Sicko Page #2

Over 25.000 people

had sent me

their healthcare horror stories.

Some of them decided

not to wait for me to get back to them.

Like Doug Noe. Who took matters into

his own hands. Without my permission.

His daughter was nine months old when

they discovered she was going deaf.

His health insurance company.

CIGNA.

Said they'd pay for an implant

in only one of her ears.

According to the letter they sent.

It's experimental

for her to hear in to ears.

If a cochlear implant

is good for one ear,

it doesn't even make any sense that

it wouldn't be good for the second ear.

Especially when a child

is just starting to learn how to talk,

she has to learn

from both sides of her head.

(Moore) That's when he sat down

to write CIGNA a letter.

This is to CIGNA.

"Noted filmmaker Michael Moore

is in the process of gathering information

for his next film."

"I've sent information concerning CIGNA's

lack of caring for its policy holders."

"Has your CEO ever been

in a film before?"

(Moore) Before he knew it. He received

a call on his voice mail from CIGNA.

(answerphone) Tuesday. 8.:54 am.

Obviously all this worked because Annette

is going to get her second implant in July.

(woman) "Dear Mike.

I work in the industry. "

(woman #2) "I work for an HMO."

(Moore) I started to get hundreds of letters

of a different sort

from people who work inside

the healthcare industry.

They'd seen everything

and they were fed up with it.

(man #2) "Health insurance

companies suck. Flat suck. "

(Moore) Like Becky Malke. Who was

in charge of keeping sick people away

from one of America's

top insurance companies.

(Becky) I work in a call center, so people

call in and ask for insurance quotes.

There are certain preexisting conditions,

basically industry-wide,

that will not be covered -

diabetes, heart disease,

certain forms of cancer.

If you have these conditions, you are likely

not going to get your health insurance.

(Moore) How long is this list of conditions

that make you ineligible?

It would be a really long list.

It would be a long list.

It could wrap around this house.

(# "Star Wars" theme plays)

Sometimes you know they're gonna

be declined at the end of the application,

and they're like...

God, like one time I had a couple,

and they were so happy to get...

I'm gonna cry.

They were so happy that they were...

I took them through this application.

And the husband was late for work.

And the wife said to him,

"Don't worry, baby, it's gonna be OK."

"We have health insurance now."

And when I looked, I could tell

they were gonna get declined

because of their health conditions.

And they were so happy.

I thought, "God, they're gonna get

that call in a couple of weeks

telling them

that they're not eligible for insurance."

I just felt so bad

'cause I just really thought

and I knew

and I couldn't say anything to them.

I just felt like crap.

That's why I'm such a b*tch

on the phone to people,

because I don't wanna

get to know them,

I don't wanna know about their lives,

I just wanna get in and out,

and get done with it

'cause I can't take the stress of it.

(Moore) In spite of Becky being

a bit of a pain on the phone.

A quarter billion Americans

are still able to get health insurance.

Let's meet some of these

happy insured customers.

Maria has BlueShield.

And Diane. Horizon BlueCross.

BCS insures Laurel.

And Caroline has CIGNA.

And it's a good thing

that they're all fully covered.

I ended up being diagnosed

with retroperitoneal cancer.

- Brain tumor.

- Breast cancer.

Brain tumor on the right temporal lobe.

(Moore) As they were insured. They got the

red-carpet treatment at the doctor's office.

She requested for me

to see a neurologist.

The way they would treat it

was to remove it.

Surgery was scheduled

for December 9.

There is a test that you can take

that will show whether or not

you would benefit from chemo.

(Moore) They got their treatment. But not

before battling their insurance companies.

Investigated whether or not

this was a preexisting condition.

"It's not medically necessary."

They claim that it's experimental.

"We don't consider that life-threatening."

(Moore) Diane died

from her non life-threatening tumor.

Laurel's cancer is now spread

throughout her body.

Her "experimental test"

proved that Caroline needed chemo.

While vacationing in Japan.

Maria became ill

and got the MRI that BlueShield

of California had refused to approve.

The doctors in Japan

told her she had a brain tumor.

BlueShield had said repeatedly

she didn't have a tumor.

That's when she said:

"Well. I'm pretty sure I have a lawyer."

(man #3) March 13, 2003.

I'm gonna direct your attention

to exhibit one.

Please describe for me what it is.

It is a denial for referral

to an ophthalmologist.

- (man #3) Is it your signature on this?

- Yes.

(man #3) I'd like to direct your attention

to exhibit two.

This is a denial

of a request for referral

for a magnetic resonance imaging test

of the brain.

- (man #3) It has your signature?

- Yes.

(man #3) Directing your attention

to exhibit three. Please read this document.

This is a denial of a referral

to a neurosurgeon.

(man #3) Can you explain for me

how you came to sign the denial letter?

This is a standard signature

put on all denial letters.

- (man #3) Is it your signature or a stamp?

- That is a stamp.

(man #3) Did you ever see a denial letter

before your signature was stamped on it?

No, but the denial letters

are fundamentally the same.

The denial letters that are sent out...

- (man #3) The answer is no.

- No. All right.

The definition of a good director was

somebody who saves the company money.

(Moore) Dr. Linda Peeno

was a medical reviewer for Humana.

She left her job because she didn't like

their way of doing business.

(Dr. Peeno) I was told when I started

that I had to keep a 10% denial.

Then they were giving us reports weekly

that would have all the cases we reviewed,

the percent approved

and the percent denied.

And our actual percentage denial rate.

Then there would be another report that

compared me to all the other reviewers.

The doctor with the highest percent

of denials was gonna get a bonus.

(Moore) Really? So you, as a doctor,

working for the HMO,

if you denied more people healthcare,

you got a bonus?

(Dr. Peeno) That was how they set it up.

Any payment for a claim

is referred to as a medical loss.

That's the terminology

the industry uses.

I mean, when you don't spend money

on somebody, you deny their care,

or you make a decision that brings

money in and you don't have to spend it,

it's a savings to the company.

(Moore) This is Tarsha Harris.

BlueCross didn't deny her

her treatment.

And actually approved her operation.

But then they discovered

that in the distant past.

She had had a yeast infection.

Apparently it's common.

Men, women can get a yeast infection.

Rate this script:5.0 / 1 vote