Le prix de la santé

I saw this movie again recently. The first time I saw it I was incredulous, and the second time, even more so. Is this really truly how health care is funded in America?? Isn't there any kind of public system at all?

I just can't get over the apparent fact that a country that claims to be the most advanced of the so called developed countries would only have private health care. It's ridiculous.

Here only elective surgery is rationed, hip replacements, cataract surgery, that kind of thing. If you've got insurance, then you can go private, but otherwise, if you've got enough points, you get put on the waiting list and you eventually get your op for free. (The thing with the heart transplant would *never* happen here, that sort of thing isn't covered by our main health insurance company, as it's fully funded by the government.)

Although people are constantly winging and moaning about expensive doctor visits, (about NZ$50-$60 for an unsubsidised adult) if you need to go to A & E, you just go. In an ambulance, or otherwise. You don't have to ask permission.

What, prey tell, do people do if they can't afford health insurance?

A pivotal point of this movie which raised my ire was when a self-righteous transplant surgeon accused the HMO of committing "murder" by its refusal to bankroll a one-million dollar heart transplant procedure. Suppose the HMO officer had countered by saying: "O.K., we'll put up half the money if your team at the hospital hospital agrees to do the procedure for half price"; hopefully that would have given the doctor pause for thought - I suspect in most cases the outraged retort might have been something like "no way! we're running a hospital not a charity!" The crux of the matter is that the progress of medical science has made it technically possible to treat more and more formerly fatal conditions, but it has not made it affordable in most cases. Is any health care provider morally obligated to treat a patient regardless of cost or patient circumstances - even if it deprives other patients of the care they need? Some years ago, the British National Heath Service was excoriated by the tabloid press for refusing to finance a second bone marrow transplant for a young cancer patient whose first transplant had failed. The NHS management team replied that there was about zero chance of another transplant saving the girl's life and what right did they have to spend another million pounds on just one patient and deprive thousands of other patients the care they needed. Utilitarianism is a theory of ethics based on quantitative maximization of good for society or humanity - sometimes summarized as "The greatest good for the greatest number." All health care professionals should remember this principle; there isn't ever going to be enough cash available to do everything you would wish to do. Medical ethics become comparatively simpler in an emergency situation, e.g. a war zone or terrorism situation - doctors use the triage system, i.e. separate the wounded into three groups: (a) the seriously wounded who can be helped with the resources available (b) those with slight wounds who will survive anyway without treatment (c) those so badly injured they will inevitably die even if treated. Start with group (a), continue with group (b) if resources permit, leave group (c) to die.

Very nice movie. runs for around 1 hour and 50 minutes. Laura Dern does an amazing job in portraying the character of Dr. Linda Peeno who plays a medical adviser for 2 HMOs. An HMO is a Health Maintenance Organization, somewhat similar to an insurance company. She plays the whistle-blower in the movie who exposes the corruption in the system people are unaware of. A very thought provoking movie which at moments leaves you shocked and at times frustrated with the existing medical system. The supporting cast is also very good (except for the person playing her husband's part) but Laura Dern steals the show. This movie falls in the Erin Brokovich category. It is one of the few movies which you MUST watch with your family.

This movie wasn't a blockbuster though it did make an important point about US health care with its rising cost and declining quality. This made for TV movie portrays an honorable doc called to be the hatchet - woman for the dishonorable insurer out to save its Yankee green. Theee is much feel good liberal predictability in the denouement. To an extent the movie does show how doctors are willing conspirators or accomplices in the process. The acting flagged in places but overall the film did portray the essential ethical conflict between being a doctor and being the hatchet person kaboshing medical procedures treating doctors thought necessary. Too much feel - good liberalism enters the picture. In real life, insurers have little trouble finding replacements for such as the honest doc portrayed here and few docs if any ever become whistle blowers.

I didn't even know Laura Dern existed until 6 month ago when I saw "Wild At Heart". Maybe I did see her in Jurrassic Park, but she didn't leave a mark on me. This time she did!! Wow!! what a great, super actress!! I found that after seeing LD in several movies, she is great in factual stories, like October Sky. Whatever she does, she makes a believer out of me!! Here, she is a top grade doctor who blows the whistle on the HMO doctors. Well, I always thought there was something wrong with this system, anyway. There is something wrong with the new American people, that whenever they can steal a dollar, they'd rather do that than earn it. This is a story about such people. Not about poor people, but about rich people who want to get richer and they use the poor peoples money to do it. Thanks, Laura, I love you more today than I did yesterday. By the way, if you ever see this, I only give "10" rarely, but your best movie, a brave movie, was without question, was "Citizen Ruth". I ought to know, I've watched it 10 times or more. Please give my best to Alexander Payne, greatest Director of all time.