Sicko' a pain in the neck for health care industry

[Guest guest]

Sicko' a pain in the neck for health care industry

Uncomfortable attention on insurers, drug companies

Colliver, Chronicle Staff Writer

Saturday, June 30, 2007

In " Sicko, " his new film assailing the U.S. health care system,

filmmaker doesn't try to be fair to health insurers and

pharmaceutical companies.

That's because -- the man behind anti-Bush " Fahrenheit 9/11 " and

pro-gun control " Bowling for Columbine " -- makes no pretense of

balance. He has a point of view: Greedy pharmaceutical companies need

to be much more tightly regulated. And health insurers? They shouldn't

exist at all, replaced instead by government-subsidized health care.

It's safe to say the health care industry looked forward to the film's

opening Friday about as much as they would to open-heart surgery.

All the same, industry representatives tried to downplay the potential

impact and insisted the film was causing them nothing more than a mild

case of angina.

" Unfortunately, this is a Hollywood editorial. It is not a documentary

and it should be seen as such, " said Mohit Ghose, spokesman for

America's Health Insurance Plans, the industry trade group. " He

() made no attempt to contact us ... about the issues he raises

in the movie. "

Ghose said he has no plans to see the film. But many insurance

insiders admit to having already seen the film in previews, clips or

in a bootlegged copy that appeared briefly on the Internet almost two

weeks ago.

builds his case against managed care through a series of

anecdotes: a woman whose health insurer denied treatment on the basis

she was " too young " to have cervical cancer; another who was billed

for an ambulance ride after a car accident because she failed to get

the trip " pre-approved. "

Some cases are heart-wrenching, such as a Kansas City man who died

from kidney cancer after his insurer deemed his treatment options

" experimental. "

Focus on talking points

As part of its damage-control strategy, insurance industry executives

talked among themselves and agreed to focus on a few " talking points. "

They say they encourage debate about health care reform and support

initiatives to reduce the number of uninsured Americans.

Insurers decided it was not in their interest to enter a public battle

of wits with , whose " Fahrenheit 9/11 " was the top-grossing

documentary of all time.

" We all agreed that taking the high road as opposed to taking on

is what we wanted to do, " said Schiffgens,

spokesman for Kaiser Permanente.

Troughton, spokeswoman for WellPoint Inc., the parent company

of Blue Cross of California, said there was no " strategy on our part

to handle this in any specific way. "

" There's a difference between the movie, which is more of a one-sided

piece of entertainment, versus what really needs to happen, which is a

dialog and conversation at all levels about health reform, " she said.

Kaiser's rebuttal

Still, many companies have taken it on themselves to clarify the ways

they believe they've been misrepresented in the film.

Kaiser, headquartered in Oakland, posted a rebuttal on its Web site to

the way it was portrayed in specific portions of the film.

The HMO features prominently in a 1993 case involving 18-month-old

Mychelle . The little girl died from a blood infection shortly

after being transferred to a Kaiser hospital from Luther King

Jr. /Drew Medical Center in Los Angeles.

While the film contends she died because Kaiser refused to authorize

tests that would have determined her condition, Kaiser said it was a

case of medical malpractice, not denial of treatment. The jury found

both doctors involved to be liable, with King/Drew responsible for 75

percent of the more than $1.35 million in damages and Kaiser for 25

percent.

Kaiser also took issue with the film's portrayal of a conversation

between Nixon and Ehrlichman, in which the former

president's top domestic adviser urged him to set rules authorizing

the health maintenance organization structure. He cited Kaiser as an

example, arguing that its model of medicine provided less care and

therefore made more money.

" Ehrlichman's distorted paraphrase badly misrepresents Kaiser

Permanente, its goals, its strategy and its not-for-profit model, "

Kaiser's Web site states.

As for a segment in which Kaiser is accused of dumping an indigent

patient near a Los Angeles shelter, Kaiser admitted to handling the

transfer " very badly " but called it an isolated incident. Kaiser said

it has changed its practices to prevent the inappropriate discharge of

homeless patients.

Blue Shield of California, based in San Francisco, said did not

tell the full story in the case of Watanabe, a woman who

explained in the film she was denied an MRI and finally received one

in Japan, where she discovered she had a brain tumor. The filmmaker

ends her story by saying she hired a lawyer.

" Blue Shield was completely unaware of the women's medical condition

until we were sued, and we prevailed in a jury trial. The filmmaker

was aware of the trial and undoubtedly knew the outcome, " Blue Shield

spokesman Tom Epstein said.

Blue Cross of California declined to discuss the case of a woman whose

policy was retroactively canceled for failing to disclose she had a

yeast infection. The company said the case was " favorably settled by

both parties. "

A pharmaceutical-makers' trade group fired off an early counterattack

with a press statement in May accusing of producing a " biased,

one-sided attack. " The industry, which plays a smaller role in the

film than it apparently expected, has laid low in recent weeks.

Enough said

For his part, has said he didn't try to hunt down industry

executives as he famously did with General Motors in " & Me. "

Industry -- pharmaceuticals in particular -- already has had more than

enough say, he argued.

" The nightly news seems like every other ad is a pharmaceutical ad.

Their story is told over and over again every single day. This is an

attempt for two hours during the whole year -- two hours, the length

of this film, to say here's the other side, " he told the Seattle Times.

This article appeared on page C - 1 of the San Francisco Chronicle

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2007/06/30/BUGOPQOIJT1.DTL