Oprah took on healthcare, insurance and the lack thereof today. While I think she did an astounding job of moving the discussion forward, I think a major point was missed — and needs to be pointed out.

Joining Oprah were Michael Moore, the director and producer of Sicko, Karen Ignagni who is the top lobbyist for the association of health care insurers, and Uwe Reinhardt, a health economist. The debate was heated, hit many of the important points, and during the hour, Oprah asked several times, “What do we believe?”

Believe? Here’s how it was posed: “Do we believe the child of a gas station attendant and the child of a CEO deserve the same access to healthcare?”

How many answers can there be? Of COURSE that child should have the same access!

.. but guess what… they don’t.

This is not new to anyone. And then, of course, the question about the 47 million Americans who don’t have health insurance is imposed…. but then — Joe Average American retreats to this thought process, “well, at least I’m insured and my family is insured, and I’m only one person anyway, and there’s nothing I can do about it, because I am only one person.”

Here’s the point that was missing — The great majority of Americans think like Joe Average American — and that thinking is flawed! Joe Average American — you have missed the point! Joe — you have coverage that isn’t going to cover what you think it is! You have coverage that will pay far less than you think it will, despite the fact that it has already cost you hundreds if not a thousand dollars a month just to have that coverage to begin with!

Yes — Lisa Ling showed the stories of three people who had insurance, yet were denied care. Those are huge, and sad, stories.

But that’s not what I’m talking about. I’m talking about those people who need help with normal, every day care. Their child breaks a leg? It costs them hundreds or thousands of dollars in addition to their insurance coverage. Find out you’ve got allergies? It will be declared a pre-existing condition and it won’t be covered. You’ve got GERD? Even though your health is covered, you prescriptions may not be — it will cost you an additional $300 or $400 per year for the drug you need.

Michael Moore and Oprah reiterated a number of times that they don’t understand why anyone should profit from healthcare. And I do differ with them on that, at least to a degree. I think that profitability is a great motivator for innovation, and it’s profit that drives good research, new discoveries and treatments, and eventually, advanced care.

But I don’t believe that’s true for insurance. Profitability should not be allowed when it comes to human lives.

For those who have insurance and who think they have decent insurance (even though they are usually wrong) …. be advised that you are likely clueless about how little coverage you really have. Be advised that your healthcare dollar won’t go nearly so far as you think it will. And be advised that the health insurance lobby owns too many legislators who will make sure that doesn’t change anytime soon.

I don’t know how Karen Ignagni sleeps at night. Honestly. I’ve seen spin doctors, but hers spins only a much more tangled web.

And those tangles are costing more lives every day.

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Find more commentary on Sicko here.

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Last week I told you about my email pal, Tom, who fought valiantly with his health insurance company to get clearance for specialized heart surgery. Tom won permission — and his surgery was performed last Wednesday.

I received an email last night — from the man himself — and he tells me he made it through the surgery and is beginning to get back on his feet. woo hoo!

He promises some details later. He alluded to some snafus and even says he has become familiar with hot flashes! But his short email did sound, well, relieved.

Thanks to those of you who kept Tom in your prayers and thoughts. And yes, I promise to keep you posted.

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Last week, Newsweek’s My Turn featured an essay by Dr. Richard Karl. Newsweek called it “Good Doctors Spot Mistakes, Save Lives”… a lousy headline for a well-meaning essay, even if the essay needs a postscript.

(I’ve provided that postscript below.)

Dr. Karl, a surgeon, describes the frustration of trying to track down a sponge which he fears he has left inside his patient. He uses this example to cite one of the many ways physicians, and the medical system in general, harm patients — 15 million of them per year, by count of the Institute of Heathcare Improvement.

He then provides the reasons he thinks this phenomenon has gotten so out of control, from too much innovation to development of too many new drugs and treatment techniques to patients demanding to be a part of their own care decisions.

He’s right. The world has changed.

But the real measure of this man is in his bottom line, where he states, “Most everybody I know in medicine is bright, hardworking and altruistic. Many, though, have been beaten down by hundreds of urgent pages, middle-of-the-night phone calls, decreasing reimbursement, more paperwork and less grateful patients. These doctors have become less careful, and their patients suffer as a result.

It is time for my colleagues and me to reclaim our profession. It is time for doctors and nurses to work together, time for electronic records to actually work in providing the right information to the right person, time for pharmacists and nurses and social workers and doctors to see patients together.”

I hear you Dr. Karl, and I can see that you are trying to shift your thought process from being a blamer to being a fixer. I appreciate that.

But here’s the postscript: in your description of who needs to work together on the “healing together” team, you’ve missed the one person who is, arguably, the most important participant of all: The patient!

Patients: you’ll understand the need to take responsibility by understanding the constraints your providers operate under (as described by Dr. Karl) — it only makes sense for you to be an active participant in your care decisions.

Doctors: if you embrace the empowered, informed patient as a part of the healing team, you’ll find that everyone will benefit. And that, after all, is why you became a doctor.

	………………
	Want more tools and commentary for sharp patients? Sign up for Every Patient’s Advocate once-a-week or so email tips Or link here to empower yourself at EveryPatientsAdvocate.com
	………………

Last week, Newsweek’s My Turn featured an essay by Dr. Richard Karl. Newsweek called it “Good Doctors Spot Mistakes, Save Lives”… a lousy headline for a well-meaning essay, even if the essay needs a postscript.

(I’ve provided that postscript below.)

Dr. Karl, a surgeon, describes the frustration of trying to track down a sponge which he fears he has left inside his patient. He uses this example to cite one of the many ways physicians, and the medical system in general, harm patients — 15 million of them per year, by count of the Institute of Heathcare Improvement.

He then provides the reasons he thinks this phenomenon has gotten so out of control, from too much innovation to development of too many new drugs and treatment techniques to patients demanding to be a part of their own care decisions.

He’s right. The world has changed.

But the real measure of this man is in his bottom line, where he states, “Most everybody I know in medicine is bright, hardworking and altruistic. Many, though, have been beaten down by hundreds of urgent pages, middle-of-the-night phone calls, decreasing reimbursement, more paperwork and less grateful patients. These doctors have become less careful, and their patients suffer as a result.

It is time for my colleagues and me to reclaim our profession. It is time for doctors and nurses to work together, time for electronic records to actually work in providing the right information to the right person, time for pharmacists and nurses and social workers and doctors to see patients together.”

I hear you Dr. Karl, and I can see that you are trying to shift your thought process from being a blamer to being a fixer. I appreciate that.

But here’s the postscript: in your description of who needs to work together on the “healing together” team, you’ve missed the one person who is, arguably, the most important participant of all: The patient!

Patients: you’ll understand the need to take responsibility by understanding the constraints your providers operate under (as described by Dr. Karl) — it only makes sense for you to be an active participant in your care decisions.

Doctors: if you embrace the empowered, informed patient as a part of the healing team, you’ll find that everyone will benefit. And that, after all, is why you became a doctor.

	………………
	Want more tools and commentary for sharp patients? Sign up for Every Patient’s Advocate once-a-week or so email tips Or link here to empower yourself at EveryPatientsAdvocate.com
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