EMS: Courage and Compassion in Action: U.S. Health Care: An Oxymoron?

By Shawn Godfrey12:20AM / Monday, November 26, 2007Print Story | Email Story

Shawn Godfrey///

Over the weekend, I had the pleasure (or displeasure depending who you ask) of seeing Michael Moore's new film, "Sicko." Yes, I said Michael Moore; the most incendiary filmmaker of our time has released another documentary. This time he tackles the U.S. health care system by presenting real-life examples of how the system is corrupt and the different ways it can turn a proverbial blind eye from its people. Although Moore spends a lot of time exploring health care in smaller European countries without actually comparing how they work or their overall statistics in relation to the U.S., I was deeply affected by "Sicko" and its description of the disastrous state of the outrageously expensive but poorly managed health-care system in the United States. The documentary walks viewers through several parts (as listed below), each highlighting separate health care issues in the U.S. and how the system is poorly structured and implemented: ● Many Americans are potentially forced to reduce their overall quality of life because they are not adequately covered by health insurance. The film profiles one man who had to choose between saving either his middle or ring finger on his left hand after they were severed during a table-saw accident. Because of "limited eligibility requirements," his insurance carrier would only pay for one reattachment procedure. He chose the ring finger in order to continue wearing his wedding band. ● Another unfortunate account includes denial of payment for ambulance services because a woman, who was seriously injured in a motor vehicle accident, didn't call her insurance provider from the accident scene for prior authorization for transport. When was she to call? After her momentary lapse of unconsciousness? ● Most, if not all, health-care company medical directors, applicant reviewers and medical boards are employed for the sole purpose of denying membership coverage, and some are even offered incentives, like cash bonuses or extended vacation time, for meeting or exceeding a certain number of claim denials. Many companies also employ "health-care sleuths." These investigators are handsomely paid to scour through past medical records in order to find a reason for retroactively denying payment for care. ● Hillary Rodham Clinton's crusade for socialized medicine, or "Hillarycare," burned up approximately 15 minutes of the film. This segment includes a video track from Ronald Reagan's infamous stance on U.S. health care, and President Nixon's clandestine support for Kaiser Permanente and the company's spearheading of the current "for-profit" model. ● Unfortunately, the film weakly examines how the British, French, and Canadian systems work, although it does illustrate how some Americans manage to benefit from these other systems. One American woman, now living in France, says she feels guilty for the health-care advantages she is afforded while her parents, living in the U.S., are part of a vastly inferior system. Moore, frequently labeled as anti-American by the right, makes a point of presenting Canadians and French who are pro-American and conservative, but strongly believe that socialized medicine is the ideal health-care paradigm. ● Sadly, the film shows how a fragmented system is able to dump patients from the hospitals to the doors of low-income clinics when they no longer have the means to pay for treatment. One scene portrays a taxi cab dropping off a disoriented elderly woman, barefoot and dressed in only a hospital gown, on the busy city streets. The woman continues to aimlessly wander until a nearby clinic's staff member intervenes. ● The segment that affected me most is how 9/11 EMTs, firefighters and rescuers who, years after being heralded as heroes, are now unable to pay for medical care for illnesses acquired while volunteering at Ground Zero. A disturbing piece of the film reveals a high-ranking military official bragging that the care given to 9/11 terrorists detained at Guantanamo Bay (Gitmo) is far superior to the health-care citizens receive while living in the U.S. Moore personally takes a group of the volunteers to Gitmo. However, after being turned away, the 9/11 heroes are treated pro bono by Cuban doctors; receiving tests, medications and treatment strategies they were otherwise denied in the U.S. In addition, after hearing of their dilemma, a Cuban fire department honored the volunteers, dispelling the myth that most Cubans (like the French and Canadians) are viscerally anti-American. ● A final part of the film, rich with irony, is when the No. 1 anti-Michael Moore site on the Web is nearly shut down because the webmaster couldn't afford to maintain the site and pay for his wife's ever-growing medical bills for cancer treatment. Moore anonymously sent a $12,000 check to the site founder and, to this day, the site is running stronger than ever. Judging by the testimonies expressed in the movie, albeit all of them containing a "Moore Slant," there is, in the very least, an iota of proof that the U.S. can provide far better health-care coverage for its people. Other than exorbitant capital gain for pharmaceutical companies and for lobbying politicians, the one question I was waiting for Moore to answer is: why do we pay more than the other countries profiled? The closest is France, which still only pays about half as much as we do and, bear in mind, their health-care coverage pays for physician house visits, nannies, and other ancillary medical assistance, like eyeglasses and time missed from work. I am certain film critics, film buffs and filmmakers are able to pick this movie apart much better than I, however, in the very least, I feel it does a wonderful job of bringing our health-care predicament to the forefront. It makes you think and, more importantly, makes you talk. Isn't that the point of most documentaries? With that in mind, this is a documentary everyone should see.

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In answer to your question there are multiple reasons we pay twice as much per capita than other countries, while getting significantly worse health outcomes (longevity, infant mortality, and almost all quality indicators except for in the area of cancer care), and not covering 47 million Americans. First and foremost is the staggering waste of overhead and administrative costs imposed by the multitude of private insurance entities that ration our care-HMOs, PPOs, POSs, fee for service, etc. The crushing burden of paperwork they demand with their requirements for documentation, denials of care, refusal to pay claims, underwriting, costs us literally 31% of every health care dollar spent in this country. Instead of that huge percentage of every dollar going to provide care, instead it goes toward denying claims, often with the aim of creating so much bureaucratic hassle for both patients and providers that they give up on getting fair payment. Medicare only uses 2-3% of every dollar for administrative costs, while 97% goes toward valuable health care. Another reason is simply that US doctors and hospitals are paid much more than those in other countries, and we have a much higher percentage of specialists, and too few primary care providers, because specialty care is much better paid. We need many more primary care doctors to provide the preventive care we need to avoid illness in the first place, whenever possible. There is much evidence that people who are wealthy and can pay well for care receive too much care, often placing them at risk, and resulting in worse health outcomes. More is not always better when we are talking about invasive medical tests, drugs, and procedures. Meanwhile the poor and middle class, who cannot afford expensive cost sharing with their insurance plans, or are uninsured and cannot afford care, often delay going for the basic preventive care needed to avoid expensive illness, and then end up spending much more when they develop serious conditions. Medical malpractice is only a very minor cause of extra health care costs. It is only a myth that doctors order many more tests and procedures to CYA. Much excessive testing, imaging studies, etc., are ordered because the fees they made pay for the equipment and staff to maintain it, or represent high fees for the provider or facilities. A great deal of this excess could be reined in with absolutely no added risk for the patient. In many cases it would benefit the patient, because so many tests involve risk of complications. The best answer to our out of control health care costs is an expanded "Medicare for All" program that covers us all, cradle to grave, like those that exist in every single other civilized country. We could cover everyone for all necessary medical care with the savings from the 31% of every dollar now spent on wasteful bureaucracy with these private health insurance companies. Read HR 676, the Conyers/Kucinich National Health Insurance Bill in Congress, it describes the gold standard in health care proposals. I've been a first responder for 34 years, and seen more than my share of the awful problems of the uninsured. The pain, irreversible disability, and premature death people are suffering is unspeakable. To me it is a moral imperative that we help our neighbors get the health care they need. But for the Grace of God there go I, it can happen to anyone.
from: 7rescue	on: 11-27-2007 12:00AM I Agree (0) - I Disagree (0)

I would like to go to my doctor and not be rushed out the door after a 5 minute consult. For my $15 co-pay I should at least get the full 15 minutes of the doc's time. After all, he will get a king's ransom from the insurance company as a result of his quick assessment of my condition, why shouldn't I get what I deserve from it too?? Then I would like to be able to get the tests done that I really need without having to fight about it with someone who isn't even a doctor...(i.e. the insurance company employee who is denying my test). Just those two aspects of the whole insurance thing are enough to make me sick! Looks like another trip to the doctor.... blah. ;)
from: gold deuce girl	on: 11-29-2007 12:00AM I Agree (0) - I Disagree (0)

Brien Center Announces Vice President of Human Resources

03:42PM / Wednesday, May 01, 2024

PITTSFIELD, Mass. — Amy Thomson was recently named Vice President of Human Resources for the Brien Center, Berkshire County's largest behavioral health provider.

In her new position, she will provide strategic direction and oversight for all aspects of the Human Resources functional areas including recruitment and retention, employee relations, compensation and benefits, performance management and professional development.

Immediately prior to joining The Brien Center, Thomson served as the Vice President of Human Resources for the Annie Selke Companies. Other career positions include Director of Human Resources for Berkshire Healthcare Systems' Long Term Care Division, Vice President of Human Resources for Legacy Banks and Director of HR for Cranwell Resort, Spa and Golf Club.

She is a resident of Pittsfield.

"We are excited that Amy has joined our leadership team, "said Christine Macbeth, President and CEO of the Brien Center. "The agency will benefit from her 30+ years in Human Resources and her skills in employee relations, compliance and benefit management, performance management and strategic focus. Her previous experience will serve her well as she leads her team in developing and implementing efficient and creative initiatives that will advance the HR components of the organization's strategic plan."

Thomson earned a Masters' Degree in Human Resources Management from Leslie University and a

Bachelor of Arts in Psychology from Boston College. She enjoys skiing, hiking, horseback riding and spending quality time with family and friends.

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