What are your thoughts on our health insurance system? In the stories that we’ve covered here, which one do you relate to most...?
Your program, like almost all the programs on the health care issue, lacks one important statistics -- where did all the money go? In 2007, over 70% of the total health care expenditures went to hospital care, professional services and nursing homes. Prescription drugs only accounted for 10% of the total cost and the net cost of health insurance was even lower. That is to say, even if we force all the pharmaceutical companies to provide us free drugs and wipe out all the profit the insurance companies made, we won't get any meaningfully lower cost of health care. If you really want to do a high quality investigational report and responsibly address our health care crisis, just follow the money.
All these numbers can be easily found from the website of US Department of Health and Human Services:http://www.cms.hhs.gov/NationalHealthExpendData/downloads/tables.pdf
New Haven, Connecticut
I thought your program was excellent. I note that the insurance exec speaking towards the end called on doctors and hospital administrators to reduce their pay but said nothing about insurance CEO's doing the same. As a family physician, I know that some of these insurance CEO's make millions of dollars.
I feel we need to move towards a single payer system.
In December of 2008, I was laid-off from my job. I lost my health care. My husband and I applied for a family plan through Kaiser Permanente; we had been with Kaiser for several years. My husband was accepted but I was rejected. Kaiser rejected me for a history of colon polyps (my father had died of colon cancer and I have regular colonoscopies), and some very minor reasons, like rosacea. I appealed this decision, sending letters from 3 of my physicians at Kaiser, along with the appeal.
We had just seen the Frontline report on Health Care. Today, I received a letter stating that Kaiser had rejected my appeal because of my history of colon polyps. Now, I feel like some of the people that were profiled in the report. I am being denied health coverage because I am trying to maintain my health. I have regular colonoscopies to prevent getting colon cancer. I just saw a commercial with Katie Couric, urging people to get colonoscopies to avoid this cancer. For now, I am covered by an expensive Cobra plan, after the loss of my job. I don't know what I will do in the future to maintain my health. Perhaps seek medical care overseas, in countries that place the patient before the coverage.
I am an insurance broker and can see both sides of the arguement. It is understood within the industry that premiums have reached a tipping point for both participants and small business. I am disappointed at how consumer driven health was brushed off as an invalid option and poor coverage. In actual fact, consumer driven health is a sure way to decrease the amount of money given to the insurnace company on a monthly basis and often times has a stop loss of less than $3000 for any one calander year. Additionally preventive care and screenings are built in to the premiums and offered at 100% to the insured. That is RICH coverage.
One of the reasons for the rising cost of healthcare is that nearly 100% of claims are paid by a third party (either govt or insurance company). The actual patient has no idea, or vested interest in how much a particular service may cost. Whether it be an office visit, CAT Scan, MRI or Viagra the insured does not care how much it costs. In fact all they care about is how much the copay is. If the insured had a vested interest in some cost share of medical expenses there would not be such a spike in medical costs. For instance Lasik surgury is one of the newer and more popular services offered and does not qualify under any medical plan. The cost for such surgury has decreased enormously since it's inception. The same can be true for all other services paid direct by the consumer as well. It sometimes amazes me how detached people are (and want to be) when it comes to health care costs. Insurance should be in place to cover all catostrophic costs and preventive services. The costs in between should be "budgetable" and paid through a tax advantaged account. All in all a thoughtful program.
My husband and I view your program regularly. Last nights show was particularly topical for me. Today I received a rate increase from my health insurance carrier raising my monthly premium from $764.16 to $893.02. I have a $50.00 copay, $5000.00 deductable and I pay 20% of all bills within the PPO network. Only I am covered by this policy. We pay premiums for my husbands too. Like many Americans, I was laid off in October of 2008. I just found employment at less than half of my former salary and am so greatful to have work. You showed America how the middle class is struggling and falling. I hope our congressional and senatorial representatives were watch too. Excellent reporting.
The reason why medical costs have spiraled out of control and health care in this country is way too expensive for the average person is essentially because Medicare and Medicaid are the health-care industry's built in government bailout money -- always has been -- therefore there's no incentive for the industry to lower, and keep, medical costs down. Doctors, hospitals, pharmaceutical companies and researchers, and medical supplies companies all need to step up to the plate and implement reductions in salaries and costs, and face the music just like the rest of the country in this bad economy. With all due respect to their educations and professions, doctor's salaries are astronomical, and need to come down. At least this would help begin a cycle of lowering health care costs.
Thanks, Frontline, for another insightful presentation.
In response to the "Sick Around America" report.
I recall I believe it was the 2nd presidential debate between Obama and McCain where an audience member asked
"Do you believe health care should be treated as a commodity?"
For profit insurance companies exist for exactly that...FOR PROFIT! Is it too hard to understand that? Must we accept that our health, our very lives depend on how some corporate auditor assesses the impact our illness has on the profit margin??
For pity sake...wake up, America!
While I found the program informative (as always), I was disappointed in your discussion of Massachusetts' attempt to provide universal health coverage. By showing one family, which just missed the cut-off for subsidized care, you neglected to show the thousands of poor Americans who have benefited tremendously from Mass's subsidized plan (I know; I'm one of them)-- people who don't necessarily have the option of picking up a job with insurance, as the family you focused on did. As I considered this, I thought about the fact this program really was "Sick and Middle-Class Around America"-- certainly more likely to tug on viewers' heartstrings, but by neglecting to mention the working poor at all, I think you ended up giving a far more negative portrayal of Massachusetts than it deserved, rather than offering it as a model or at least a positive first-step that the rest of the country could consider. Why not talk about the poor?
"Sick Around America" leads me to the conclusion that was never said or even suggested in the program: our health care insurance is too essential and important to be conducted on a for-profit basis. People die so others can make a profit, sometimes a considerable profit. It doesn't have to be that way and this may be the biggest change that has to be made in our health care system if we are to make any progress. Our lives are not commodities.
san francisco, CA
I work for a large health insurance company. I must agree with one of the posts that I read that there should be a primary focus on preventive health whether it is a government-run program or a private health plan. The company I work for, and likely many other companies, are already doing this. There are programs that provide discounts on health clubs, offer tobacco cessation programs, and have preventive coverage up-front such as yearly physicals to those that are covered by our plans. These types of things have proven to improve the overall health of a person and catch a treatable disease early on if one would actually participate in those offerings. I do believe that a large percentage of Americans do not take responsibility for their own health and choose to not take advantage of these types of programs. I have seen our company offering payment in the form of gift cards just to "entice" enrollees to participate in the "healthy-living" programs we offer. I think this shows what is wrong with our system- -- we have to pay people to actually take care of themselves..
I have been an Oncology nurse for 39 years. The health care system has increased in complexity and decreased its ability to care for patients. Part of my work in recent years involved getting insurance approval for cancer therapies and most recently Hospice. My message for ALL OF US is that although we may pay for insurance we have no idea what will really be covered until the time of our illness - many times a loop hole is found to avoid payment. There are some very disreputable companies who approve therapy (including Hospice care!) and then do not pay the bills after the service; finding loop holes. They have methods to force customers and providers to give up seeking payment (i.e. voice mail with no option for a live person, circular transfers where after 40 minutes you end up where you started, many hoops to jump through, will not put anything in writing; their approval is over the phone - easily deniable).
It is wrong for insurance to be for profit because the profit will always come before the patient.
Thank you for a wonderful program.
I only wish that the health care picture in Massachusetts were as rosy as Dr Bigby portrays it. My daughter and her family of four live in Mass. She has been diagnosed with Sclerederma and her husband needs surgery for an intestinal condition and has a history of cancer. She cannot work. He cannot afford the premiums for the plan offered by his employer. The family income is in the $60,000 range. The state recently took a portion of their much needed tax refund as a penalty. For them it is a roof over their head and food on the table or health care and yet they have been punished by the state. They were far better off in Rhode Island where they had Neighborhood Health. My daughter suffers from her symptoms daily yet receives no health care at all. Massachusetts has the best hospitals in the country but the worst health care system.
West Greenwich, RI
As a pharmacist with 25 years of experience in a variety of health care settings and a keen interest in improving the health care system it is refreshing to see a candid expose of how our disfunctional health care "system" results in profound negative effects on peoples lives. Thank you for helping me make a more informed idea of our current system and what alternatives are possible. There is no doubt that there are other models of providing health care that do a much better job of meeting the needs of their participants than ours does.
Why was nothing said about the huge cost of malpractice insurance the Dr. have to pay that drives up the cost in the USA that other nations do not have! Tons of money is spent just trying to cover the possibility of being sued and not really helping the patient. I am a small business owner wanting to drive the cost of health care down, but that is not going to happen without some huge changes like limiting the liability of Dr., cutting service, and more preventive care. Are we still spending half our lifetime health care cost in the last 6 months of life?
Your program failed to include the affects the legal system has had and currently has on the escalating costs of medical care. The Obama administration should also include tort reform in the equation along with health providers, hospitals, pharmacies, pharmaceuticals, etc.