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Published: 2014

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Money-driven medicine provides the essential introduction Americans need if they are to better understand and address the unmet challenges of healthcare reform during the coming decade. Produced by Academy Award winner Alex Gibney (Taxi to the dark side; Enron: The smartest guys in the room) and inspired by Maggie Mahar's acclaimed book, Money driven medicine: the real reason health care costs so much, the film goes beyond health insurance to offer a behind-the-scenes look at the {dollar}2.6 trillion U.S. healthcare system, how it went so terribly wrong and what it will further take to fix it. Effective care, or Just expensive care? The U.S. spends twice as much per person on healthcare as the average developed nation, one-sixth of our GDP, yet our outcomes are often worse. The problem is that much of that spending is wasteful, and provides no benefit to the patient. The reason? The U.S. is the only developed nation that has chosen to turn medicine into a largely unregulated, for-profit enterprise. In Money-driven medicine, Dr. Donald Berwick, president of the Institute for Healthcare Improvement (IHI), explains: We get more care, but not better care. If you look at how we manage chronic diseases, he points out, our outcomes are not as good. We focus resources on the high-tech, exorbitantly expensive rescue care that patients need after they become terribly sick, and pay far less for the preventive and primary care more likely to keep people out of the hospital in the first place. Emergency rooms overflow while primary care physicians are becoming an endangered species. Medical students explain that the compensation system is driving them away from primary care, and into high-paying specialties. Medical ethicist Larry Churchill doesn't mince words: The current medical care system is not designed to meet the health needs of the population. It is designed to protect the interests of insurance companies, pharmaceutical firms, and to a certain extent organized medicine. It is designed to turn a profit. It is designed to meet the needs of the people in power. These businesses comprise the medical-industrial complex. They've gradually wrestled power from doctors, turning medical care into just another commodity and patients into profit centers. As the familiar Direct-to-Consumer TV ads shown in Money-driven medicine make clear, the more drugs pharmaceutical companies produce, the more they must sell them, and sell them they do-- whether or not we need them. The result: while many uninsured and underinsured Americans receive too little care, the well-insured too often receive unnecessary, even risky care. More than two decades of studies by researchers at Dartmouth reveal that fully one-third of our healthcare dollars are squandered on unnecessary tests, ineffective or unproven procedures, and over-priced drugs and devices no better than the less-costly ones they replace. The studies reveal the need for evidence-based, accountable care that is both more effective and less expensive than our current fee-for-service system. Taking back healthcare in Money-driven medicine frustrated doctors and outraged patients testify to how things can go horribly wrong when the concerns of patients and families are ignored and corporate interests trump patients' needs for high quality, affordable care. Veteran physicians stress that reform must begin with the doctor-patient partnership: we need consistent patient-centered care built around informed, shared decision-making. Before patients can reclaim their rightful place at the center of our healthcare system, Maggie Mahar notes, we must empower doctors and nurses to practice patient-centered care based, not on corporate imperatives, but on the best scientific research available. Money-driven medicine can encourage health professionals and patients to work together to take back control of healthcare. The film alerts Americans that universal coverage is just the first step in a long and arduous battle for comprehensive reform that will continue long past whatever bill emerges from Congress this fall. We can be sure that the industry's lobbyists continue to resist measures aimed at cost-containment and affordable, results-based care. Screening Money-driven medicine will help viewers distinguish between the structural changes we need and sham reform proposals. It will help them realize why a sound, sustainable medical infrastructure is crucial not just to their personal futures but to the economy and society as a whole; why curing America's healthcare crisis is a matter of national life and death.