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Transcript:

August 21, 2009

BILL MOYERS: Welcome to the Journal.

Some years ago, surgeons opened my daughter's skull and removed a brain tumor that threatened to kill or blind her. Less than a month later, when one of my arteries suddenly shut down, open heart surgery saved my life, those skilled physicians and hospital still glow in my family's memory.

But the dual crisis in our lives cost tens of thousands of dollars. When the insurance came through, we breathed a sigh of relief. The economist and Nobel Laureate, Paul Krugman, says that's the thing about health insurance; you'll never know when you will need it. If you need it and don't have it your in deep, deep trouble.

That's what happened to the families that you will meet in this week's broadcast. The filmmaker Roger Weisberg, whose work has long been dedicated to putting a human face on public policy, traveled the country to meet people who desperately needed health care that they couldn't afford.

What they went through and what they had to say about it is potent reminders that the need for health care reform is a national emergency. Here's a look at CRITICAL CONDITION.

DALE STORNAIUOLO: Joe and I have been together 22 years. They say you find one love in life. For me it was Joe.

CIARA STAR CHRISTOPHER: Just go to the next one.

JOE STORNAIUOLO: What are you doing, playing with it? My Christmas tree?

DALE STORNAIUOLO: Joe was a doorman for almost 15 years.

JOE STORNAIUOLO: You want a bow in your hair

DALE STORNAIUOLO: He didn't make great money but he always said the benefits were good.

We cannot find the angel.

CIARA STAR CHRISTOPHER: What are you putting on top, then?

JOE STORNAIULO: You!

CIARA STAR CHRISTOPHER: So what are you hoping for, for Christmas? What do you want?

JOE STORNAIUOLO: My health, I guess. That's what I would wish for.

DALE STORNAIUOLO: When Joe first got sick he was diagnosed with liver disease. I guess they felt that he just couldn't do his job no more. So Joe got terminated. Right after that they stopped his health insurance. And now it's like, what do we do?

DR. WAYNE MCWILLIAMS: Hello.

JOE STORNAIUOLO: Hello.

DR. WAYNE MCWILLIAMS: How are you doing today?

JOE STORNAIUOLO: Not too good.

DR. WAYNE MCWILLIAMS: What's happening?

JOE STORNAIUOLO: Well, my leg is still swollen.

DR. WAYNE MCWILLIAMS: Well, you know that you have this underlying liver disease. It's not related to alcohol use or to hepatitis virus. It's just really from the liver um the liver not working right and then it develops into cirrhosis.

And that's really the main reason that you've got all this swelling in the legs. The diabetes is sort of a separate issue but it still, still complicates things dramatically. So how often are you taking insulin?

JOE STORNAIUOLO: I take it once a day.



DR. WAYNE MCWILLIAMS: You should be probably taking that three times a day.

DALE STORNAIUOLO: But we skip because the tabs are expensive.

DR. WAYNE MCWILLIAMS: This is a really tough thing to deal with, not being able to get the medicines that you need or that we think you need.... it makes it all, all the more tough for you. Especially for your liver disease. These diuretics, I consider these life-saving medications the same way I would with the insulin. We have some samples of the insulin. We didn't have much, unfortunately. Okay?

DALE STORNAIUOLO: Okay. Dr. McWilliams, thank you again. I appreciate your time.

DR. WAYNE MCWILLIAMS: Thank you.

DALE STORNAIUOLO: We'll see you soon.

JOE STORNAIUOLO: I don't want to live like this. I mean, can't get Social Security, I'm too young. Can't get welfare, make a little bit too much. In the meantime, I've got 50, 60 thousand dollars in doctor bills.

DALE STORNAIUOLO: So, you need to stop worrying about those collection agencies and the medical bills that we're getting….

JOE STORNAIUOLO: Well, I'm dying anyway, put me in collection.

DALE STORNAIUOLO: Joe, I'll be damned I'm going to let you sit there and give up hope.

JOE STORNAIUOLO: Oh without a liver, I'm not going to get better. Liver transplant costs about 150 to 200 thousand dollars. If you're broke, you could get the medicine, you could get the hospital, everything else. But if you work hard all your life you get nothing. DALE STORNAIUOLO Things will work out. If Joe had insurance, he would have never had to skimp on his medication. He would never have used the same needle six to nine times. So yeah, you cut medical corners. It's like playing Russian roulette with your life.

JOE STORNAIUOLO: 452.

DALE STORNAIUOLO: Oh, my God. Normal is 120.

JOE STORNAIUOLO: Is that more bills?

DALE STORNAIUOLO: Yep. Lehigh Valley, physician's business center. Oh, my goodness. This is from when you were in the hospital the last time. Please call our collection department. Joe, I don't want to go into collection anymore.

JOE STORNAIUOLO: Here. $28 thousand dollars.

DALE STORNAIUOLO: I can't believe they think we can pay that.

JOE STORNAIUOLO: I can't believe they charge so much.

DALE STORNAIUOLO: : Ridiculous. But when we go in, we go in honest and we say this is what we have and we have nothing and you can't get blood from a stone.

JOE STORNAIUOLO: Maybe I could win the lottery.

DALE STORNAIUOLO: Ah, you never know.

KAREN DOVE:
Approximately five months ago, the pain started on my lower stomach area, that's when I started getting concerned about cancer. A lot of the doctors wouldn't see me because I didn't have insurance and they actually turned me away. That was a denial of service, out and out denial of service.

I called the Cancer Society and told them that I didn't have insurance and that I was having trouble being diagnosed. And, Dr. Smith's office called and asked if I would like to have a visit with her. I was like, what? You're who? And you want to see me?

DR. ELLEN BLAIR SMITH: Why don't you lay down and put your feet up here.

KAREN DOVE:
Ok.

DR. ELLEN BLAIR SMITH: Did you go a while without seeing a doctor?

KAREN DOVE:
Yes.

DR. ELLEN BLAIR SMITH: Do you have any pain when you press here?

KAREN DOVE:
Yeah. Over there.

DR. ELLEN BLAIR SMITH: It's worse?

KAREN DOVE:
Yes.

DR. ELLEN BLAIR SMITH: With what we see in your blood and what we feel on examination, we have to take your ovaries out.

KAREN DOVE:
Ok.

DR. ELLEN BLAIR SMITH: If these ovaries look like they're cancer, we're going to have to make a big incision.

KAREN DOVE:
Ok.

DR. ELLEN BLAIR SMITH: I'd like for us to operate next Wednesday.

KAREN DOVE:
Next Wednesday, okay.

DR. ELLEN BLAIR SMITH: Karen, you're going to meet the financial councils, you'll meet all sorts of people who'll help you working on the bill part....

KAREN DOVE:
Ok.

DR. ELLEN BLAIR SMITH: But you know, right now it's bills be damned, let's do this.

KAREN DOVE: Ok, thank you.

DR. ELLEN BLAIR SMITH: Ok?

KAREN DOVE:
The first visit with Dr. Smith's was 1139 dollars.

RECEPTIONIST: What we can do is we can set up a payment plan. So what are you going to be able to feel comfortable paying?

KAREN DOVE:
I'll say 40 a month and try to do 40 a month.

RECEPTIONIST: Ok.

KAREN DOVE:
I worked like the dickens to keep insurance. I was an apartment manager for 10 years and I had insurance that whole time. The apartment complexes kept getting bigger and I couldn't do the stairs anymore because I've got pulmonary disease. Me not being able to handle the job physically, I had to let it go. That meant I lost my insurance too.

RONNIE DOVE: What'd the doctor say?

KAREN DOVE:
They're talking about surgery.

RONNIE DOVE: I'm glad it was better news.

KAREN DOVE: Me too. I'm still worried.

RONNIE DOVE: It's got to be done.

KAREN DOVE:
I love you.

RONNIE DOVE: I love you too, baby.

KAREN DOVE:
We've been married 30 years and we've always worked. Ronnie's working two jobs. He's working for a merchandising company and then he's grounds keeper for an apartment complex.

RONNIE DOVE: I make a little over 14 thousand max for the year. We were able to pay our bills and put a little bit aside, too. Of course all of the stuff that we had put aside is long gone now, because we had to use it immediately whenever she first got ill. We didn't have insurance.

CARLOS BENITEZ: Once you don't have insurance you don't really know what the problems are for you. About 15 years ago, my back really started to hurt. Slowly it was just bending and bending until it got to where I am, so I lost about 7 inches. My wife tells me "Let's go to the park to play with the kids." I just cannot play with them because it's just...painful.

MARICELA PINEDA [Spanish in English subtitles]: We are going to find a solution. God is going to provide the means. I don't know how but He will.

CARLOS BENITEZ [Spanish in English subtitles]: I don't know what will happen. Truly, I can't tell you.

Twenty-five years ago when I came to the United States, I felt very happy to become a U.S. citizen. Right now I am a chef working for a French restaurant. A year I make 45 thousand dollars. Many years ago when I had insurance, they were giving me it was just medication that you can buy over the counter. And expenses is starting to go up, rent it went up, so it got to the point that I just needed that money that I was paying for the insurance in order to support my family. So I had to discontinue the insurance. What I didn't realize was that when I was taking all this medication for my back pain that I was like bleeding inside of me.

DR. PATRICK T. DOWLING: One time you had some health insurance, but you could no longer afford the, the premiums. Is that right?

CARLOS BENITEZ: That's right, yes, that was.

DR. PATRICK T. DOWLING: Carlos Benitez came to this health fair six months ago. He looked very pale, because he was missing almost 70 percent of his blood. And when we saw you in September you were taking Tylenol, and Motrin, and the other thing you were taking…

CARLOS BENITEZ: Naproxen.

DR. PATRICK T. DOWLING: Naproxen. How many of those a day?

CARLOS BENITEZ: I was taking 10 pills.

DR. PATRICK T. DOWLING: So the medicine you take for pain causes ulceration so you'd almost bleed to death. We said you need to go the hospital right away. Was that correct?

CARLOS BENITEZ: And I said to Dr. Dowling "But it going to cost to go to a hospital, besides I have to go to work." And Dr. Dowling tell me, "No, I don't think you're going to work, right now you're going to go to the hospital, because on your way to work you can die." I was scared, it really scared me.

DR. PATRICK T. DOWLING: We successfully convinced him to go to the hospital emergency room, where he was admitted and transfused. So the bleeding was all due to the medicines he was taking for his chronic pains. I wondered if you would stand up for a minute. I just wanted to see your back, if that's okay?

CARLOS BENITEZ: Yeah, it's fine.

DR. PATRICK T. DOWLING: Although his bleeding has resolved now he's still very worried about his back problems. We don't know what the reason is, but it's very painful. And he's still without health insurance, so he's got some real challenges down the road.

DR. ELLEN BLAIR SMITH: Hi, I'm Doctor Smith. Hi, good to meet you.

RONNIE DOVE: Ronnie Dove.

KAREN DOVE:
That's my husband and my mom.

DR. ELLEN BLAIR SMITH: Got any plans?

KAREN DOVE:
I hope. I hope we're going to get this over with.

DR. ELLEN BLAIR SMITH: Well let's go in there, let's get it out and fix you. Alright? See you back there.

KAREN DOVE:
Alright. Thank you, Doctor...

NURSE: It's time for a hug and a kiss.

DR. ELLEN BLAIR SMITH: Can I have a marking pen please? It is cancer. It's cancer of the ovaries. It's spread in the upper abdomen. In a couple of weeks, she'll get six courses of chemotherapy. It's given one day every three weeks, until she's done six of them.

RONNIE DOVE: How far advanced was it, as far as stage one, two, three?

DR. ELLEN BLAIR SMITH: It's stage 3C. And most people with this stage of cancer die of their cancer. Most people...

RONNIE DOVE: Karen had been sick for several months before she finally got the diagnosis. Even though, you know, in the back of my mind I felt like I knew what was going on, you still can't be prepared for it when it's someone this close to you as, as your wife.

NURSE: That looks pretty good.

KAREN DOVE:
The hardest thing was being diagnosed. I had a cancer specialist and he knew something was wrong but he just didn't want to follow through with more costly tests. Had I had insurance I really believe it would have been diagnosed a lot earlier. It probably would have not been in stage three. If we had some kind of medical system where everybody could get in there and be tested, they could stop some of this heartache. They could stop a whole lot of it.

We were doing a lot better financially until the cancer hit and all the doctor bills started coming. I've racked up some pretty good size bills and I have no idea what the hospital bill will be. And that's twice a day. I take14 pills a day. Potassium that's three times a day. And the medication alone is 25 thousand dollars a month. For a while I was desperate to get my medicine because I didn't have any. And I did go to Mexico and buy some medicine. That's once a day.

KAREN DOVE:
With my insurance, when I had it, that medicine was $50. In Mexico it was $4.95.

NURSE: Oh they do keep coming, huh?

KAREN DOVE:
Yeah.

KAREN DOVE:
Of course I'm scared. I'm scared about the chemo. I realize that I've still got a battle ahead of me. It's been rough. I've lost about 40 pounds. You just can't seem to get the strength that you used to have.

RONNIE DOVE: You sure you don't want some eggs?

KAREN DOVE:
This is all I can do.

KAREN DOVE:
You got questions for the doctor?

RONNIE DOVE: Yeah. How soon before I can start hitting on you again?

KAREN DOVE:
Right.

RONNIE DOVE: Do you have to do anything else to get ready to go?

KAREN DOVE:
Cover up my bald head.

RONNIE DOVE: You need another nausea pill. I'm sorry.

KAREN DOVE:
I'm tired of not being able to hold down food.

RONNIE DOVE: The hardest part is just seeing what Karen has to go through on a daily basis. It's real hard to keep from worrying.

DR. ELLEN BLAIR SMITH: Hi. How are you?

KAREN DOVE:
I just threw up.

RONNIE DOVE: She's been throwing up while you were out.

DR. ELLEN BLAIR SMITH: Now if you get over to the hospital and you don't feel better and you're still vomiting, I'm going to ask you to stay there. We're still at a very touch and go time.

RECEPTIONIST: Do you want to take care of that now?

KAREN DOVE:
No, I'll have to put that on my bill and pay it out.

RECEPTIONIST: Alright.

KAREN DOVE:
The financial part of this has been very difficult because you think about owing thousands of dollars that you never expected to owe, and thought you might own a house one day but come to find out it's all going to go on medical bills, and you're not going to have anything for old age either.

DALE STORNAIUOLO: Because Joe has liver disease, Joe has edema. And he's filling up with fluid. This is about the fourth time we've gone to the hospital this year with this problem.

DALE STORNAIUOLO: I'm hoping that you come home soon.

JOE STORNAIUOLO: I hope so too. We have, I have to come home.

DALE STORNAIUOLO: Actually you take 12, 13, there are 14 medications here that you're suppose to take daily.

JOE STORNAIUOLO: Daily, yes. I don't even know what I'm going to do when we come out. We have no money to pay for this medicine.

DALE STORNAIUOLO: I know. And I don't know how we're going to pay for this hospital bill.

JOE STORNAIUOLO: If I paid for the medicine I wouldn't have been in the hospital to begin with. I'm going to have pain in a minute.

DALE STORNAIUOLO: It's okay. You want to hold my hand? Breathe in through your nose, out your mouth. Count, remember count, focus on your fingers. Well, I'm hoping that they can figure out what's wrong with you and get this water out.

JOE STORNAIUOLO: Why am I so blown up?

DR JAMES WERTZ: Well, you're blown up because you know that you have the cirrhosis of the liver.

JOE STORNAIUOLO: Yes.

DR. JAMES WERTZ: And when you're on your medicine, the diuretic regimen, that helps prevent the fluid build-up.

So I think if we can keep you on these medicines, we'll try, we'll get you out of trouble.

JOE STORNAIUOLO: I know, but I have no money for the medicines, which gets me into trouble.

DALE STORNAIUOLO: There are people that are dying, because they cannot afford their medication. I don't want my husband to be one of those victims. When I come home and he's not here at night, it's hard. It causes me anxiety. It causes me a lot of stress. And we already have these bills that we are not able to pay. Every time Joe is in the hospital, you're thinking, "Oh God, how much is this costing? How am I going to pay for this?" It's just really hard.

CARLOS BENITEZ: For the last 15 years, I have never seen a specialist. I just wish that I see someone that can really give me, tell me, what I really have.

DR. PATRICK T. DOWLING: Unless you're a trauma case or you're in a car accident, there going to have to triage people. It's a crisis situation with people waiting and waiting…and waiting.

CARLOS BENITEZ: If I see a specialist at least it will be a chance that the doctor will say that the pain will go. That will be really a miracle for me. DR GREGORY YOSHIDA: Looking at your X-rays, you've got ankylosing spondylitis.

CARLOS BENITEZ: Uh huh…

DR. GREGORY YOSHIDA: So like on your hip right here, this used to be a clear line, like this. There was a joint here. Your body responds by turning your ligaments and your tendons into bone. That's the underlying disease.

But at least we know what you have... I mean, this is the real deal. Now, the problem is it's a disease that continually progresses. The most important thing is we have to keep your head looking forward. Carlos is not at the point where he requires surgery. If he were fused in a bad position we can go in and we cut the spine, realign them and get them to heal a new position. But it's a very large scale surgery, very high risk. If he can avoid a surgery of that magnitude, I'm all for that.

DR. GREGORY YOSHIDA: That's pretty dangerous. As long as he can look straight ahead, we're not going to touch you. Verygood. Let's see him back here in a year, okay?

NURSE: Okay.

CARLOS BENITEZ: I was kind of disappointed. I am in a lot of pain and it's going to just get worse. I think it all matters about the money because we're talking about maybe $150,000 dollars for a surgery. My cousin in Mexico, she's a nurse, and she's been telling me to go down to Mexico, to see if surgery can be done.

CELINA RODRIGUEZ BENITEZ [Spanish with English subtitles]: Hi! I'm glad you finally got here. I'm so glad you are here.

CARLOS BENITEZ [Spanish with English subtitles]: How are you, cousin?

CELINA RODRIGUEZ BENITEZ [Spanish with English subtitles]: Fine, you look smaller to me. You can see I'm smaller? Holy father, I thank you Lord for Carlos arrival. And I want to put all this time in your hands, that all we do, Lord, you will direct. Bless the doctor who is going to examine him. In the name of Jesus Christ. Amen.

CARLOS BENITEZ: The doctor in Mexico, he gave me a lot of hope. 40 thousand dollars will cover the whole surgery and a month in the hospital. And the doctor says there's going to be no more pain.

CARLOS BENITEZ [Spanish with English subtitles]: I feel more at ease now because I know there is hope. The only thing preventing the surgery right now is the money.

MARICELA PINEDA [Spanish with English subtitles]: If there is no money, there is no cure. You die. I have faith.

CARLOS BENITEZ [Spanish with English subtitles]: I have it. I have faith. You know, you are always by my side. That's why I love you so much.

KAREN DOVE:
When you don't have insurance, you have to worry about how long is your resources going to last?

SUSAN ROGALIN: Now what about medications? Are you…

KAREN DOVE:
I have some nausea medicines and hopefully I won't have to get anymore of that because one of them is 1100 dollars a month.

SUSAN ROGALIN: What are you taking for pain?

KAREN DOVE:
Just some Tylenol.

SUSAN ROGALIN: Tylenol usually doesn't do it for cancer pain.

KAREN DOVE:
Yeah, it doesn't, but I just try and bear with it. The main pain is in my hands and feet.

SUSAN ROGALIN: No, that's not good, Karen. If you're having more pain than what Tylenol will cover, I want you to go to Dr. Smith and ask her what she would give you.

KAREN DOVE:
Ok.

SUSAN ROGALIN: But I don't want you walking around in pain.

KAREN DOVE:
Alright.

SUSAN ROGALIN: Ok?

KAREN DOVE:
Yeah. I really never knew how much a cancer patient had to deal with, until it was put in my face.

ERICA: Ma'am, Stevens Health Care has placed you folks in our office for a past due bill 578.08 dollars. This call is an attempt to collect. Any information will be used for that purpose.

KAREN DOVE:
All I can do is come in and start making some payments.

ERICA: Ok.

KAREN DOVE:
But I can't promise more than $20 dollars a month. I'm trying to pay out several people.

ERICA: Ok. I can't secure it for that low.

KAREN DOVE:
The Cancer Center did have to finally turn us into the collection agency. I turn off my phone because the collectors calling so often that you can't even rest. It's removal of ovary tubes, but they charge you for each tube. Well, so far we still got all of these. It's 23,775.89 dollars. I'm ready to pull my hair out, what hair I've got left. I can't stand it no more. It's driving me crazy. Our full debt is probably 80 thousand, and we only made 16 thousand last year.

RONNIE DOVE: You're going to sell those?

KAREN DOVE:
Yep. We have to get rid of as much as we can so we can pay the bills and try and make it until we can get moved. I think we can get some pretty good money on this.

RONNIE DOVE: It's got to stay, baby.

KAREN DOVE:
How often do you play it, Ronnie? That's how we're going to get money. We've thought about possibly filing bankruptcy. If we can pay off the bills, we would prefer to pay them off. I think the stress and strain has finally hit me, you know. But I just have to keep reminding myself things could be worse.

CROWD: Surprise!

KAREN DOVE:
Hi, I didn't expect all y'all here.

RONNIE DOVE: The last year and a half it's been pretty stressful.

SHELLY PARKER: Happy Birthday!

KAREN DOVE:
Thank you.

SHELLY PARKER: You're welcome

RONNIE DOVE: It has gotten better knowing that the cancer is in remission. Still it's always in the back of my mind, what if it doesn't last? What are we going to do then because we still don't have insurance. This is something that I'll have to think about as long as I'm lucky enough to have Karen with me.

CROWD: Happy Birthday to you! Happy birthday dear Karen! Happy birthday to you!

KAREN DOVE:
Oh those are cool. I think that was my junior year picture. The bald headed one of course. Well, I'm glad to be 50 and I'm glad to still be here. Life is to be lived to die and that's just the way it is. Everybody's going to be there one day. I just look at it I got another day I'm happy.

DALE STORNAIUOLO: Joe is getting all this expensive treatment, but honestly it doesn't make any sense. If he'd just had basic care and the medication that he needed, I don't think Joe would have been this sick. This is the worst I've ever seen Joe. This should be the best time of our lives! I mean we've been together over 20 years, we should be enjoying each other. This should have been our time, and it's not! We're supposed to be the richest country in the world, and yet I live the poorest life and my husband worked all his life and paid taxes, so could somebody explain that to me, because it doesn't make no sense.

DALE STORNAIUOLO: You're looking at me.

JOE STORNAIUOLO: I love you.

DALE STORNAIUOLO: I love you, too. What? Are you going to tell me something? Tell me.

JOE STORNAIUOLO: I'm finished.

DALE STORNAIUOLO: You're finished? That's not true. I love you. You can't leave me.

JOE STORNAIUOLO: I'm finished.

DALE STORNAIUOLO: No.

JOE STORNAIUOLO: I can't walk.

DALE STORNAIUOLO: Don't make a difference. I'll take you any way I could take you. I always told you that.

JOE STORNAIUOLO: Yeah.

DALE STORNAIUOLO: Don't leave me, Joe.

When I drove home that night, there was a peace within me that said it was ok, Dale to let Joe go. That he was suffering; he was in pain and couldn't even tell you he was in pain. And that I had covered everything of all the years we had spent together, and he knew when his time came that I really did love him. Two days before Joe passed away, Joe was approved for Medicaid. I figured what's the point now?

CARLOS BENITEZ: I was trying to go back to Mexico and have the surgery done, but $40,000 dollars for me is impossible to come up with. When I realized that it was not going to be possible, I was sad. I wasn't expecting much from life really.

DR. PATRICK DOWLING: Just relax now.

If Carlos had health insurance something would have happened by now. So we do ration care in this country. People don't like to hear that, they don't like to say that, but the truth is, we do ration care based on ability to pay. I want you to breathe in and out through your mouth, ok? Whenever you're ready. Ok, deep breath. Public hospitals in Los Angeles are overwhelmed and in the private system things move quicker, and Carlos Benitez…he's just a nice guy with three kids and he needs a break. So I'm trying to get him through with the private system.

Well, the goal is to evaluate you and then refer you to the orthopedic surgeons at UCLA and see whether the surgery would be merited. If they feel they can help you, they've agreed to do this all for free 'cause we know there's no way you could possibly afford it. They will give you their honest opinion.

CARLOS BENITEZ: Right.

DR. PATRICK DOWLING: And we'll go from there. And I don't know the answer. I don't, I don't know.

DR. NICK SHAMIE: The lumbar curve is uh, is compensating quite a bit. Can you bend forward? Ok alright, very good. Straighten back. He's got quite a significant kyphosis here.

DR. JAMES LUCK: 80 degrees maybe.

DR. NICK SHAMIE: 85 degrees here. So this is eight years later, and it's progressed from an 85 to a 97 degree curve. And what we look for to determine whether anything surgical can be done is a few things. Whether the curve is progressive, which in your case has been, and the other thing is pain....

CARLOS BENITEZ: Oh yeah...

DR. NICK SHAMIE: ...which you've been experiencing. So the two reasons are good reasons to have surgery. This is a surgery we do for patients who this condition affects their life. The fact that Carlos Benitez is getting this care for free is only a testament to the fact that he was lucky, nothing else. He's lucky because he met the right people at the right time, and so this is a very unique situation.

DR. PATRICK DOWLING: Everything going ok?

DR. LUCK: Very well....

DR. SHAMIE: And for Carlos, I think, being a part of this documentary he's getting a lot more attention than the average patient.

DR. PATRICK DOWLING: I'm very pleased that we are able to help this one individual out, but what we're really talking about is 47 million Americans who have no public or private insurance. We can't do endless surgery on uninsured people. It begs a national solution.

DR. SHAMIE: And then gradually increase your activity.

CARLOS BENITEZ: For me, it means a lot. That means, that you know, the pain is going to stop. That maybe I will not have to deal with pills anymore. It means a lot, maybe my whole life.

DR. SHAMIE: I know you've given this a lot of thought. And I want you to be aware that this is a big surgery. When we straighten the spine, the nerves can be stretched and that can damage the spinal cord and it may make you paralyzed. Because it is such a big surgery, there is about a ten percent risk of dying from this surgery. We're going to do our best for that not to happen obviously, but we can't predict the unexpected.

NURSE: Ok here we go. This is where you say 'I'll see you later.'

DR. SHAMIE: Carlos Benitez' case is certainly in the rank of one of the worse I've seen unfortunately. The worse the curve, the higher the risk involved with this surgery. Give me the screwdriver please. If Carlos Benitez had insurance, we could've probably intervened and addressed his deformity before it got as severe as it is today. I think if we just compress the down here a little bit, that might help us out. If Carlos Benitez were to pay for his surgery, it would cost two to three hundred thousand. Tough angle. This is a big operation.

MARICELA PINEDA [Spanish with English subtitles]: Every time I remember how all this began, all I can say is that it was a miracle.

CARLOS BENITEZ [Spanish with English subtitles]: If it hadn't been for the media and for Dr. Dowling, none of this would be taking place. I'm very grateful and very happy.

MARICELA PINEDA [Spanish with English subtitles]: Now comes happiness. The best is coming. Our child. Our best gift is coming with the birth of our child and your returning health.

CARLOS BENITEZ: Hey, Doctor Shamie.

DR. SHAMIE: Nice to see you. How are you?

CARLOS BENITEZ: Good to see you.

DR. SHAMIE: You look more upright! You look great.

CARLOS BENITEZ: Yeah, yeah I look better.

DR. SHAMIE: How'd you feel?

CARLOS BENITEZ: I can breathe a lot better. Yeah.

DR. SHAMIE: Fantastic.

CARLOS BENITEZ: Yeah. I told my wife, at least, you know I'm at the same height as you now. Because I was shorter you know?

DR. SHAMIE: Don't advertise that. Because when're going to have people coming in wanting to get taller, and it's a big surgery for that.

CARLOS BENITEZ: Right, right.

DR. PATRICK DOWLING: You gained a little over three inches in three weeks.

CARLOS BENITEZ: Which is really good, yeah.

DR. PATRICK DOWLING: So this has been a remarkable journey.

CARLOS BENITEZ: It has been.

DR. PATRICK DOWLING: For you and your family.

CARLOS BENITEZ: And I thank you so much. I have no words to describe how much I feel. You have practically saved my life.

MARICELA PINEDA: Dr. Dowling you started our dream, and Dr. Shamie you ended it.

DR. PATRICK DOWLING: Ironically, it all started two years ago this past weekend.

CARLOS BENITEZ: Yes, exactly, two years ago.

DR. PATRICK DOWLING: At the medical student health fair, which we had again this weekend, and we still saw throngs of people with health problems with no health insurance. So that's part of the bigger issues is how do we care for everybody in this country?

CARLOS BENITEZ: After 15 years of having a lot of pain, I feel that I'm new. I can be a better father with my kids, be a better husband.

MARICELA PINEDA: Say cheese!

CARLOS BENITEZ: Cheese! And I feel like I'm very lucky.

BILL MOYERS: Since producer Roger Weisberg first reported on the families in CRITICAL CONDITION, here's what has happened to them.

In the aftermath of Joe's death, his widow Dale has been struggling to raise their granddaughter alone. She still receives collection notices for outstanding medical bills and continues to blame Joe's passing on his lack of insurance.

Carlos Benitez is without great pain for the first time in years and four inches taller since his surgery. He returned to his chef's job at that French restaurant but still has no insurance. Even if he could pay, his pre-existing condition probably means no insurance company would cover him. He takes pain medication that he buys much more cheaply in Mexico and he has a soft tissue lump on his chest which remains undiagnosed - he can't afford the X-rays he needs.

Six months after CRITICAL CONDITION was completed, Karen Dove had a recurrence of her cancer. She opted for an oral drug protocol but a serious side effect of the treatment sent her back to the hospital, where she contracted pneumonia and died, only 50 years old.

Her husband Ronnie is living with his daughter. He got a job at a grocery store that has an insurance plan. But the medical bills for his wife's treatment keep coming - they may pile up to as much as 150 thousand dollars. Ronnie, who lives from paycheck to paycheck, has only been able to pay back a tiny fraction of what he owes.

If you want to find out more about these families and producer Roger Weisberg's work, log onto PBS.org and click on BILL MOYERS JOURNAL. We'll link you to the CRITICAL CONDITION Web site and some of Roger's other documentaries.

Contrast these real-life experiences with the wheeling and dealing in Washington, where the health care negotiations now turn on such arcane factors as "bending the curve," "advanced information technology," and "actuarial projections".

Meanwhile, on the airwaves, factions of every stripe are hammering at each other in 30 and 60 second spots, each characterizing the other side in the health care debate as everything from marauding sharks…

MOVEON.ORG AD: Let's take on the real predators, health insurance companies.

BILL MOYERS: ...to Dr. Frankenstein.

DR. FRANKENSTEIN AD: Now we face his most dangerous experiment of all, government take over of healthcare.

BILL MOYERS: And on the ground, those congressional town hall meetings have been hijacked by yelling, jeering, and belligerent shock troops of protest who have turned the media spotlight on themselves, away from the issue of how to get health care to the people who need but can't afford it.

When all the flash and fury have turned to ash, here's what remains: our present system treats medicine as a profit center instead of a human need and public service. Next week we'll hear from some doctors who think that's a scandal. The Oscar-winning filmmaker Alex Gibney has teamed up with producers Peter Bull, Chris Matonti, and director Andy Fredericks to produce a film based on Maggie Mahar's powerful book MONEY-DRIVEN MEDICINE. Take a look:

LARRY CHURCHILL: The current medical system is not designed to meet the health needs of the population. It's designed to turn a profit. It's designed to meet the needs of the people in power.

RASHI FEIN: The worst thing that could happen to the director of a hospital is that everybody, all of sudden would be healthy. What they're selling is hospital beds.

MAGGIE MAHAR: Many people think they know what's wrong with the healthcare system in this country. Millions of people are uninsured, and sure that's part of the problem, but that's not the whole problem. The whole problem is bigger than that.

DR. KEITH JUNIOR: Hey this is somebody's mother, this is somebody's father, this is somebody's brother and if I don't do right by them, just understand that people die in my profession.

DR. ANDREY ESPINOZA: What you have is a system built by revenue and that money is not being put back in the system to help people, we've lost our way.

BILL MOYERS: Join us next week for MONEY-DRIVEN MEDICINE. I'm Bill Moyers. See you then.


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