Story last updated at 4/3/2013 - 3:26 pm
Exactly what is going with health care in this country? Does it have to be so complicated? Does it have to be so expensive? And for all this money and effort, are we healthier?
"Escape Fire: The Fight to Rescue American Healthcare" is a new documentary film by Matthew Heineman and Susan Froemke." According to Heineman and Froemke, Americans are still unclear about why our health care system is broken, despite the bright spotlight of politics and press. "Escape Fire" is their attempt to compile a digestible explanation for what's wrong with the America' s health care system.
More than that however, Heineman and Froemke attempt to offer solutions as well. This could elevate "Escape Fire" above a more typical "we're all doomed" documentary.
Heineman and Froemke consider our current health care system dangerously entrenched. A few very powerful people make a lot of money off sick people. Pharmaceutical companies, medical device manufacturers, hospitals, and insurance companies have large profit incentives to keep things just the way they are. And so do their lobbyists. This entrenchment problem touches on one of the basic tenants of the film: The United States does not have so much a health care system as a disease care system.
Heineman and Froemke describe the evidence suggesting we over-medicate and over-treat ourselves. The U.S. spends some $300 billion annually on pharmaceuticals. This is nearly the same amount - here's an eye popping statistic - as the rest of the world combined. Do we really need all these drugs? The science says no. For many conditions health outcomes can be just as good without all the prescriptions. Similarly, a trip to the hospital may lead to unnecessary diagnostics and tests according to Heineman and Froemke. These procedures in turn can take a toll on finances and health. Of course there is a flip side. We and our doctors want to be as thorough as possible in determining a diagnosis. Ordering every conceivable test to track down a diagnosis is easy to justify.
Justifiable or not, ordering tests and procedures leads to another focus; reimbursement. Our health care system uses a "fee for service" for payment. Insurance and governments pay hospitals and doctors by procedure. Not surprisingly, this encourages more procedures. Heineman and Froemke figure the idea of quality over quantity gets lost in our current system. If a patient gets healthy and leaves the health care facility, they are no longer are a source of income. As profits require sick people, the theory goes, our current health care system perversely discourages health.
What hasn't been seen in the press information is whether or not Heineman and Froemke address the nutty paperwork burden associated with health care. Have you ever tried to file claims for yourself? It is a part time job. Has your insurance company ever lost your paperwork, or become confused by the discrepancies between the invoice and service dates, or otherwise found any excuse to grind the reimbursement the process to a halt? Why do there always seem to be questions regarding possible secondary insurances before processing even if you have already proven there is no secondary insurance on a previous claim ... during the same benefit year ... for the same person? And heaven help you if you are "lucky" enough to actually have a second insurance. That just makes the process even more complicated. The primary insurance can't pay the claim until they know whether you have secondary insurance. If you do have secondary insurance the primary insurance can't pay until the secondary insurance pays, but the secondary insurance can't pay until the primary insurance pays ... and ...
The crazy part is; it's still better than no insurance. Dealing with insurance makes DMV look like a model of courteous efficiency. Perhaps that is a subject for another movie.
This movie, "Escape Fire," is hosted by the Juneau Public Health Center and State Public Health agency partners, Alaska Public Health Association, and American Public Health Association. "Escape Fire" will play April 4, 2013 at the Hangar on the Wharf Ballroom from 6 p.m. to 8:30 p.m. The showing is part of National Public Health Week. A moderated panelist discussion of the film will follow the showing. Panelists will include Dr. George Brown, a local pediatrician, Kate Slotnick who works in Public Health Nursing, Dr. Emily Kane, a local naturopath, and Sandra Kohtz from Rainforest Recover Center. The moderator is Jayne Andreen, a state expert in public health.
You can go to http://escapefiremovie.com/ to read more about the issues this film covers.
Clint J. Farr is an epidemiologist with the State of Alaska's Chronic Disease Prevention and Health Promotion program. He is a Juneau resident. Farr can be reached at firstname.lastname@example.org.