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Insurers Face A Screen Test
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By DIANE LEVICK
Courant Staff Writer
June 21, 2007
If filmmaker Michael Moore had his way, Aetna, CIGNA, and other health insurance companies across the nation would be dead meat - replaced by a government-run system.
It's not clear yet how much of a threat his new documentary, "Sicko," is tothe industry. But with its general release currently set for June 29, thefilm's previews and advance promotions are reigniting the resentment againstinsurers that tends to simmer between boiling points.
Local companies don't fare as badly as some in the movie, which revels in tales of patient-dumping and death-hastening denials by other insurers.
The film slaps CIGNA for approving one hearing implant instead of two for a toddler, and Aetna gets off with just a flash of its corporate logo sign. Moore has said Aetna insures his employees.
The film goes relatively easy on the local companies, but Moore doesn't play favorites. He takes direct aim at the U.S. health care system and the whole insurance industry, which employs thousands of people in the Hartford-Middletown region.
Rather than pick on individual companies, the veteran rabble-rouser urged a rally last week in Sacramento to wage "a war against health insurance companies, who are more interested in lining their pockets than caring for
the people of the United States of America."
"We have to get rid of them once and for all," he said. The receptive crowd, which included nurses, picked up his next line as a chant: "It's time for them to go."
Insurers say they're not worried sick about "Sicko," despite the popularity of Moore's previous films such as "Fahrenheit 9/11" and "Bowling for Columbine."
However, America's Health Insurance Plans, a national trade group, has been issuing frequent statements aimed at defusing Moore's call for a government-run - "single payer" - health care system.
"I think it's very, very clear the American people don't support a government takeover of the health care arena," Karen Ignagni, the trade group's president and chief executive, said in an interview Tuesday. She warned of rationing and long waits for care in other countries with
single-payer systems.
She said insurers view "Sicko" as an opportunity to discuss their proposals to get more people insured through public-private partnerships, and "talk about the value we provide" through disease prevention and management, and
other programs.
As for Moore, "Essentially what he's done is filmed an editorial," Ignagni said. "There was never any attempt by Mr. Moore to seek out our members to answer questions, to respond to cases in the movie."
Publicists for Moore said he was too busy to be interviewed for this story.
Some of the patient cases Moore used are more than 10 years old, Ignagni said.
CIGNA, whose health insurance operations are based in Bloomfield, wouldn't talk about details of its own case in "Sicko." But the company did discuss the general subject - cochlear implants, which are complex electronic,
surgically implanted devices that provide a sense of sound for deaf people.
The movie shows parents who were shocked that CIGNA initially approved coverage for only one cochlear implant instead of two for their deaf daughter. The toddler's father says in the film that CIGNA apparently felt it was "experimental to hear in two ears."
The father calls CIGNA to say Moore has taken an interest in the case and asks, "Has your CEO ever been in a film before?" The film shows CIGNA's Philadelphia headquarters and replays a taped phone call from a company representative, cheerfully reporting the denial was reversed and two implants would be covered.
Only about 3 percent of 100,000 people worldwide who have cochlear implants have two, according to the University of Wisconsin Waisman Center. Medicaid
and some private insurers will cover only one. Insurers cite the risks and until recently, a shortage of evidence showing the benefits of doing two implants.
One risk noted by the U.S. Food and Drug Administration is bacterial meningitis, a serious and sometimes fatal infection. Also, some doctors recommend against implants in both ears because it precludes trying new, better technology that might be developed.
CIGNA's policy was to cover only one implant, figuring two would double the meningitis risk, said Dr. Jeffrey L. Kang, the company's chief medical officer. Besides, there was little evidence of improved hearing from bilateral implants until a couple of recent studies found they helped deaf
people determine where sounds were coming from, he said.
Based on the new evidence, CIGNA changed its policy in March to cover two implants without requiring prior approval. Kang said the change didn't stem from Moore's film.
A single implant can cost $50,000, but Kang said, "Our [decision] process is a scientific, clinical one which is devoid of any considerations of cost." The doctors at CIGNA who are involved in the process aren't given financial incentives to base decisions on cost of medical procedures, he added.
Aetna still won't cover dual implants, saying the latest trials are "small, uncontrolled, and non-randomized studies," and the one randomized trial doesn't support implants in both ears.
Aetna spokesman Fred Laberge said it's not surprising the name of his company - one of the nation's largest health insurers - would appear in a film about the health care industry. He declined comment on the film's
message, saying, "It is what it is. We'll see it when it comes out."
"Sicko" tears into other insurers with anecdotes:
A woman recounts how Blue Shield in California wouldn't cover an MRI test because she didn't have cancer. On a trip to Japan, she fell ill and got an MRI showing a brain tumor.
A mother sits on a playground recalling how her 18-month-old daughter died after developing a 104-degree fever. She was rushed to a Los Angeles hospital, but their insurer, Kaiser Permanente, wasn't going to cover it
because it wasn't a Kaiser hospital. The child's condition worsened, and two hours later, an ambulance took her to a Kaiser hospital. But by then, the little girl had gone into cardiac arrest.
A worker from a rescue mission says a Kaiser Permanente hospital in Los Angeles discharged an incoherent woman with dementia and without identification bands, and dumped her on skid row. A surveillance video shows
the 62-year-old woman getting out of a taxi there, unescorted, and stumbling aimlessly and shoeless in a hospital gown. It was one of the patient-dumping
examples on a "60 Minutes" show.
The film also includes footage of Moore's widely publicized trip to Cuba, which the U.S. Treasury is investigating, allegedly because of embargo restrictions on travel to the country. Moore took several ailing people who had worked at the 9/11 World Trade Center disaster to Guantanamo Bay, where terrorism suspects are detained by the United States - and given free medical care.
"They don't want any more than you're giving the evildoers, just the same," Moore yells through a bullhorn to the military base from the boat. He didn't gain entrance, but the passengers were treated by doctors elsewhere in Cuba.
Time will tell how successful "Sicko" will be in advancing a new health care system, but local activist Beverly Brakeman said, "It can't help but get more people talking about this issue."
Brakeman is director of the local labor-community coalition Citizens for Economic Opportunity, and advocate of a single-payer system.
Moore "can get discredited pretty easily because his tactics are `out there,'" but his films are well-researched, said Brakeman, who hadn't seen "Sicko" before the interview.
"I think he has a way," she said, "of getting into the heart of what people can understand."
Contact Diane Levick at dlevick@courant.com
Ron Dicker, a free-lance writer, contributed to this story.
Copyright 2007, Hartford Courant
--------------------
Visit Connecticut News from The Hartford Courant ::: State, National, & World News On courant.com for Connecticut news updates, sports stories,
entertainment listings and classifieds.
--------------------
Insurers Face A Screen Test
--------------------
By DIANE LEVICK
Courant Staff Writer
June 21, 2007
If filmmaker Michael Moore had his way, Aetna, CIGNA, and other health insurance companies across the nation would be dead meat - replaced by a government-run system.
It's not clear yet how much of a threat his new documentary, "Sicko," is tothe industry. But with its general release currently set for June 29, thefilm's previews and advance promotions are reigniting the resentment againstinsurers that tends to simmer between boiling points.
Local companies don't fare as badly as some in the movie, which revels in tales of patient-dumping and death-hastening denials by other insurers.
The film slaps CIGNA for approving one hearing implant instead of two for a toddler, and Aetna gets off with just a flash of its corporate logo sign. Moore has said Aetna insures his employees.
The film goes relatively easy on the local companies, but Moore doesn't play favorites. He takes direct aim at the U.S. health care system and the whole insurance industry, which employs thousands of people in the Hartford-Middletown region.
Rather than pick on individual companies, the veteran rabble-rouser urged a rally last week in Sacramento to wage "a war against health insurance companies, who are more interested in lining their pockets than caring for
the people of the United States of America."
"We have to get rid of them once and for all," he said. The receptive crowd, which included nurses, picked up his next line as a chant: "It's time for them to go."
Insurers say they're not worried sick about "Sicko," despite the popularity of Moore's previous films such as "Fahrenheit 9/11" and "Bowling for Columbine."
However, America's Health Insurance Plans, a national trade group, has been issuing frequent statements aimed at defusing Moore's call for a government-run - "single payer" - health care system.
"I think it's very, very clear the American people don't support a government takeover of the health care arena," Karen Ignagni, the trade group's president and chief executive, said in an interview Tuesday. She warned of rationing and long waits for care in other countries with
single-payer systems.
She said insurers view "Sicko" as an opportunity to discuss their proposals to get more people insured through public-private partnerships, and "talk about the value we provide" through disease prevention and management, and
other programs.
As for Moore, "Essentially what he's done is filmed an editorial," Ignagni said. "There was never any attempt by Mr. Moore to seek out our members to answer questions, to respond to cases in the movie."
Publicists for Moore said he was too busy to be interviewed for this story.
Some of the patient cases Moore used are more than 10 years old, Ignagni said.
CIGNA, whose health insurance operations are based in Bloomfield, wouldn't talk about details of its own case in "Sicko." But the company did discuss the general subject - cochlear implants, which are complex electronic,
surgically implanted devices that provide a sense of sound for deaf people.
The movie shows parents who were shocked that CIGNA initially approved coverage for only one cochlear implant instead of two for their deaf daughter. The toddler's father says in the film that CIGNA apparently felt it was "experimental to hear in two ears."
The father calls CIGNA to say Moore has taken an interest in the case and asks, "Has your CEO ever been in a film before?" The film shows CIGNA's Philadelphia headquarters and replays a taped phone call from a company representative, cheerfully reporting the denial was reversed and two implants would be covered.
Only about 3 percent of 100,000 people worldwide who have cochlear implants have two, according to the University of Wisconsin Waisman Center. Medicaid
and some private insurers will cover only one. Insurers cite the risks and until recently, a shortage of evidence showing the benefits of doing two implants.
One risk noted by the U.S. Food and Drug Administration is bacterial meningitis, a serious and sometimes fatal infection. Also, some doctors recommend against implants in both ears because it precludes trying new, better technology that might be developed.
CIGNA's policy was to cover only one implant, figuring two would double the meningitis risk, said Dr. Jeffrey L. Kang, the company's chief medical officer. Besides, there was little evidence of improved hearing from bilateral implants until a couple of recent studies found they helped deaf
people determine where sounds were coming from, he said.
Based on the new evidence, CIGNA changed its policy in March to cover two implants without requiring prior approval. Kang said the change didn't stem from Moore's film.
A single implant can cost $50,000, but Kang said, "Our [decision] process is a scientific, clinical one which is devoid of any considerations of cost." The doctors at CIGNA who are involved in the process aren't given financial incentives to base decisions on cost of medical procedures, he added.
Aetna still won't cover dual implants, saying the latest trials are "small, uncontrolled, and non-randomized studies," and the one randomized trial doesn't support implants in both ears.
Aetna spokesman Fred Laberge said it's not surprising the name of his company - one of the nation's largest health insurers - would appear in a film about the health care industry. He declined comment on the film's
message, saying, "It is what it is. We'll see it when it comes out."
"Sicko" tears into other insurers with anecdotes:
A woman recounts how Blue Shield in California wouldn't cover an MRI test because she didn't have cancer. On a trip to Japan, she fell ill and got an MRI showing a brain tumor.
A mother sits on a playground recalling how her 18-month-old daughter died after developing a 104-degree fever. She was rushed to a Los Angeles hospital, but their insurer, Kaiser Permanente, wasn't going to cover it
because it wasn't a Kaiser hospital. The child's condition worsened, and two hours later, an ambulance took her to a Kaiser hospital. But by then, the little girl had gone into cardiac arrest.
A worker from a rescue mission says a Kaiser Permanente hospital in Los Angeles discharged an incoherent woman with dementia and without identification bands, and dumped her on skid row. A surveillance video shows
the 62-year-old woman getting out of a taxi there, unescorted, and stumbling aimlessly and shoeless in a hospital gown. It was one of the patient-dumping
examples on a "60 Minutes" show.
The film also includes footage of Moore's widely publicized trip to Cuba, which the U.S. Treasury is investigating, allegedly because of embargo restrictions on travel to the country. Moore took several ailing people who had worked at the 9/11 World Trade Center disaster to Guantanamo Bay, where terrorism suspects are detained by the United States - and given free medical care.
"They don't want any more than you're giving the evildoers, just the same," Moore yells through a bullhorn to the military base from the boat. He didn't gain entrance, but the passengers were treated by doctors elsewhere in Cuba.
Time will tell how successful "Sicko" will be in advancing a new health care system, but local activist Beverly Brakeman said, "It can't help but get more people talking about this issue."
Brakeman is director of the local labor-community coalition Citizens for Economic Opportunity, and advocate of a single-payer system.
Moore "can get discredited pretty easily because his tactics are `out there,'" but his films are well-researched, said Brakeman, who hadn't seen "Sicko" before the interview.
"I think he has a way," she said, "of getting into the heart of what people can understand."
Contact Diane Levick at dlevick@courant.com
Ron Dicker, a free-lance writer, contributed to this story.
Copyright 2007, Hartford Courant
--------------------
Visit Connecticut News from The Hartford Courant ::: State, National, & World News On courant.com for Connecticut news updates, sports stories,
entertainment listings and classifieds.
But whether you agree or disagree with Moore, he certainly makes you think, and that is a good thing.
I also have strong opinions about insurance companies. I know a deafblind CI user who has Usher's and can't get a second CI because Medicare won't cover it. He's been trying to find funding for the past 6 years. I was fortunate enough to have Medicaid cover my bilateral. However, my audi told me that if it were not for the fact that I had Medicaid coverage, I would not have received a second CI.
