It's Time for a Change

Sicko, the new film by Michael Moore, presents the stories of Americans who
are coping with a broken health care system any way they can.

"Moore sums up the film in one sentence," says Tony Stuart, principal of
Stuart Law Firm in Santa Monica, California. "He asks the audience, 'Is
this what we have become?'"

In Sicko, Larry and Donna Smith, who worked hard all their lives and put six
children through college, find themselves drowning in medical debt as they
undergo treatment for heart problems and cancer. Ultimately, the Smiths are
driven into personal bankruptcy, and out of their home. The camera follows
them as they move into a storage room in their daughter's house.

"Illness and medical bills drove them into bankruptcy." Stuart says. "Their
story is not exceptional. The Smiths found themselves in the same boat as
two million Americans annually - most of whom had health insurance."

Stuart's clients come to him in even worse circumstances. They are victims
of out-and-out health insurance fraud.

"During the sales presentation, they are assured up and down that they will
be covered if they experience a catastrophic illness," he explains. "Then
they fall ill, and are made to understand that the insurer will cover only a
fraction of the bills. The policy language is intentionally confusing. It
is disorganized, it is misleading. It's impossible for an average person to
understand. Even professionals can have difficulty with it. I am
constantly amazed that there are companies that will sell such junk to
people seeking to protect their families."

The system is hemorrhaging people like the Smiths, and deceptive and unfair
practices are a big part of the reason why.

In Sicko, a woman's insurer refuses to pay for her ambulance after it
transports her - unconscious - to a nearby hospital because the ride was not
"pre-approved." A mother's infant daughter passes away in her arms because
the nearest hospital is not "in-network." A 22-year-old woman diagnosed
with cervical cancer crosses the Canadian border in search of care after her
insurer denies her claim on the basis that people as young as she is do not
have cervical cancer.

In the film, a former insurance industry employee talks about how her
company awarded bonuses to employees who denied the most claims. Dr. Linda
Peeno, a physician, testifies before a Congressional committee that as a
medical reviewer for Humana, she denied needed treatment to a patient, and
thereby caused his death.

"Believe it or not," says Stuart, "there is nothing especially unusual about
such industry practices. We regularly confront such people in the course of
representing fraud victims."

Most Americans who fall into financial ruin due to illness and medical bills
are middle class. More than half begin their ordeals as homeowners. More
than half attended college.

And more than half ultimately go without needed medical care.

Says Stuart, "I would hazard to guess that by now, almost every American
knows a person who has experienced a healthcare nightmare, whether or not he
or she had health insurance. I help fraud victims pick up the pieces after
the fact, but I would much rather see a healthcare system in this country
that did not allow people to fall into such circumstances to begin with."

"The system is broken," Stuart says. "It's time for a change."