This weekend dh and I decided to enjoy our day off from the kids (on Sunday they go to Granny’s) by watching a pay-per-view movie. After going through the long list of horrible options, we decided on Michael Moore’s documentary on the health-care industry Sicko. We weren’t sure that we were really up for such a serious topic, but we have enjoyed Moore’s movies in the past.

I really believe that it is one of those must-see movies, and probably Moore’s best and most important one yet. Unfortunately, I think it may not have been quite as popular due to a little bit of Michael Moore backlash. Now, I am not saying that Michael Moore may not skew the facts at times (but what journalist or commentator doesn’t these days); however, his over-all messages are usually pretty sound. At least, in my opinion.

Sicko briefly mentions the plight of all those poor Americans who try to get by without any medical coverage. His real focus, though, is the way the health-care industry does everything in its power to keep from paying the medical bills of those Americans who invest their hard-earned money into insurance premiums each year. He shows the struggles of families who have lost everything from their homes, their dignity, and sadly even their loved ones because insurance companies refused to approve life-saving medical treatment and medical care-givers refused to give the treatment without guarantee of payment.

Then Moore goes on to discredit all of the misinformation that is deliberately sewn by those who are against socialized medicine. He visits four countries with socialized medicine (Canada, Great Britain, France, and Cuba) and talks with doctors, hospital administrators, and patients to debunk the myths that socialized medicine equals inferior health care, lack of doctor choice, and poor and beleaguered medical staff. And if a third-world country like Cuba can afford socialized medicine, why can’t the richest country on the planet?

The fact of the matter is that in the United States profit has become more important than doing the right thing, especially in the medical field. I’ve seen it first hand. After I graduated from college, I worked in medical billing for almost four years. At my first job, I had to handle benefits and pre-certifications for durable medical equipment. For instance, if someone broke their foot my company supplied the various walking boots and braces until their fracture healed. There was one insurance company that would not cover any equipment unless it was customized and pre-approved. So everyday I would call this company and I would ask for Michael (because he would let me do more than three patients per phone call and he was sadly in on the joke of it all) and give them all of my patients’ id numbers and what they needed and then he would send me and the patients denial letters.

Another part of my job at the company was to fill in as a receptionist at one of the physical therapy clinics. Everyday the number of treatments (exercises) that each patient received by each therapist was added up. Then the therapists were expected to do a minimum of three treatments per patient, but they were strongly encouraged to do more “if they are medically necessary, of course”. You see more treatments equaled more money. At my second company, there was an incentive program for nurse practitioners who saw more patients and did more procedures in a week. They received expensive electronic equipment, in addition to their hefty salaries (while those of us in the billing department fought for an extra 25 cents a year). The company was later investigated for insurance fraud and went bankrupt about a year after that.

Our insurance through my work changed within two months of becoming pregnant with my first child. As a result, I had to find a new OB/GYN office. Since medical billing is dominated by women, I had plenty of people to ask for recommendations. I looked into one group that was highly recommended, but before I made my first appointment one of my co-workers took me aside. She explained that she used to work for that office a few years before. She told me that they had a special prize each month for the doctor who brought in the most money and that as a result the group had the highest cesarean rate in the city. Considering that the U.S. Cesarean rate is already grossly out of proportion compared to the rest of industrialized nations and the infant and mother mortality rate higher as well, I opted to look for a different doctor (which is a story for a whole other post).

We always hear that the Hippocratic oath that doctors are required to take has the words “First, do no harm.” Sadly, these days the American medical motto seems to be “Only help if there’s a profit in it, and don’t worry about doing harm from unnecessary procedures as long as there is a profit in it.” I feel truly sorry for those doctors, nurses, and other health-care professionals who truly want to help people but are pressured and harassed by their company’s CFO and other business administrators into sometimes working against their patients’ best interests. And I wonder how those in the medical community who lie to, steal from, cheat, and harm people in the name of profit in personal greed live with themselves.

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