go into detail, but I was hoping if I could find his name, I could Google more info. No luck so far.