Google Protects Healthcare From Michael Moore

An anonymous reader suggests we stop over to ZDNet for a case where Google may be stepping on the wrong side of that famous Don't Be Evil line. A Google staffer is offering to help the healthcare industry contain the damage that Michael Moore's film is about to do. (Here is the original Google Health Advertisement blog post by Lauren Turner; in case it disappears, it is reproduced in full in the ZDNet post.) Quoting from the Google post: "Many of our clients face these issues; companies come to us hoping we can help them better manage their reputations through 'Get the Facts' or issue management campaigns. Your brand or corporate site may already have these informational assets, but can users easily find them? We can place text ads, video ads, and rich media ads in paid search results or in relevant websites within our ever-expanding content network. Whatever the problem, Google can act as a platform for educating the public and promoting your message. We help you connect your company's assets while helping users find the information they seek."

Not Evil

This isn't anwhere near as evil as collecting user's browsing data or cooperating with Chinese censorship. They are offering companies a PR service. I hope you're not saying that it's wrong to counter propaganda? That's all Moore's 'documentaries' are really, even when he makes good points (which isn't all that often).

Re:Not Evil

Indeed. From the title, one could expect something like "Google is censoring search results about Sicko!". But really, Google is saying "hey, healthcare guys, you've got stuff on your website - here's how to get us to index it better and find it" (insert standard non-spammy search engine optimization strategies here) "and you can even advertise with us while you're at it!"

Now, I guess if your friends in the Healthcare industry are pure evil, then Google is being evil, but I don't see how you can construe that as "protection". Apparently the submitter, however, would like to protect "Sicko" from the health care industry's web sites. Meh. Lame.

Pfft

Not even the diet-coke of evil.

Re:Pfft

You kids and your newfangled evil. Back in my day, evil had Moxie.

Re:Not Evil

Now, I guess if your friends in the Healthcare industry are pure evil, then Google is being evil, but I don't see how you can construe that as "protection".

There's a film out that, if you take the point of view that the vast majority of the people who see it do, talks about how people who are sick and dying are not being helped by people who amass large amounts of money (and prestige, public goodwill, etc.) for helping sick people. Google, in the role that I and a lot of people understood them to have for most of the last decade, could reasonably be expected to do nothing about it - only make sure that people found the information on the subject that they chose to try to find. In a more realistic worldview, they sell ads, they advertise that they sell ads, and if people on side of the debate or the other, or both, buy ads that's how it goes - the service is there for anyone who wants to buy. Instead, when:

Many of our clients face these issues; companies come to us hoping we can help them better manage their reputations through "Get the Facts" or issue management campaigns.

they don't say "Fuck off. We don't do propoganda." No, they get involved. If no one's come to them yet, they actively reach out. To one side. The one with the money. The one with the blood money. If you weren't there already, this is the last nail in the coffin of the notion of Google as anything more than any old corporation with its requisite ration of evil.

Re:Not Evil

If no one's come to them yet, they actively reach out. To one side. The one with the money. The one with the blood money. If you weren't there already, this is the last nail in the coffin of the notion of Google as anything more than any old corporation with its requisite ration of evil.

Now, if you do believe that our friends in the health care industry are pure evil, and that they're spending blood money, then yes, Google is, indeed, being evil. And I suppose if you obediently believe every line that Moore has to tell you about the matter is the whole and honest extent of the truth, then there is no possibility that anything could counter it. As such, anything that the companies say to contradict that must, in fact, be evil propaganda utterly devoid of any informative content, with the ultimate design to boost their image (and their profits) - at the expense of all that is well and good in the world, if necessary.

And if that's your world view, you're probably adequately opinionated that no one can hope to convince you that it is otherwise. I'd like to hope that most people can entertain the notion of a middle road which characterizes both Moore and the health care industry as neither impeccable nor pure evil, ascribing to both the property of providing some information which is both true and valid.

Re:Not Evil

Forget Moore's general idiocy for one moment and concentrate on the health insurance industry. Everything he is saying about the american health insurance industry is true. They do give bonuses to their employees for finding excuses to deny patients operations they desperately need. They do everything they can to weasel out of their obligations when other people's lives are on the line.

The insurance companies deny payments for life saving operations to their clients because they know they can get away with it. This is evil. This is not closed source kind of evil. This is not copyrighting music kind of evil. This is killing honest hardworking americans who are paying them kind of evil. I think the term 'blood money' is totally appropriate.

Re:Not Evil

moore is a sensationalist idiot

many people who are sick and dieing cling to unproven treatments which aren't covered by the funds for very good reasons

Just watch the movie before being prejudicial. You have no clue what you are talking about. It's not just about the "Rainmaker" cases where they kill someone that needed a bone marrow transplant (not experimental at all) which they do show one case of. It's also not about the millions of Americans that have absolutely no health insurance even though that should be enough to upset anyone. No, what's really wrong with the system is how every single step of the way, the medical companies are fighting with you. From the ambulance ride to the IV drugs to the overpriced prescriptions, they are looking for some way to stick it to you. The fact alone that they make more money by giving less medical care is completely flawed and ultimately a case of "letting the wolves guard the chicken coop".

Re:Not Evil

OK, I will bite. What does he say about the american health insurance companies that is untrue? Im not talking about the cuba trip, or his fascination with socialism in general, just want to know what you think is untrue about the health insurance companies. I am not defending him as a filmmaker, I know a lot of what he says is horribly misleading. But he really cant help but be correct when he talks about the health insurance industry because there are serious problems there. So what is he saying about the health insurance companies that is untrue?

Re:Not Evil

It's "fox guarding the henhouse" but I take your point.

The primary problem with any indirect services setup (indeed, any system where people make regular payments into the kitty and expect a payout in time of need) is that you've divorced the cost of said services from the ability of people to pay for them. Like any socialist state, that can work, as long as you can trust your foxes.

Whenever people pay for goods or services directly, out of their own pockets, there's a limit on how much can be charged. At a certain point, either people stop buying from you (if what you're selling isn't a necessity) or someone else comes in, undercuts you, and takes your business: in other words, there's a negative feedback loop established between consumers and providers. Much of modern business practice revolves around finding the sweet spot, the price point where you've balanced off the sales price and the number of customers willing to pay that price to maximize profit. It's a tricky proposition.

WIth the health insurance system, there is no direct connection between what the consumer pays for health care, and what the health care providers charge the insurance company. The feedback loop is open, which is great because it means that you get to set your own sweet spot and who cares what the patient can pay! What's even worse, though, is that the same people that sit on the boards of hospitals also sit on the boards of insurance companies and pharmaceutical outfits, so we don't even benefit from an adversarial relationship between those three. How much people can pay (and how much suppliers can charge) have no intrinsic relationship to each other anymore. Whether or not the insurance company even bothers to pay for a given individual's needs has no relationship to how much that person paid into that company. "I've been paying you guys for thirty years! Can't you help me?" "We don't cover that." Tough.

Normal economic incentives and controls simply don't apply in the insurance business, the people running the show don't really care if you live or die, and providing health care is, at best, a secondary objective.

not closed source kind of evil

This is the closed source kind of evil.

I don't like Michael Moore's work, but somebody had to point at the elephant in the living room here.

The AMA set itself up as a gatekeeper to the medical profession and medicine. A legal system embedded in our culture keeps the information and materials required to treat injuries and illness out of the hands of the public. This was purportedly (and logically) done to improve the quality of care in general, since a great deal of medical treatment was once done by unlicensed quacks who did more harm than good. The problem is that this occult (hidden) cabal has evolved into a self-serving priesthood of medicine that limits availability of care in order to drive its value up. A necessary part of this equation is that a large number of people have to suffer from the deprivation of care in order to maximize the value equation. Even the kindest, most generous doctors must participate in the system in order to get into the profession in the first place and to remain in it. If they want to donate their time and expertise to the poor they can only do it if they go abroad.

Add that the medical profession has been victimized by another unaccountable secret cabal of insurance providers set up as gatekeepers to the doctors, and you get a system that's horribly broken. If a doctor wants to treat the indigent for free, for cash or for reduced rates, he can't because the insurance companies would terminate his ability to be compensated through insurance and he would go bankrupt in short order. The proponents of the status quo are horrifically wealthy and intend to stay in that condition. I heard somewhere that medicine accounts for a ridiculous percentage of our GNP, and it's growing at a terrifying rate.

Throw in a third layer of gatekeepers, the lawyers that sue out of business every doctor that doesn't have absurd amounts of insurance coverage and you have a system that can't be fixed. I have often wondered if the lawyers were in collusion with the insurers to keep this broken system in place.

This is not some academic theoretical discussion for me. For nearly 20 years I lived without coverage. Through great care, the avoidance of treatment I really needed and the good fortune to be close enough to cross the Mexican border one day I really needed care, the American healthcare system only bankrupted me once in that period. I can't imagine what poverty I would be living in if I were chronically ill, less fortunate or less careful.

So don't be confused. This is very much the "closed source" kind of evil. If it were possible for a kind and generous soul to study medicine and get accepted by the medical community and devote their life to the general practice of medicine for the good of their community, there would be a clinics everywhere that took cash at reasonable rates because that quality of person is abundant still and they could make a decent living at it. I'm not saying it would be a route to country club membership, but not everyone who wants to be a healer cares about that.

Re:Not Evil

And I suppose if you obediently believe every line that Moore has to tell you about the matter is the whole and honest extent of the truth, then there is no possibility that anything could counter it.

The point is, it's hard to dispute Moore's facts. Of course he presents those facts in a biased way. But he's making an argument, you can't blame him for that. The core facts he uses to make his case are true (http://www.cnn.com/2007/HEALTH/06/28/sicko.fact.c heck/index.html?eref=rss_topstories [cnn.com]).

Quite Evil - from a physician

Pharma and the insurance industry are evil. Moreover in the case of the health insurance industry they serve no purpose. Previously insurers would assume risk and in doing so merit some financial reward. With the advent of capitation and risk selection, they don't even do that anymore. They are leeches, that in the words of Sicko: Flat Suck.

And I can also assure you that the denials of care that Moore described were not the exceptions, but the rule. I have a patient (whose details are a bit obscured in this story) who has a number of serious medical problems. He has a history of a bleeding ulcer and recently began to have symptoms that were the same as he'd had when he had the ulcer. So I prescribed a Proton Pump Inhibitor (the one that was the preferred drug on that insurer's formulary.) They denied it saying that he had reached the limit of the number of medicines he was allowed to have. In order to have the ulcer medicine he would have to go off of one of his diabetes, blood pressure, or asthma medicines or pay for one of them out of pocket.

And sorry, but the cries of 'socialized medicine' being worse than what we have are for shit. If everyone has the same insurance, then every doctor and hospital would take it. I transfer patients every day from the ER to other hospitals when mine is perfectly able to provide them treatment and the patients want to stay at my facility. But their insurer says they won't pay for them to stay to have their appendix removed at the community hospital in their town, but demands they be transfered to a facility 40 miles away that is 'in network.' Of course they can choose to stay if they want (and we would treat them as required by the EMTALA law.) However their insurer gives them the ultimatum: be sent to another hospital they don't want or be faced with the $30,000 bill for their surgery and recovery in the hospital they do want. So the claims of not being able to 'choose your doctor or hospital' are not what you'd have in a single payer system, but are what you get every day if you are insured under an HMO, PPO, or other device used by the insurance industry to deny you care.

And that is what its like for those with insurance. For those without it can mean death or permanent disability. I see people in the ER every day who have delayed or avoided care because of uninsurance who experience severe consequences because of it. Perforated appendicitis because of a delay due to worries about costs. A child admitted to the hospital with a kidney infection that could have been easily treated with oral antibiotics days before but wasn't because of lack of access. Renal failure in a person with diabetes left untreated. People with bent forearms because while they were appropriately treated and splinted in the ER, they were unable to see an orthopedist for subsequent definitive treatment because of lack of insurance. That is stuff you expect to see in the developing countries, not the richest country in the world. Of course it is easy to see the villain in that scenario as the evil orthopedist who would not see him for free. (And I will admit ortho is one of the worst offenders for unwillingness to provide uncompensated care.) However why should one group of professionals (health care providers) be expected to shoulder the cost of health care for 15-20% of the US population simply because the country refuses to? I don't mind paying taxes to support health care for all in the US, but I do take issue with the tax being exclusively applied to doctors and nurses and PTs and RTs etc, while an attorney or programmer or businessman who makes as much or more than I do pays nothing.

The saddest part is that we already spend in GNP well more than enough to cover every man, woman, and child in the US with a health care system that the world would envy. We pay about 15% of our GNP for health care, while most developed nations spend around 7-8%. If we took all of the money that goes to 'profits an administration' (about 30%) in the fo

Re:Quite Evil - from a physician

That would be a tax to cover a percentage of the population: those who are over 65 who have worked (or their spouse worked) ~10 years while paying that tax, many of the disabled, and those who have end stage renal disease (ESRD) who need dialysis. That would not be what I spoke of in the quote you used which is health care for all.

Though to be honest paying that tax pisses me off a bit precisely because of one specific wastefulness: Medicare Renal (for those with ESRD.) Diabetes affects about 20 million Americans (mostly type-2). If you have diabetes and no insurance, you are most often unable to treat your diabetes. Untreated diabetes results in many complications, but a common one is kidney damage resulting in ESRD.

So instead of paying $1000/year to treat a type 2 diabetic with a pill costing $1/day, we wait till he has developed severe and inevitable complications of that untreated diabetes. Then once the horse is out of the barn, we decide to treat him at the cost of $30,000-40,000 per year plus often a kidney transplant (about $100,000 of yours and my taxpayer dollars). So in addition to costing much more, this squanders a scarce resource (kidneys for transplant) into a group whose ESRD could have been easily an inexpensively treated. An ounce of prevention is not only worth a pound of cure, its a shitload less expensive as well

Its like refusing to pay to put oil in your car till the engine seizes and then buying a new engine. That is, fucktarded.

Nick

Here's the facts on Canadian health care

Here's a comparison of Canadian vs. U.S. health care from a peer-reviewed medical journal, by Gordon Guyatt, who is one of the world's top experts on comparing health care systems. The article points out that the U.S. health care system costs about twice as much per capita for the same or worse results.

http://www.openmedicine.ca/article/view/8/1 [openmedicine.ca]

Open Medicine, Vol 1, No 1 (2007)

A systematic review of studies comparing health outcomes in Canada and the United States

Gordon H. Guyatt, P.J. Devereaux, Joel Lexchin, Samuel B. Stone, Armine Yalnizyan, David Himmelstein, Steffie Woolhandler, Qi Zhou, Laurie J. Goldsmith, Deborah J. Cook, Ted Haines, Christina Lacchetti, John N. Lavis, Terrence Sullivan, Ed Mills, Shelley Kraus, Neera Bhatnagar

ABSTRACT

Background: Differences in medical care in the United States compared with Canada, including greater reliance on private funding and for-profit delivery, as well as markedly higher expenditures, may result in different health outcomes.

Objectives: To systematically review studies comparing health outcomes in the United States and Canada among patients treated for similar underlying medical conditions.

Methods: We identified studies comparing health outcomes of patients in Canada and the United States by searching multiple bibliographic databases and resources. We masked study results before determining study eligibility. We abstracted study characteristics, including methodological quality and generalizability.

Results: We identified 38 studies comparing populations of patients in Canada and the United States. Studies addressed diverse problems, including cancer, coronary artery disease, chronic medical illnesses and surgical procedures. Of 10 studies that included extensive statistical adjustment and enrolled broad populations, 5 favoured Canada, 2 favoured the United States, and 3 showed equivalent or mixed results. Of 28 studies that failed one of these criteria, 9 favoured Canada, 3 favoured the United States, and 16 showed equivalent or mixed results. Overall, results for mortality favoured Canada (relative risk 0.95, 95% confidence interval 0.92-0.98, p = 0.002) but were very heterogeneous, and we failed to find convincing explanations for this heterogeneity. The only condition in which results consistently favoured one country was end-stage renal disease, in which Canadian patients fared better.

Interpretation: Available studies suggest that health outcomes may be superior in patients cared for in Canada versus the United States, but differences are not consistent.

Further reading on the Canada vs. U.S. comparison is:
http://www.washingtonmonthly.com/features/2000/000 7.marmorsul.html [washingtonmonthly.com]
Canada's Burning!
Media myths about universal health coverage
By Theodore Marmor & Kip Sullivan

Re:Here's the facts on Canadian health care

Well, it depends on what you mean. If you mean Canada has the same or better results for everybody, no, it does not. Indeed, for many people, it has significantly worse results, especially those in the upper and upper middle class, and that's the point: no one is willing to have their freedom taken away, and their taxes increased, in order to be significantly worse off, even if it benefits others. There's better solutions out there that don't harm a lot of people for the sake of improving the care of a lot of other people.

Canadians have decided long ago that it is not right for a rich man to have better service when it means that everyone else will have worse.

Everyone has the same service; this guarantees that the rich will not gut the service.

This is called "social justice", something sorely lacking in the US.

Ever wondered why the crime rate is so low in Canada? It's not because guns are outlawed. No, it's simply because welfare helps ensure that someone that hit the bottom of the barrel will not have to turn to crime in order to survive.

Paying slightly more taxes than in the US is a very cheap price to pay to insure that I do not risk being mugged each time I walk home late at night.

And everyone is glad to pay those few extra tax dollars.

The "freedom" those measures take away would only benefit the top 0.01% of the population anyways.

Re:Here's the facts on Canadian health care

The American health care system is hugely inefficient, in part because it devotes huge resources to deciding who to cover and who to deny coverage. Spending large amounts of money to figure out who is likely to get sick makes sense to improve the bottom line of individual companies, but overall it lowers the quality of care for patients by reducing available resources.

I live in Canada. I have quite a bit of experience with our health care system, having an elderly family member with cancer. I can only describe his care as excellent. I spent days in the hospital, and I got to observe in detail what went on there, and I cannot think of anything that could have significantly been improved.

That said, the quality of care has been declining recently. However, this is primarily due to cutbacks instituted by neoconservative leaning governments. They are deliberately starving the public health care system with the eventual goal of creating a parallel private system. The reasons they are doing this are largely ideological, in that they believe the private sector can do no wrong. It also seems likely to me that our government has been bought and paid for by private health care interests.

That said, our system is still quite good. Someone else I know is currently going through cancer treatment, and there isn't much I can see wrong with her care. Because her treatment was urgent, she didn't have to wait very long for her chemotherapy. But what is perhaps more important is that the treatment was received without fear of bankruptcy. We don't fear losing our coverage here. We don't wonder whether or not our claim will go through. We simply show up to the doctor or hospital and receive our care.

With the release of Sicko, be prepared to be deluged by propaganda against public health care. There is just too much money to be lost by the private health care industry for them to give up in this battle. Although Michael Moore tends towards bombast and exaggeration, his basic thesis is correct. The American health care system is deeply flawed, and other countries do a far better job of caring for their citizens.

Re:Here's the facts on Canadian health care

First of all, let's just note the fact that federalized health care is blatantly unconstitutional. No, I won't explain that in detail, because I am tired of explaining about enumerated rights and the Tenth Amendment.

I agree, and what I don't understand is why the issue of universal/socialized health care is rarely suggested at the state level. Clearly there is some significant portion of Americans who are interested in seeing universal health care, or there wouldn't be a discussion. So why don't some of the states try it? But all discussion I've seen has been for or against implementing federal health care.

I watched Sicko, and if nothing else, it did get me thinking more about the issue of health care. I don't quite buy Moore's argument that we need federal health care, but I do believe it's a worthy debate to have at the state level. In the movie, he tries to sell us the idea of socialized health care by pointing to the other socialized services we enjoy: firefighters, education, police departments, etc. All of these serve the public good (in theory, if not always in practice), but these services are largely managed at the state or local levels. I think there could be room for health care in that list. At the very least, I believe it's a worthy enough issue to be on the table for debate.

Re:Here's the facts on Canadian health care

We also have humane and effective universal health cover in Australia and you can take out private insurance if you want a private room for mum and baby, silicone implants, ect. The idea that "world class" health care could bankrupt any family is a bipartisan "evil" in this country.

Re:Not Evil

I agree that our health care system could be improved. However, Michael Moore's proposal - go to a single payer system - is not the answer. In Canada, one of the systems highlighted by his film...

The US has the most expensive per capita healthcare in the world, and Canada comes in second. The U.S. ranks only 37th in the world in quality health care - yet nationally America spends 82% more per person on health care than others. Canada also fails to fully benefit from the money spent, so I don't think either is a model for healthcare efficiency.

There are countries which perform better than the US while still spending less than the US government already spends. You'd be better looking at New Zealand, the UK and Australia to see what works.

The U.S. ranks last of six nations overall. As in the earlier editions, the U.S. ranks last on indicators of patient safety, efficiency, and equity. New Zealand, Australia, and the U.K. continue to demonstrate superior performance, with Germany joining their ranks of top performers. The U.S. is first on preventive care, and second only to Germany on waiting times for specialist care and non-emergency surgical care, but weak on access to needed services and ability to obtain prompt attention from physicians.
http://www.commonwealthfund.org/publications/publi cations_show.htm?doc_id=482678 [commonwealthfund.org]

The real tragedy from Australia's point of view, is that our government has an ideological commitment to drag our healthcare system down to the US's level, instead of bringing it up to match the top performers.