The radically fierce and funny fireball he aims at our health-care system is a flat-out invitation to steal. First, Moore shows us how France, England, Canada and – yikes! – Cuba actually help sick people instead of letting them wither and die for lack of health insurance. Then he instructs us to loot those places for ideas. Anti-American? Hell, no. Moore argues that if another country builds a better car, we buy it. If it crafts a better wine, we drink it. Why not free universal health care?
Found this piece at www.rollingstone.com
Monday, October 29, 2007
Tuesday, October 9, 2007
SICKO - 50 Million Americans without Health Insurance!
I found this portion of a review of the SICKO movie at www.rottentomatoes.com.
It's a nice overview of the film's basics. What I'd like to know, for those of us/you who work in the Medical Billing industry, how does our current health care situation effect our industry? How would drastic changes effect OUR security in Medical Billing?
Sicko is not a movie about the 50 million Americans walking around without health insurance. Sicko is a movie about the other 250 million of us who have insurance, but are just as well and truly screwed. It’s also about freedom, real freedom, not the empty kind that gets thrown around as a buzzword; the freedom to live your life with the certainty that forces beyond your control won’t take away everything you have and everything you are. We don’t have that kind of freedom here in America, and Moore’s film makes that point by simply talking to real people. They’re your neighbors, your friends, your parents, some of them are even 9/11 heroes. Moore uses his camera to let them tell their stories of insurance company mistreatment and in the process paints a complete picture of a corrupt and fatally flawed system which isn’t just killing people but taking away their dignity and their liberty.
It's a nice overview of the film's basics. What I'd like to know, for those of us/you who work in the Medical Billing industry, how does our current health care situation effect our industry? How would drastic changes effect OUR security in Medical Billing?
Sicko is not a movie about the 50 million Americans walking around without health insurance. Sicko is a movie about the other 250 million of us who have insurance, but are just as well and truly screwed. It’s also about freedom, real freedom, not the empty kind that gets thrown around as a buzzword; the freedom to live your life with the certainty that forces beyond your control won’t take away everything you have and everything you are. We don’t have that kind of freedom here in America, and Moore’s film makes that point by simply talking to real people. They’re your neighbors, your friends, your parents, some of them are even 9/11 heroes. Moore uses his camera to let them tell their stories of insurance company mistreatment and in the process paints a complete picture of a corrupt and fatally flawed system which isn’t just killing people but taking away their dignity and their liberty.
Wednesday, September 26, 2007
The U.S. spends more on health care than any other!
This rings home when seeking articles concerning our current health care system in the U.S. I took excerpts from an article written by Dr. Schroeder, published in the New England Journal of Medicine. What do you think???
The United States spends more on health care than any other nation in the world, yet it ranks poorly on nearly every measure of health status. How can this be? What explains this apparent paradox?
The two-part answer is deceptively simple — first, the pathways to better health do not generally depend on better health care, and second, even in those instances in which health care is important, too many Americans do not receive it, receive it too late, or receive poor-quality care.
Among the 30 developed nations that make up the Organization for Economic Cooperation and Development (OECD), the United States ranks near the bottom on most standard measures of health status (One measure on which the United States does better is life expectancy from the age of 65 years, possibly reflecting the comprehensive health insurance provided for this segment of the population.) Among the 192 nations for which 2004 data are available, the United States ranks 46th in average life expectancy from birth and 42nd in infant mortality. It is remarkable how complacent the public and the medical profession are in their acceptance of these unfavorable comparisons, especially in light of how carefully we track health-systems measures, such as the size of the budget for the National Institutes of Health, trends in national spending on health, and the number of Americans who lack health insurance. One reason for the complacency may be the rationalization that the United States is more ethnically heterogeneous than the nations at the top of the rankings, such as Japan, Switzerland, and Iceland. It is true that within the United States there are large disparities in health status — by geographic area, race and ethnic group, and class. But even when comparisons are limited to white Americans, our performance is dismal. And even if the health status of white Americans matched that in the leading nations, it would still be incumbent on us to improve the health of the entire nation.
Although inadequate health care accounts for only 10% of premature deaths, health care receives by far the greatest share of resources and attention. In the case of heart disease, it is estimated that health care has accounted for half of the 40% decline in mortality over the past two decades.
Improving population health would be more than a statistical accomplishment. It could enhance the productivity of the workforce and boost the national economy, reduce health care expenditures, and most important, improve people's lives. But in the absence of a strong political voice from the less fortunate themselves, it is incumbent on health care professionals, especially physicians, to become champions for population health.
Americans take great pride in asserting that we are number one in terms of wealth, number of Nobel Prizes, and military strength. Why don't we try to become number one in health? -Steven A.Schroeder, MD
The United States spends more on health care than any other nation in the world, yet it ranks poorly on nearly every measure of health status. How can this be? What explains this apparent paradox?
The two-part answer is deceptively simple — first, the pathways to better health do not generally depend on better health care, and second, even in those instances in which health care is important, too many Americans do not receive it, receive it too late, or receive poor-quality care.
Among the 30 developed nations that make up the Organization for Economic Cooperation and Development (OECD), the United States ranks near the bottom on most standard measures of health status (One measure on which the United States does better is life expectancy from the age of 65 years, possibly reflecting the comprehensive health insurance provided for this segment of the population.) Among the 192 nations for which 2004 data are available, the United States ranks 46th in average life expectancy from birth and 42nd in infant mortality. It is remarkable how complacent the public and the medical profession are in their acceptance of these unfavorable comparisons, especially in light of how carefully we track health-systems measures, such as the size of the budget for the National Institutes of Health, trends in national spending on health, and the number of Americans who lack health insurance. One reason for the complacency may be the rationalization that the United States is more ethnically heterogeneous than the nations at the top of the rankings, such as Japan, Switzerland, and Iceland. It is true that within the United States there are large disparities in health status — by geographic area, race and ethnic group, and class. But even when comparisons are limited to white Americans, our performance is dismal. And even if the health status of white Americans matched that in the leading nations, it would still be incumbent on us to improve the health of the entire nation.
Although inadequate health care accounts for only 10% of premature deaths, health care receives by far the greatest share of resources and attention. In the case of heart disease, it is estimated that health care has accounted for half of the 40% decline in mortality over the past two decades.
Improving population health would be more than a statistical accomplishment. It could enhance the productivity of the workforce and boost the national economy, reduce health care expenditures, and most important, improve people's lives. But in the absence of a strong political voice from the less fortunate themselves, it is incumbent on health care professionals, especially physicians, to become champions for population health.
Americans take great pride in asserting that we are number one in terms of wealth, number of Nobel Prizes, and military strength. Why don't we try to become number one in health? -Steven A.Schroeder, MD
Monday, September 24, 2007
SICKO Healthcare System
I found this blurb at http://www.bestamericanhospital.blogspot.com
It is certainly true that Sicko is not a careful accounting of the pros and cons of the U.S. insurance system. But the basic truth of Moore's indictment is undeniable. A recent survey by Consumer Reports found that nearly half of adults younger than 65 — most of them insured — say they are "somewhat" or "completely" unprepared to cope with a costly medical emergency in the coming year. A substantial share of the more than 1 million personal bankruptcies in the United States each year — perhaps as many as half — are due in part to medical costs and crises. In no other rich country are people even remotely as likely to report having trouble with paying medical bills or going without care because of the cost. These problems are long-standing — yes, "dating back to the 1980s" — and worsening. And they are largely due to our reliance on employment-based, voluntary private health insurance.
The question is why we let these problems fester and what we can do to address them.
How do you Medical Billers feel about this?
It is certainly true that Sicko is not a careful accounting of the pros and cons of the U.S. insurance system. But the basic truth of Moore's indictment is undeniable. A recent survey by Consumer Reports found that nearly half of adults younger than 65 — most of them insured — say they are "somewhat" or "completely" unprepared to cope with a costly medical emergency in the coming year. A substantial share of the more than 1 million personal bankruptcies in the United States each year — perhaps as many as half — are due in part to medical costs and crises. In no other rich country are people even remotely as likely to report having trouble with paying medical bills or going without care because of the cost. These problems are long-standing — yes, "dating back to the 1980s" — and worsening. And they are largely due to our reliance on employment-based, voluntary private health insurance.
The question is why we let these problems fester and what we can do to address them.
How do you Medical Billers feel about this?
Thursday, August 23, 2007
SICKO - A Review
I found this review at http://www.stylusmagazine.com/articles/movie_review/sicko.htm by Yannick LeJacq.
The review is quite long, so visit the above site to read more...
When I went to see Sicko, I sat next to a group of middle-aged, mild-mannered women who were talking softly before the movie started. Then a large picture of George W. Bush appeared on screen, and the women next to me, along with most of the theater, began jeering and laughing so loudly I couldn't hear what the President was actually saying. This continued throughout the movie. The audience enunciated each punch line not with a laugh, but with a resounding “ohhhhh!” as if this were an episode of “Yo Momma.”
You could say this is all circumstantial. But, really, I think this is what Sicko is supposed to be. Almost all the overviews and reviews I've heard of the movie begin with a phrase like, “Michael Moore: first, he took on GM. Then, he took on the NRA. Next up was the Bush administration. Now, he's setting his sights on health care.” The movie poster shows Moore putting on a doctor’s glove with a mischievous and aggressive look on his face under the tagline, “This might hurt a little.” Moore is picking a fight with someone.
Many critics have noted that Sicko is Moore's most mature work, and they praise the new observational, tragic tone he carries alongside his trademark cynicism. I agree that the opening interviews of the movie are some of the best work Moore has ever done. The first half of Sicko consists largely of individual stories of people affected by America's health care system. Moore shows people cheated out of proper financial assistance for obscure reasons, and pairs them with startling confessions by people who used to work for HMOs, describing how they received praise for denying as much financial assistance as possible. But he's only interviewing people that fundamentally corroborate his view on health care. Looking back through his films, you can see that Moore reserves the most eloquent outrage for those with whom he sympathizes.
I think this is because Michael Moore, as the ideologue that he enjoys being, has no real appreciation for journalistic research. He prefers to take a polemic than analytical approach to an issue. It's easy to see why he does this. It gives him his gruff, un-intellectual charm that's made him compelling from the beginning of his career. People didn't go to see Fahrenheit 9/11, just as I'm sure they didn't go to see Sicko, to learn anything new (you can find out very easily that socialized health care means you get treated at the hospital for free); they went because, by supporting Michael Moore, they're inherently becoming part of his rant. Through him, they're shouting at the powerful, incompetent elite they're also sick of.
The review is quite long, so visit the above site to read more...
When I went to see Sicko, I sat next to a group of middle-aged, mild-mannered women who were talking softly before the movie started. Then a large picture of George W. Bush appeared on screen, and the women next to me, along with most of the theater, began jeering and laughing so loudly I couldn't hear what the President was actually saying. This continued throughout the movie. The audience enunciated each punch line not with a laugh, but with a resounding “ohhhhh!” as if this were an episode of “Yo Momma.”
You could say this is all circumstantial. But, really, I think this is what Sicko is supposed to be. Almost all the overviews and reviews I've heard of the movie begin with a phrase like, “Michael Moore: first, he took on GM. Then, he took on the NRA. Next up was the Bush administration. Now, he's setting his sights on health care.” The movie poster shows Moore putting on a doctor’s glove with a mischievous and aggressive look on his face under the tagline, “This might hurt a little.” Moore is picking a fight with someone.
Many critics have noted that Sicko is Moore's most mature work, and they praise the new observational, tragic tone he carries alongside his trademark cynicism. I agree that the opening interviews of the movie are some of the best work Moore has ever done. The first half of Sicko consists largely of individual stories of people affected by America's health care system. Moore shows people cheated out of proper financial assistance for obscure reasons, and pairs them with startling confessions by people who used to work for HMOs, describing how they received praise for denying as much financial assistance as possible. But he's only interviewing people that fundamentally corroborate his view on health care. Looking back through his films, you can see that Moore reserves the most eloquent outrage for those with whom he sympathizes.
I think this is because Michael Moore, as the ideologue that he enjoys being, has no real appreciation for journalistic research. He prefers to take a polemic than analytical approach to an issue. It's easy to see why he does this. It gives him his gruff, un-intellectual charm that's made him compelling from the beginning of his career. People didn't go to see Fahrenheit 9/11, just as I'm sure they didn't go to see Sicko, to learn anything new (you can find out very easily that socialized health care means you get treated at the hospital for free); they went because, by supporting Michael Moore, they're inherently becoming part of his rant. Through him, they're shouting at the powerful, incompetent elite they're also sick of.
Tuesday, August 14, 2007
SICKO Billing - Words Directly From Michael Moore
How about some words DIRECTLY from Michael Moore!
I found this excerpt from an article in LA times.
For more on this, visit http://www.latimes.com/entertainment/news/la-et-moore21may21
"When people say there is no confrontation in this movie, to me there is a big confrontation in this movie," Moore said in an interview here. "Because I am confronting the American audience with a question: 'Who are we, and what has happened to our soul?' To me, that's maybe more confrontation than going after the CEO of Aetna or the CEO of Pfizer." The reason Moore feels compelled to ask this "Sicko" question is because, he feels, the country unthinkingly settles for substandard and ruinously expensive medical treatment, especially when compared with countries with universal healthcare.
"I don't have to convince the American public that there is something wrong with our health care system. I think most American people already feel that way," said Moore, who enjoys great coverage himself through the Directors Guild of America. "That's why I don't spend a lot of time in the film on the healthcare horror stories. I wanted to propose that there's a different way we can go with this. I'm hoping that the American people, when they see this film, will say, 'You know, there is a better way, and maybe we should look at what they are doing in some of these other countries..."
Medical Billers need to stay up with all news in health care, whether sparked from their own individual client's level OR from a documentary which brings our health care crisis to light.
I found this excerpt from an article in LA times.
For more on this, visit http://www.latimes.com/entertainment/news/la-et-moore21may21
"When people say there is no confrontation in this movie, to me there is a big confrontation in this movie," Moore said in an interview here. "Because I am confronting the American audience with a question: 'Who are we, and what has happened to our soul?' To me, that's maybe more confrontation than going after the CEO of Aetna or the CEO of Pfizer." The reason Moore feels compelled to ask this "Sicko" question is because, he feels, the country unthinkingly settles for substandard and ruinously expensive medical treatment, especially when compared with countries with universal healthcare.
"I don't have to convince the American public that there is something wrong with our health care system. I think most American people already feel that way," said Moore, who enjoys great coverage himself through the Directors Guild of America. "That's why I don't spend a lot of time in the film on the healthcare horror stories. I wanted to propose that there's a different way we can go with this. I'm hoping that the American people, when they see this film, will say, 'You know, there is a better way, and maybe we should look at what they are doing in some of these other countries..."
Medical Billers need to stay up with all news in health care, whether sparked from their own individual client's level OR from a documentary which brings our health care crisis to light.
Thursday, August 9, 2007
Medical Billing - "Transparent" Charges; Is This Possible?
As I have mentioned, previously, a DRASTIC change to our health care system, LIKE Socialized Medicine, makes me nervous as a Medical Biller. I feel that this type of change would put my job in jeopardy.
I did, however, see a news segment recently that spoke about "Transparency" in insurance billing and payouts, according to specialty and whether the services received by the patient were done so at a hospital, clinic or private practice.
This seems like an interesting idea and I'll explain why.
The current system varies to extremes.
I have TWO Physical Therapy clients. Each submits an identical code. One of my clients receives a reimbursement of $69.27, while the other - for the exact same code - receives $16.38! What is with these numbers?? There is no rhyme or reason and getting a valid explanation from a payer is next to near impossible.
It's almost as if the representatives employed at these carriers are unable to explain such vast differences in payouts also.
In a revised "Transparent" health care system, all providers within a specialty would be reimbursed at the exact same rate, regardless of history or longevity, or which size the moon was at the time while credentialing with the carrier.
There would be SOME variation depending upon the location of the services; hospital, clinic or private practice. But, Medicare would need to impose such a regulation in order for all carriers to follow suit.
Asking Medicare for a change to this magnitude is like asking the sun to quiet its rays for a while; impossible!
However, the only organization that could force Medicare to oblige would be the government, somewhat, unfortunately...
SICKO and Michael Moore are, of course, considered fiercely liberal.
What this movie has done though, is forced a dialogue to occur regardless of one's position in the political spectrum. A republican from Iowa - Charles Grassley -is the individual that coined "Transparency".
Many advocates for change in our health care system see this point of view as the closest to the best outcome for all to date.
What do you think??
I did, however, see a news segment recently that spoke about "Transparency" in insurance billing and payouts, according to specialty and whether the services received by the patient were done so at a hospital, clinic or private practice.
This seems like an interesting idea and I'll explain why.
The current system varies to extremes.
I have TWO Physical Therapy clients. Each submits an identical code. One of my clients receives a reimbursement of $69.27, while the other - for the exact same code - receives $16.38! What is with these numbers?? There is no rhyme or reason and getting a valid explanation from a payer is next to near impossible.
It's almost as if the representatives employed at these carriers are unable to explain such vast differences in payouts also.
In a revised "Transparent" health care system, all providers within a specialty would be reimbursed at the exact same rate, regardless of history or longevity, or which size the moon was at the time while credentialing with the carrier.
There would be SOME variation depending upon the location of the services; hospital, clinic or private practice. But, Medicare would need to impose such a regulation in order for all carriers to follow suit.
Asking Medicare for a change to this magnitude is like asking the sun to quiet its rays for a while; impossible!
However, the only organization that could force Medicare to oblige would be the government, somewhat, unfortunately...
SICKO and Michael Moore are, of course, considered fiercely liberal.
What this movie has done though, is forced a dialogue to occur regardless of one's position in the political spectrum. A republican from Iowa - Charles Grassley -is the individual that coined "Transparency".
Many advocates for change in our health care system see this point of view as the closest to the best outcome for all to date.
What do you think??
Tuesday, August 7, 2007
SICKO Billing - Single Payor System Would NOT Impact Quality of Care?
As a Professional Mdical Biller, I continuously seek information on the possible impact of a change in our health care system.
The reason that I do this, is because I survive on the process as it exists today.
Private practice owners generally do not have the resources or the money to support the overhead in keeping medical billing in-house. They seek an outsourced solution, like ME to process electronic medical claims on their behalf.
I am convinced that a single payor system would NOT improve anything BUT the paperwork currently required. That is it. It would not impact the quality of care at all.
So, with that said, perhaps health care system in the US shouldn't change all that much?
What I would like to see change are the numbers of people that lack health coverage go away entirely.
Every person deserves health insurance and all should have it for proper medical care.
I found this quote at http://whynow.dumka.us/2007/07/02/more-on-the-sicko-issue/
"Paperwork is a major cost of the American health care system that would be radically cut by a single payer system, and would have no impact at all on the quality of care. This is something that the insurance companies could have done decades ago, but chose not to, and just made it worse. Confusing billing procedures delays payouts, and that is one of the reasons they do it, no matter what they tell you."
And, I agree.
The reason that I do this, is because I survive on the process as it exists today.
Private practice owners generally do not have the resources or the money to support the overhead in keeping medical billing in-house. They seek an outsourced solution, like ME to process electronic medical claims on their behalf.
I am convinced that a single payor system would NOT improve anything BUT the paperwork currently required. That is it. It would not impact the quality of care at all.
So, with that said, perhaps health care system in the US shouldn't change all that much?
What I would like to see change are the numbers of people that lack health coverage go away entirely.
Every person deserves health insurance and all should have it for proper medical care.
I found this quote at http://whynow.dumka.us/2007/07/02/more-on-the-sicko-issue/
"Paperwork is a major cost of the American health care system that would be radically cut by a single payer system, and would have no impact at all on the quality of care. This is something that the insurance companies could have done decades ago, but chose not to, and just made it worse. Confusing billing procedures delays payouts, and that is one of the reasons they do it, no matter what they tell you."
And, I agree.
Tuesday, July 31, 2007
Michael Moore - "I've been saved"
This article can be found at http://www.comcast.net in their news section.
Moore: I've Been Served
Sun Jul 29, 8:05 PM
Maybe Michael Moore isn't paranoid, because it sure seems like the government really is out to get him.
The firebrand filmmaker says he has been served with a subpoena by the federal government for a trip to Cuba for his hit health-care documentary, Sicko. The Treasury Department confirmed two months ago that it was probing Moore's visit to Cuba, during which he was accompanied by some ailing 9/11 rescue workers.
Appearing Thursday on NBC's Tonight Show with Jay Leno, the Oscar winner said he had just learned backstage that he had been served with an order compelling him to testify about his sojourn to the communist nation.
"I haven't even told my own family this yet," Moore said. "I was just informed when I was back there with Jay that the Bush administration has now issued a subpoena for me, going after me for helping these 9/11 rescue workers."
Michael Moore's No Paris Hilton
Bootleg Sicko Copies Quarantined
Moore to Bush: Stop Pestering Me
E! Online
"No, no, for going to Cuba, not for helping them," chimed in Leno.
In March, the Fahrenheit 9/11 helmer and a trio of first responders who had fallen ill after working around ground zero traveled to the U.S. Naval Base at Guantanamo Bay to demand the same quality health care that administration officials publicly promised was being given to suspected Al Qaeda terrorists held there.
After getting no response from U.S. authorities, Moore and his traveling companions subsequently received free medical treatment from Cuban doctors, which the 53-year-old helmer depicted in Sicko, ostensibly to point out the failings of America's health-care system.
"I didn't go there like Cameron Diaz, to get a tan," quipped Moore. "I was there to help them, and now I'm going to face this further harassment from the Bush people. Aren't they busy with something else?"
In May, the Treasury's Office of Foreign Assets Control, or OFAC, sent a letter to Moore requesting information about the trip, which it claimed was not approved. (Under the U.S. government's comprehensive trade embargo, American citizens are forbidden to work in Cuba unless granted an exception.)
Moore shot back with an open letter to U.S. Treasury Secretary Henry Paulson, calling for an end to the investigation and accusing the White House of playing politics by using a government agency to try to silence him.
He also stated he informed the OFAC in October about the Cuba trip, asserting that as a journalist, he qualified for an exemption to the travel ban, a point he reiterated with Leno last week.
"A journalist can go, and this is a work of journalism," said Moore. "And frankly, the larger point is being missed here. The point is that first of all, can we all agree we should take care of our 9/11 rescue workers?"
The statement elicited cheers from the studio audience.
Moore's attorney, David Boies, could not be reached for comment.
According to Reuters, Boies was contacted by a representative of the U.S. Department of Commerce, who requested the name of a person to accept the subpoena on Moore's behalf.
Aside from his burgeoning offscreen problems, Moore dropped another bombshell to Leno, saying that Harvey Weinstein—whose Weinstein company is distributing Sicko and who's also one of Hilary Clinton's biggest Hollywood supporters—asked Moore to cut scenes criticizing the Democratic presidential candidate.
The reason? Because Moore called out Clinton for purportedly accepting the most campaign donations of any senator from lobbyists representing the same private insurers and drug companies she's railed against in the past.
Moore refused, and Weinstein eventually backed down. The director also announced on The Tonight Show that the Weinstein Company has agreed to donate 11 percent of Sicko's box office to help ailing 9/11 workers who have been ignored by the Bush administration
Moore: I've Been Served
Sun Jul 29, 8:05 PM
Maybe Michael Moore isn't paranoid, because it sure seems like the government really is out to get him.
The firebrand filmmaker says he has been served with a subpoena by the federal government for a trip to Cuba for his hit health-care documentary, Sicko. The Treasury Department confirmed two months ago that it was probing Moore's visit to Cuba, during which he was accompanied by some ailing 9/11 rescue workers.
Appearing Thursday on NBC's Tonight Show with Jay Leno, the Oscar winner said he had just learned backstage that he had been served with an order compelling him to testify about his sojourn to the communist nation.
"I haven't even told my own family this yet," Moore said. "I was just informed when I was back there with Jay that the Bush administration has now issued a subpoena for me, going after me for helping these 9/11 rescue workers."
Michael Moore's No Paris Hilton
Bootleg Sicko Copies Quarantined
Moore to Bush: Stop Pestering Me
E! Online
"No, no, for going to Cuba, not for helping them," chimed in Leno.
In March, the Fahrenheit 9/11 helmer and a trio of first responders who had fallen ill after working around ground zero traveled to the U.S. Naval Base at Guantanamo Bay to demand the same quality health care that administration officials publicly promised was being given to suspected Al Qaeda terrorists held there.
After getting no response from U.S. authorities, Moore and his traveling companions subsequently received free medical treatment from Cuban doctors, which the 53-year-old helmer depicted in Sicko, ostensibly to point out the failings of America's health-care system.
"I didn't go there like Cameron Diaz, to get a tan," quipped Moore. "I was there to help them, and now I'm going to face this further harassment from the Bush people. Aren't they busy with something else?"
In May, the Treasury's Office of Foreign Assets Control, or OFAC, sent a letter to Moore requesting information about the trip, which it claimed was not approved. (Under the U.S. government's comprehensive trade embargo, American citizens are forbidden to work in Cuba unless granted an exception.)
Moore shot back with an open letter to U.S. Treasury Secretary Henry Paulson, calling for an end to the investigation and accusing the White House of playing politics by using a government agency to try to silence him.
He also stated he informed the OFAC in October about the Cuba trip, asserting that as a journalist, he qualified for an exemption to the travel ban, a point he reiterated with Leno last week.
"A journalist can go, and this is a work of journalism," said Moore. "And frankly, the larger point is being missed here. The point is that first of all, can we all agree we should take care of our 9/11 rescue workers?"
The statement elicited cheers from the studio audience.
Moore's attorney, David Boies, could not be reached for comment.
According to Reuters, Boies was contacted by a representative of the U.S. Department of Commerce, who requested the name of a person to accept the subpoena on Moore's behalf.
Aside from his burgeoning offscreen problems, Moore dropped another bombshell to Leno, saying that Harvey Weinstein—whose Weinstein company is distributing Sicko and who's also one of Hilary Clinton's biggest Hollywood supporters—asked Moore to cut scenes criticizing the Democratic presidential candidate.
The reason? Because Moore called out Clinton for purportedly accepting the most campaign donations of any senator from lobbyists representing the same private insurers and drug companies she's railed against in the past.
Moore refused, and Weinstein eventually backed down. The director also announced on The Tonight Show that the Weinstein Company has agreed to donate 11 percent of Sicko's box office to help ailing 9/11 workers who have been ignored by the Bush administration
Tuesday, July 24, 2007
Michael Moore slams CNN, Wolf Blitzer on live TV
As a Professional Medical Biller, I am fascinated by this film SICKO along with the positive OR negative chats it is creating. I commend Michael Moore and his ability to succeed in his goal in creating the film; to spark conversation about our current health care system in the US.
This article that I found can be printed by visiting www.rawstory.com site and searching under Michael Moore or SICKO.
Read this and share what YOU think!
Michael Moore slams CNN, Wolf Blitzer on live TV
David Edwards and Josh Catone
Published: Monday July 9, 2007
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Before a live interview with documentary filmmaker Michael Moore, CNN aired a segment entitled "Sicko Reality Check" in which Dr. Sanjay Gupta, the network's chief medical correspondent, aimed to keep Moore "honest" and fact check his new film, Sicko.
The 4-minute piece concluded that Moore "did fudge the facts," and implied that Sicko was misleading in portraying health care systems in other countries, such as France, the UK, and Canada, as better than the one in the US.
When given a chance to speak, Moore immediately put host Wolf Blitzer on the defensive.
"That report was so biased, I can't imagine what pharmaceutical company's ads are coming up right after our break here," said Moore. "Why don't you tell the truth to the American people? I wish that CNN and the other mainstream media would just for once tell the truth about what's going on in this country."
Moore argued that CNN has such a lousy track record of reporting the truth about the war in Iraq and asking tough questions, that Americans should be skeptical of their reporting on health care.
"You're the ones who are fudging the facts," said Moore. "You've fudged the facts to the American people now for I don't know how long about this issue, about the war, and I'm just curious, when are you going to just stand there and apologize to the American people for not bringing the truth to them that isn't sponsored by some major corporation?"
Blizter grew defensive and backed up his fellow CNN employee, saying that he would stand behind correspondent Sanjay Gupta's record on medical issues. Moore, in response, vowed to post a rebuttal to his website, MichaelMoore.com, showing that Gupta's facts weren't accurate.
"I'm going to put the real facts up there on my website," said Moore, "so that people can see what he just said was absolutely wrong."
Turning to the war in Iraq, Moore accused Gupta, who spent time embedded with US troops in Iraq, and the mainstream media at large of refusing "to ask our leaders the hard questions, and demand the honest answers." Moore laid the blame for the continued US involvement in the war in Iraq at the feet of the media, arguing that they failed to do their jobs and question the Bush war policy.
Blitzer refused to argue with Moore about Iraq, and instead steered the conversation back to the topic of health care. Moore was asked which of the US presidential candidates he thought would best fix America's health care system.
Moore did not name a specific candidate, but said that the Democratic candidates as a whole need to be more specific about how they plan to achieve their goal of universal health care.
"Our own government admits that because of the 47 million who aren't insured, we now have about 18,000 people a year that die in this country, simply because they don't have health insurance. That's six 9/11s every single year," concluded Moore. We need "universal health care that's free for everyone who lives in this country, it'll cost us less than what we're spending now lining the pockets of these private health insurance companies, or these pharmaceutical companies."
After the interview, Blitzer found sympathy from fellow CNN hosts Lou Dobbs and Jack Cafferty.
"After watching that Michael Moore interview," said Cafferty, "I've decided whatever CNN's paying it ain't enough."
This article that I found can be printed by visiting www.rawstory.com site and searching under Michael Moore or SICKO.
Read this and share what YOU think!
Michael Moore slams CNN, Wolf Blitzer on live TV
David Edwards and Josh Catone
Published: Monday July 9, 2007
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Before a live interview with documentary filmmaker Michael Moore, CNN aired a segment entitled "Sicko Reality Check" in which Dr. Sanjay Gupta, the network's chief medical correspondent, aimed to keep Moore "honest" and fact check his new film, Sicko.
The 4-minute piece concluded that Moore "did fudge the facts," and implied that Sicko was misleading in portraying health care systems in other countries, such as France, the UK, and Canada, as better than the one in the US.
When given a chance to speak, Moore immediately put host Wolf Blitzer on the defensive.
"That report was so biased, I can't imagine what pharmaceutical company's ads are coming up right after our break here," said Moore. "Why don't you tell the truth to the American people? I wish that CNN and the other mainstream media would just for once tell the truth about what's going on in this country."
Moore argued that CNN has such a lousy track record of reporting the truth about the war in Iraq and asking tough questions, that Americans should be skeptical of their reporting on health care.
"You're the ones who are fudging the facts," said Moore. "You've fudged the facts to the American people now for I don't know how long about this issue, about the war, and I'm just curious, when are you going to just stand there and apologize to the American people for not bringing the truth to them that isn't sponsored by some major corporation?"
Blizter grew defensive and backed up his fellow CNN employee, saying that he would stand behind correspondent Sanjay Gupta's record on medical issues. Moore, in response, vowed to post a rebuttal to his website, MichaelMoore.com, showing that Gupta's facts weren't accurate.
"I'm going to put the real facts up there on my website," said Moore, "so that people can see what he just said was absolutely wrong."
Turning to the war in Iraq, Moore accused Gupta, who spent time embedded with US troops in Iraq, and the mainstream media at large of refusing "to ask our leaders the hard questions, and demand the honest answers." Moore laid the blame for the continued US involvement in the war in Iraq at the feet of the media, arguing that they failed to do their jobs and question the Bush war policy.
Blitzer refused to argue with Moore about Iraq, and instead steered the conversation back to the topic of health care. Moore was asked which of the US presidential candidates he thought would best fix America's health care system.
Moore did not name a specific candidate, but said that the Democratic candidates as a whole need to be more specific about how they plan to achieve their goal of universal health care.
"Our own government admits that because of the 47 million who aren't insured, we now have about 18,000 people a year that die in this country, simply because they don't have health insurance. That's six 9/11s every single year," concluded Moore. We need "universal health care that's free for everyone who lives in this country, it'll cost us less than what we're spending now lining the pockets of these private health insurance companies, or these pharmaceutical companies."
After the interview, Blitzer found sympathy from fellow CNN hosts Lou Dobbs and Jack Cafferty.
"After watching that Michael Moore interview," said Cafferty, "I've decided whatever CNN's paying it ain't enough."
Friday, July 13, 2007
Americans Cheer "SiCKO," But NOT all Convinced
So, continuously searching for updates as a professional medical biller. I think that this movie and the conversations that it is continuously spurring, are powerful. So, here is another article that I found of interest. For more information on this, visit www.reuters.com
By Andrea Hopkins
CINCINNATI (Reuters) - Fresh from the hospital and still hurting from a $757 prescription drug bill, moviegoer Ron Jackson emerged from a screening of Michael Moore's documentary on the U.S. health system feeling outraged and exuberant.
"It's a great movie," said Jackson, 63. "I have insurance, and I still paid over $700 for one prescription -- just 30 days' worth. They've let Wall Street control the whole thing, it's as plain as the nose on my face."
Weeks into the staggered release of Moore's "SiCKO" across the United States, moviegoing Americans have revived the debate over national health care -- a staple in most of the developed world, but long resisted in the United States.
Health-care reform is a hot topic in the 2008 presidential campaign, and a slew of candidates have promised changes to bring better care to both insured Americans and the nation's 45 million uninsured.
Atia Huff, 64, said she was heartened by the applause that broke out at the end of the movie but worried only those who already agreed with Moore's outlook would bother to attend.
"I think it's preaching to the choir," Huff said.
Moore won an Academy Award for 2002's anti-gun documentary "Bowling for Columbine." He made more enemies -- and drew the label "enemy of America" from the right -- with a critical look at President George W. Bush's war on terrorism in his 2004 documentary "Fahrenheit 9/11."
"SiCKO" tells the stories of Americans who say they were denied life-saving treatment by insurers. The film has received mixed reviews, with some criticizing it for a lack of substantive comparison of the U.S. health-care system with that of countries that offer universal health care.
"It should be compulsory viewing for everybody, but some people don't want to hear," said Huff, a retired interpreter. She said she's already seen the movie twice -- the first time with a school teacher who said she'd worked too hard for her health-care benefits to pay for those who hadn't.
"I'm very pessimistic it will ever change," Huff said.
Many Americans remain firmly opposed to universal care.
"We are not a socialist country .... If our system is so poor, how is it we have one of the highest standards of living in the world?" asked Cincinnati electrician and businessman Mike Cavanaugh, who offers health insurance to his workers.
"Anyone, and I mean almost anyone, who is willing to go to work 40 or 50 hours a week and pretty much just do the minimum can have a decent life here," he said. "Tell Michael Moore to find a new home if he cannot appreciate the blessings this great country has bestowed upon him."
But in downtown Washington, Tom and Sue Stevens left a "SiCKO" screening more convinced than ever that the United States should adopt universal health care.
"We are ready, but the politicians and the businessmen are not. The health-care industry certainly is going to oppose this for all they're worth," said Tom, a college professor.
Sue, a retired medical technician, said she'd seen hospital administrators fight to contain costs for needed care.
"Everything now is based on cost -- how much money they can save. And a lot of people that work in hospitals themselves can't afford the insurance that hospitals offer because their pay is so low," she said.
In New York City, 75-year-old Philip Peppis said he was ready to vote for change in November 2008.
"How did this country get so completely selfish?" he asked after leaving a "SiCKO" matinee. "It's really embarrassing, the way this country treats people."
But in Columbus, Ohio, small business owner Sherry Pymer said she had no intention of seeing the movie and would never support universal health care.
"I'd be very, very afraid of that. You hear the stories about how bad health care is in Canada," said Pymer, 55. "Michael Moore is nothing to me. He's just somebody looking to get a big rise out of somebody."
By Andrea Hopkins
CINCINNATI (Reuters) - Fresh from the hospital and still hurting from a $757 prescription drug bill, moviegoer Ron Jackson emerged from a screening of Michael Moore's documentary on the U.S. health system feeling outraged and exuberant.
"It's a great movie," said Jackson, 63. "I have insurance, and I still paid over $700 for one prescription -- just 30 days' worth. They've let Wall Street control the whole thing, it's as plain as the nose on my face."
Weeks into the staggered release of Moore's "SiCKO" across the United States, moviegoing Americans have revived the debate over national health care -- a staple in most of the developed world, but long resisted in the United States.
Health-care reform is a hot topic in the 2008 presidential campaign, and a slew of candidates have promised changes to bring better care to both insured Americans and the nation's 45 million uninsured.
Atia Huff, 64, said she was heartened by the applause that broke out at the end of the movie but worried only those who already agreed with Moore's outlook would bother to attend.
"I think it's preaching to the choir," Huff said.
Moore won an Academy Award for 2002's anti-gun documentary "Bowling for Columbine." He made more enemies -- and drew the label "enemy of America" from the right -- with a critical look at President George W. Bush's war on terrorism in his 2004 documentary "Fahrenheit 9/11."
"SiCKO" tells the stories of Americans who say they were denied life-saving treatment by insurers. The film has received mixed reviews, with some criticizing it for a lack of substantive comparison of the U.S. health-care system with that of countries that offer universal health care.
"It should be compulsory viewing for everybody, but some people don't want to hear," said Huff, a retired interpreter. She said she's already seen the movie twice -- the first time with a school teacher who said she'd worked too hard for her health-care benefits to pay for those who hadn't.
"I'm very pessimistic it will ever change," Huff said.
Many Americans remain firmly opposed to universal care.
"We are not a socialist country .... If our system is so poor, how is it we have one of the highest standards of living in the world?" asked Cincinnati electrician and businessman Mike Cavanaugh, who offers health insurance to his workers.
"Anyone, and I mean almost anyone, who is willing to go to work 40 or 50 hours a week and pretty much just do the minimum can have a decent life here," he said. "Tell Michael Moore to find a new home if he cannot appreciate the blessings this great country has bestowed upon him."
But in downtown Washington, Tom and Sue Stevens left a "SiCKO" screening more convinced than ever that the United States should adopt universal health care.
"We are ready, but the politicians and the businessmen are not. The health-care industry certainly is going to oppose this for all they're worth," said Tom, a college professor.
Sue, a retired medical technician, said she'd seen hospital administrators fight to contain costs for needed care.
"Everything now is based on cost -- how much money they can save. And a lot of people that work in hospitals themselves can't afford the insurance that hospitals offer because their pay is so low," she said.
In New York City, 75-year-old Philip Peppis said he was ready to vote for change in November 2008.
"How did this country get so completely selfish?" he asked after leaving a "SiCKO" matinee. "It's really embarrassing, the way this country treats people."
But in Columbus, Ohio, small business owner Sherry Pymer said she had no intention of seeing the movie and would never support universal health care.
"I'd be very, very afraid of that. You hear the stories about how bad health care is in Canada," said Pymer, 55. "Michael Moore is nothing to me. He's just somebody looking to get a big rise out of somebody."
Monday, July 9, 2007
SICKO - Michael Moore Takes on Capital Blue Cross
I found this article which made the hairs on the back of my neck stand tall!
More on this article and Michael Moore at www.MichaelMoore.com
Moore takes on Capital BlueCross
By David Wenner / Patriot-News
Central Pennsylvania's Capital BlueCross walked right into the crosshairs of Michael Moore.
The controversial director of the documentary "Sicko" obtained a memo written by Barclay Fitzpatrick, Capital's vice president for corporate communications.
Moore gave the memo top billing on his Web site yesterday. His taunts at Capital soon spread across the Internet.
Of Fitzpatrick, Moore writes: "His job, it seems, was to go and watch 'Sicko,' observe the audience reaction, and then suggest a plan of action to deal with the movie."
Fitzpatrick wrote in the memo, "You would have to be dead to be unaffected by Moore's movie."
In previous films, Moore has gone after the auto industry and the federal government's reaction to the Sept. 11, 2001 terrorist attacks. In "Sicko," now playing nationwide, he takes on the health care industry.
"Sicko" recounts stories of people who were denied medical care by insurers. Moore shows former health insurance employees who say their goal was finding ways to deny claims. He ends with a call for a government-run health system.
But Fitzpatrick says Moore focused on exceptions rather than the norm, and called the movie one-sided and misleading. Often, the medical treatment being denied was experimental, he noted.
Moore challenged Capital yesterday on his Web site, calling for a debate involving "just me and your CEO openly debating the merits of a system that kills thousands of innocent Americans every year."
In an e-mailed statement, Capital spokesman Joe Butera said, "Like most health-care companies, we already were being asked about Michael Moore's movie before it came out. So our communications person decided to see it. He wrote a memo summarizing his personal opinions and impressions of the film."
Butera added, "What his memo doesn't say is the company's position on [Moore's] movie. So here it is: We think anything that addresses the complex subject of health care is overall a good thing because it is such an important issue for our nation."
Butera said neither CEO Anita Smith nor Fitzpatrick would comment further.
In his memo, Fitzpatrick chided the film for ignoring the main culprits of America's health care crisis, which he said have much to do with lifestyle factors including poor nutrition, obesity and lack of exercise.
Still, he concluded that the vast majority of moviegoers who see the film will "have their perceptions substantially affected" in a way that would harm the reputation of Capital and other health insurers. Capital should prepare employees to respond to questions from customers, friends, family and neighbors, he wrote.
Fitzpatrick suggested "the most successful strategy will not be in attacking the movie for its weaknesses or misperceptions, but in distancing ourselves and our brand from the groups and motivations he attacks, demonstrating the good that we do and achieve ... and in articulating our disappointment that he did not address the truly relevant issue of improving our health and wellness."
Butera said Capital isn't interested in a debate.
"We remain focused on our mission -- not on debating others. We will continue to work hard every day to fulfill our mission by delivering quality health care at an affordable cost," he wrote.
Fitzpatrick's memo pointed out Moore makes no distinction between for-profit insurers, which include many of the nation's best-known insurers, and non-profit plans such as Capital.
The for-profit plans, which in the Harrisburg area include Health America and Aetna, generate profits for stockholders. The non-profit Blues accumulate "reserves," which must benefit their customers, or serve a charitable purpose.
In 2005, Pennsylvania's four Blues plans agreed to contribute $1 billion toward the state's insurance program for the poor. The Blues have pointed out that most of their reserves are amassed through investments, and they aim to collect premiums that are roughly equal to what they pay toward medical expenses and overhead.
In an online chat, Moore noted that Capital has $795 million in reserves and that Smith's salary is "over $800,000 a year."
"If that is non-profit, I am sure a lot of people would be interested in working for that kind of pay. Where is all that money coming from?" Moore wrote.
Smith actually earned $1.2 million in 2006, according to the Pennsylvania Insurance Department. Ken Melani of Highmark Inc. was the highest paid Blues CEO in the state, earning $3.2 million.
More on this article and Michael Moore at www.MichaelMoore.com
Moore takes on Capital BlueCross
By David Wenner / Patriot-News
Central Pennsylvania's Capital BlueCross walked right into the crosshairs of Michael Moore.
The controversial director of the documentary "Sicko" obtained a memo written by Barclay Fitzpatrick, Capital's vice president for corporate communications.
Moore gave the memo top billing on his Web site yesterday. His taunts at Capital soon spread across the Internet.
Of Fitzpatrick, Moore writes: "His job, it seems, was to go and watch 'Sicko,' observe the audience reaction, and then suggest a plan of action to deal with the movie."
Fitzpatrick wrote in the memo, "You would have to be dead to be unaffected by Moore's movie."
In previous films, Moore has gone after the auto industry and the federal government's reaction to the Sept. 11, 2001 terrorist attacks. In "Sicko," now playing nationwide, he takes on the health care industry.
"Sicko" recounts stories of people who were denied medical care by insurers. Moore shows former health insurance employees who say their goal was finding ways to deny claims. He ends with a call for a government-run health system.
But Fitzpatrick says Moore focused on exceptions rather than the norm, and called the movie one-sided and misleading. Often, the medical treatment being denied was experimental, he noted.
Moore challenged Capital yesterday on his Web site, calling for a debate involving "just me and your CEO openly debating the merits of a system that kills thousands of innocent Americans every year."
In an e-mailed statement, Capital spokesman Joe Butera said, "Like most health-care companies, we already were being asked about Michael Moore's movie before it came out. So our communications person decided to see it. He wrote a memo summarizing his personal opinions and impressions of the film."
Butera added, "What his memo doesn't say is the company's position on [Moore's] movie. So here it is: We think anything that addresses the complex subject of health care is overall a good thing because it is such an important issue for our nation."
Butera said neither CEO Anita Smith nor Fitzpatrick would comment further.
In his memo, Fitzpatrick chided the film for ignoring the main culprits of America's health care crisis, which he said have much to do with lifestyle factors including poor nutrition, obesity and lack of exercise.
Still, he concluded that the vast majority of moviegoers who see the film will "have their perceptions substantially affected" in a way that would harm the reputation of Capital and other health insurers. Capital should prepare employees to respond to questions from customers, friends, family and neighbors, he wrote.
Fitzpatrick suggested "the most successful strategy will not be in attacking the movie for its weaknesses or misperceptions, but in distancing ourselves and our brand from the groups and motivations he attacks, demonstrating the good that we do and achieve ... and in articulating our disappointment that he did not address the truly relevant issue of improving our health and wellness."
Butera said Capital isn't interested in a debate.
"We remain focused on our mission -- not on debating others. We will continue to work hard every day to fulfill our mission by delivering quality health care at an affordable cost," he wrote.
Fitzpatrick's memo pointed out Moore makes no distinction between for-profit insurers, which include many of the nation's best-known insurers, and non-profit plans such as Capital.
The for-profit plans, which in the Harrisburg area include Health America and Aetna, generate profits for stockholders. The non-profit Blues accumulate "reserves," which must benefit their customers, or serve a charitable purpose.
In 2005, Pennsylvania's four Blues plans agreed to contribute $1 billion toward the state's insurance program for the poor. The Blues have pointed out that most of their reserves are amassed through investments, and they aim to collect premiums that are roughly equal to what they pay toward medical expenses and overhead.
In an online chat, Moore noted that Capital has $795 million in reserves and that Smith's salary is "over $800,000 a year."
"If that is non-profit, I am sure a lot of people would be interested in working for that kind of pay. Where is all that money coming from?" Moore wrote.
Smith actually earned $1.2 million in 2006, according to the Pennsylvania Insurance Department. Ken Melani of Highmark Inc. was the highest paid Blues CEO in the state, earning $3.2 million.
Wednesday, July 4, 2007
SICKO - Does it Pave a Way for Socialized Medicine?
I am an owner of a medical billing firm and medical claims processing trends are my passion and expertise. I have NOT seen SICKO (Michael Moore's newest documentary), but I have read MANY reviews and commentaries about the film. There has been one pressing question on MY mind...
WILL THIS SEND OUR COUNTRY CLOSER TO SOCIALIZED MEDICINE?
What I have always "learned" is that socialized medicine is a disaster. I am wondering if this was simply a message generated by the US government and for-profit insurance carriers to, in turn, guarantee a steady flow of high premiums for our coverage. What do you think?
In Massachusetts, there is a new law that no person can even "choose" to be WITHOUT health insurance. If, at tax time, a person is "caught" not maintaining coverage, tax penalties will apply. This simply does not make any sense to me. Most of the people that do not have medical insurance are FORCED into that predicament - they cannot afford the high premiums. Family plans are hundreds of dollars per month (more times, over $1,000 per month). So, not only does the uninsured person struggle to simply AFFORD the insurance, they'll NOW have tax penalties for NOT being able to afford it.
I watched an interview on the news early Sunday morning about this very situation and mandated change effective this July, 2007. I watched in disbelief! In the same breath, it was explained that if an individual shows up at the ER for care, they will not be refused treatment regardless of their insurance status. It is such a double-edged sword!
I am looking forward to seeing Michael Moore's movie SICKO. I am curious to see if it will change my "learned" opinion about socialized medicine.
For more dialogue and information about this and other topics, visit www.MedicalBillingFoundation.com.
WILL THIS SEND OUR COUNTRY CLOSER TO SOCIALIZED MEDICINE?
What I have always "learned" is that socialized medicine is a disaster. I am wondering if this was simply a message generated by the US government and for-profit insurance carriers to, in turn, guarantee a steady flow of high premiums for our coverage. What do you think?
In Massachusetts, there is a new law that no person can even "choose" to be WITHOUT health insurance. If, at tax time, a person is "caught" not maintaining coverage, tax penalties will apply. This simply does not make any sense to me. Most of the people that do not have medical insurance are FORCED into that predicament - they cannot afford the high premiums. Family plans are hundreds of dollars per month (more times, over $1,000 per month). So, not only does the uninsured person struggle to simply AFFORD the insurance, they'll NOW have tax penalties for NOT being able to afford it.
I watched an interview on the news early Sunday morning about this very situation and mandated change effective this July, 2007. I watched in disbelief! In the same breath, it was explained that if an individual shows up at the ER for care, they will not be refused treatment regardless of their insurance status. It is such a double-edged sword!
I am looking forward to seeing Michael Moore's movie SICKO. I am curious to see if it will change my "learned" opinion about socialized medicine.
For more dialogue and information about this and other topics, visit www.MedicalBillingFoundation.com.
Tuesday, July 3, 2007
Medical Billing - SICKO. Uninsured and Counting...
I found an interesting article yesterday at www.billadvocates.com. It gave more information about our current health care status, the costs, and what groups like MBAA are doing to help stay part of the solution of this national crisis. They are continuously fighting to keep healthcare costs down, for CONSUMERS, small businesses and healthcare providers alike.
In November of 2005, LexisNexis announced that it would launch advanced information and data access technology in association with the National Health Care Anti-Fraud Association (NHCAA), law enforcement and regulatory agencies.
Conceived as a public service for the healthcare industry, it was created in response to what the company calls a:
"$51 billion issue" and a "crime phenomenon."
The issue they're talking about is healthcare fraud, and it accounts for an estimated 3% of America's $1.7 trillion annual healthcare cost.
Guess who's paying for it?
That's right. You are.
"Health care spending in the U.S. is five times that of defense and three times that of eduction," the article says. "Health care insurers, Medicare and Medicaid, and consumers bear the cost of fraud, which represents an ever-growing burden in the form of increased premiums, taxes, co-pays and deductibles."
Of this $51 billion issue, upwards of $10 billion of it is likely coming from overcharges on medical bills like yours.
Today's complex medical billing system allows fraud and abuse to go undetected. Studies have shown that as many as 9 out of 10 medical bills from hospitals and providers contain errors. Their errors are compounded by the fact that insurance companies are not reimbursing correctly--they just pay the incorrect bills unquestioningly, but deny legitimate charges.
And people wonder why healthcare costs are skyrocketing?
With 61 medical billing advocates across the country, MBAA is fighting to keep healthcare costs down, for consumers, businesses and healthcare providers alike.
MBAA has also developed a self-help workbook, The Medical Bill Workbook, to help individuals counter out-of-control medical costs.
MBAA also provides CONSUMER cost awareness seminars to educate the public about insurance reimbursement and billing practices rampant in the medical profession today that are creating the massive rise in healthcare costs we've all seen first hand.
To learn what you can do as a MEDICAL BILLER, keep watch on a growing group called The Medical Billing Foundation. The members of this foundation are professional medical billers and THEY offer webinas, conference calls, and regional seminars to keep those working as medical billers remain on top of the latest industry changes and upcoming mandates in the industry. Visit www.MedicalBillingFoundation.com regularly as this is an ever-changing site filled with valuable resources. Be patient however, as this is a foundation LONG in the making.
In November of 2005, LexisNexis announced that it would launch advanced information and data access technology in association with the National Health Care Anti-Fraud Association (NHCAA), law enforcement and regulatory agencies.
Conceived as a public service for the healthcare industry, it was created in response to what the company calls a:
"$51 billion issue" and a "crime phenomenon."
The issue they're talking about is healthcare fraud, and it accounts for an estimated 3% of America's $1.7 trillion annual healthcare cost.
Guess who's paying for it?
That's right. You are.
"Health care spending in the U.S. is five times that of defense and three times that of eduction," the article says. "Health care insurers, Medicare and Medicaid, and consumers bear the cost of fraud, which represents an ever-growing burden in the form of increased premiums, taxes, co-pays and deductibles."
Of this $51 billion issue, upwards of $10 billion of it is likely coming from overcharges on medical bills like yours.
Today's complex medical billing system allows fraud and abuse to go undetected. Studies have shown that as many as 9 out of 10 medical bills from hospitals and providers contain errors. Their errors are compounded by the fact that insurance companies are not reimbursing correctly--they just pay the incorrect bills unquestioningly, but deny legitimate charges.
And people wonder why healthcare costs are skyrocketing?
With 61 medical billing advocates across the country, MBAA is fighting to keep healthcare costs down, for consumers, businesses and healthcare providers alike.
MBAA has also developed a self-help workbook, The Medical Bill Workbook, to help individuals counter out-of-control medical costs.
MBAA also provides CONSUMER cost awareness seminars to educate the public about insurance reimbursement and billing practices rampant in the medical profession today that are creating the massive rise in healthcare costs we've all seen first hand.
To learn what you can do as a MEDICAL BILLER, keep watch on a growing group called The Medical Billing Foundation. The members of this foundation are professional medical billers and THEY offer webinas, conference calls, and regional seminars to keep those working as medical billers remain on top of the latest industry changes and upcoming mandates in the industry. Visit www.MedicalBillingFoundation.com regularly as this is an ever-changing site filled with valuable resources. Be patient however, as this is a foundation LONG in the making.
Monday, July 2, 2007
Medical Billing - SICKO Movie Review by Victoria Alexander, FilmsInReview.com
As a Medical Biller, I am continuously seeking education (in all forms) about the status of our country's health care system. And, that education can include newspaper articles, web announcement and resources and FILMS! I found an interesting review of Michael Moore's SICKO that I decided to post here for YOUR review.
If you get sick, move to Canada, France, or Cuba.
If Michael Moore’s “Sicko” is seen by enough Americans it can actually make a positive impact for change. But only if people start protesting and rioting in large numbers for a change in policy.
I’m terrified now that I might get sick. I’ll have to move to Europe or hope that the Brazilian healer John of God can work a miracle for me.
Why is Moore so impressed with the national health care of countries like Canada, France and England? Why does he go to Cuba? Could it be that instead of building a war industry and invading countries, they are spending tax money on their citizen’s health care? All three countries have free health care for any medical crisis.
A new report from the Congressional Research Service says the U.S. is now spending close to $10 billion dollars a month on the occupations of Iraq and Afghanistan – an increase of nearly $8 billion dollars from one year ago.
$10 billion dollars each month could subsidize a lot of prescriptions.
“Sicko,” as you all know, is Moore’s documentary on the health care system in the U.S. Moore has a clear message: there are billions of dollars in profits at stake that the industry wants to keep for itself. They do not want to pay any medical bills and thereby provide so many technical loopholes that it is impossible to outsmart them.
The private health care industry wants you to have an insurance policy in place but they are not willing to pay for your health care once you get sick. The industry policy is to deny claims. They get away with outrageous practices by doling out enormous contributions to politicians and employing an army of lobbyists with ready cash.
Moore introduces a group of average Americans who have had to face dire medical emergencies and whose claims were denied by their insurance carriers. It is sickening. Kaiser Permanente is at the top of Moore’s Evil Triumvirate.
A friend of mine’s teenage son was diagnosed last year with leukemia. To date, and his treatment is ongoing, his medical bills have exceeded $700,000. Even with a good health insurance plan, my friends have huge, supplemental medical bills. (In London, Moore cannot find a billing department. There is no place to pay for a hospital stay and they give you cab fare when you leave the hospital.)
When Moore hears about how terrorists are being cared for at Guantanamo Bay, Cuba, he decides to take a group of volunteer Ground Zero rescue works and sick people to Cuba. While they are not allowed on the base, they go to a Cuban hospital where they are welcomed and treated. One woman starts crying when she is told she can have her bottle of medicine for five cents. In the U.S. the same bottle costs her $120 a month.
Moore blames President Nixon for starting the whole HMO debacle now plaguing average Americans. Hillary Clinton was tasked to bring universal health care to every American but the health industry spent more than $100 million to defeat her plan. Hillary learned her lesson and has now recognized her error in judgment. She has embraced the “for profit only” scheme of the health industry.
Apparently, sick people do not vote. Why not have voter registration forms at hospitals and pharmacies?
“Sicko” is important and well done. Moore takes a backseat and allows his subjects to express themselves and show us how a medical crisis has changed their lives.
While we are led to believe we are the most powerful, rich and caring country in the world, we are only allowing the well-heeled to have appropriate medical care. When Americans do not have to cross the Canadian and Mexican borders to fill their prescriptions and the health care industry plays fair, then we can turn our attention to Darfur and spreading “democracy” in the Middle East.
If you get sick, move to Canada, France, or Cuba.
If Michael Moore’s “Sicko” is seen by enough Americans it can actually make a positive impact for change. But only if people start protesting and rioting in large numbers for a change in policy.
I’m terrified now that I might get sick. I’ll have to move to Europe or hope that the Brazilian healer John of God can work a miracle for me.
Why is Moore so impressed with the national health care of countries like Canada, France and England? Why does he go to Cuba? Could it be that instead of building a war industry and invading countries, they are spending tax money on their citizen’s health care? All three countries have free health care for any medical crisis.
A new report from the Congressional Research Service says the U.S. is now spending close to $10 billion dollars a month on the occupations of Iraq and Afghanistan – an increase of nearly $8 billion dollars from one year ago.
$10 billion dollars each month could subsidize a lot of prescriptions.
“Sicko,” as you all know, is Moore’s documentary on the health care system in the U.S. Moore has a clear message: there are billions of dollars in profits at stake that the industry wants to keep for itself. They do not want to pay any medical bills and thereby provide so many technical loopholes that it is impossible to outsmart them.
The private health care industry wants you to have an insurance policy in place but they are not willing to pay for your health care once you get sick. The industry policy is to deny claims. They get away with outrageous practices by doling out enormous contributions to politicians and employing an army of lobbyists with ready cash.
Moore introduces a group of average Americans who have had to face dire medical emergencies and whose claims were denied by their insurance carriers. It is sickening. Kaiser Permanente is at the top of Moore’s Evil Triumvirate.
A friend of mine’s teenage son was diagnosed last year with leukemia. To date, and his treatment is ongoing, his medical bills have exceeded $700,000. Even with a good health insurance plan, my friends have huge, supplemental medical bills. (In London, Moore cannot find a billing department. There is no place to pay for a hospital stay and they give you cab fare when you leave the hospital.)
When Moore hears about how terrorists are being cared for at Guantanamo Bay, Cuba, he decides to take a group of volunteer Ground Zero rescue works and sick people to Cuba. While they are not allowed on the base, they go to a Cuban hospital where they are welcomed and treated. One woman starts crying when she is told she can have her bottle of medicine for five cents. In the U.S. the same bottle costs her $120 a month.
Moore blames President Nixon for starting the whole HMO debacle now plaguing average Americans. Hillary Clinton was tasked to bring universal health care to every American but the health industry spent more than $100 million to defeat her plan. Hillary learned her lesson and has now recognized her error in judgment. She has embraced the “for profit only” scheme of the health industry.
Apparently, sick people do not vote. Why not have voter registration forms at hospitals and pharmacies?
“Sicko” is important and well done. Moore takes a backseat and allows his subjects to express themselves and show us how a medical crisis has changed their lives.
While we are led to believe we are the most powerful, rich and caring country in the world, we are only allowing the well-heeled to have appropriate medical care. When Americans do not have to cross the Canadian and Mexican borders to fill their prescriptions and the health care industry plays fair, then we can turn our attention to Darfur and spreading “democracy” in the Middle East.
Friday, June 29, 2007
Medical Billing and SICKO's Impact
As a professional Medical Biller, I feel that it is my responsibility to stay current with our country's health care system and that does include the viewing of Michael Moore's movie SICKO - scheduled for release today, June 29, 2007. Regardless of one's political views, I encourage billers to place their (political) opinions on the back burner while viewing this film. Even if you have not been a fan of Michael Moore and his previous documentaries, the importance of seeing THIS Michael Moore's movie should be of great importance as an active member of the medical billing industry. Many of us can agree that our health care system is (politely) chaotic, regardless of where we fall in the political spectrum. Remaining a TOP medical biller requires staying current with ALL heath care news from ALL sources and sides. I happen to be a fan of Michael Moore and of his previous documentaries. I am sure that, like his last, Moore will offer his usual mix of cynical humor contrasted with piercingly sobering personal narratives, which brings both a chuckle and an "oh my" type of reaction. I understand that Moore traces the START of our health care crisis all the way back to the early 1970's to the presidency of Richard Nixon - pressured to launch the Health Maintenance Organization (HMO) system. That HMO system is the largest, internationally, of for-profit medicine. That HMO system is also the direct cause of phenomena like NO-insurance, UNDER-insurance and toppling health care standards. The direct result has been a continuous downhill tumble, crashing under the health care standards of similarly wealthy countries around the world - most of which have government sponsored and paid universal heath care structures. As many billers, I too hope to remain part of a solution toward improving the processing of healthcare claims and insurance follow up - ultimately getting practices paid. I love what I do. I especially love the glee evident on my client's faces while they witness the immediate, positive impact made to their practice by choosing to work with my medical billing firm and me. I, too, encourage billers to use this film as a conversation point with prospective clients - to point out where the system falls down in places where billers can pick things UP.
Thursday, June 28, 2007
Medical Billing - OUTSOURCED; a Not-so SICKO option
I am very excited about the release of Michael Moore's documentary, SICKO, this Friday June 29! I am not only a member of the American general public who subscribes to an HMO Plan, I am also the owner of a Medical Billing Firm. Eligibility, Authorizations, Referrals, Diagnosis Codes, CPT Codes, Electronic Claim Submissions, EOB's, Payment Postings, Aging Tracking, Patient Statements, Claim Payments and Claim Denials, along with the ever-changing Insurance Carrier Rules are ALL part of my day-to-day world. Keeping up with Medicare, Medicaid, and all Other insurance carriers and their regulations is at a MINIMUM, a daunting task! I understand that the point behind Michael Moore's movie SICKO is to spark passions and cause debates nationally about the current state of our healthcare system (or there lack of) and to generate NEW, perhaps radical plans for our nation's future when it comes to healthcare. The primary reason that we, medical billers, are directly, often negatively effected by our weak healthcare system is due to to (a) the incapability of following the goings on and changes per specific insurance carrier nationally and (b) the difficulty in getting compensated for claims processed. Both the advantage to our medical billng clients and the CURSE of our own business strategy is that we DO NOT earn a dime until the practice is paid for services rendored for their patients. And, when (not if) claims are denied, we billers are faced with the frustrating task of follow up to learn the rejection reasons in order to REsubmit the original claim. See, what many don't realize is that on the busy CMS 1500 forms, each box requires DIFFERENT information according to each individual carrier. If ONE single piece is either missing or out of place, the claim is rejected. The EOB's don't offer a total explanation either in a lot of cases. This forces the tying up of phone lines ringing into these carriers from the 4 corners of the country every day of the week. The frustrated doctor and/or medical practice owner has more than likely undertaken this process for him or herself at one point or another. From those agravations of TRYING to get paid, they do one of 2 things; they either hault excepting health insurance entirely OR they seek an outsourced solution - a medical billing firm. Although I don't support or recommend that any practice owner stops taking insurance, especially in this economy, I certainly do appreciate the decision to do so. "Pocket money" even for health care or maintenance is simply NOT as readily available to the general population. People PAY for their insurance coverage and they will more than likely select a healthcare professional based on whether that practitioner accepts their health insurance or not. In fact, many practice owners who once had the luxury of NOT taking health insurance are returning to it being accepted due to their patient's financial circumstances - EVEN their own! This, of course, does WONDERS for my medical billing business. If it makes sense - and MOSTLY it does - practice owners should seek outsourced medical billers to fill the necessary filing process. It is SO much more cost-effective for that practice. Eliminating staff is neither recommended or an absolute necessity. There will always be a need for a front desk person AND a back office manager. Those folks have a lot of responsibilities BEYOND medical billing that should keep their jobs safe. Who would otherwise check patients in, verify elegibility and authorizations for visits, deal with the copier machine repair person, make sure all information is gathered for filing, help GROW the practice? The practice owners? Not likely! Their job remains as it should - to effectively practice good medicine. Medical billers ensure that happens and in fact, HELPS the general public receive the best possible care that they require and deserve by taking over this pain on behalf of practice owners. So, Michael Moore's movie SICKO points out the "issues" of our healthcare system, which is LONG overdue. Where do we go from here? I, for one, am determined to remain a part of the SOLUTION toward IMPROVING the state of our current system by accurately and effectively filing medical claims on my client's behalf. I look forward to learning other medical biller's feedback and reviews of the movie, considering OUR necessary positions in the healthcare industry. Share your comments here OR visit www.MedicalBillingFoundation.com. Many more opinions, suggestions and strategies will be offered there. All of us medical billing business owners should use the release of this film to our advantage by discussing it and pointing out how WE ARE part of the working solution!
Tuesday, June 26, 2007
SiCKO Shows Reality of Medical Biller's World
With the release this Friday (June 29) of Michael Moore's "SiCKO", audiences will get to see firsthand the vagaries of the U.S. health insurance system. Those of us in the medical billing field, who do our level best to process and advocate for appropriate payment to the doctors we represent, see the games the insurance carriers play every day.
Depending upon the day of the week, it seems, the rules change. What was supposed to be represented in each field of the CMS1500 one day, is unacceptable the next, requiring resubmission after resubmission. The payers know all too well that a significant portion of these rejected claims will fall by the wayside eventually. Hence the point of Moore's documentary.
And of course, the payers will rely on "government regulations" as the reason for modifications, clarifications (obfuscations, in fact). The reality, as SiCKO reflects, is that the massive lobbying community has a chokehold on the leadership of this country. Those new regulations that are fomented in a dizzying fashion out of Washington are, of course, absurdly beneficial to the insurance companies, but lawyered in such a way as to appear either (a) legitimate, or (b) completely hidden from view altogether until a rejected claim comes our way, illustrating the new rule.
The "When did THAT happen?" feeling we often get tends to make one unsure of one's professional abilities from time to time. Not to mention the doctor's frustration that payments for services rendered are increasingly questioned.
For medical billing professionals, this is not a do or die mission, but hopefully with the light shed by SiCKO, perhaps some of the lobbyists will not be quite as bold in the future, and more importantly, health insurance plans will be more accountable to the patient and to the medical practices in this country.
Donald Roche
The Medical Billing Foundation
http://www.MedicalBillingFoundation.com
Depending upon the day of the week, it seems, the rules change. What was supposed to be represented in each field of the CMS1500 one day, is unacceptable the next, requiring resubmission after resubmission. The payers know all too well that a significant portion of these rejected claims will fall by the wayside eventually. Hence the point of Moore's documentary.
And of course, the payers will rely on "government regulations" as the reason for modifications, clarifications (obfuscations, in fact). The reality, as SiCKO reflects, is that the massive lobbying community has a chokehold on the leadership of this country. Those new regulations that are fomented in a dizzying fashion out of Washington are, of course, absurdly beneficial to the insurance companies, but lawyered in such a way as to appear either (a) legitimate, or (b) completely hidden from view altogether until a rejected claim comes our way, illustrating the new rule.
The "When did THAT happen?" feeling we often get tends to make one unsure of one's professional abilities from time to time. Not to mention the doctor's frustration that payments for services rendered are increasingly questioned.
For medical billing professionals, this is not a do or die mission, but hopefully with the light shed by SiCKO, perhaps some of the lobbyists will not be quite as bold in the future, and more importantly, health insurance plans will be more accountable to the patient and to the medical practices in this country.
Donald Roche
The Medical Billing Foundation
http://www.MedicalBillingFoundation.com
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