Fwd: CLNews: Insurance companies arrogant; Sicko and the Politics of Health...

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In a message dated 6/27/07 5:47:56 AM !!!First Boot!!!, List...@CLNews.org writes:

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From: Compton Mary

Sent: Tuesday, June 26, 2007 9:59 PM

Subject: Insurance companies arrogant; Sicko and the Politics of Health Care

Posted on Tue, Jun. 26, 2007 A column by Edith Kenna Insurance companies arrogant I have saved an article from a Fort Wayne newspaper of 2006 that reported Jason Govrevic, president of Wellpoint/Anthem’s New York market, had been spearheading an effort to encourage personal responsibility in its consumers (of health care). Mr. Govrevic is quoted as stating, “It’s all really designed to make you a more engaged consumer. We know that if you’re more involved in your health care — if you’re acting more as a conscientious consumer — it’ll be better for your health.” I saved this article as I knew the time would come when I would have the opportunity to talk “responsibility” with my health insurance company. Well, that time arrived last month when I attempted to be a “conscientious consumer” by contacting Anthem after receiving what appeared to be a response to my physician’s request for prior authorization for a recommended procedure. The exact quote from the response that I received from Wellpoint/Anthem is as follows: “This is not an approval for claim payment. This approval is a confirmation of medical necessity only. We have not yet reviewed your health care plan. Depending on the limitations of the health care plan, we may pay all, part, or none of the claims.” Wanting to be “engaged” in my health care decisions, wanting to be responsible (vs. irresponsible), and certainly not wanting to join the ranks of the 77,000 Hoosiers who in 2005 declared bankruptcy due to medical expenses, I decided to phone customer service of Wellpoint/Anthem to find out just when they were planning to “review my health care plan.” I requested an estimate of my out-of-pocket costs if I were to undergo this procedure. To be a “more engaged and conscientious consumer,” perhaps I would have to compare costs at various facilities, or even save money to have the procedure done. Don’t we “responsible consumers” usually get an estimate to have the car repaired, the house painted or the leaky toilet fixed? I just wanted to take this cost under consideration and make a financial plan in keeping with my budget. I am simply a middle-class worker with modest salary and savings trying to do the “responsible” thing. Wellpoint/Anthem, a multimillion-dollar industry with many technological and financial resources available, wants me to be responsible, but they say they cannot, or will not, provide me with any such “estimate.” Wellpoint/Anthem states that I must first undergo the procedure, which they state is a medical necessity, before they will review my health care plan or let me know my out-of-pocket costs. Somehow, this is not what Mr. Govrevic of Wellpoint/Anthem was implying in the copy of the Fort Wayne newspaper that I saved for just this occasion. I mean, after all, Anthem has a contract with my physician, the facilities at which the procedure could be provided and a contract with both me and my employer. Somehow, I don’t think I’m the only person who has ever had this particular procedure done in Fort Wayne. My out-of-pocket costs should not be a secret from me. Surely someone at Anthem has a calculator, and, at this particular point, it is only they with whom I have a contract. Being a “well-informed consumer,” I have not hired the facility nor the physician to complete this procedure because I don’t know what it costs. I am insulted again by private health insurance talking about what consumers need to do but not providing simple customer service in good faith. Once again I am dealing with the arrogance of a health insurance company that, in my opinion, is acting in bad faith by insisting that only I act responsibly. It is ridiculous that I must first incur the debt to know the final cost that will be borne by me. Private insurance companies have become too arrogant and too powerful. It is no longer clear what role private insurers serve in the delivery of health care, other than to skim money from the consumer while defining ever more narrowly who is deserving of what care – or any care whatsoever. We have become a society of insiders and outsiders. We currently have a non-system of illness management. It is clearly time for all Americans to have access to a simple plan that it accessible, affordable, portable and of quality. It is time for a single-payer system in which we all are on the inside and not pushed toward or treated as an outsider. The health care coverage we all need and deserve is currently outlined in a bill, HR 676, which has been reintroduced by Rep. John Conyers into the House Ways and Means Committee. This bill, if enacted into law, would extend Medicare to all at reasonable costs, simply, affordably and with responsibility shared between the individual, the government and the medical system. It is definitely time for all Americans to encourage a hearing on HR 676. Compromise plans being proposed by cautious reformers will all provide more muddle and run into the same political problems and strong pharmaceutical and insurance company lobbies. Edith Kenna is on the board of directors of Hoosiers for a Commonsense Health Plan

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© 2007 News-Sentinel and wire service sources. All Rights Reserved.
http://www.fortwayne.com

June 26, 2007

Good Movie, Now Where's the Movement?

Sicko and the Politics of Health Care

By RALPH NADER

He sat there dejected and indignant-twenty years ago-in our office. His position as editor of the monthly muckraking magazine, Mother Jones, had broken up. He was looking for a job that would allow him to bring his conscience to work.

We gave him a place and support to start Moore's Weekly-a media critique.

Michael Moore has gone a long way since that short-lived publication. He went on to do documentary films, starting with Roger and Me-meaning of course, Michael Moore.

Rich, famous and Hollywood chic, Moore will open his latest film-'Sicko' in theatres around the country on June 29, 2007. To many of those who have already seen this indictment and conviction of the corporations that sell health care under an array of tricky conditions, it is his best move yet.

He was in Washington, D.C. last week, for a preview at the large Uptown Theatre and for testimony before a House Committee. The media followed him with a frenzy hitherto reserved for Paris Hilton.

But Michael Moore is no Paris Hilton from any dimension you wish to choose. He is a heavyweight reformer, pitching his film toward full Medicare for everyone. This also means displacing the health insurance industry the way Medicare partially did in the mid-Sixties for the elderly.

"I think one movie can make a difference;.I believe it will be a catalyst for the type of real change people want," Moore told the New York Times.

Great movies and documentaries raise people's latent indignation levels-for a short time. Norma Rae, The China Syndrome and The Grapes of Wrath had this effect. But films do not usually move either people or legislators to action. Their effect does not reach enough people. Their urgent 2 hour impact tends to diminish quickly, as compared with the omnipresent and powerful corporate or commercial interests determined to preserve the status quo.

Will 'Sicko' be any different? Certainly the giant HMOs, hospital chains and drug companies are firmly entrenched with all the sinews of power that have left this country, alone among western nations, without health care for all. They have endured easily many mainstream print and television exposés (see the New York Times, AP, 60 Minutes and the nightly evening news, for example) year after year.

Authoritative reports documenting over $200 billion a year in computerized billing fraud and abuse or the loss of 18,000 American lives yearly due to the unaffordability of health care (The Institute of Medicine) bounce off this two trillion dollar industry like marshmallows.

Having been a taught community organizer in Michigan, (see the new book, Citizen Moore by Roger Rapaport) Moore has prepared with all this in mind. He allied himself with the great California Nurses Association and their nationwide colleagues to demonstrate in favor of the film, contact legislators and other large unions.

The anticipatory media for the movie have been generous; citing the U.S. government's move against Moore for what it claims was an unauthorized trip to Cuba. Right wing think tanks, funded by this hyper-profitable, subsidized industry, pour out inane rebuttals and offer quotes against Moore for reporters.

Unlike for other social justice movies, there is even a bill in Congress, H.R. 676 with 74 cosponsoring legislators, led by Cong. John Conyers (Dem. Mich.), to establish full Medicare for all.

That is a number of lawmakers considerably less that those who signed on to a similar bill in 1993.

There are 17 million more Americans uninsured today than in that year, totaling nearly 48 million without coverage in 2006. So you see where that trend is heading.

If Moore is serious about getting "real change," as he phrases his goal, he will have to make at least two more contributions. First, he will need to make a comprehensive effort to get many of the 6 million or more people, who will see the film, to sign up as they enter or leave the theatres so that they can be given a chance to connect with each other for a cohesive change constituency.

Secondly, some of the millions he will make from this movie should be put into a full time lobbying organization in Washington and back in the Congressional districts to press for enactment of H.R. 676.

With all his super-rich Hollywood contacts and admirers, Moore should be able to multiply this proposed group's budget several fold. Michael can even call it 'Moore's Miracle!'

Ralph Nader is the author of The Seventeen Traditions

 

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