The individuals in Sicko have limitations and gaps in their insurance coverage which is considered to be 'under insurance'.
An updated story about the under insured occurred this morning on WBUR. Please see/listen to the story at WBUR's page.
Carol
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One thing I considered while watching Sicko was that the insurance companies must have reasons for these limitations. The individual cases as seen in Sicko were obviously upsetting to hear about but what must also be considered is the number of people who purposely omit past medical conditions. Unfortunately the few people who try to get money from the companies without being honest end up hurting the majority. If the insurance company did not put these limitations and rules regarding policies people would abuse them. The question I debated for some time was who was being more unethical, the companies or the few people abusing the system?
ReplyDeletein response to Corey - In one of my other class, we watched a film called "Sick Around America", where they talked about the problems with the heath care, recission, medical underwriting, guaranteed issues, and so on. Medical underwriting for example, is basically a questionaire about a patients health status and previous health conditions, which insurance companies will use to decide whether or not to accept the client. If the insurance companies find out through medical underwriting detects that a client had some previous health condition, the client will be denied. One of the biggest reason why insurance companies deny cover for someone who has been previously ill is because it'll cost the company more money to cover for the sick than the healthy. In this situation, I believe that the companies are the unethical ones denying coverage to people who need help only because it will cost more money on the company. An example of a question on the medical underwriting can be "have you ever had a mental illness". People who never got an actual diagnosis of having a mental illness would reply no, but for the insurance companies, if you were taking a medication such as prozac for a month to help with the grief of a family death, they will most likely deny coverage. Health insurance companies do not necessarily take the hippocratic oath, but I think that working as part of the health care system, as hard as it is, profit should not be one of the leading factors for the companies to decide whether or not to provide care.
ReplyDeleteAlthough the companies have there moments where they seem like the unethical ones making the health care system more complicated, they aren't the only ones. Massachussetts has guaranteed issues where everyone has to have health insurance. This may sound like a step towards national/universal coverage, but since the costs are so high, not everyone gets insurance. Some people think that they are healthy, they probably won't get sick, so they take a risk by not getting insurance with the idea of "why get insurance when i won't get sick" - as seen in Sicko. In this case, people aren't cooperating with health care in trying to improve the system, which puts the blame on them.
I think that both companies and people are acting unethical because most decisions made by anyone has some selfish intent. When policies and changes are brought up to improve health care or any other problem, I think that everyone thinks at one point or another how the change will affect him/herself. When the change may seem like a negative effect, people will oppose, with a positive effect, people will support - but like I always say, there is no way to satisfy every single person.
I disagree with Corey because, although Michael Moore is very extreme in his opinions and often does not tell the whole trush, i think the film made it quite obvious that insurance companies go hunting for past medical conditions. One person who worked for an insurance company who was interviewed in the movie said that they are made to go through the applicant's file to find anything they can that could possibly be turned into a pre-existing medical condition or another reason for the insurance company to reject them or not have to pay for a procedure. The only reason a person would lie to an insurance company is in fear of being rejected for a pre-existing medical condition. The U.S. is probably the only nation in the world that can deny a person medical insurance based on a pre-existing condition.
ReplyDeleteThe health care system in the United States is violates ethics in many ways. This system violates the right to health. If you are poor, unemployed, or sick, then you will not get the medical care that you need. In general, these people are the ones who need medical attention the most. Hospitals and insurance companies who turn people away because they can't pay for a procedure, or for care are not acting beneficiently. These people know that by turning someone away, they could, as in some cases in the film "Sicko", die. Or have to make ridiculous decisions, like the man who could only afford to have one of his fingers sewn back on after he cut two of them off.
On the other hand, many U.S. citizens are unwilling to have government involvement in their lives, which makes it very difficult to create a national health care system. Medical professionals have not violated ethics in any ways because they have been forced by the health care system in the U.S. to compromise the way they provide health care in order to meet the standards of insurance companies, or they too may lose their jobs, and therefore their own health insurance.
I also have to disagree with Corey. While I don’t believe that it is right to lie to an insurance company, our health care system makes it necessary. It’s absurd for insurances companies to deny medical care based upon past medical conditions, some of which are completely irrelevant. The case in the video that most shocked me was the woman that was denied treatment because her insurance company discovered she had a yeast infection in the past. This proves that insurance companies do their best to make sure people remain underinsured so they can make a profit. I envy the citizens of other countries that do not have to worry about being covered for certain conditions. That fact that Americans are dying every day because they cannot afford to pay their medical bills is just wrong. Our health care system essentially puts a price on saving a life. Other countries laugh at our system, and they do so with good reason. To them, health care is a right not a privilege. For a country with such wealth and power, the U.S. has failed to implement a system that actually makes sense. As noted on the WBUR page, the new bill will help the underinsured still require middle income people to pay as much as 12% of their income on premiums. That does not include anything not covered in their insurance plan. The new bill may be a step in the right direction, but as Sicko proved, the “underinsured” are not the only ones having a hard time getting medical treatment.
ReplyDeleteAlthough Michael Moore is an extremist, I think the point he was trying to make through SICKO was simple, the way in which health care is delivered in the U.S. needs to change. Has it really come down to choosing which body parts to save; or dropping patients of at the curb to fend for themselves? I truly feel that ethics has left the health care field as insurance companies have taken over.
ReplyDeleteThe two players that will be affected most by the recent health care debate are the insurance companies and the patients. The insurance companies, who do provide jobs for a good number of citizens, do not want to lose their place in health care. While patients believe as human beings they have a right to health care. The ethical dilemma in this particular situation is that those who have some insurance are paying more than those who have no insurance at all. If insurance companies require people to pay for insurance in order to receive care, then why are those who are “under-insured” being charged extravagant amounts while those without any insurance at all are getting their care for free? This discrepancy in the insurance game is completely unethical.
The reason people without any insurance are being covered is due to government interventions such as Medicaid. Since the government is supporting those without any means, it is not fair to leave at the mercy of money minded insurance companies, those who have just enough income to be independent from government support. To punish people who are succeeding financially seems unrighteous. It also is not fair to say that middle income people are required to pay 12% for their health insurance premiums. Health insurance companies can increase your premium do to your usage. Therefore people who are unfortunately sick more often than others will be forced to pay more for care. This bill should not be passed.
The immediate answer to this issue that will be most beneficial to both players, insurance companies and the patients, is for the government to intervene. Through congress laws can be passed to put a cap on how much insurance companies are allowed to charge. Congress can also ensure that insurance companies stop denying people due to past medical conditions. If we all had a set amount that we have to pay toward insurance companies regardless of how much medical care we use, then pre-existing conditions would not be a threat to neither insurance nor the patient. This plan allows for the stability of jobs for the citizens currently employed through insurance companies while taking away the insurance companies reign over the health care system.
Side note (this is just an immediate plan to this particular issue, I truly believe in universal health care!!!)
~Jenna Freitas
In Michael Moore’s documentary, Sicko, major problems in our U.S. healthcare system are addressed. Nearly 16 million Americans went underinsured in 2003, and from the WBUR story, that number has grown to nearly 25 million Americans. These statistics themselves are a great problem in our healthcare system. With this problem we face an ethical dilemma of who should pay? Is it fair that the wealthier pay for those less fortunate simply because they have done well for themselves financially? Is it fair that the middle class pay 10-12% of their income on healthcare alone? Should we abandon government run programs that provide healthcare for the poor? Clearly we face violations of beneficence and justice with this dilemma. Doctors and insurance companies are not acting beneficently in providing the care patients need, and costs are not being distributed fairly. On one hand we have the stakeholders of insurance companies, physicians and the upper class, all who could lose profits if the government intervenes to make healthcare more accessible. On the other hand we have the other stakeholders, the patients, who will not receive the care they need and deserve without a change in the healthcare system. We do know that many Americans do not get adequate healthcare, and we rank very poorly compared to other countries. We do not know what the effects would be if the government had more control in our healthcare, and this is where many fear, as Michael Moore points out, the effects of socialism…which is obviously a very extreme point. It is evident that our healthcare system is in need of change. For such a powerful country it is unacceptable to have such inadequate healthcare, and the solution is government intervention. WBUR points out the bills going through congress would have a minimum benefits package, would place limits on premiums and out of pocket costs, and would eliminate annual and lifetime benefit caps. It also mentions that the middle class could once again get the short end of the stick and pay as much as 12% of their income. Although these solutions are not nearly as beneficial as universal healthcare, it seems it may be the best that can be done at this point in time.
ReplyDelete-Sarah Doersam
I would like to make a political point, but one that is relevant to our discussion of healthcare and Sicko. While browsing the earlier posts, I was quite taken by how others refer to Michael Moore. He was labeled by several as an “extremist” with “extreme views.” Many of those same posts then go on to agree, at least in part, with Moore. The facts are that he is not an “extremist” nor is government run healthcare. Would you call Medicare experimental or far left?
ReplyDeleteMy problem is with the political discourse in this country, which has shifted so far right that Michael Moore and Ann Coulter are equated as far left and far right, respectively. By calling Moore a radical, you marginalize his position. Not only that, but how can anyone call his views in Sicko “extreme”? He goes to post-industrial democratic countries that already have some form of government run healthcare. If Michael Moore is extreme, then what are these countries?
This is an example of how the political discussion in this country has moved to the far right. Liberalism in America has degenerated into a moderate realm. Moore would most likely want a single-payer system, one in which the government provides all healthcare. Undoubtedly that is a progressive stance. However, true progressives are so rare that we define Moore as Extreme. A public option, the plan many would like to see, is a fairly moderate position that has been framed as far left, leaving films like Sicko to be called “extreme.”
Lastly, I of course agree that insurance companies drop or do not accept people in order to turn a profit. But what should we expect? They are legally responsible to share holders to make as much of a profit as possible. Here is a key ethical dilemma: Capitalism and business vs. Universal Healthcare. If we can agree that all people have a right to be insured, then we need to remove an ethical impediment, which is the economic imperative to make as much money as possible.
While Michael Moore makes many good points about problems within the US healthcare system in his movie "Sicko," it is important to note that there is also another side of the story, that does not completely coincide with the interests of the health insurance companies. "Actuarial Fairness" is one of them. Overall, it does not seem fair that one individual must pay taxes and his or her hard earned money to help with people who are less healthy, given that the less healthy individual brought it upon themselves. For example, it wouldn't be fair if someone who took care of their health had to pay taxes for the benefits of a smoker or an alcoholic. Like the absurd amount of taxes that taxpayers dish out to maintain the health and lives of prisoners, the need to help others who bring their misfortune upon themselves.
ReplyDeleteSimilarly, Michael Moore uses many examples where he only shows one side of the argument. For example, Michael Moore shows how the French give out a ridiculous amount of sick days and time off for their ailments from their companies. Overall, this helps elevate the standing of French health care system, and only shed light on the benefits of the system. While this may be great for the citizens of France who are employed, this is actually detrimental to the overall economy in the country. Many corporations that would normally be able to be established and thrive in an economy such as America's did not appear in France due to the proposals set forth by the nation's health care system. This has in fact greatly hurt France as a nation within the world's standings as well as decreased the quality of life there as well. Overall, the addition of their health care systems retards the economy growth, which hurt all the French citizens overall. While Michael Moore highlights the beneficence from France's health care system, he overlooks that maleficence caused by it.
Of course, there can be many exceptions to this idea, and overall it might be a good idea to go towards an universal health care system. Overall, I believe that Michael Moore shed light on an existing problem within the US system and raised a lot of questions that would change the debate on health care for the better. Although many of his depictions were probably exaggerated for more effect, it serves as an honest depiction of many problems laced within the American health care system.
~ Tully Cheng
As noted on WBUR, 25 million people in America were underinsured in the year 2007. This number soared up in just 4 years; in 2003, only 16 million Americans were underinsured. Being underinsured means that an individual has to spend more than 10 percent of their income on medical bills. People that are underinsured may as well not be covered at all, as they are spending money on both medical costs and on the premium they must pay their insurance companies.
ReplyDeleteIn the film Sicko, Moore tells the stories of many Americans who are underinsured. What Moore makes clear is that these underinsured Americans are often the ones who need medical care the most. Insurance companies in the US have been the reason for many ethical issues that have arisen. If an individual in the US is predisposed to a genetic disease, they will not be covered. If a young individual is diagnosed with a disease that usually only appears in older individuals, that person will be denied coverage as well. These two examples just start to highlight the multitude of things that American insurance companies will not cover.
The first problem that arises from this is one that has to do with beneficence, a principle of biomedical ethics. The principle of beneficence refers to our duty as humans to care for others and to act in ways that benefit them. The medical system in America clearly does not follow this principle. In fact, it causes more harm than good. Although many Americans do get the care they need, the lower the class in society, the less care they receive. Because insurance companies strive to make profits, they ultimately deny many more people than they do not, because the less people they have to cover means the more money they make. This obviously points out a huge flaw in the current health care system in the US.
In the above comment, Tully says that it is not fair that individuals must pay taxes out of their hard-earned money to help cover others medical expenses. I disagree with this because although individuals work hard to make their money, they also have a duty of beneficence, and paying taxes allows them to fill this duty. In Sicko, Michael Moore discusses the universal health care systems in the UK, France, and Canada. Though Moore's opinion is very biased (he obviously thinks universal health care is the only solution), Moore does show that the health care systems in these countries are beneficial to the one in America. People in the UK have to pay taxes that go towards medical care, but in turn, everyone is always covered; their medicines are covered and their treatments are covered, no matter what the disease is.
The limitations and gaps that currently exist in insurance coverage can only be fixed by initiating a new system of universal health care in the United States. The UK, France, and Canada are all examples of countries that have strong, solid medical systems that patch up the inequalities seen in America.
I would like to respond to Laura's post above. She states that the "UK, France, and Canada are all examples of countries that have strong, solid medical systems that patch up the inequalities seen in America." I both agree and disagree with that statement. It is true that basic healthcare is much more accessible in these countries than for many people in the US. If one has a freak accident or becomes horribly ill he or she will most likely receive necessary medical treatment, no questions asked. However, there are still inequalities in each of these systems. They are not as perfect as Moore made them out to be. For instance, in the UK there is still private insurance. Citizens may purchase this insurance at their discretion, and it provides extended coverage for medical procedures and allows for higher standards of care. Those who are able to afford private health insurance can jump to the front of hospital waiting lines, receive procedures before other patients, and even upgrade their hospital rooms if they so choose. I would hardly say that this eliminates similar inequalities seen in the US that are caused by the existence of different economic classes. Those with more money in the UK are still able to buy better healthcare and better hospitals, just as those with more money in the US can. Similarly, in Canada the public healthcare system does not pay for many prescriptions, dental care, or optometry. Those who are able to may purchase these services through private insurance. Prescriptions are paid for either by private insurance companies or out-of-pocket. Although access to care in Canada is universal, there are still problems with the system that foster inequality based on financial ability.
ReplyDeletePerhaps the solution to our health care problems in the US is not universal health care, but instead reforming how we spend our money on healthcare. There is simply no way that universal healthcare can do everything that every patient needs, the numbers just cannot logically work out. However, we cannot continue to spend money the way we do in the US. A complete overhaul of our health-spending is in order.
One facet of healthcare spending is end-of-life care. As is done in England's system, we need to determine how and when to reduce patient care. As a society we pay more for end-of-life care (on average) than we do for care during the rest of our lives. We keep patients alive who would never be alive naturally. In doing so, we manage to bankrupt ourselves and our families and drive up healthcare costs. A hot topic within the healthcare debate is whether or not to have an end-of-life committee to help determine when patient care has done all that it can and a patient should be allowed to die. Keeping a patient alive long past what is natural is not only extremely expensive, but it also diverts physicians' time and attention from other patients who could benefit more. Instead of forcing life-extending procedures upon terminal patients, we should be able to let them die peacefully and with dignity. I realize that this is not a very popular idea, and that many people take offense when it is suggested that they let those who are dear to them simply die without putting their all into saving them. However, we could bring healthcare costs down and use physicians' time more efficiently if this is done, thus streamlining one aspect of our healthcare system.
Another issue that is plaguing our healthcare system is malpractice. While malpractice lawsuits serve as an important check in the healthcare system, providing patients with retribution if they have been wronged, they pose a major problem for the financial status of healthcare in general. Doctors are forced to practice "defensive medicine" in order to avoid malpractice suits. Care suffers from inflated costs because of extra procedures ordered for the sake of reducing liability. Malpractice suits are expensive and possibly life changing for practitioners, and do no favors to the patient.
The debate over healthcare reform in the United States is at an all time high. One of the prominent issues in our healthcare system is the fact that not every person has medical insurance and many of those who do, do not have the correct amount of coverage. This leads to the category of Americans who are considered underinsured. These individuals were portrayed in Sicko as having limitations and gaps in their insurance coverage which would thus be considered under insured. According to a WBUR updated story, a New York health research group says you have to spend more than ten percent of your income on health bills and half that if you are poor or near poor to be considered underinsured.
ReplyDeleteThose who are underinsured will find some relief in the health care bills being considered in Congress. The bill being debated in the Senate Finance Committee, however, would still require middle income people to pay as much as 12 percent for their health insurance premiums alone.
I consider myself extremely fortunate to have a great health insurance plan with no limitations or premiums, but just a small copayment. However, I still do not understand why people complain about the price or the coverage they receive. I personally feel that we are not grateful for the access to healthcare, unlike so many other countries around the world. Although I do feel the prices may be expensive for certain procedures, the fact that we have access to them and a possibility to have health insurance to cover those costs is what so many people around the world dream of having.
I feel health insurance is a necessity and not a commodity. Health insurance should be treated similarly to car insurance, food, and clothing for example. If you get in a crash you have insurance to pay to have your car fixed, if your hungry you buy food, and you would buy a jacket so you don’t get cold, so I do not see why people don’t see health insurance in the same way that if you want to prevent a bad outcome then it is good to be prepared. I do understand the difficulties of affording health insurance and I believe many things could be done to make it more affordable; however people should not cut it out of their expenses as a way to save money, or buy something else.
Many people blame health insurance agencies for making huge profits in this industry and for turning down individuals with pre-existing conditions. I do not blame them for either of these issues. They are companies with a goal of maximize profits, like every other company in the world. When an insurance company gives you health insurance they are investing in your health. Therefore, I do not blame them for turning down individuals with preexisting health conditions or charging more for those individuals who are at greater risk of health related issues since it is a riskier investment with a minimized reward. It is the same reason why car insurance companies charge sixteen year old drivers or those who have had multiple accidents or traffic violations more money. It is because they are at greater risk of needing the coverage. This is the same thinking health insurance company’s use when they encounter an individual who is obese, smokes, and has a genetic heart defect. This individual is more likely going to need substantial health care and thus greater health care costs. Therefore, I do not blame the insurance companies for taking profits and turning down individuals for healthcare. If a company wanted to become a non-profit and offer lower cost insurance plans then they could do so, so the fault is not solely on the large health insurance companies for the number of uninsured and underinsured people in the United States.
People need to see how fortunate we are to have accessibility to health insurance and some of the best healthcare facilities and treatment options in the world. The system currently in effect in the United States might be subpar to other countries, but it beats out so many others and therefore we should be grateful and not complaining.
-KEENAN