Finally saw Sicko | Arthritis Information

I finally saw Sicko and it was good---probably Michael Moore's best
movie to date.
Before I saw it I felt frustarted and bewildered about how some Americans
believe their system is the best when it left so many behind and without
options, but after seeing Sicko I understand (I think) what they are
thinking and why they have that opinion. I ended up leaving sort of teary
and just feeling sorry for the whole sad situation many people have been
left in.

I also now can see better where Canada's system fails after seeing how
the Brits and French do it. I was particualrly impressed by how Britain
pays Doctors more when their patients fare better. In France there are
Doctor house calls a phone call away!

Of course he's trying to make a point so he emphasises the things that
illustrate that point, but I think it's a great movie that people should
see---it really taught me a lot.

I heard they also do that with Asian medicine. The doc doesn't get paid unless the patient gets better.

Pip

Yep, it's definately an added incentive for the doctor. I don't think it would
work here because in Canada's system you can go to any doctor who will
accept you as a patient, so doctors could just start taking the easy cases,
and not the heartbreaker cases. But at least it would make sense for Doctors
to not benefit financially by prescribing meds. I'm grateful to have
medications that I need but I sure don't want any I don't need! I want to take
just enough (and the mildest) to control my condition and that's it.I saw that documentary and was thinking about it Saturday when i spent 5 hours in the emerg. for stitches! 5 hours is a long time but I must say it was an easier wait after seeing Sicko. At least it was free. And anybody who was serious were taken in right away. Once I spent about 3 hours in ER, waiting. But every other time I've gone
(and they've been about once a year) I've been seen in 15 minutes or less.
They prioritise by urgency. Last year my partner was having trouble
breathing and he waited zero minutes (it turned out to be asthma).Yah and since I was working when this happened I was driven by my boss to the busiest hospital in downtown Toronto. Smart. I should have told him to bring me to one in a residential area. So there were people that got rushed in right away understandably. Actually, the Federal Government in the US is beginning to base pay on outcomes. But, that mostly affects the hospitals, not docs. If a patient acquires an infection or a decubitus ulcer while in house, the treatment will not be paid for. It is call "present on admission". We will see how that works in the next year or two.

There are special diagnostic codes (used worldwide) that are used for complications of medical or surgical care. These are tracked and put in a "permanent" file for physicians too.

Mary, you have a completely different perspective on all of this than the rest of us. I was just wondering if you have seen Sicko yet, and if not, do you plan to? I would be very interested in hearing your feelings about the movie.

Karen

Hi Karen,

I have seen some of Michael Moore's movies (I can't remember the first one, something about the automobile business). I found his statistics slanted (of course, most people slant statistics) and I thought he used and made fun of people he interviewed. I will probably watch it on DVD when it comes out.

I do see a lot of flaws with the US system, both the private sector and government insurance. One of the associations I belong to (American Health Information Management Association) is really trying to empower patients. I work with them on the state level with regards to education. I just wish it was as simple as most people think it is to change a system such as health care. I don't think I will see it in my life time and I am 46. Maybe my kids?
I'm not going to say anything positive or negative about Michael Moore. That is for the individual to figure out for themselves. I will tell you that there is a new movie coming out called Shooting Michael Moore. Done by Kevin Leffler an old friend and collegue of Michael Moore. Gives a much different slant on Mr. Moore.

Playing devil's advocate. If all doctors get paid on the healthy outcome of a patient. What will chonically ill people (like us) where there is no cure, end up? With low end doctors becuase the smarter/better doctors don't want their patient outcomes lowered with a chronically or terminally ill patient? Kinda like the kid who doesn't take the class that will lower his GPA.

Something to think about.Good point cheesehead!

Actually, there are ways to figure out how "sick" a patient is by using diagnostic codes. It is called "case mix index". Codes and group of codes are given a numerical "weight" and then it is averaged. The higher the weight on an inpatient, the higher the reimbursement is to the facility. It is taken into account when "grades" are given to hospitals and doctors. A specialist should have a higher number than a generalist. A state trauma hospital has a higher number number than a community hospital.

The codes for medical or surgical complications are normally due to the provider. These are kept track of separately.

The earlier discussion on this thread about the 5 hour wait in the ER, followed by a discussion of codes reminded me of a story. (Of course, everything reminds me of a story. . .) LOL!

Several years ago my son injured his leg and went to the ER for treatment. He basically took a large chunk of skin out of his knee, as though it were "spooned" out, if that helps you picture it. My husband took him in to the ER and they waited several hours to be seen, which is expected, since it wasn't by any means serious or life threatening.

After checking it, the ER physician decided that there really wasn't anything he could do other than cleaning the injury, bandaging it and making sure he was current on his tetnus shot, which he already was. Since the chunk of skin was gone, and it was a bending joint, he couldn't stitch it up.

Everything was great until we received the bill - the code that was used was for a surgical procedure, and the bill was for more than 0, for the physician! For cleaning and bandaging! I called the hospital and complained, and I was told that there was nothing they could do, that the physician who was on call wrote it up that way. Yes, it was being submitted to insurance, but I was going to end up paying for it due to my high deductible.

I called the physician's office and after much debate, and after being treated as though I was a complete lunatic for questionning this, they finally agreed to a reduced charge, but never admitted that an error was made.

So waiting for a few hours and not being charged at all sounds pretty damn good to me!

Yikes Hillhoney that is insane! I shudder to think of some of the billing errors I come across. I keep spreadsheets to keep it all straight (with 6 kids it does get confusing at times. Even then if gets confusing and I teach reimbursement classes
I tend to give more merit in those who are more balanced than one sided in either direction when it comes to educating myself.

It does seem that Moore is fanatically one sided. But he really can't help himself, can he? He is after all, a die hard lefty who is ate-up with his own agenda. He needs to find a hobby, a wife, or...wait...even better, a so called "partner."

Blessed39307.882025463Michael Moore is married and has two children. I'm more interested in what
people think of what was presented in the movie, if anyone has any
comments.

He brings up some interesting points. And he certainly opens the door for some well needed discussions. He tends to see things only in black and white though when there is a whole lot of gray out there. Like any good position documentary he only presents those numbers and facts that support his position. He tends to ignore stats /facts that may put a different spin on things so while Sicko should be part of the discussion it should not be all of it.

How to fix what is broken without messing up what does work is a gargantuian undertaking. Many Americans have a very real fear of more govt involvement. Picture the challenges of rolling out Medicare Plan D. The size and diversity of the U.S. population complicates things.

We all know something needs to be done. When the Clinton plan was rolled out the public wasn't really ready to accept the changes now they are more willing but its going to be a rocky road getting there