* In the ensuing court case, a doctor admits to denying her request without having reviewed it.
o Blue Cross of California approves one woman's $7,500 treatment, but the approval is later denied for her failure to report a previous medical incident - a yeast infection.
* "They're just looking for a way out," she says
* Other examples of how health insurers avoid paying for treatment:
o One graph (from Humana) shows that doctors with the highest % of denials get a bonus.
o Michael Moore interviews a former health insurance employee who specialized in denying care to patients retroactively - by finding inconsistencies in their medical records.
o A 5-minute piece in the beginning of the movie .
* The film also focuses on the politicians and the funds they raise from Pharma and other player in the health care industry and alleges that the system has been heavily influenced by lobbyists and contributions.
Barclay Fitzpatrick
Vice President
Corporate Communications
Capital BlueCross
MichaelMooreTalkingPoints61807.doc
Blue Cross and Blue Shield Association
Talking Points in Response to Michael Moore's "Sicko"
June 2007
1) The Blue Cross and Blue Shield Association (BCBSA) and the 39 Blue Cross and Blue Shield companies are committed to improving the U.S. healthcare system for our nearly 100 million members through continuous innovation that reflects the ever-changing healthcare landscape and the needs of the consumer.
2) The Blues recognize the need for improvement of both the coverage and delivery of healthcare. But the divisive tone set forth by Michael Moore and his movie "Sicko" is not helpful. Positive change to our healthcare system can be best achieved through shared responsibility, not recrimination. To ensure Americans have access to the best healthcare that is both timely, efficient, and of high quality, requires the collective contribution of all stakeholders -- consumers, providers, employers and the government.
3) The Blues participation in the Health Coverage Coalition for the Uninsured is a primary example of how the broader healthcare community is working together to reduce the number of uninsured in the United States.
4) The Blues are working on myriad initiatives that ensure Americans have access to quality and affordable healthcare. Each day, Blue Plans across the country are bringing healthcare value to their members in a number of ways such as new advances in health information technology and greater access to cost and quality information. In addition:
o The Blues recently created Blue Health Intelligence a data resource that will shine light on emerging medical trends and treatment options in an unprecedented way. To further the use of evidenced-based medicine, BCBSA has called upon Congress to establish an independent, payer-funded institute that will study the comparative effectiveness of new and existing medical treatments and procedures.
