THCB Reader mail

Journalist Maggie Mahar, the author of "Money-Driven Medicine" and a
frequent contributor here at THCB, begs to differ with Matthew’s
lukewarm review of Sicko. (Theme: "Will Sicko Hurt more than it helps?") She emailed in to say:       

"I think that the movie will help push healthcare reform forward–in part because the filmis controversial … Focusing on the middle-class underinsured rather than the uninsured 
was, I think, a very shrewd move on Moore’s  part, and I don’t think the Cuban finale hurts him)." 

Skeptic disagrees about Moore’s picture. He had the following comment:

"Whether or not he realizes it, Moore has become a useful idiot for some
of the most reactionary interests in health care … I predict this film will be as effective in helping the
medically underserved as “Fahrenheit 911” was in preventing the
re-election of George Bush in 2004."

Peter Chowka, the author of an early review of Moore’s film in American Thinker ("Prepare to be sickened by Sicko"), that provoked a fair amount of heated discussion in the blogosphere obviously didn’t like the film very much. But he emailed in to say the following:

"My disagreements with Moore aside, I have to hand it to him for stoking
the discussion and debate about U.S. health care policy to
unprecedented levels, certainly a degree not seen since 1993-’94.
Hopefully, I (and I know many others) will have future opportunities to
delve more deeply into the core of the issues that Moore and his
supporters are highlighting, as the issues continue to emerge and, we
can hope, become more clearly defined."

Meanwhile, Mona writes in to tell us about OutofPocket.com, a start-up that seeks to use the power of social networking to shed light on
the weird world of health care pricing.

"I wanted to let you know about a grassroots
consumer initiative for consumers to look up true prices
for common health care services.  The website consists of
consumer-contributed data and CMS payment data for common Medicare
services.  As a consumer advocate, my goal is to achieve critical mass
for consumer participation in this initiative. I believe consumers have
the power to positively influence the future direction of healthcare
and encourage healthy competition in the industry.  In order to
accomplish this goal, we need your help promoting www.OutOfPocket.com to get the word out."

In response to last week’s THCB post on Los Angeles OB-GYN Dr. Gil Mileikowsky and his fight to win protections for doctors who report medical errors at their hospitals, Bart Lee of Spiegel, Liao & Kagay writes.

"John Irvine’s note is most welcome. We represented Dr. Mileikowsky. Charly Kagay of this office handled the appeal. Dr. Mileikowsky’s Black Box idea is a system of anonymous and objective review

Presently "Peer Review" as a discipline is all too often biased. These biases go largely uncorrected because of the immunity provisions of the Health Care Quality Improvement Act, which has not improved the quality of health care. There is a sword available, by a simple amendment, to untie this Gordian Knot: My suggestion, which follows, as to the best and quickest way to fix HCQIA’s immunity problem, is  … (Comment edited for length. See full version here.) …  to amend this section:

"A professional review body’s failure to meet the conditions described in this subsection shall, in itself, constitute failure to meet the standards of subsection (a)(3) of this section."

"That is, take out the "not." A hospital that that runs a kangaroo court should not get to take advantage of its own wrongdoing. Each and every National Practitioner Data Bank report that results from a peer review body that fails to meet the specified conditions should not be privileged, should be enjoin-able in equity in state or federal court, and should give rise to a damages action including attorneys’ fees. Each and every kangaroo court "peer review" should not enjoy immunity from any damages causes of action."

If you missed Dr. Mileikowsky’s original YouTube appearance, you can find it here … [Uber]

Dr. Thom writes in to opine on Maggie Mahar’s excellent essay – "Do Non-Profit Hospitals deserve their tax breaks?"   

"I am a for profit doctor with privileges at a not-for-profit institution.  I do my share of unassigned calls, see uninsured patients and I practice with the largest private provider of Medicaid services in my state.  When someone comes in for care and can’t pay, I charge him the full amount on the front end and mark down the charges or write it off completely on the back end.  Rarely do folks who can’t pay get sent to collections.   Our hospital, on the other hand, has what our consultants have told us as the most aggressive collection policy they have ever seen, profit or not."

Meanwhile, reader speculation that start-up social networking site PeerWisdom might be changing its name at some point soon turns out to have been exactly on target. The company’s Jude O’Reilly writes to us happily:

"As if on your cue, we’ve just announced the change of our name from PeerWisdom to Trusera. (We’re not giving up on being wise, just using wisdom in our name!)  PeerWisdom was intended to get us through our early funding." 

In response to Scott Shreeve’s post arguing that recent reports of the death of the consumer-driven-health care movement (gulp!) may be slightly exaggerated, B.E. Rodin writes:

"There are few other industries where information on product quality and cost are so difficult to obtain.  Of course, this is compounded by the third party payment system.  When someone else foots the bill, we have no motivation to efficiently spend limited dollars.  The second key ingredient in consumer driven health care is to have consumers be responsible for allocating limited funds to spend on their health care.  Perhaps consumers will then routinely question the effectiveness/necessity of medical treatments and look for alternatives.  Perhaps they will start to live a lifestyle which promotes health, rather than assume that there will be a pill to cure almost anything that goes wrong."

Chris Johnson writes to weigh in on the debate over the merits — and lack thereof — of health savings accounts.

"I’m a self-employed physician with an HSA, and even I have
trouble using the thing effectively. In spite of the inside knowledge I
have of the system, it’s just as hard for me to find out how much
things really cost as it is for anyone else."

Meanwhile, insurance agent Chris – presumably no relation – writes in on
the controversy surrounding the business practices and standards of certain health insurers.

"I’ve researched the Mega and Midwest plans and honestly cannot find
a lot of room for those companies to get out of paying what they say
they will. I think the problem is that agents tell people they have
more coverage than they actually have.  My personal experience has been
that I have NEVER been encouraged to make the plan appear better than
it actually is…" 

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