Saturday, February 23, 2008

Movie Review: Sicko

Lee and I finally got around to watching Sicko, the Michael Moore movie about the health care system in America. Michael Moore definitely has a view point but I appreciate that. I would recommend this movie to anyone who has had problems with their healthcare, so basically, I recommend this movie to every American! I can not believe how much Lee and I pay for healthcare: copays, deductibles, medicine, hospital stays, and we have health insurance! Having lived in England for a year I felt like I experienced their system - I saw the doctor 3 times (for free), and had positive experiences. It felt strange to pay about $10 for any amount of medicine, and I admit I stocked up on birth control pills (which were free!) right before we left to come back to the states. Since I was a pastor in England I would regularly visit the hospital and also a nursing home for seniors. Both were very nice, and free. One of my congregation members had to wait 2 years to have cataract surgery, but she was able to see - and it was free!

I enjoyed the special features on the DVD as well; What Would Jesus Deny was a favorite (a play on the What Would Jesus Do bracelets) and the discussion about the country of Norway - a year off of maternity leave! Sicko will definitely make you think and there is nothing wrong with that!


Brian and Kristie Gibson said...

We still need to see the movie. As a purchaser of our company's health insurance, I can tell you from my point of view we need major change in our healthcare system. I cannot say that I am convinced on what the perfect solution is. I just went to a really good lecture by a Trinity Univ. HCAD professor. According to him, your England experience neglected to mention that if you turn 65 and are on dialysis, they turn it off. Either you can pay for it, or you die. Actually that simple.

To me there are two main flaws in our current private insurance system:

1) Pooling is too small. Insurance companies set premiums based on the pool of the business they are selling to (or in the case of individual plans your own health exam and questionnaire). That maeans the sytem works the worst for employees of small businesses and self-employed. Small business is still the far largest employer in our country. Example: our carrier had our company's business for 3 years. We had one major cliam in the third year that gave them a break-even (claims = premium). For two years they earned a profit (claims = approx 85% of premiums, which is about average). But the reward we got was a 25% rate increase quote. Which of course means we went to another carrier. The point is, why don't they just quote the same price to all covered individuals and establish pricing to providers (expenses) and to premium payers (revenue) that result sin a profit? Why don't they just pool risk at the highest level possible? Probably because they would make less money that way . . .

2) There is no transparency in pricing. Best example is prescription drugs, which are te same no matter where you buy them. We are on an HDHP with HSA plan, so we pay out of pocket full cost until we hit our $2500 annual deductible (no co pays). That means we know to price shop drugs. Same generic drug, here were the prices:
- Albertson's: $67 for 30 days
- Mail order preferred by insur. co: $105 for 90 days.
- Costco: $14, yes $14, for 90 days.

Same drug . . . different profit margins.

The real problem is that in a workd of co-pays, nobondy even knows that the cost is, or that prices can vary wildly from one pharmacy to another.

Do you think that happens with doctor's offices, labswork, hospitals? You bet.

At this point, I am really in favor of a highly regulated private insurance "administrator" system where provider pricing and insurance premium costs are set at a Federal level. I also think everyone's insurance should work like an HSA so you know how much things cost and treat it like your own money. The deductible and premium costs could be indexed based on income level (and below a certain level be free or nominal) and then subsidized by the Federal governement. Everyone would have to have it to make it work. Actually, such a system would be a lot like Medicare supplement programs, which are administered by the private insurance companies.

My two cents.


Kerry Sumpter Smith said...

fascinating, thanks for sharing!

Elise said...

I had a good experience with Kaiser Permanente in California. I'm not sure what this kind of organization is officiallycalled...but it's basically an insurance company and provider in one (not what I think of as an HMO). Every doctor you go to, every physical therapist, pharmacy, etc. is all on one campus. I wrote a $100 check the day of my surgery ($10,000+ w/not insurance) and never got any follow-up bills, notifications or copay bills from the labs, the 2-3 different docs I saw, the pharmacy, or even the optometrist that made my glasses for me. The place looks, feels and smells like a public high school, and you may be sitting next to a drunk complaining about his catheter in the waiting room, but something about it works. (note: now I'm on Sam's plan, which is a traditional PPO), I'll keep you posted :)