Sick Around America

Investigating the stories of Americans whose lives have becomes a quest to find and keep health insurance...

pbs.org/wgbh/pages/frontline/sickaroundamerica/

posted march 31, 2009

pbs.org/wgbh/pages/frontline/sickaroundamerica/talk/

Dear FRONTLINE,

I am disappointed that this long-awaited special on healthcare did not address the single payer option. There were ample interviews with insurance company lobbyists but no discussion of this obvious choice. Our nation's people are in crisis and the shameful greed displayed in other industries is replicated in the for profit hospital corporations, insurance companies and pharmceutical industries. We cannot afford profit in healthcare, as we will continue to have a chaotic, threadbare system riddled with donut holes and pitfalls for those who can least navigate: patients and their families. I'd like to see equal time -- a Frontline on the single payer option.

Grace Gifford
Conway, SC

FRONTLINE's editors respond:

Many viewers have written criticizing this report for not looking at solutions, in particular, a single payer system. Certainly, the topic is another important piece of any examination into the health care system and how it can be improved. And it would warrant a separate program of its own. We would like to point out that we did examine how the single payer system works in many European countries in our program last season, Sick Around the World. You can view this online.We believe that our report this week, Sick Around America, was equally of value in focusing on our current private health insurance system and showing how many Americans are only one or two events away from financial disaster or total ruin because they can't afford this insurance, or because it offers inadequate coverage, or because it suddenly can be rescinded by the insurer for alleged omissions or errors. We also felt it important in this report to look at another major problem with the private insurance system: America's for-profit medical system means that insurers have a fiscal duty to avoid risk and make profits for investors. Thus, insuring people who already have serious, chronic illnesses works against the interests of stockholders.

Dear FRONTLINE,

How many letters will get published? By cutting off the debate, you have once again silenced the single payer advocates like myself. Single payer represents social justice, compassion over greed. Why are our voices silenced? Sick people don't deserve to be sick. Illness and disease are not punishment for a poor life style.

Pamella Gronemeyer
Glen Carbon , IL

Dear FRONTLINE,

Thank you for investigating America's health care system and bringing to light many facts that all of us need to be aware of. A national discussion on what is beginning to look like an American tragedy is obviously way past due.

It is now clear to me that "the market" has failed as a mechanism to provide health care for all Americans due to an inherent conflict of interest within the health insurance industry. Whereas companies in most industries fail their investors unless they provide value and service to their customers, companies in the health insurance industry achieve success by minimizing (excluding, denying and delaying) value and service. This is wrong. It is also wrong-headed.

If our nation really wants to live up to its Christian and democratic ideals it needs to be a moral and just nation. Should we really allow the invisible hand of "the market" to decide whether this or that human being is worthy of care? I can see that in many aspects of our lives the "market" system serves us exceedingly well. But, when it comes to fulfilling our basic needs for defense, police, roads, fire protection, education . . . and health care, it seems to me that we are best served by pooling our resources and caring for one another. Medical care for sick people should be a right, not a privilege.

How we respond to the fact of our broken health care system is not only a test of our morality. It is a test of our intelligence. And, it's a test that we can't afford to fail.

Karen Scarvie
Bainbridge Island, Washington

Dear FRONTLINE,

I am a health insurance agent in Utah. I sit on the board of the utah health underwriters as webmaster for www.uahu.org and www.benefitsmanager.net. I was heavily envolved in designed a web connector to help Utah residents by pulling private and state sponsored insurance mechanisms together. Low budget of around $150k that virtually guaranteed health insurance coverage through either the private or state programs. Our state insurance committee rejected the idea. The elected to go for a Mass. type connector program that isn't working well when you check the actual facts. Our state approved H.B. 188 with a zero fiscal note attachment. My point is, I have been a fly on the wall in countless legislative meetings, insurance board meetings, hospital board meetings, the list goes on. The problem is conflict. Your episode brought perspective. You are absolutely right when you claim that healthcare is now unsustainable. I have been crying that a long time. Nobody listens.

Mike Oliphant
Layton, Utah

Dear FRONTLINE,

Dear Frontline,

Your program was as informative as it was interesting.

You highlighted a case where a man was caught in a downsizing and had to move in with his mother. Of course we all are troubled about his situation, but you did not explore lifestyle choices that may have lead to his 95% clogged artery.

Lifestyle choices can be addressed through "Wellness Programs" by addressing a problem BEFORE it becomes life threatening.

There are many cost reductions available in our health care system that could be addressed through more control on fraud. Isn't it possible to achieve cost reduction & improved efficiencies through streamlining red tape and allowing various computer systems to share certain data bases?

And shouldn't tort reform be a part of the solution? There is a large problem nationally of OB-Gyn's leaving their practice due to the high cost of liability insurance. Who benefits most in that area - the lawyers or ???

Lastly I was surprised there was NO mention of our Illegal Immigration situation on medical costs.

Mark Kennedy
Scottsdale, AZ

Dear FRONTLINE,

I have two thoughts on Sick Around America. If we go to a healthcare system like they have in Canada and Europe, be expected to pay a lot more in taxes. At least up to 20% more in taxes. Is this exceptable? An extra 20% more taken out of your paycheck? It would be cheaper to pay the insurance offered by the company.

My other thought is this. I have a lot of dealing with the health care system as I have kidney disease and had a kidney transplant. I have had to have procedures done when I was not on health care. I have dealt with a couple of hospitals under these circumstances. I set up a payment plan with them at surprisingly affordable monthly payments. Hospitals seem to be helpful if you at least try to set something like this up since they will get their money one way or another. Just some thoughts.

Brainerd, Minnesota

Dear FRONTLINE,

I got home late from work and ran sum errands finally turned on the TV to my favorite channel 11.

I was glued to your program and was relieved to finally here that someone got it right about our health system and spoke out about it. We desperately all need to get involved no matter what level of income we live on. In time it will affect us all.

I am currently working for one of the major health organization you have mention in your program. To keep my identity safe I cannot mention names. However I can relate to most of the issues that were talked about in your program.

Let me explain how it ran from the inside. I do know why some of the insurers are given the wrong plans. Everything seems to be done by call centers or on line, so allow me to describe briefly how they work. First of all you are at your desk for 8 or more hours call after call and told you must take 70 calls a day and are allowed to only be on a call for not longer than 10 minutes. So to keep customer volumes up you must rush through to the contents of a policy that you may think best fits their needs with a scripted you must follow. If the caller asks too many questions you suggest mailing then an application or they can apply on line or call back if they have any other questions. While you are on the phone looking up several option for the customer and navigating through several screens (7 or 8 sometimes) and logging information into the system all at once. You are not allowed to put the customer on hold or call them back, so if the customer is satisfy with you he may not get to talk to you again and would have explain his situation all over again to another repersenitave.

That is just a very few of the rules employee need to follow for the companies and I am sure this applies to several other organizations. Take for instance the big groups that run our doctors' offices. Most are allowed only 10 to 15 minutes with a patient. I mean I could go on and on about rules and guidelines in organizations and I am sure we could all tell our stories. What happen to making our customers happy maybe we all should eliminate some of these rules and slow it all down, and give one another the time we need? I know it's all about the making profits and fast sales. But people are canceling and tired of facade. We are all customers and deserve the best. Remember, don't forget in the end it's all about the work of the mouth.

By the way I will be leaving my company shortly. I do believe in treating all my customers with the utter most respect and receive several compliments thanking me for being patient with them and giving them the time they need.

Willowbrook, IL

Dear FRONTLINE,

I am an independent insurance agent and life marketer. I too was irritated by lack of mention of a single-payer or 'Medicare for all' option on your program, but not for the reasons already pointed out by many. I read your editor's note in response to this issue and agree it was not necessarily the point of this program. However the producers failed miserably in the context that, during the segment on Obama's meeting regarding healthcare, a statement was made to the effect that "all parties were in attendance", This is an outright lie - all but one were there. This administration point-blank refused to consider the single-payer route from day one. Any supporters of the most popular concept with the general public were specifically not invited to attend, including several persons on the grass roots level who have been Obama's staunchest supporters for years. Just like the massive giveaways to the financial sector, the Obama administration is comfortably in the back pockets of their campaign contributors.

Craig Honaker
Jupiter, FL

Dear FRONTLINE,

Your program, like almost all the programs on the health care issue, lacks one important statistics -- where did all the money go? In 2007, over 70% of the total health care expenditures went to hospital care, professional services and nursing homes. Prescription drugs only accounted for 10% of the total cost and the net cost of health insurance was even lower. That is to say, even if we force all the pharmaceutical companies to provide us free drugs and wipe out all the profit the insurance companies made, we won't get any meaningfully lower cost of health care. If you really want to do a high quality investigational report and responsibly address our health care crisis, just follow the money.

All these numbers can be easily found from the website of US Department of Health and Human Services:http://www.cms.hhs.gov/NationalHealthExpendData/downloads/tables.pdf

New Haven, Connecticut

Dear FRONTLINE,

I thought your program was excellent. I note that the insurance exec speaking towards the end called on doctors and hospital administrators to reduce their pay but said nothing about insurance CEO's doing the same. As a family physician, I know that some of these insurance CEO's make millions of dollars.

I feel we need to move towards a single payer system.

Alice Frazier
Delaware, OH

Dear FRONTLINE,

In December of 2008, I was laid-off from my job. I lost my health care. My husband and I applied for a family plan through Kaiser Permanente; we had been with Kaiser for several years. My husband was accepted but I was rejected. Kaiser rejected me for a history of colon polyps (my father had died of colon cancer and I have regular colonoscopies), and some very minor reasons, like rosacea. I appealed this decision, sending letters from 3 of my physicians at Kaiser, along with the appeal.

We had just seen the Frontline report on Health Care. Today, I received a letter stating that Kaiser had rejected my appeal because of my history of colon polyps. Now, I feel like some of the people that were profiled in the report. I am being denied health coverage because I am trying to maintain my health. I have regular colonoscopies to prevent getting colon cancer. I just saw a commercial with Katie Couric, urging people to get colonoscopies to avoid this cancer. For now, I am covered by an expensive Cobra plan, after the loss of my job. I don't know what I will do in the future to maintain my health. Perhaps seek medical care overseas, in countries that place the patient before the coverage.

Nancy Maekawa
Vallejo, CA

Dear FRONTLINE,

I am an insurance broker and can see both sides of the arguement. It is understood within the industry that premiums have reached a tipping point for both participants and small business. I am disappointed at how consumer driven health was brushed off as an invalid option and poor coverage. In actual fact, consumer driven health is a sure way to decrease the amount of money given to the insurnace company on a monthly basis and often times has a stop loss of less than $3000 for any one calander year. Additionally preventive care and screenings are built in to the premiums and offered at 100% to the insured. That is RICH coverage.

One of the reasons for the rising cost of healthcare is that nearly 100% of claims are paid by a third party (either govt or insurance company). The actual patient has no idea, or vested interest in how much a particular service may cost. Whether it be an office visit, CAT Scan, MRI or Viagra the insured does not care how much it costs. In fact all they care about is how much the copay is. If the insured had a vested interest in some cost share of medical expenses there would not be such a spike in medical costs. For instance Lasik surgury is one of the newer and more popular services offered and does not qualify under any medical plan. The cost for such surgury has decreased enormously since it's inception. The same can be true for all other services paid direct by the consumer as well. It sometimes amazes me how detached people are (and want to be) when it comes to health care costs. Insurance should be in place to cover all catostrophic costs and preventive services. The costs in between should be "budgetable" and paid through a tax advantaged account. All in all a thoughtful program.

Gabriel Christensen
norfolk, va

Dear FRONTLINE,

My husband and I view your program regularly. Last nights show was particularly topical for me. Today I received a rate increase from my health insurance carrier raising my monthly premium from $764.16 to $893.02. I have a $50.00 copay, $5000.00 deductable and I pay 20% of all bills within the PPO network. Only I am covered by this policy. We pay premiums for my husbands too. Like many Americans, I was laid off in October of 2008. I just found employment at less than half of my former salary and am so greatful to have work. You showed America how the middle class is struggling and falling. I hope our congressional and senatorial representatives were watch too. Excellent reporting.

Joliet, Illinois

Dear FRONTLINE,

The reason why medical costs have spiraled out of control and health care in this country is way too expensive for the average person is essentially because Medicare and Medicaid are the health-care industry's built in government bailout money -- always has been -- therefore there's no incentive for the industry to lower, and keep, medical costs down. Doctors, hospitals, pharmaceutical companies and researchers, and medical supplies companies all need to step up to the plate and implement reductions in salaries and costs, and face the music just like the rest of the country in this bad economy. With all due respect to their educations and professions, doctor's salaries are astronomical, and need to come down. At least this would help begin a cycle of lowering health care costs.

Thanks, Frontline, for another insightful presentation.

James Stellhorn
Scottsdale, AZ

Dear FRONTLINE,

In response to the "Sick Around America" report.

I recall I believe it was the 2nd presidential debate between Obama and McCain where an audience member asked

"Do you believe health care should be treated as a commodity?"

For profit insurance companies exist for exactly that...FOR PROFIT! Is it too hard to understand that? Must we accept that our health, our very lives depend on how some corporate auditor assesses the impact our illness has on the profit margin??

For pity sake...wake up, America!

Ed Crist
Sarver, PA

Dear FRONTLINE,

While I found the program informative (as always), I was disappointed in your discussion of Massachusetts' attempt to provide universal health coverage. By showing one family, which just missed the cut-off for subsidized care, you neglected to show the thousands of poor Americans who have benefited tremendously from Mass's subsidized plan (I know; I'm one of them)-- people who don't necessarily have the option of picking up a job with insurance, as the family you focused on did. As I considered this, I thought about the fact this program really was "Sick and Middle-Class Around America"-- certainly more likely to tug on viewers' heartstrings, but by neglecting to mention the working poor at all, I think you ended up giving a far more negative portrayal of Massachusetts than it deserved, rather than offering it as a model or at least a positive first-step that the rest of the country could consider. Why not talk about the poor?

Gloucester, MA

Dear FRONTLINE,

"Sick Around America" leads me to the conclusion that was never said or even suggested in the program: our health care insurance is too essential and important to be conducted on a for-profit basis. People die so others can make a profit, sometimes a considerable profit. It doesn't have to be that way and this may be the biggest change that has to be made in our health care system if we are to make any progress. Our lives are not commodities.

Robert Cambra
san francisco, CA

Dear FRONTLINE,

I work for a large health insurance company. I must agree with one of the posts that I read that there should be a primary focus on preventive health whether it is a government-run program or a private health plan. The company I work for, and likely many other companies, are already doing this. There are programs that provide discounts on health clubs, offer tobacco cessation programs, and have preventive coverage up-front such as yearly physicals to those that are covered by our plans. These types of things have proven to improve the overall health of a person and catch a treatable disease early on if one would actually participate in those offerings. I do believe that a large percentage of Americans do not take responsibility for their own health and choose to not take advantage of these types of programs. I have seen our company offering payment in the form of gift cards just to "entice" enrollees to participate in the "healthy-living" programs we offer. I think this shows what is wrong with our system- -- we have to pay people to actually take care of themselves..

Robbinsdale, MN

Dear FRONTLINE,

I have been an Oncology nurse for 39 years. The health care system has increased in complexity and decreased its ability to care for patients. Part of my work in recent years involved getting insurance approval for cancer therapies and most recently Hospice. My message for ALL OF US is that although we may pay for insurance we have no idea what will really be covered until the time of our illness - many times a loop hole is found to avoid payment. There are some very disreputable companies who approve therapy (including Hospice care!) and then do not pay the bills after the service; finding loop holes. They have methods to force customers and providers to give up seeking payment (i.e. voice mail with no option for a live person, circular transfers where after 40 minutes you end up where you started, many hoops to jump through, will not put anything in writing; their approval is over the phone - easily deniable).

It is wrong for insurance to be for profit because the profit will always come before the patient.

Thank you for a wonderful program.

Katherine Finstuen
Portland, Oregon

Dear FRONTLINE,

I only wish that the health care picture in Massachusetts were as rosy as Dr Bigby portrays it. My daughter and her family of four live in Mass. She has been diagnosed with Sclerederma and her husband needs surgery for an intestinal condition and has a history of cancer. She cannot work. He cannot afford the premiums for the plan offered by his employer. The family income is in the $60,000 range. The state recently took a portion of their much needed tax refund as a penalty. For them it is a roof over their head and food on the table or health care and yet they have been punished by the state. They were far better off in Rhode Island where they had Neighborhood Health. My daughter suffers from her symptoms daily yet receives no health care at all. Massachusetts has the best hospitals in the country but the worst health care system.

Janet Bagley
West Greenwich, RI

Dear FRONTLINE,

As a pharmacist with 25 years of experience in a variety of health care settings and a keen interest in improving the health care system it is refreshing to see a candid expose of how our disfunctional health care "system" results in profound negative effects on peoples lives. Thank you for helping me make a more informed idea of our current system and what alternatives are possible. There is no doubt that there are other models of providing health care that do a much better job of meeting the needs of their participants than ours does.

Joel Gingery
Plymouth, MN

Dear FRONTLINE,

Why was nothing said about the huge cost of malpractice insurance the Dr. have to pay that drives up the cost in the USA that other nations do not have! Tons of money is spent just trying to cover the possibility of being sued and not really helping the patient. I am a small business owner wanting to drive the cost of health care down, but that is not going to happen without some huge changes like limiting the liability of Dr., cutting service, and more preventive care. Are we still spending half our lifetime health care cost in the last 6 months of life?

jeff Ballard
Dallas, TX

Dear FRONTLINE,

Your program failed to include the affects the legal system has had and currently has on the escalating costs of medical care. The Obama administration should also include tort reform in the equation along with health providers, hospitals, pharmacies, pharmaceuticals, etc.

Robert Fiore
Newton, NJ

Dear FRONTLINE,

FRONTLINE'S Sick Around America did a fine job, in a limited time, of providing insights into several facets of our national disgrace aka the financing of our healthcare non-system. Arm Chair Quarterbacks, like myself, would have wanted the film to include:

1. A spotlight on the politics of healthcare, which sustains hollow reform and enables those benefiting financially from it to prevail ... indeed, proliferate their roles.

2. A focus on the impact of fraud, waste, and abuse, which are exponentially more costly than technology, malpractice insurance, defensive medicine, or other superficial excuses for not dealing directly with the paralyses of real reform.

3. The fundamental question: Why should the nation entrust the insurance industry, which has exhibited for decades patterns of egregious business practices, blindness to public interest concerns, unbridled greed, and an unconscionable contempt for its customers?

Terry Brauer
Chicago, IL

Dear FRONTLINE,

Sadly Frontline left out discussion of Single Payer or even Obama's Public Option plan that he ran his campaign on, but at least the problems of private health insurance have been exposed because until you have to deal with it, you just have no idea that it runs the way it does. I was laid off from my job 2 months ago, where I carried the health insurance for my husband and I because we couldn't afford his company's insurance. It's great for some that Cobra is subsidized and more affordable now, but I am ineligible for Cobra because insurance is "available" through his company. Yes, the same unaffordable insurance that caused me to take the full time job that I lost. The result is that we will probably insure my husband through his company and I will face a life with NO insurance since I have been denied private insurance due to a pretty bogus pre-existing condition.

I would love to see the problem exposed even more by getting loud mouth right-wing talk hosts and hypocritical members of Congress who have the best taxpayer-funded insurance available but who rail against "socialized medicine" to apply for private health insurance just to see if they could get it. My bet would be that they couldn't. Remember how even cancer survivor John McCain would've been denied the very insurance that he wanted the rest of us to get? What a joke.

Cecil Township, PA

Dear FRONTLINE,

There are three issues that I believe carry much weight that were not discussed in the episode.First is the main cost that drives our medical system into the ground- poor health. Lack of exercise and poor diet contribute more than any other factor to high cost problems like heart disease, high cholesterol, diabetes, and obesity. As a nation, we need to improve the mindset of the citizens by pushing health initiatives like eating healthy, exercising daily, and quitting smoking.Second, I believe uninsureds need some way to negotiate their medical costs. These costs are inflated by providers in order to recoup a greater portion from insurers. Doctors & hospitals should be limited to charging the Medicare-approved rate for services to those without any bargaining power.Third, another culprit in the inflation of costs is the incredible cost of malpractice insurance. Though technology is a major cost for doctors and hospitals, the liability insurance costs that they face are also being passed on to patients and society. These high costs also act as a barrier to entry for doctors who would otherwise become general practitioners. This has moved the delivery of care away from the family doctors to a host of higher cost specialty doctors. Finally, it is up to Americans to decide to live more healthy lives, which will in turn reduce the demand for medical procedures and prescriptions and thus lower costs.Thank you for your reporting.

Charles Rosenbaum
New York, NY

Dear FRONTLINE,

Thank you Frontline for producing this and the "Sick Around the World" episodes. Although we, as Americans, may disagree about healthcare in this country, we need to be aware that along with education, energy policy, and the economy this issue should and must be addressed.

As I see it, and as were discussed in both pieces, there are two essential questions: 1) Should we have some sort of universal healthcare?2) If so, how do we pay for it?

Personally, I believe deeply and with great moral conviction, yes, we should. To me, it is a basic human right. There are many who would disagree, but I think it speaks to what sort of person they are, and I hope there are more who would agree rather than not. As for cost, it will have to be balanced and come from all sectors. Doctors, hospitals, insurance companies (or other healthcare entities/payers), government, and consumers. We all have a stake and we all should make sacrifices and contribute. Idealistic? Perhaps, but I also think it's cold hard realism.

Joel Steinbrecher
Chicago, IL

Dear FRONTLINE,

Until health care comes to be seen as a right, nothing will change, and it only such a change in attitude that will make a single payer system possible. Perhaps if Mr. Long's suggestion is taken, and people only got the medical care they could afford, the true costs would be more apparent--particularly as those costs come to be paid in numbers of bodies, of people dying in their homes and on the streets of this nation. I fear it will take such a Dickensian spectacle to permit the political powers that be to effectively address the problem. In the interim, I expect to work until I die (without medical coverage and precious little medical care), or until I get too ill to work and die in penury.

Des Moines, Iowa

Dear FRONTLINE,

While you did make some good points for folks who are totally uninformed( and never saw SiCKO) it seemed as if this was to promote Obama's health plan. I was also disappointed that all the examples were white middle class folks-no diversity at all. Pretty sad.

Speaking as a long time Single Payer activist it sure would be refreshing to see PBS do a documentary on why Single Payer is the only real solution-interviewing folks from the other countries who have coverage and why they would not want to trade for ours. Debunking all the myths that the other countries' systems are failing and unpopular. More and more states have Single Payer bills going through the legislative process. The public and now more than half of the doctors are supporting Single Payer. Amy Goodman seems to be the only responsible journalist pointing this out on her Democracy Now program. You mentioned Taiwan and could have expanded more on it as a model for the US. It was in the Sick Around the World piece, as I recall.

Lynn Huidekoper,RN
Menlo Park, CA

Dear FRONTLINE,

A daunting task like establishing universal healthcare is best approached incrementally. I suggest step one should be to see to it that everyone gets access to preventive medicine - I mean routine diagnostics. Add to that a substantive effort at public education, letting people know how important it is to get those tests. If you don't tackle preventive medicine first you are making work for yourself in terms of people needing more expensive treatment.

Then you can go after universal repair medicine.

lucy flanagan
seattle, wa

Dear FRONTLINE,

Your "Sick Around America" show was excellent in all respects except one. Once again you held to the media standard of maintaining absolute blackout regarding the option of a "Single Payer" system. Most advanced countries provide superior care, far more efficiently, with less cost without the burden of insurance. Your coverage never included that possibility as proposed by HR 676. And, you stated that President Obama's meeting included all the stakeholders without mentioning that Single Payer advocates were deliberately excluded. Such coverage withholds critical information from the public.

Jerry Reed
Grants Pass, Oregon

Dear FRONTLINE,

I doubt America's health insurance companies are interested in any meaningful reform. Insurance executives with their nine-figure compensation packages and large institutional investors who have fared extremely well under our market-based health care financing system are not willing to give all that up.

Other nations that use private plans do so within a program of social insurance. Their plans are designed for the public good, assisting individuals in receiving the care they need without having to be concerned about the source of payment. They fulfill the insurance function by effectively pooling risks, whether through a single risk pool or though various methods of risk adjustment. Our private plans are based on a business model designed to ensure success in the health care marketplace. Success is defined by the medical loss ratio, spending the least they can on health care. Much of their profound administrative waste is due to their elaborate efforts to avoid paying for care.

The nations with the most efficient health care delivery systems use a single, universal risk pool that is equitably funded. This is most easily accomplished through progressive taxes. If we did the same here in the United States, why would we continue to support the intrusion of the wasteful private insurers who do no more than take away our choice of hospitals and physicians while laying bets on our health?

With single payer, public administration is much more efficient, plus enrollment is a one-time event - absolutely everyone is covered for life.

Representatives for Single Payer are legion. Frontline could do no harm by interviewing them.

Martin Bring
Bellingham, Washington

Dear FRONTLINE,

After seeing both the "health programs" (World vs US), I think Obama should just take the Taiwan system and ramp down Congress to get that pass. I am pretty sure all Americans will support him. We have enough smart people here than can come up with a system w/out the input of the insurance companies. There only two parts to this equation: doctors and patients. I am pretty sure all "good" and conscientious doctors will make all effort to cure the sicks -- the last things they want is to look at the bill. So do the patients -- the last thing they want is to worry about the bill when disasters struck them.

1) Make health care universal2) Train more doctors and nurses -- the universities are monoplizing this and dont make enough efforts to get the more peope through the systems. Today, with so much needs for nurses -- why can't we train them? 3) Get rid of the insurance companies -- we really don't need them.

When I see the bill for $1Millions -- I wonder how is that possible? Someone makes profit on that -- it's sure isn't the sicks. We have a system that acting like a parasite on the sicks -- until we see it that way, it's hard to do much.

Zachery

Zard Zachery
Fremont, CA

Dear FRONTLINE,

Why don't we eliminate the middle man (Insurance Companies).Insurance Companies do nothing to help people get better. They are just a middle man making a profit off the sick I see no reason for them having anything to do with health! It should be illegal for them to have anything to do with medicine. How do they help with anyone's health?I am a diabetic and have survived for 43 years of diabetes having only had insurance for the first 5 years of my disease.Insurance companies are a joke, if you have any illness you are out of luck. No compassion from them.

Petaluma, CA

Dear FRONTLINE,

There is more than enough blame in this entire mess to go around.The real reason health care is such a mess is the same reason the economy is in such a mess. We as a society, value money, more than we do people.

Willard Gatzke
Canon City, Colorado

Dear FRONTLINE,

My father and I just finished watching the piece on America's health care, it was very interesting to say the least. I myself am only eightteen and I am pretty sure I don't have to worry about health problems for a while, but what concerns me are my loved ones. My father is in his fifties, without health care and his only insurance is "Don't get sick". I find this ridiculous and no one no matter what age should have that type of mindset, especially with our technology.

I find it amazing, but not surprising, how our government has let this go out of control for so long. What I find even more amazing is that the American people have let this happen. Do the people who run the insurance companies have no souls? Does the government really care? Or is it just more money in their pockets..? All in all I don't think there is any reason or excuse what so ever, to treat people like this. It is unjust, and I honestly don't know how these people sleep at night.

Hopefully later on in my life this country will finally get it together and make this whole insurance thing work. This is no small issue and cannot be slept upon. If other countries can make it work why not this one? One answer I can think of is, we are one selfish country and everything is about ourselves. As long as the top dogs are making big bucks off of our misfortune, who really cares? We are of no importance to them, we are just the little people that keep them at the top.

So please, become informed and not let them blind you with their haze. Thank you PBS for clearing up that haze and making great programs such as Frontline.

Continue to tell it like it is :)

Renee Park
Los Angeles, California

Dear FRONTLINE,

Thank you for covering this. Now that the middle class is being significantly impacted by job losses, the ridiculous practice of tying health benefits to an employer is finally coming under scrutiny. This is absolutely an economic issue and I'm disappointed that President Obama has decided to take single payer coverage off the table.

Everyone will need health care at some point. This needs to be a shared risk that we bear. Every western nation, except ours, provides this and their health metrics beat ours in every category.

Amy Flynn
Phoenix, AZ

Dear FRONTLINE,

Dear Frontline:

Where in the world did we ever get the idea that healthcare should be just another "typical" consumer good or service that we can either purchase or forgo? Didn't we ever stop to think that the guaranteed health of our citizens, families, and loved ones is not an OPTIONAL thing? Why is it right and proper for government to provide fire department services, police protection services, military services, and legal services - but NOT healthcare services? Who in their right mind would not put healthcare ahead of all these other government-provided services? Who would put up with having to provide a credit card number or a suitable insurance policy before they could summon the services of a policeman or fireman?

How can we possibly think of continuing this uncontrolled profit-intensive healthcare system when by all indications it is an abject failure and a national embarrassment? How many lives must be lost, sufferings prolonged, savings decimated, and bankruptcies endured before we finally decide that the only way for any moral society to provide healthcare for all is to put it at the top of government-provided services?

There are plenty of ways to utilize for-profit market mechanisms but healthcare is NOT one of them. At the end of the day for-profit healthcare is simply immoral.

Jim Thomas
Marietta, Georgia

Dear FRONTLINE,

As Americans we are all faced with this problem of the health care crisis. Yes this is what it is, a crisis. Our government just spent billions of tax payers money to bail out the banks and wall street. It's interesting that our financial health as a nation is more important than our physical and mental health.

The question we need to ask ourselves, and this is the issue, what kind of society do we want to live in? I read on letter on this forum in which the writer refused to pay for someone else. His attitude was pay your own way and leave me out of it. This speaks volumes to me. The subtext of this mans selfish comments, and I bet he considers himself a good christian, the subtext is that in America we are individuals. This is a bastardization of some mythological ideal left over from the frontier age of the 19th century. The fact is there was no period like this. The settlers of the past knew about collective living, their lives depended on it.

It's time we as country grow up and make decisions that are good for our collective good as a nation. I would also like to add that the Massachusetts model is the wrong model to follow, I should know I live here.

I am also so very disappointed with president Obama on so many fronts. From the health care issues to the financial crisis it is clear to me that I voted for a man who has turned out to be nothing more than another politician who is good at being rhetorical without any vision or ability to really solve problems.

The insurance companies are the major problem as I see it.One can also point to the way we educate doctors who end up with enormous debt from all the schooling they go through. When you start to dissect this problem you start to see that our whole system from cradle to grave is broken, the health care issues is just one of the larger problems we a country have created for ourselves.

boston, MA

Dear FRONTLINE,

Where are the people of color? Where are the poor, the working poor, the gay people with AIDS? Your documentary showed precisely two people of color, both of whom are administrators in the "system". Regardless of the intent of the documentary's producer, shame on you for failing to show "all of America" - particularly when so many of the front line of America's healthcare system - the nurses - are women of color, often immigrants. We were truly disappointed in you, PBS! An otherwise great show ruined by your myopic view of who is America.

Marc Matheson
San Rafael, CA

Dear FRONTLINE,

Frontline's Sick Around America touched only the tip of an sick 'health? care system.

Some one should do a documentary on the accounting practices of hospitals? How profit and 'non' profit is dependent on physicians ordering multi and repeatative examinations? How levels of patient acuity are manipulated to increase profit? How prolonged Intensive care stays cover costs of excessive overrides in other departments?

denver, cO

Dear FRONTLINE,

What a journalistic failure. The problem with health care is coverage of people, obviously stricken with Munchausen syndrome [maybe by proxy], who go to the doctor for something like an antibiotic for the common cold. Antibiotics, by definition, don't work with the common cold. The "victims" should be charged for the full cost, and the doctor shouldn't be able to bill a dime to the same plan that I, a non narcissistic "victim", pay into.

I don't mind that 99.9% of my premiums pay for people like the cute girl with Lupus who died. I am disgusted that the vast majority of my premiums pay for painfully stupid "victims" who go to the "doctor" for a sniffle, and insist on coverage, and thus cause the death of people who really need coverage that I grudgingly pay for. The blood of the cute girl with Lupus who died is on the hands of every "victim" who goes to the doctor with what is obviously an untreatable common cold.

I'm disappointed in the recent Frontline producers who can't ask the real questions. Dot con rocked, but it's like Frontline production was taken over by suburbanites with degrees from CU in ethnic studies or something. I think I'd rather watch Fox News for entertainment.

Phil Kaplan
San Francisco, CA

Dear FRONTLINE,

As a family physician, I have witnessed 33 of my primary care collegues bancrupt, close their doors without a buyer, or change careers in the last 7 years. Meanwhile, we have twice as many ER physicians and hospitalists in my town. What this means is that if you live here and don't have a primary care physician you get your care later in the disease process and at a higher cost. Please don't talk to me about physician prices, being a family phyisican is like being a family farmer or small grocer, we are getting killed in the marketplace and the public needs to wake up to this fact and stop lumping us with specialists bringing down a half million a year.

John Bender
Fort Collins, CO

Dear FRONTLINE,

We need universal health care, with whatever streamlining and rationing it will require. There are too many people who have done everything right, but just don't happen to work for a major employer. So they get to die or go bankrupt when they get a serious illness? Do we have to choose our jobs by the type of health insurance, regardless of our skills? I think we have to ask ourselves if someone deserves to die because they are under-insured, unemployed, self-employed, bankrupt, work for a small company, a new college graduate, widow, or full-time caretaker (those were just a few examples). This documentary did a great job of showing how those too young for Medicare and newly graduated from college are particularly vulnerable.

Sandi Dooley
Libertyville, IL

Dear FRONTLINE,

To say that I'm scared is an understatement. I, like Nikki, have a chronic condition that appeared with no rhyme or reason. No doctor, none of my six specialists can tell me how it came about and NO PREVENTATIVE ACTIONS (I was never a smoker) would have made a difference! I hit the jackpot on the "rare not so rare" disease list. And there are many like me who need real medical care, not just a checkup every year.

Medical insurance is life and death issue for me, but only because it opens access to medical care. I have insurance that I bought on the private market when I was well, but it is hard for me to afford the doctors' appointments and CTs that I desparately need to determine my current status. My insurance is better than most, but it only covers 1 doctor's appointment a quarter and only $1000 of one procedure a day. Many days I feel as if America is telling me to die, which really pisses me off, because with access to regular care I believe that I can keep this "monster" in the box. Some symptoms exist, but I have to ignore them and am putting off a trip to a specialist until I can afford the co-pays. Folks this is the reality of healthcare in America; most people even if they have insurance face crushing debt (and the possibility of not having an income source if you get well). The healthcare debate is NOT about insurance coverage... It is about whether Americans truly understand and are willing to embrace the value of creating the right to medical treatment without the stress of financial ruin and being a "loss" on some company's income statement.

Irving, TX

Dear FRONTLINE,

You're program on healthcare was disappointing and slanted. The bulk of the interviews were of people in the healthcare industry, the heads of the companies or people who represented the industry as a whole. I saw only two physicians who didn't represent the healthcare industry interviewed. Dr. Delbanco works at a large tertiary hospital and thus does NOT have to deal with the day to day rigors of having to battle with health insurers for services, medications, etc. The general public has very little idea of how their insurers attempt to insinuate themselves into people's personal and private lives. The dirty little secret of the insurance industry is that if one had the opportunity to look at their ledger sheets, the number one item on accounts payable would be administrative costs and not reimbursements. This program sadly did nothing to confront the way the health insurance industry is run.

Michael Katz
Norwell, MA

Dear FRONTLINE,

Let me add my voice to the others who wish that this program had discussed the option of a single-payer system. Can America afford the continued existence of the private health insurance industry?

Oak Park, IL

Dear FRONTLINE,

The first thing to be done is identify the true culprit here -- False Costing. Then take away the "false buffer" that exists. The Insurance Companies selling health insurance. Let insurance companies sell their other products for a profit. Such as car insurance, life insurance, flood insurance, etc. These are rare events that strike randomly. Let the insurance companies play in these sandboxes. Then we can concentrate on the real problem which is a run away cost process within the actual health system. One which we cannot clearly see now. But take away the "buffer" and suddenly the air will clear revealing a greedy system that feeds on the people's fear of being hurt and dying. Do you ask the cost of fixing your broken leg as you lay there in pain? Probably not, and this is the root of the problem. When we buy a product in a store it is clearly labeled with the price and we can make a decision. Why is this opportunity denied us in the health system? The health system is important to us all, just like the water we drink and the utility system. These are price regulated. Why not the health system?

Shreveport, LA

Dear FRONTLINE,

It is utterly dissapointing that the program spends so little time talking about solutions; analyzing and comparing the data, the arguments and the criteria that seperate the key proposals for a solution going forward. In illinois, the health care justice act, sponsored by then State Senator Obama created a comission to study key proposals for achieving universal healthcare in Illinois. Eight proposals were put forward, most by insurance industry backed groups. The most cost effective solution by a wide margin was the single-payer proposal. It was estimated to cost Illinois tax payers around $600 million per year. Incedentally, that turns out to be near the amount in combined reported operating profits by Illinois' health insurance industry.

This is the kind of information we need to see in order to fuel a truely constructive national dialog. How many single-payer spokespeople did you have on the program? I didn't count one. How many industry spokespeople did you have on the program? A half dozen.

What kind of public-interest reporting is this?

I'm again dissapointed by Frontline.

Dorian Breuer
chicago, il

Dear FRONTLINE,

While you have presented a lovely apologetic for socialized medicine, you completely ignore the lack of transparency in health care cost and quality. If I walk into an emergency room with a broken finger under current circumstances no one within five floors, possibly even 100 miles, can tell me how much it will cost. No wonder costs are out of control. Rather than trumpeting ideas like forcing everyone to purchase health insurance and fixing wages and prices, how about proposing medical providers and insurance companies be forced to notify consumers of the cost of service in advance (including the enormous discounts offered to large insurers). If I can get a good faith estimate from my auto mechanic, why is it that a bunch of MD, PhD, and MBA's are too stupid to do the same.

Scott D
Springfield, VA

Dear FRONTLINE,

President Obama, reportedly, has declared that a single player health plan is "off the table" in his administration, deliberations on health care reform. I found it deeply disappointing that Frontline, in "Sick Around America", also clearly chose to take the concept of a single player health care plan off the table. What a shame, to be left wondering if PBS and Frontline's editorial judgement has been compromised by the influence of the for profit health care industry.

Larry A. Unruh
Chicago, IL

Dear FRONTLINE,

Thank you for your efforts tonight to show viewers a few of the glaring shortcomings of the U.S. medical insurance system, as well as your past coverage of how our medical insurance compares to other systems from around the world. Given this body of coverage, then, it seems to me it would have been logical tonight to discuss alternatives to our system; to take this moment in time to show viewers how other developed nations have been able to develop systems that deliver high quality medical care at lower costs. It is not news to us that the U.S. health insurance system is broken. It is news to consumers that other nations do it better. If debate continues to be limited to the insurance architects we saw tonight, this nation is doomed to the idea that underwriting, or rescision, or whatever buzzword is now in vogue to describe medical insurance denial, is acceptable.

Pat Motherway
Oakdale, Minnesota

Dear FRONTLINE,

Health care is not a right and we shouldn't try to make it one. The American people need someone to tell them that if they get sick it is their own personal responsibility to pay for it. The government should not be forcing individuals to subsidize others health care costs, and yes that goes for the people on medicare and medicaid too.

The best way to solve the healthcare "problem" is for the government to get out of the health care business. Let's put an end to medicare and medicaid and tell people that if they get sick to pay for it themselves. If they can't pay... then too bad.... that's your problem not mine.

Hugh Long
Atlanta, Georgia

Dear FRONTLINE,

The last visit I made to my doctors I was the only person sitting and waiting to see the doctor and whilst I sat there, a never ending line of prescription drugs reps walked in and dropped off samples for promotion to my doctors patients, there is only one word for this kind of activity and that is OBSCENE.It is time now for the USA to revamp the system and throw out all the people and corporations in this industry that are bitten by the greed weed and also make every single citizen contribute to a better health care system, every other country on the planet earth has better than us and it should be unacceptable to us here in the USA to have anything less

st charles, missouri

Dear FRONTLINE,

Until we all share the costs of health care as a nation, we are all at risk. Many of us make just enough to not qualify for help paying for health insurance. In Massachusetts having health insurance has been mandated. I got on board and did my share to join the system. It went from about $600 to $850 per month for just one individual, certainly not affordable. I also do not see any cost containment, or needed reductions. It is no longer possible to afford this "slanted system". Every month I paid into insurance, the less I had to pay those who actually provided me good medical care, such as my dentist. I was being forced to choose between having insurance and putting my money into real health care such as dental fees. As individuals we are one illness away from financial ruin.

We as individuals and families are bring told that we are too costly to insure, while most of us pay taxes to support the health insurance coverage of municipal workers, teachers, police officers, our legislators, state and federal employees, service men and women.

We as individual citizens are not looking for free health care. We do however need and demand a system that is fair to all. As long as we send our dollars monthly to the insurance companies we will always be at their mercy for rescision, for for monthly increases. My dollars are my vote and I for one am not willing to pay until the system is reformed to fairly share the burden of health care.

Vineyard Haven, MA

Dear FRONTLINE,

[This] documentary portrays so much of what is wrong with the health care financing industry in this country. My daughter's insurance company denied her claim for coverage of a complication of delivery, and after two appeals, a letter from the Obstetritician, and enlisting the aid of a billing advocate, the company rescinded its decision and paid, twelve months after my grandson was born. How many people would have just given up and paid? Or gone bankrupt? I am one of the 59% of American physicians who suppports Single Payer healthcare reform.

Carol Paris
Leonardtown, MD

Dear FRONTLINE,

Thank you, Frontline, for your inspiring programs first on health care around the world and now on health care in the U.S. We should draw three conclusions:

1. As Dr. Delbanco stated so eloquently, the first step is to provide health care to everyone. Only then, and at the same time, should we tackle the problems of cost and quality. If we wait to expand health coverage until we have succeeded in curtailing costs, we will wait forever and acquiese in the suffering of those without access to the care they need.

2. If we truly want everyone to have health insurance, we need to provide it to them, i.e. to make signing up as autonmatic and easy as possible. Mandates to purchase health insurance are inefficient, expensive, incomplete, and unnecessary.

3. To make universal health care as efficient and inexpensive as possible, we need to institute a single payer system, i.e. to eliminate the hassle imposed on patients and providers by the private insurance system and eliminate the waste of health care dollars in marketing, claims processing, administrative salaries, and profits. The models are the single payer bills introduced by Representative Conyers in the House and by Senator Sanders in the Senate.

Thank you again, Frontline, for teaching us these lessons.

Paul Sorum
Schenectady, New York

Dear FRONTLINE,

The insurance consultant's conclusion is that patients, doctors and hospitals should all take less. Naturally, he makes no mention of the insurance and pharmaceutical companies' exhorbitant profits. If we took those profits, we could cover the cost of health care for everyone in this country. In our country, we have the insurance companies running the system for their own profits and people be damned! Health care should not be a profit-making enterprise, it should be a right for everyone in the US. I think the only answer is a single-payer system and we can design one that fits our country. It will be more cost effective and will bring decisions about medical care back to the physicians and the patients, and not leave it to the insurance companies to say who can get care and who can not based on their profit-making needs.

Euthemia Matsoukas
Delmar, New York

Dear FRONTLINE,

I am a physician in private practice (pathology) in Wisconsin. Your program made some very good points, with the usual big insurance versus physicians versus government issues pretty well explored. From a physician's standpoint, it is a constant source of annoyance to be held up for ridicule for what is seen by the public to be excessive income. While many physicians do earn solid six figure incomes, look at the level of skill and training they require (8-10 years or more of expensive medical school and further training AFTER college before making any serious money)! By the way, even the best paid and most highly skilled physicians' compensation pales in comparison to the $100 million plus BONUS paid to the CEO of United Healthcare Insurance in 2005! Why do people balk at the thought of a neurosurgeon, for instance, making a half million dollars or more a year for arguably the most technically skilled job in the world, working inside human brains where the slightest slip or mistake could easily be fatal, and not complaining at all about their favorite NFL quarterback getting 50 times that or more per year to play a game, or a corporate CEO who can make a neurosurgeons LIFETIME income in a single "bonus"! Where are our priorities???????

James Kranz
Kenosha, WI

Dear FRONTLINE,

Sick Around America" is a good assessment of the sorry state of health care in our country, but there was one glaring omission--the possibility of a single-payer system. A discussion of an expanded "Medicare for All" system should have been a part of this program and should be on the table in Obama's health care reform plans. As Harvard professor Uwe Reinhardt said in the program, cutting the administrative costs of the health insurance companies would easily pay for all the uninsured. In other words, by eliminating the health insurance industry as middleman, we solve the health care crisis. Medicare for all makes both good business and moral sense. Are our legislators brave enough to take this step?

Carolyn Ferguson
Pittsburgh, PA

Dear FRONTLINE,

Time to move beyond story after story of the dysfunctional, for profit U.S. health insurance system; the public is ready to learn how "other developed countries" manage to provide health care for everyone. Frontline had nary a word about single payer system. Oddly, there was no mention of the highly popular U.S. single payer insurance called Medicare. Have you ever met a 65 year old person willing to forego Medicare because it is a government program? I am disappointed that Frontline did not provide basic information about how a European country or Canada manages national healthcare, including the "premiums" that the citizenry pays.

Phyllis Stutzman
Goshen, IN