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Monday, July 30, 2007

Health Insurance: SiCKO Has the Right Idea
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I had the chance to see Michael Moore's new documentary: SiCKO. I did not read any reviews before going in and did not go on his website before seeing the movie.

See this movie.

Getting an education in the mess we call health care is more complex than a degree in astrophysics from MIT but we all have to get it and we have to start somewhere. Whether you agree with Moore or not, see the movie. He is right about the one thing that a vast majority of readers of this blog were right about: The insurance companies are THE MAJOR reason we are in the mess we are in.

Since the movie came out there are a number of critics out there who have been trying to bring up all the accessory problems that health care has. Many, if not all of these are true. The problem is that whenever someone waters the arguments down with a claim about the quality of hospitals, the amount of money paid to hospitals and doctors, the grading of performance, the useless tests ordered, or medical malpractice is a problem one fact always will emerge. No problem in health care can be fixed without first a massive restructuring of the system with which we pay - the insurance system.

OK. We now know the problems. What are we going to do? It is about time the biggest lobby in the country - the American People - got it together to put an end to the insurance abuses. If you have been under a rock for the last 30 years here is what happens:

  1. Insurance companies take your monthly premium payment. If you do not pay immediately, you are quickly canceled.
  2. Insurance companies decide on the premium based on the profit they want to obtain.
  3. Any profits from the system go to executives and shareholders and not back into health care.
  4. Insurance companies routinely and arbitrarily deny approval for necessary tests for patients.
  5. Insurance companies routinely and artificially deny payments to doctors and hospitals for services already approved and performed.
  6. Insurance companies have the goal to NOT PAY a claim.
  7. Insurance companies interfere with clinical decision making of physicians.
  8. Insurance companies have lobbyists that have heavily influence your Congressman and Senator.
  9. Insurance companies have no interest in "maintaining" your health. HMO's are designed for profit even when they call themselves non-profit.
  10. Insurance companies abide by their own rules of behavior.

There is really only one solution. Reform the health insurance industry as we know it. Make it illegal to sell health insurance in America until every American is covered with a basic universal plan and then, and only then, insurance companies can sell gap-type insurance.

Here is the bottom line. There are a ton of real problems in health care. If you want to get a good idea of some of the issues I recommend you read the book Better by Atul Gawande. It is an excellent balanced view of how we can hope to improve American health care.

In the meantime, while we are looking for balanced solutions get your Congressman, Senator, or Presidential Hopeful to outline a plan for meaningful regulatory controls over the insurance industry and start working on a fair and open universal health care system that covers all Americans, allows doctors to opt out, but assures an acceptable quality of care for every citizen.

Doctor K

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Posted by: Doctor K at 1:19 PM

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