People Features
Michael Moore goes to Washington
By Stone Martindale Jun 21, 2007, 20:45 GMT
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Older Talkback
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It is simple -- the country needs national health care now. Most people do not understand the almost 50% of all health care money now comes from the government add the rest and get over it.
I don't agree with the comment 'In taxes and inflated premiums we pay the medical bills for people who are not even citizens of this country'. I am a IT specialist working on a H-1 B visa and also pay the same taxes and premiums that a citizen does. Despite the issues with Social Security drying up before it can be availed by the citizens of my generation, if it were available, we wouldn't be able to avail that facility. In effect we end up paying more. I don't think the above mentioned comment is fair and was thrown in without looking at the situations from all sides and how it affects all sections of a population (Economics 101).
I was referring to the people in emergency rooms and hospital beds who are not legally employed - as you are by permit - the people who are not legal citizens yet are taken care of for medical issues.
Come to California, spend an hour in any emergency room. These aren't educated IT workers on a permit visa I am referring to.
I work for a private ambulance company that covers a really large county in the midwest, and right now we are averaging a 27% collection rate in our largest city because we have a high indigent population and a very high number of illegal immigrants (put down your pitchforks, people. I'm not being racist, this is a fact). So, because we (or the hospitals) never turn anyone away and we do not receive any tax dollars, the burden sits on the shoulders of those who actually do have social security numbers and pay their bills. A trip on the ambulance for someone who needs it shouldn't be more than $500, but because of the situation we're in it runs around $1300 in order for us to stay afloat. And we are all that our county has in regards to EMS providers who transport patients. How do we level this out?
Side note: If you're gonna have socialized health care, then you've gotta deal with immigration as well, otherwise we're in the same boat where the number of people who use the system is much, much smaller than the number of people who pay into the system.
The fallacy in Moore's comments is the idea that 'every American has the RIGHT to have health care.' Not so and you'll never find it in the Constitution or any of the founders writings. There is no such RIGHT whatsoever. If care is deemed appropriate for everyone, then the best it can be considered is a privilege.
There are far too many people in this country screaming about far too many things they construe as 'rights' that are not rights at all...other than their own assumption...and demand...that they are.
Moore is not talking about constitutional rights, he is talking about ethics. Anyone who has taken the Hippocratic oath would be in violation of that oath if a patient with treatable disease presented and was subsequently turned away because a lack of ability to pay. Hospitals only provide free acute treatment, and sometimes not even that. Chronic disease is much more prevalent and does a great deal of harm if there is no intervention. Universal care allows both patients and good doctors to rest easier at night.
HA HA this is too funny.Being a former DC resident i can confirm that most people there are about as bright as Moore.The world would be a better place if the district and surrounding cities where sold to France.seriously most dc people are out of touch with reality.They are nice people though....
Dr. Gary tries to vindicate his position by means of semantic diversion, and not by citing a substantive issue that actually has to do with bettering health care. The fact is U.S. citizens suffer disproportionately more from disease: they live shorter lives because of it and have higher infant mortality rates than any other industrialized nation with universal health care. And that relative gap is widening over time, even though many of those countries have similar rates of obesity and its associated chronic diseases. If our country could win an arms race, why are we losing the health race?
'sowhatnow' brings up a good point: we are already paying for the poor to some extent. But we are paying for them when they are much more expensive to treat. There is a massive savings when you intercept disease early, a savings our country would realize only with some form of inclusive care, since you can only maximize the early utilization of health services by at-risk populations when, as a people, we remove the barriers to it.
Moore seem bright to me. His satires may be hyperbolic, but the stories he presents do spotlight many of the reasons our healthcare system is failing national health.
Mr. Moore has hardly been shy about sharing his political beliefs, but he has never before made a film that stated his bedrock ideological principles so clearly and accessibly. His earlier films have been morality tales, populated by victims and villains, with himself as the dogged go-between, nodding in sympathy with the downtrodden and then marching off to beard the bad guys in their dens of power and privilege. This method can pay off in prankish comedy or emotional intensity — like any showman, Mr. Moore wants you to laugh and cry — but it can also feel manipulative and simplistic.
In “Sicko,” however, he refrains from hunting down the C.E.O.’s of insurance companies, or from hinting at dark conspiracies against the sick. Concentrating on Americans who have insurance (after a witty, troubling acknowledgment of the millions who don’t), Mr. Moore talks to people who have been ensnared, sometimes fatally, in a for-profit bureaucracy and also to people who have made their livings within the system. The testimony is poignant and also infuriating, and none of it is likely to be surprising to anyone, Republican or Democrat, who has tried to see an out-of-plan specialist or dispute a payment.
I hope this debate will not be diverted in a plead against healthcare because occasionaly some illegal immigrant gets a free ride on it .Altogether the poorest part of the population will benefit from it AND the middle classes too of course.To the doctor that states health is not a right,of course it is.If it is not yet in the constitution ,it should be ammended.Even the charter of the UN states health and education as rights for all citizens on this planet .A lot still needs to be done in many countries but I hope soon the people from the USA will benefit from it;ll freeing them from financialy worrying over their children,parents and friends in case disease strikes them .I've just read a post that stated a 500 dollar bill for a ride in an ambulance .Cost here in Belgium is about 100 dollars .Quite a difference I would say .I would love to see you guys divert some money spent on weaponry into health care and education .Dont you think it would improve the quality of ligfe itself .A spinoff would also be a less costly incarceral and repressive justice .Ir is a simple fact that when quality of life improves criminality is reducing .It is a win win situation for all.
These healthcare juggernauts are cracking into the fortune 500. Does that seem weird to anyone else? These megacorporations need to be abolished. We need a nationalized healthcare where doctors and nurses are government employees. That's the only answer. Otherwise we have private organizations telling us what medical conditions we can and can't live with.
I am currently trying to deal with a preventable medical problem that has been greatly exacerbated by a long period of neglect stemming from lack of funds or insurance coverage.
Basing health care coverage on employment seems to me the least effective way of holding down costs. Had I had coverage all along, treating my problem would have cost money, but the total cost of preventive treatment over my entire lifetime would probably be only 2/3 to 3/4 of the cost of dealing with its current acute manifestation.
Outside of any humanitarian or medical considerations our current system is just flat economically inefficient. When political types like Senator Brownback go around saying that increased privatization will lead to more informed consumer choices, they are only rationalizing the system's inefficiency.
Insurance is about sharing risk, not about making consumer choices. Since we all need health-care and since it is expensive, the debate should be about pooling risk and not consumer choice.
Other countries have pooled their risk by including everyone in their insurance systems, until the advocates of increased privatization address this issue, their proposals only represent varying degrees of demagoguery.
I would like to direct a comment to Dr. Gary.
Dr. Gary states that there is no constitutional right to health care.
I refer him to the ninth amendment which states that the enumeration of rights in the constitution should not be construed to limit them.
Dr. Gary, if you are going to apply strict construction to the Constitution, you should read it first.
Robert Chapman
Lansing, NY
I think alot of viewers miss the importance of the film, in my opinion the film not only speaks about the cost of health care and who should provide it, but it also shows an industry that seems to be underregulated or not regulated properly and as such policy holders are mistreated by these insureance companies.
It is one thing to believe that the government should provide universal health insurance but i think that some one or some authority should stand up and represent the society against these profit hungry insuance companies.
I haven't seen the film yet so I can't comment on it. However, I will say this. My one worry about SICKO is Michael Moore's track record. As a political moderate, I don't subscribe to his politics to begin with. And his track record of taking liberties with the truth (if SICKO takes the same liberties) could harm efforts to popularize universal health care among other moderates. This would be sad since I'm a big believer in universal health care.
This belief is not some sort of touchy feely position on my part. It's based on my eight years of experience as a claims analyst for Blue Cross Blue Shield carriers in Oregon and Washington states. That eight year period is not one I'm proud of. Insurance companies are not in the business of paying claims. They are in the business of putting barriers between patients and medical service providers (deductibles, copays, risk pools, exclusions). Further, health insurance companies have perverted the true meaning of health care - dividing it into categories with different pay levels and restrictions that most patients find confusing. Why do we need VISION benefits ... OUTPATIENT benefits ... INPATIENT benefits ... DENTAL benefits ... MENTAL HEALTH benefits ... when every one of those benefits apply to the life of a patient? There should only be ONE type of benefit ... PATIENT HEALTH benefits, covering all expenses a patient might endure to insure the health of their mind and body. Period.
PS #1 - A lot of people who knock universal health care point out the problems with the Canadian and British systems. But, they neglect to mention the successes of other universal health care systems. Case in point - Australia. How is it that Australians live measurably longer and healthier lives in a country where health care costs have been held to only one percent of the GDP? It's because Australia has a single-payer system that melds government service with services of private sector insurance companies. In short, a single-payer system need not be 100% government-run to be universal (and work).
PS #2 - A few years ago, there was a conservative political ad on TV that showed elderly Canadian residents getting on a bus to travel to the USA ... to acquire drugs they couldn't readily acquire in Canada. It never happened but I'd always hoped the Democrats would do a follow-up ad using the same theme. In this ad, it would show the Canadians leaving the bus ... replaced by Americans who continued on the bus until it reached Mexico ... so the Americans could acquire the drugs they needed at 40% (or less) than they cost in the USA.
What??? You want those of us who work, pay taxes, and pay for our own heathcare to pay for the heathcare for those who want it for FREE!!!!!!
Huh!!! Go jump off a cliff...and take Hillery with you!!!!
Mikey Moore is trying to rebuild his reputation. If some good comes out of it, all the better.
Tonny, compare survival rates for these diseases in Europe versus the USA and get back to us:
Colon Cancer
Prostate Cancer
Breast Cancer
I was going to say that A.O. Scott just plagiarized the NY Times movie review until I realized that he actually wrote that review. If that really is him on this board, nice work, until the gratuitous 'rather ingeniously' line at the end. You injected yourself too directly into the review, and in so doing, undermined the credibility of an otherwise compelling review. Bummer.
Kudos to Michael Moore for bolstering my faith in humanity. At a certain point, I was convinced EVERYBODY was prime asshole material. Sicko's popularity proved me wrong.
To me, Michael Moore is now the quintessential American. He now is the model.
SP4 what exactly would be your explanation for different figures of survival for some cancer types between the USA and some european countries ?Social security ?THink again and give some arguments .Meanwhile I will tell you that people here in Europe are less easily persuaded to have their breasts or prostate examined regularly than in the USA.Good for you but that indicated only behaviour mistakes .THe later a cancer is detected the lower the survival rates .I kno because my ex-wife is exactly in that situation because she dragged her feet in having her breasts examined .It took her six months to have a biopsy,because she was too afraid .After that she had two operations,she refused chemo and consulted a wacko new age idiot who gave her silly remedies .Now she is due for mastectomy and chemo,finally .Meanwhile she adds to tthe statistics you mentionned .But the fina
Meanwhile some material concerning mortality rates,infant mortality and longvity in Europe and the USA .THey indicate people in Europe live longer,less infants die,etc?Now how would that happen ,do you think.
One conclusion only.
Its about money over ethics. There needs to be transparency in the system plain and simple. Hopefully Sicko will keep lights on after the movie is over.
To see that there are still Michael Moore bashers out there even AFTER his F9/11 documentary keeps proving itself, it shows how uninformed and closed minded the citizens of this country really is!
SP4 what exactly would be your explanation for different figures of survival for some cancer types between the USA and some european countries ?Social security ?THink again and give some arguments .Meanwhile I will tell you that people here in Europe are less easily persuaded to have their breasts or prostate examined regularly than in the USA.Good for you but that indicated only behaviour mistakes .THe later a cancer is detected the lower the survival rates .I kno because my ex-wife is exactly in that situation because she dragged her feet in having her breasts examined .It took her six months to have a biopsy,because she was too afraid .After that she had two operations,she refused chemo and consulted a wacko new age idiot who gave her silly remedies .Now she is due for mastectomy and chemo,finally .Meanwhile she adds to tthe statistics you mentionned .But the financial price is still benign .A full mastectomy with reconstruction of the breat,nipple tatto,the hospitalisation costs and doctors consultations cost roughly 4000 dollars .And that is expensive because breast reconstruction is considered an esthetical surgery .A open heart operation would be much cheaper.Less than 1000 dollars alltogether.In Europe ,honestly everybody can enjoy the same standards of medical care .High standards that is ,to insinuate otherwise only reflects ignorance or lack of information .
Meanwhile some material concerning mortality rates,infant mortality and longvity in Europe and the USA .Notice how the USA are somewhat lagging behind .THey indicate people in Europe live longer,less infants die,etc?Now how would that happen ,do you think.I realy dont understand how one can be opposed to decent health care for everybody,including yourselves ?
Of course reform goes beyond systems .One can safely guess that if financial burdens relating to medical treatment are taken away a lot of diseased patients will show up,stretching the system and causing more queues in hospitals .
It also is my educated guess that even the people opposed to social security in these posts wailing that they will end up paying for others to enjoy free medical care are in fact gaining from a new system .Now medicare is market regulated in the USA,that means that profit is made from the suffering of diseased people .Immoral and highly irrational .Invest this money in social security and end up paying less .
One conclusion only.
Meanwhile here is some intersting comparisons between USA and Europe
www.os-connect.com/pop/p1a.htm
Just another lame attempt to do damage to America by Mr. Moore.
Anyone who has been alive for more than a few years is already familiar with the Anti-American load of crap that Mr. Moore keeps shoveling. I am in high hopes that the U.S. Justice department will finally put this low-life piece of scum behind bars. His little trip to Cuba was illegal and should be prosecuted fully. I eagerly await Mr. Moore in his next movie, 'Manhole' describing his free and enthusiasticly given FORCED RECTAL ENLARGEMENT by the inmates at whichever federal facility he is placed in after his conviction.
To watch Mr. Moore receiving the same treatment he gives America will be a delightful time well spent !!!!
How can anybody mabem %ichael Moore an anti-american is beyond belief.Can previous poster perhaps explain how he reached that conclusion,or are we to take his insults towards Mr Moore as gospel(no pun intended)
Mr.Moore has only re-enlightened the 'Rich feeding off the Poor' scene. Nothing new, but oh boy does is disturb some of the healthy and comfortable.
Keep pushing it in their faces Mr.Moore - stick it under their noses until they can't stand the stink any longer and have to turn their heads in a new direction.
Some say he is not a loyal American and maybe your right, but he is definitely an active part of the Human Race and for that I am thankful.
Thankyou Mr.Moore, my hat if off to you sir.
-GH-
Dan wrote - 'What??? You want those of us who work, pay taxes, and pay for our own heathcare to pay for the heathcare for those who want it for FREE!!!!!!'
Yes, Dan, I do. By the way, medical service providers not only pass on the costs of uninsured health care to other patients, they also pass on the costs of attempting to collect those costs. In the meantime, insurance companies pass on the costs of processing claims (ie., my salary when I was a claims analyst), advertising to compete with other companies, other infrastructure costs common in insurance companies, and dividends to stockholders in the company. Why would those of us who pay insurance premiums want to feather the nest of a stockkholder who buys the stock to PROFIT OFF MY HEALTH PROBLEMS?
Our society has long accepted the principle that taxpayers should cover the cost of childhood education, law enforcement, and fire department protection - even if the persons who make use of those services don't pay taxes. Are YOU suggesting that schools, cops, and firemen should check to make sure that someone is a taxpayer before they render their services? I doubt it. The very idea is ludicrous on its face. If schools, cops, and firemen don't check out people's wallets before they provide service, why should doctors and hospitals?
But, you didn't address one item, Dan. Why is the cost of health care so high in this country when it's limited to only one percent of GDP in Australia? Simple. It's because insurance companies in the USA use a USUAL/CUSTOMARY FEE schedule that is set by averages charged by providers ... fees that constantly spiral upward without any regulatory limit.
In a democracy, voters can set funding limits to schools, police, and fire districts. Why in God's name can't they set the same limits on medical service providers?
Really, I can trace roots through my maternal line to the Mayflower. Even more 'american': I am also 1/16th indigenous.
I'm arthritic AND unemployed. Can't get work because of the arthritis, can't get healthcare because of my employment status.
I'm also entirely frustrated, disgusted and repulsed by 'true americans' that respond to each and every attempt at pursuit of the general welfare with reactionary impulses that look to me to be nothing more than self-serving maintenance of the status quo: the rich get richer and the poor get anally reamed until they have no more blood to give and are discarded in the scrap heap of statistical detritus.
Look, private property IS freedom. We get the message. However, civil liberties, civil rights, and quality of life issues in general are also 'measuring sticks' of freedom. The denial of basic human rights, guaranteed to the rest of your fellow americans by virtue of the USA being a signatory nation to the UN Declaration of Human Rights (chiefly authored by a US first lady, Elanor Roosevelt) in pursuit of the benefit of the richest 1% of americans is evil, repressive, and counter to basic democratic principals of which the country is allegedly founded on.
Labeling those advocating for our rights 'un-american' merely exposes those critics as the reactionary forces against freedom that they truly are.
Answer # 1 - Look at the foreigners who come to the USA for treatment versus those who go abroad. Hell, Clinics in N. Dakota, Illinois, Montana, and New York, get Canadians every day, paying out of their own pockets so they won't die from waiting for procedures their system drags its feet in providing. I guess death therapy is pretty effective.
Answer # 2 - Michael Moore realizes that he is a pariah and he is doing some fancy P.R. to get around it. Sitting in Al Jazeera's booth at the Republican convention certainly didn't buy him any friends. Tell the fatboy, when you see him, all the best.
To the last poster:
Why did US citizens (years ago) have to go to South Africa to get a heart transplant ... or more recently, to France to get certain cancer therapies tied up in the FDA's waiting game? People go where the treatments are if they need them (and if they're lucky enough to have the money to pay for the travel and treatment). The USA doesn't have a lock on state of the art treatment. It's just that non-domestic treatment generally gets page 32 coverage in domestic newspapers.
As a former claims analyst who read medical journals, I know this for a fact. Read a few medical journals before conferring treatment superiority to the USA. You might be surprised. Sometimes, we are on top. Sometimes, we aren't.
Universal provision of healthcare to a meaningful level SHOULD be a goal of society, otherwise the 'have nots' who cannot afford their personal bills will be disenfranchised and if they don't die off quickly enough will realise that significant numbers of people of influence and power don't really care about them. Then there will be a backlash.
That is right Answerman,you seem by the nature of your work to have a deep understanding of the market mechanisms that rule healthcare in the USA .Of course I never claimed that Europe provides the best possible healthcare in every possible way all the time .We consist of different countries with different systems .Difficult to compare .THe thing I never understood is the urge that pushes people to burn their own houses to the ground .It is pretty clear that most people opposing health care reform in the USA would in fact greatly benefit a larg majority of people from it once it is introduced .Look at it as a piggy bank from which no stockholders ,CEO or anybody else than patients profit .Easy to calculate that it is superior to private health insurance .Is it burocratic ? Not more than privatized healthcare ,probably less as competing private companies spend more ressources in competing administrations,representants,public relations and publicity than a single service to patients .THat too is money diverted from better spending .
I guess a lot of opposition against modern health care also derives from the perception by a great deal of americans of the state as a useless instance only capable of reaping money from the citizens without providing much service .A lot of americans hate to pay tax.
We might pay a little bit more tax here in Europe,again their is quite some difference between european countries,but most of us do not think the state is a waiste of money .It is a impersonification of all the citizens in a governing body.
Bu the biggest question mark for me remains how it is possible many people in the USA still find no problem in their government spending trillions of dollars on useless weapon systems ,completely ineffective or obsolete in the post cold-war period,meanwhile many people in their own country suffer from poverty,lack o healthcare and lack of education funds .Those guys should have a heart for their fellow countrymen.At least I do.
The talking-up of American healthcare is simply part of the propaganda exercise by the medical providers to justify the high fees they charge and persuade users they are getting good value.
Undoubtedly the American medical services have some world class facilities and techniques, but so do many other countries. Don't take the usual blinkered 'america is best' attitude to this - get some objective comparisons from around the world
The sad thing about those who support privatized health care is that many of them actually believe that it will protect them from paying the health care costs of others. Health care costs for ALL persons are ALWAYS paid by SOMEBODY. If an uninsured person defaults on paying his/her medical bills, providers first attempt to collect by use of collection agencies. For example, if an uninsured patient owes $10,000 to a hospital and the patient won't pay, they simply sell the patient's account to a professional collector for, say, $1,000. The other $9,000 would be taken off the insurance carrier's tax bill at year's end, written off as a bad debt. And when they don't pay their taxes, who does? Joe & Suzy Taxpayer pay because their taxes go up to compensate.
Another sad thing about those who support private insurance companies is that they believe cost cutting is done by the raw efficiency of private enterprise. Not true. Costs are cut by simply not paying the costs (ie., deferring them to deductibles, copays, risk pools, strict exclusions, etc.) or passing the costs on to REINSURANCE companies to which the insurance companies pay their OWN premiums. Imagine filing your income taxes with the IRS ... only to receive a 2nd tax bill from a 2nd IRS. Patients aren't the only insured people. Insurance companies have insurance, too. And guess who ultimately pays for REINSURANCE premiums?
Privatized health care is nothing more than a money pit ... set up to make money for an oligarchy of industry fat cats, lobbyists, and stockholders.
Just a thought. I sometimes wonder how health insurance company stockholders can sleep at night. If a patient elects not to have a needed surgery because they don't have the money to pay costs beyond insurance, and if the patient dies as a result, the company makes money by indirectly allowing the patient to die ... and the stockholder takes a cut on the profit from the patient's death. Hippocrates surely turns over in his grave every time this happens. And it does happen often.
Another example of (I'd laugh if it wasn't so grim) ccst cutting is the attitude of private carriers that could best be described as pennywise and pound foolish. Most insurance companies will pay for a quadruple bypass (up to limits), a very expensive procedure involving hospital costs, surgical costs, anesthesia costs, post-op costs, and a litany of other costs. But the same company that would pay for a quadruple bypass operation might NOT pay for a routine physical exam ... considering it a contract exclusion ... even though the relatively cheap exam could have caught the heart problem before it became an expensive one.
I think the article to some extent misstates the intention of Moore's documentary. Sure there are some 40 million Americans who are uninsured, but the documentary focuses mostly on those who are insured and still receive substandard care. The poor uninsured and illegal immigrants are an issue, however, even people who do everything right (are employed with insurance) are treated badly by health insurance companies. These companies can make excuses for there behavior but, and this is the bottom line: American's who pay for health insurance in many, many cases are not getting what they paid for. On a side note, I would have like to have seen Moore address problems with professional medical organizations who ensure that doctors' wages remain high which necessarily limits the supply of medical talent.
1. - Because the heart transplants in S. Africa were not approved by the FDA.
2. - Because these cancer therapies are not, yet, approved by the FDA.
Now, I'm no dictor, and I have some real axes to grind withthe FDA, but I'd rather have their expertise than have France's or S. Africa's.
The real fact is that 47 million Americans lack Health INSURANCE, not health CARE. You can walk into ANY federally funded emergency room and the MUST help you. In certain states, like Oregon, citizens are provided with state health insurance if they are minors, or indigent adults.
I may not like Michael Moore, or the way he chooses to communicate his thoughts, but I understand what he's trying to say. I'm lucky to have a good job, and insurance because of it. But I had to go without for 6 months in order to earn the insurance with this new company I work for. Because I had a job the state wouldn't cover me under their policy, and I couldn't afford my prescription because I didn't have insurance. They wanted $120.00 for 30 days worth of pills, instead of the usual $10.00 before I got laid off and lost my insurance (cobra insurance would have cost me $356.00 a month-not affordable). Luckily, it wasn't heart medication, etc. that could have killed me without it. Something simply needs to be done. I've seen a story on this medication I take, and it costs them pennies per pill to produce, this includes the wages of workers, and packaging. Why are they charging $4.00 apiece when it only cost them a few cents to make and package? If the government could simply get the price gouging under control, it would be a wondrous first step in solving this healthcare issue.
SP4,
I understand where you're coming from. Until I worked for a medical insurance company, I had complete faith in our system of health care ... and in our system of research and development of lifesaving drugs and treatments. But, after seeing the system from the inside ... and after reading medical journals like Lancet, Hippocrates (which may no longer be in print), New England Journal of Medicine, etc., etc., I've come to see that innovation is a global phenomenon. Many therapies perfected in the USA come from international efforts. And some therapies used in the USA were perfected elsewhere. And, other therapies are still in the process of being perfected or improved upon ... with input from medical innovators around the world.
Just a brief humorous note on innovation. Remember the film about our Mercury astronauts, THE RIGHT STUFF? There's one scene in the film that's priceless. The USSR got Yuri Gagarin into space, making him the first man in space. A politician asks one of our NASA scientists how the Russians got ahead of us ... and whether it was due to their German scientists. The scientist replied, 'NO ... OUR GERMAN SCIENTISTS ARE BETTER THAN THEIR GERMAN SCIENTISTS.' (grin)
Chris,
You raise a VERY GOOD point ... that many insured persons in this country are not getting what they paid for (or thought they paid for). My insurance is through Kaiser. On May 30th, I had two dental fillings done, both porcelain fillings. Two days ago, one of them just fell out. I was lucky to get an emergency appointment on Saturday with a different Kaiser dentist. The new dentist put in a new filling. And while he didn't come out and say the first dentist did something wrong, he did say that the tooth needed a metal filling - that porcelain fillings wouldn't work on that particular tooth. But here's the rub.
Kaiser is not only the insurance carrier, they're also the health care provider, too. As such, they billed me for the 2nd filling just like the 1st filling ... even though their first filling was inappropriate for that tooth. The advice nurse asked me if I wanted to contest the fee of the first procedure. I said I did. But guess who makes the decision about whether or not the first fee should be refunded? You guessed it ... the dentist who put in the bad filling.
Now ... if the dentist decides not to refund the fee, I have two options. Complain to the state dental association, requesting a peer review of both procedures. Or, I could file a formal complaint with the state insurance commissioner. If the fee is not refunded (evil grin), I will do both.
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