Reminder: NY Premiere of Money-Driven Medicine This Thursday (Clip from the Film Below)

Alex Gibney, best known for his 2005 film, Enron: The Smartest Guys in the Room  and his 2007 Academy Award Winning documentary, Taxi to the Dark Side has made a 90 minute documentary of my book, Money-Driven Medicine: The Real Reason Health Care Costs So Much

The Century Foundation and the New York Society for Ethical Culture are co-hosting the New York premiere on June11,  7p.m.  at the New York Society for Ethical Culture, 2 West 64th Street at Central Park West. Doors open at 6:30.  Admission is free.  If you’re planning to attend, please RSVP  Loretta Ahlrich ahlrich@tcf.org  or (212) 452-7722 so that we can have a rough idea of how many people will be coming.

Alex Gibney will be there, and following the screening, he will take questions about film-making and I’ll answer questions from the audience about healthcare and healthcare reform.  
Here’s a clip of the opening sequence of the film: 

About the Film

Money-Driven Medicine explores how a profit-driven health care system squanders billions of health care dollars, while exposing millions of patients to unnecessary or redundant tests, unproven, sometimes unwanted procedures, and over-priced drugs and devices that, too often, are no better than the less expensive products they have replaced. As I have said on this blog, this isn’t just a waste of money. It’s ‘hazardous waste’—waste that is hazardous to our health.

In remarkably candid interviews both doctors and patients tell the riveting, sometimes funny, and often wrenching stories of a system where medicine has become a business. “We are paid to do things to patients,” says one doctor. “We are not paid to talk to them.”

Patients and physicians star in the film. They include Dr. Don Berwick, author of Escape Fire and founder of the Institute for Health Care Improvement , and Dr. Jim Weinstein, Director of Dartmouth’s  Institute for Health Policy and Clinical Practice.  ( Dr. Jack Wennberg,  the founder of what I often refer to as “the Dartmouth Research” passed the torch to Weinstein  in 2007.)

Lisa Lindell, a HealthBeat reader, patient advocate and author of 108 Days, also appears in the documentary, talking about her husband’s experience in a Texas hospital after he was seriously burned in a freak industrial accident.

How Physicians Inspired Money-Driven Medicine

I narrate the film, and in the course of the narration, recall how the story began:

“When I started writing the book, I began phoning doctors, explaining the project, and asking for interviews. To my great surprise the majority of them returned my calls.  In most cases, I didn’t know them. I expected responses from perhaps 20 percent. Instead, four out of five called back.

“‘We want someone to know what is going on,’ explained one prominent physician in Manhattan. ‘But please don’t use my name. You have to promise me that. In this business, the politics are so rough—it would be the end of my career.’”

They were right. Everyone needs to know.

15 thoughts on “Reminder: NY Premiere of Money-Driven Medicine This Thursday (Clip from the Film Below)

  1. “But please don’t use my name. You have to promise me that. In this business, the politics are so rough—it would be the end of my career.”
    In my twelve years of cancer medicine research, I found this statement to be an epidemy. Virtually the only way I received honest information.
    Cancer medicine has been driven by external forces into dark corners, such as what amounts to generating more of an advertisement sent directly to a patiet, than patient information and more disturbingly, on TV and other media.”

  2. Maggie, will there be a way to see the movie on-line?
    Thanks, Pat
    P.S break a leg with the grand premier!

  3. Maggie,
    I absolutely loved both Bull and Money Driven Medicine. As a medical student interested in the policy and system of health care delivery, is there any way to get a copy of this video online or via DVD so I could introduce it to other medical students at my institution? Asking people to read is a rather difficult task even at the professional level and a well put together visual version of Money Driven Medicine in the form of a documentary film would be terrific and a much more interesting discussion video than the endless drone of SICKO every year.

  4. what do the insurance companies do with our money ?
    do they reinvest like banks? do they make money off our money?

  5. Congrats in the film!!! This is great.
    I have a 47 year old friend who just had a quadruple bypass here in TX. No symptoms.
    “Did you get a second opinion?”
    “No.”
    “At any point, did the doctor sit you down, go through your diagnosis, give you all the treatment options and the plus/minus of each?”
    “No.”
    I am so grateful that I will be able to direct people to your documentary so that they can see for themselves what is going on today in health care.
    Thanks for writing the book and making the movie.

  6. David:
    That’s a good question.
    Typically, insurers would like to pay claims from your premiums, and have the reserves for catastrophic situations.
    This strategy conflicts with Medicare, in that the payroll taxes (premiums) are placed in the general fund of the Treasury, and used for general expoenses (including Medicare and Social Security).
    Of course, the ” trust fund reserves” are spent for other governmental expenses. The reason interest accumulates on the “reserves” is to pay back the trust fund for this use of non trust fund expenses.
    Don Levit

  7. Slippping-Sloth–
    I gave your e-mail to the distributor, but apparently they haven’t yet sent you the DVD.
    Please e-mail me with a mailing address and I’ll send it to you.

  8. Looking at United Health’s latest (quarterly) earnings report I find that premiums were $20 billion, while “medical costs” were $16.5 billion.
    In other words 17.5% of the money we paid in we didn’t get back in useful services. The number for Medicare is about 3%.
    In normal times insurance companies invest the premiums and supplement their income this way. The economic downturn has limited this source of revenue and UHC only made $158 million for the quarter.
    Given these numbers is it surprising that the insurance industry (and their paid shills in congress) are so opposed to a public plan or other system that would eliminate the middleman?
    That the press allows itself to be bamboozled by bogus arguments about freedom of choice and rationing is one of the disgraces of modern life.
    The old adage is still true: see whose ox is getting gored.
    Not only would a real public option put for-profit insurance firms out of business (unless they continued to be subsidized as now), but it would cut overall health costs.
    The Obama admin is going through all sorts of contortions to claim that they may be able to cut 1.5% from the rate of health care cost growth, but refuse to look at an area that offers potentially much larger savings.

  9. robertdfeinman said:
    “That the press allows itself to be bamboozled by bogus arguments about freedom of choice and rationing is one of the disgraces of modern life.”
    Absolutely. Furthermore, I would add to this that when your life is really on the line like after an auto accident or any real medical emergency, you will be taken care of by the system as the system sees fit with no significant personal choice or any shopping around. I is just astonishing that after all this time there are people still covering up the real social nature of the system when it really counts for some personal economic advantages in lesser important areas.

  10. Robert:
    The operations of the for-profit insurance companies are not sustainable.
    But remember, their operations are responses to the total health care system – hospitals, physicians, and patients.
    We all have to sacrifice to make our health care system financially viable.
    Introducing the federal government in a single payer system does not solve the problem.
    It merely defers financial breakdown, due to the government’s seemingly infinite ability to borrow.
    I can understand your frustration with for-profit health insurance companies. Getting rid of them does not solve our long-term problems.
    Don Levit

  11. Don:
    I spent my career working at non-profits (not in the health sector) and one thing I discovered is that the motivations are different.
    First the motivations of those working there are different from those who work at for-profit firms. Very few people at non-profits are in it for the money, especially since the salaries are generally modest.
    Second, the tone set by management is different. They don’t have to account to stock holders, don’t have demands to improve the bottom line and aren’t driven by a constant need to show steady gains in earnings.
    The result is that what gets done and how it gets done is different. I’m confident that if the profit motive were removed from our system we would see a similar shift in motivation and that costs would moderate as well.
    If you want a close by example, study Canada. Health costs are not anywhere as high as here and the prospects of runaway increases also doesn’t exist.
    If you think the US is unfixable then you need to explain why. Not only do Canadians pay less, they have better outcomes.

  12. There is an interesting post on the HealthAffairs blog concerning trying to reform the costs of our system so we can make it universal and sustainable. Attempts to just rein in provider payments may well result in more unnecessary care and no better outcomes, maybe worse.
    http://healthaffairs.org/blog/2009/06/09/public-plan-option-sustainable-growth-rate-formula-on-steroids/
    It seems to me that the question of what is effective and efficient care must be defined or answered first before any payment schemes can have any beneficial effects. Paying for performance or just paying less cannot work unless we truly know what good performance is. So that must be the first priority to any reform. Concerning such a definitional effort, the two big questions that jump out to me are:
    (1) just who will define this efficient and effective care?
    (2) what do we do if such effective and efficient care potential ends up costing more, not less?? In such an ?inevitable case, who will make rationing calls to keep the system sustainable??

  13. Robert:
    I agree with your statement regarding the profit motive.
    It is a totally different mindset and culture.
    This is why I am recommending 501(c)(9) insurers.
    If you can provide your E-mail, I will be glad to send you some information from the IRS on them.
    NG: I agree that we need to define effective and efficient care. We need to provide incentives as well as a country culture which encourages people to think of themselves, and also consider the bigger picture. How will my individual costs impact the costs for the community?
    Whatever, the illness, I am not alone. This has to be encouraging.
    While the care must be efficient, so must the dollars associated with that care. The taxes (premiums) go into the Treasury’s general fund, just like all other revenues. The trust fund’s reserves are loaned out to the Treasury to pay for other governmental expenses. That is why the trust funds pay interest – to pay for defense, etc., not for Social Security and Medicare. Is that an efficient way to run an insurer, even a social insurer?
    Don Levit

  14. Robert-
    Yes, insurers typically keep 17% to 20% of premiums to cover their administrative costs, profits for shareholders etc.
    But private insurers cover less than half of all health care in the U.S.
    That is why, when you total up their administrative expenses it amounts to around 5% of total health care spending.
    Imagine a pie chart– the slice eaten up by private insurers’ admninstrative costs is 5% of the total $2.6 trillion that we spend on healthcare.
    The government’s administrative expenses equal about 2% to 3% of total health care spending.
    So if the government replaced private insurers,
    it could do what private insuers are doing at a cost of half the private insurers’ administrative expenses.
    The results: the payer’s share of administrative expenses would fall from about 7 1/2 percednt of total health care spsending (5% private insurers, 2 1/2% govt) to
    about 5% (all govt.)
    In other words we would save 2 1/2 percent of the $2.6 trillion pie.
    Trouble is, the pie is growing by about 6 1/2 percent a year. So that savings would be wiped out by less than six months of health care inflation.
    Obama’s goal– to trim 6 1/2 inflation to some closer to GDP growth (around 1% to 2% for the foreseeable future)AND simultaneously cover everyone.
    The only way to do that is to clamp down on overtreatment and over-utilization.

  15. Maggie —
    One thing I would add about the notion of administative overhead of private insurers vs. Medicare is that the overhead of the insurers, public and private, is only part of the issue.
    Private insurers also contribute significant increased overhead costs for providers. On average, providers pay 11% of billing for collections from private insurers, compared with 3% for dealing with Medicare.
    In the end, there is a lot less potential savings than many advocates of single payer suggest, but potential savings are not insignificant. I think we could save between $100 billion and $200 billion a year if overheads for private insurers were reduced to or near to overheads for Medicare, with a large part of the savings coming from the providers’ costs, which could be saved without effecting the financial position of the insurance companies.
    That savings would be in the same ballpark as combined potential savings from getting management of low back pain and coronary artery disease to comply with best standards.