SiCKO: the 15 Year Reunion

In spring of 2007, Michael Moore released a blockbuster documentary showing the extraordinary damage the U.S. healthcare system inflicts upon ordinary Americans. Story by story, SiCKO pulled back the veil of how ordinary illness and injury, when paired with deadly healthcare profiteering, leads to suffering, financial ruin, and even death.

15 years later, together with our friends at Progressive Democrats of America, we are bringing together the patients featured in SiCKO, whose extraordinary stories impacted Congress, shaped the Affordable Care Act, and helped to launch the modern Medicare for All movement.

Show Notes

Our guests today are:

  • Donna Smith and husband Larry experienced financial ruin after multiple health crises forced them into medical debt, bankruptcy, and the loss of their home.
  • Adrian (Campbell) Montgomery, despite being fully insured, had to drive to Canada to get affordable treatment for cervical cancer.
  • Reggie Cervantes was a 9/11 first responder who has suffered from lung issues caused by her lifesaving work in New York City.
  • Lee Einer was a health insurance company “hit man,” whose role was to find any loophole to avoid paying large medical bills. Since then he’s become a whistleblower, shining a light on fraud and dirty tricks by the healthcare industry.

SiCKO was released just in time to have a major impact on the 2008 Presidential elections, and – I think – really helped push healthcare to the top of the agenda within the Democratic Party, which won the Presidency, the House, and the Senate. This led to the Affordable Care Act, which although it preserved the profits of the healthcare industry and was FAR short of a just or affordable system, addressed exactly some of the health insurance industry’s most disgusting practices that were featured in the film.

Aside from the ACA, the film was also a major event in the Medicare for All social movement, which grew tremendously across the country. Gillian shares how the film convinced her that her struggles with the healthcare system wasn’t just a personal problem, but a systemic problem for the whole nation. That launched her into healthcare justice organizing.

Thanks in large part to SiCKO pulling back the curtain on the worst behaviors of the insurance industry, a number of those practices were banned by the Affordable Care Act, including:

  • Denying coverage to people with pre-existing conditions;
  • Recissions (retroactively canceling your insurance coverage); and
  • Lifetime caps or annual caps on coverage.

Has anything changed for our guests?

Donna shares that without the ACA she would never have been insurable, and her health forced her to leave the job that provided her with employer insurance. The expansion of Medicaid was also a huge step for people without insurance. But since then, we’ve seen the insurance companies make even more money, and we’re facing more attacks, including the efforts to privatize Medicare. The biggest change for Donna is that she has aged into Medicare, and now knows the security of having coverage.

With her previous cancer diagnoses, Adrian acknowledges that due to the ACA ban on denying coverage to patients with pre-existing conditions, she’s insurable, but not much else has changed. Her insurance company vetoed her doctor’s plan of care for her third bout with cancer, and made her go through a different surgery before they’d cover the hysterectomy her doctor determined she needed. She almost died during that surgery, and after all of that, it wasn’t successful.

Reggie also recently became eligible for Medicare, but dealing with the managed care system is still a nightmare. It took her 9 months to get approval for the care needed for uterine cancer because the insurance company disagreed with her oncologist’s plan. She moved from Oklahoma because she didn’t have access to specialists that she does have now in California.

Lee notes that the ACA made a big difference by eliminating asset testing for Medicaid (for which eligibility now is determined only by income. Before the ACA people would have to spend down all of their assets and go into poverty to qualify for Medicaid.) Unfortunately the ACA didn’t take away the profit motive, and the insurance business model of profiting more by denying needed care. And for most Americans, our medical care is still tied to our employment status. Finally, an estimated 70,000 Americans die from lack of access to healthcare.

Gillian shares a question from Healthcare-NOW friend Cathy Courtney in Texas: She is concerned that her friends’ “political leanings have prejudiced their opinions against what they view as ‘Socialist’ in their immersion in our Capitalist healthcare system…. alas…How can we communicate beyond the choir?”

Lee suggests talking to those people about their own self interest, not politics. How would they feel if they lost their healthcare, their home, or a loved one because the insurance company denied them care? Medicare for All is in the self interest of all working Americans. Stick to the bread and butter issues that impact the people you talk to.

Donna notes that everyone but the super-wealthy suffer from the same trauma due to our healthcare system. We shouldn’t shy away from having those conversations with our neighbors. Focus on how much money we could save if we weren’t paying premiums and co-pays and deductibles, while still having trouble accessing care.

Reggie wants us to humanize the situation. We all know someone who has gotten sick or even died due to lack of care. And we all know people – even with insurance – who have skipped care due to the overwhelming fear of being swamped by medical costs.

Adrian uses the term “peopleism” instead of socialism, to keep the focus on the people who need care.

Lee also shares the pro-business argument for M4A: the cost operating within the dysfunctional American healthcare system has to be built into the cost of all goods and services in the United States. Even if an employer doesn’t provide insurance, they deal with the cost of turnover, recruitment and training when an employee gets sick or dies. This is a competitive disadvantage for any American company doing business in the global marketplace.

Alan Minsky, the Executive Director of PDA, joins us to close the podcast with thoughts on what we need to do next. Alan highlights that we have strong Medicare for All bills, with more co-sponsors than we’ve ever had before. (HR1976 – Jayapal and S.4204 – Sanders). Organizing at the state and local level has built momentum over the years, with more and more Democrats signing on as co-sponsors. With dozens of Democrats retiring, we could come out of the 2022 elections with dozens more Medicare for All supporters in Congress. To keep the momentum going will require us to get involved in organizing, elections and pressuring our elected officials.

One way to build momentum is to volunteer for the Healthcare Census. Our goal is to interview 10,000 Americans between now and the end of the year. Anyone with any level of experience can participate. Please visit the link to volunteer.

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