SiCKO

Yesterday I learnt one of the most horrible phrases ever invented by a civilised nation¹, and saw the most horrifying CCTV footage² I am ever likely to see, short of seeing someone die on television.

Michael Moore's latest documentary is yet again another "must see" film. Admittedly the issues at stake do not affect any of us directly, since it is solely about the state of the US medical system and the healthcare medical organisations (HMOs), but it is none the less shocking for that. Patients denied treatment that could have saved them, or had treatment delayed by red tape until it was too late. Patients left with huge medical bills, or had their insurance retroactively cancelled because they failed to mention they had a bad case of flu ten years ago. One twenty-five year old woman who was denied treatment for cervical cancer because, according to her HMO, she was too young to get cervical cancer. I wish that was a joke.

It's not just the medical professionals that come under fire. Politicians are targeted too, particularly because of a campaign to prevent socialised healthcare for all (ie like the NHS) by associating it with communism. Then came the prescription reform bill, which had a tagline from a prominent senator of "I love my momma. And I want her to have affordable healthcare." The bill, which passed in 2004, pretty much allowed pharmaceutical companies to charge whatever they wanted for prescriptions. That senator then quit and got a job at an HMO, by the way.

The film is very moving (you will need tissues) and some of the small details are almost as interesting as the big points he's making, like the woman he takes to Cuba for treatment. The doctor takes her off five of the eleven drugs she has been on (and paying for) for ten years because they don't do anything for her. Because her HMO wouldn't pay for a full set of diagnostic tests, she was taking drugs she didn't need.

And who do we have to blame for this situation?
Surprisingly (or not depending on your cynicism level), the answer is Richard Nixon.

Moore isn't proposing a solution to the problem. He's simply saying that the current system in America is broken and needs urgent reform, and that reform will probably need to dismantle and rebuild it from the ground up.

Possibly the worst thing I found out is that only the rescue workers paid to be at the world trade centre got government healthcare to take care of their respiratory problems. Volunteers got nothing. Even the government healthcare fund set up to help the volunteers was run like an HMO, designed to avoid paying for treatment. For example, people had to prove how much time they'd spent on the site and you only got the healthcare after so many hours. As one woman put it; how do you prove how long you spent as a volunteer?

Score: A

OQ: These people aren't falling through the cracks. These companies are making the cracks and sweeping these people towards them.

¹ The phrase is "Prudent Person Pre-Existing Condition Symptom Clause". Basically it means that if you had a symptom that would make a normal prudent person seek medical advice, and you failed to do so, it's the equivalent of not disclosing a medical condition to the HMO, regardless of whether that condition is related to your current condition that you're seeking medical help for. In essence, if you had a headache and didn't seek a doctor's opinion, then developed back problems, the HMO could claim that the headache was an early symptom of the back problem and deny you care for failing to mention you had a back problem when you applied for insurance.

² The footage is of a patient called Carol, dumped on the street by the hospital once she could no longer afford the hospital bills, wearing nothing but a hospital gown. The day before Michael Moore turned up to film the mission she was dumped next to, another woman was pushed out of a taxi there. She had a broken collar bone, three broken ribs and was hypertensive (which basically means the experience could have killed her). The district attorney was there collecting information to mount a criminal investigation into the matter.