I am on the neurology housestaff for a major university hospital in the NY/NJ Metropolitan area who deals with the travesty of health insurance and uninsured patients everyday. I applaud Michael Moore for his movie exposing some of the horrors of healthcare that I deal with everyday.
Note to readers: I have not personally seen the movie myself as it hasn't been released, yet I'm basing the title on an assumption that MM will address the horrors of healthcare insurance in America. I also have left out MANY details in regards to the example I discuss for the sake of saving time and preventing anyone from identifying the unique case and hence the patient I'm referring to (conforming to HIPAA regulations).
Mr. Moore is correct in his assertions regarding the health care industry.
As I'm a resident physician on the front line of the health care crisis in America, I see first-hand how horrific the insurance companies treat my patients. I get calls, along with my attending physicians, from insurance claims supervisors constantly questioning my management of each patient.
For example, just the other day, I saw a patient as a consult in the ER with signs and symptoms of a new stroke. The standard of care is to obtain an MRI, especially if the patient presents to the hospital before 6 hours of symptom onset (this patient had come within 3 hours after he first noticed symptoms). The patient was fully insured, but his insurance required approval for tests that are $500+. My attending physician and I, knowing that time is of the essence in stroke cases, disregarded the protocol to call for approval from the insurance company until after we did our emergent job...for the benefit of our patient.
After the MRI was completed, we called the insurance company. After waiting for 30 minutes to speak with someone, I was put on the phone with a claims supervisor (a lawyer with a medical textbook next to her at her desk). Because we didn't call for approval beforehand, the hospital will not be paid by the insurance company for the MRI. The lady also had the audacity to tell us how to proceed with the case, directing our standard of care as if she was the attending physician.
This happens day in and day out at my institution. As a neurologist who deals with stroke victims everyday, I know that time is of the essence, yet there are non-medically trained people who control the purse strings for their policy holders who believe that they can direct medical care from afar. This problem is only growing and I almost feel like soon, I'll have to lie in order to get my patients approved for needed diagnostic tests and procedures.
I see post-9/11 emergency workers all the time in my institution for problems of the brain, such as traumatic brain injury. I'm appalled that most of them have to pay out of the pocket as their government insurance refuses to acknowledge the extent of problems they have. There is a refusal to accept that certain medical conditions can be attributed to the cleanup effort.
Overall, I'm just sick of this culture. I came into medicine thinking that I was doing something noble for people, only to find out that the reality of the situation is that I'm prevented from doing my all by people who control the payments. Its disconcerting that health care in this country is treated like any other business in a capitalistic society. The insurance companies are only concerned about profit and the bottom line. This is immoral and wrong.