If you haven’t seen this movie by Michael Moore yet, I highly recommend it. This movie does an excellent job of showing the state of healthcare today in human terms. I mentioned that I had watched the movie to some fellow nurses. Many people commented that “socialized” medicine had terrible consequences. I found these comments interesting given the terrible cost of capitalist medicine in this country for the average insured person. As a nurse, patients often express their anxiety about getting their bill or comment that their insurance company has denied their claim. We are all aware that some of the people we care for will simply not be able to pay their bill. I think we sometimes forget that these are not people who are among the uninsured. There are many people WITH insurance who will be financially destroyed because of their medical bills. These are the people Michael Moore chronicles in this film.

Another striking point of the film is that the American people have been fed a steady stream of propaganda about the terrible state of healthcare in countries with universal health care. As I watched this sequence I had the sinking feeling that our politicians are not representing their constituents (the people), rather the constituents they represent are those corporations able to write checks large enough to fund their reelection campaigns. My $50 or $500 dollar contribution to the campaign of a politician I support pales in comparison the $500, 000 check someone with deep pockets can contribute. Do we honestly think that we will be equally represented by that politician?

We have to confront the reality that our system is designed for businesses (read: insurance companies) to make a profit. It is in the best interests of these businesses to spend as little on us as possible. Healthcare in other countries that provide coverage to everyone probably is not perfect, but the system is not set up so that a business will profit from your illness by denying your claim. I cannot tell you how many times I have had an insurance company refuse to authorize the treatment prescribed by one of the physicians I work with.

The process goes something life this: 1) Dr. X writes a prescription to treat Johnny’s chronic illness. 2) The insurance company denies the claim when Johnny tries to pick up the medication. 3) Johnny calls the physician’s office to tell them what happened. 4) The nurse calls the insurance company to find out why the medication is not covered. 5) The insurance company has some reasons that makes no sense, medically. 6) the physician submits a letter of medical necessity. 7) the insurance company still denies it. The physician or nurse talks to a physician for the insurance company to explain why the treatment is necessary. 9) Hopefully, it gets approved eventually.

This process takes days or weeks. Think Johnny’s health is improving in this time period? See how that your insurance company has a lot to do with how your physician determines your treatment plan?

We have to change our healthcare system. We have to find a way to make it impossible for anyone in this industry to make money off keeping people from getting well in the best way possible. Look at the healthcare plans the current presidential candidates are proposing and ask yourself if these plans take the profit for private corporations out of the equation.

Nurses have a responsibility to participate in advocating for this change along with other medical providers. We are on the front lines of healthcare and have the ability to convey the impact of the current system on the health of our patients. We can tell these stories, write letters to our representatives, think when we vote, and be sure to tell our friends and families what we know. See Sicko and start talking about what you know.