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SiCKO, Revisited.

SiCKO, the encore.We saw it last night - SiCKO.  And I have to admit - I walked out feeling a bit tangled.

Michael Moore gets people talking.  You don't have to like him and you can call him "un-American."  You can hate his films.  You can love his films.  The fact of the matter is that his films start discussions, and these discussions are necessary.

That disclaimer tossed out there, the film generated a big "sigh" from me.  The first half of it, showing images of people working three jobs to cover their healthcare expenses, negotiating "which finger to reattach" after an accidental amputation based on what a patient can afford, and the stress of making sense of insurance denials.  This portion resonated for me on several levels.  The battles faced not by someone without health insurance but by the Americans who have it.

I thought about my own insurance battles.  Like the hoops I had to jump through to have my insulin pump covered as a "medical necessity."  Or when insurance companies told me that "four test strips a day is enough for a type 1 diabetic," not taking into account any hypoglycemic unawareness, jaunts to the gym, or the need to know if I'm steady before going to bed.   I thought about the pump infusion sets I've used for more than their prescribed length because I couldn't afford the copays for an extra box of sets.  The phone calls to insurance representatives that include phrases like, "Um, I need it to live," and "I can't believe you're telling me, a diabetic, that testing my blood sugar isn't necessary."

Michael Moore makes several talking points that Chris and I talked about for the rest of the night.  Moments in the film where Moore illustrates how keeping a society blanketed in debt makes them more dedicated (desperate?) members of the workforce.  This was disturbing to me, as I thought about people I knew who worked 70 hour work weeks at incredibly trying jobs, just so that they can have medical insurance. 

The part of this film that I didn't like was Moore's blinders-on view of universal health care.  No system is perfect.  He made it seem as though after the film finished, I needed to grab my passport and go ex-Pat, heading off to France or Britain or even hopping the border to Canada.  I do think that countries practicing preventative care vs. acute care are far smarter than the reactive United States, but I don't want to pack my bags and trot off to France.  I would rather help change to happen within our own borders and take measures to fix a problem instead of abandoning it.  Aren't we a force to be reckoned with, the blogosphere?  Aren't we some of the voices that Big Pharma thinks about nervously, right before they fall asleep at night?

(Whoa, Kerri.  A bit idealistic today.  Don't you want to go to France?  They have unlimited sick days.  And government employees who do your laundry.  Stop humming "The Greatest Love of All ...")

I'm fine with doing my own laundry.  I'm fine with working hard and earning my medical insurance.  But I'm not fine with being told that my medicine isn't "covered" or "necessary" or that insurance companies would rather pay for my dialysis vs. my insulin pump.  Preventative care is what protects people with diabetes, keeping our potential diabetes-related complications quiet longer.  Being plucked for every cent we earn, or worse denied, for that preventative care is cruel.

Go see this movie.  See what gnaws at you. 

Comments

Good luck getting an insulin pump or coverage for insulin pump supplies *at all* under a system like NHS. The Internet is chock-full of emails and messageboard forums from folks who are clearly resourceful and informed and yet cannot get approval for the life of them (pun very much intended). Not to mention being assigned a GP and, if you're lucky, endo based on your geographical address.

I move frequently for work yet fly back to Portland every three months because my endo is fantastic. I would happily pay out of pocket for my visits with her, but my (individual, low-deductible, post-diabetes-diagnosis!) Blue Cross plan appears to play better with me than most other insurance plans.

Well, under the nationalized health care systems same negotiations (which finger to reattach/drug to use to treat cancer patients/how many test strips diabetic needs every day) are taking place on a much higher level. Results are usually much worse than for most of US population, especially the majority still covered by employer-sponsored plans. Oh, and in most of these countries pumps are not covered. At least Novo pushed their Novopens hard enough that they became the norm few years ago. But still - getting even 4 strips a day required a special authorization when I was living in Israel. So did Novolog. And I had to waste half working day each month to get it from the only pharmacy in the city that was authorized to provide it (at least they answered the phone and let me know if they're out of stock) And Lantus is still not available for most diabetics over there. The nationalized healthcare systems don't care about "preventing"...all they care about is spending as little money as possible to keep majority of the voting population relatively alive.

Hey All,

I saw half of Sicko last weekend (don't ask - new theatre, projector broke, long story!), so I can only comment on the first part of the film. I enjoy Moore's films as well because of the conversation they inspire.

In the film, when they crossed the border into Canada, they were in what appears to be a walk-in clinic, not an emergency. The people interviewed stated they had only waited 20 minutes, etc. for care. Where I am from, that is definitely the exception, not the rule. Having been in the Emerg Dept myself, the normal wait is at least 4 hours, and I have waited 8-10 hours only to have a family members put on a gurney in a hallway to wait another 6 or 8 hours. It's not all roses up here in Canada!

The main difference is that yes, we can walk into any hospital and have care, we can also pick any doctor we choose (provided they are accepting patients, of course!). Jana - we still have insurance companies that are alive and well - we will ALWAYS need more insurance above and beyond the public insurance.

As someone who has had Type 1 for 19 years, I have some experience in what's happening. Some provinces fund and provide pumps for children now, but some don't. Luckily, my father's provincial gov't job had great health coverage, so growing up I didn't have much of a problem finding supplies. Oh to be young again!!!

As an adult, my pump was not covered by public healthcare. My employer (at the time) provided health insurance that just happened to cover the cost of a pump and supplies by 100%. I was VERY lucky, and that's the exception, not the rule.

I now have my new employer's coverage plan which covers 80% of supplies (not too bad), and I have purchased an individual plan to cover the other 20% of my supplies. I'm not certain yet whether this is worth the money, because it's an additional $130/month out of my pocket, on top of the $50/month I pay for my current employer's health plan. Mind you, the cost of the insurance plan can be submitted on my income taxes next year.

I really don't feel that any system is perfect. I also know a few people in Canada who are having a difficult time making both ends meet, while providing sufficient care for their diabetes. It's an additional stress that makes life very difficult.

The same as you, Jana - I picked a job/career that would assure me healthcare for the future. It was the responsible thing for me to do at the time, and it has worked out very well. This province DOES have a public health policy for those on low incomes. From what I know of the plan, the difficulty is that I think people still have to buy the supplies up front, then submit the expenses for reimbursement. Often very difficult for those on limited income.

Anne

My daughter is 17 and has type 1 diabetes (diag. at 2).
When we had to go to the hospital my husband was working for a small companny (6 people all engineers). If we had lived in the USA we would of been in trouble from med bills. But in Canada we stayed for a week and paid not one penny. As a Canadian living in the USA I can tell you that yes there are waits in Canada for elective surgery, but If you are in real trouble - go to emergency - you'll get treatment for no cost. I realize that in the USA you can make it big (financially) but loose it big if you get sick. In canada we are more conservative with our money (pay higher taxes) but we dont have to worry about loosing it all. Who wins in the end? mmm..
email me your thoughts or questions.

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