captng snsored by public affairs television >> th week on "bi mers journal. >> moyers: a reality che, why do we need health ca reform in the fit place? >> a lot of people are dyi, and they're dying becae they n't have healthce. >> medical care definitely a right. nobody should be turneaway. >> the big issue is ur money or your life >> you spend most of your li workin but once you don't have fe insurance, everything you've worked for your wle li, will just go. >> it shoun't matterhether you' got a $20,000 a year job. yourife is just as important as sebody else's that makes a oft lo money. >> moyers: stay tune

>> from our studios in new yo, bill moyers. >> moyers: wco to the journa some years ago, eons opened myaughter's skull and moved brain tumor th threatene ll or ind r. less thaa month later,n one my arteries sdey ut do, open hearturgery saved my life. those skilled physicns and hospital stilllow in m family's memor but thdual crisis in our lives st ts of thousands of dollars. when the iurance came through, bathed a gh of relief. the ecomist and nobel laureapaul krugman, ys th's thehing about health insunce; you'lnever know when y wl need it. if you nd it andon't have it, yoren deep, deep trble. th'shahappened tth families tt willeein is wees oaas thfimaker roger isbe, whose workasong been decated to putting hum ce on publ polic traveled e country to meet people who desperately needed heacare that they couldn afford.

what they went thr and what they had tsaabout it is potent reminders tt the need r he care reform is a.ey here's a look at "critical coition." >> joe and i have been tether 22 yea. they say you find one love i life. for me iwas joe. >> jt go to the next one. >> what are you doing, pying with it? my christmasree? >> joe was a doorman f almost 15 years. >> you want bow in your hair? >> he didn't make eat money, but he always said the benits were good. cannot find the angel. >> what are you puttinon top en? >> you!

>> so what are you hopinfor, r christmas? what do yowant? >> my healthi guess. that's what i would wish f. >> whejoe first got sick he was dinosed with liver disease. i guess they felt that he st couldn't do his job noore. sooe got terminated. righafter that, they stopped his heth insurance. and now it's le, what do we do? >>ello. >> hello. >> how are you doing today >> not too good. >> what's ppening? >> well, my leg is still swollen. >> well, you know that y have thisnderlying liver disease. it's n related to alcohol use to hepatitis virus. it's just really fm the liver, um, the liver not woing right, and en it develops into

cirrhosis. and that's really the in reasonhat you've got all this swelling in the legs. the diabetes isort of a parate issue, but it still.. still complicates thin dramatically. so how often are you takin insulin? >> i take it once a day. >> you should be probably tang that threeimes a day. >> but we skip becau the tabs are expensive. >> this is a really tough ing to deal with, not ing able to get the medicines th you need or that we think you need. it makes it al.. all the more tough foyou. especially forour liver disee. these diuretics, i consir these life-sing medications thsame way i would with the sulin. we he some samples of the insulin. we didn't haveuch, unfortunely. ay? >> okay. dr. mcwiiams, thank you again. i preciate your time. >> thank you. >> we'll e you soon. >> i don't want to live li

this. i mean, n't get social securi, i'm too young. can't gewelfare, make a little bit too much in the meantime, i've t $50,000, $60,0 in doctor bills. >> so, you nd to stop worrying abouthose collection agencies and the medical bills thate're getting. >> well, i'm dying anyy, put me in collection >> joe, i'll be damned'm going to let you sit there and givup hope. >> oh, witut a liver, i'm not going to g better. liver tranlant costs about $150,0 to $200,000. if you're broke, you cld get thmedicine, you could get the hospital, everything else. buif you work hard all your life, you get thing. >> things will work ou

if joe had iurance, he would have never had to skimp his medication. would never have used the same needle sito nine times. so yeah, you cutedical corners. it's like playg russian roulet with your life. >> 452. >> oh, my god. normal is 120. >>s that more bills? >> yep. lehigh valle physician's business center.

oh, my gooess. thiss from when you were in the hospital theast time. ease call our collection department. joe, i don't wanto go into collecon anymore. >> here. $28,000. >> i can't belve they think we can pay that. >> i can't believe they char so much. >> riculous. but wh we go in, we go in honest a we say this is what we have, and we ve nothing, and u can't get blood from a stone. maybe i could win the ttery. >> ah, you never kw. >> approximate five months ago, the paistarted on my lower stomach area, th's when i started gettinconcerned about caer.

a lot of the doctors woun't see me because i didn't ha insurance, and they actuly turned maway. at was a denial of service, t and out denial of service. i called the cancer sociy and told them that didn't have insurance,nd that i was having trble being diagnosed. and, dr. smith's office lled and asked if i wld like to have a visit with her. i was like, what? u' who? and you want to see me? >> w don't you lay down and put your feet up her >> okay. >> did you go a whilwithout seeing a doctor? >> yes. >>o you have any pain when you press here? >> yeah. over there. >> it's worse?

>> yes. >> with at we see in your blood and what we feel on exination, we have to take your ovaries out. >> okay. if these ovaries look like theye cancer, we're going to have tmake a big incision. >> okay. >> i'd like for to operate nextednesday. >> nt wednesday, okay. >> karen, you're going to me the financial counls, you'll meet all sorts opeople who'll help you worng on the bill pa. >>kay. but you know, right now it' bills be dned, let's do this. >> okay,hank you. >> oka the first visit with dr. smith was ,139. >> what can do is we can set up a payment plan. so what are you gog to be able to feel comfortable paying? >> il say $40 a month and try to do $40 a month. >>kay. >> i worked ke the dickens to keep insurance. i was an apament manager for

10 years, and i had insunce that whole time. the apartmt complexes kept getting bigg and i couldn't do the stairs anyre because i've got puonary disease. meot being able to handle the b physically, i had to let i go. at meant i lost my insurance o. >> what'd the doctor say? >> they're tking about surgery. >> i glad it was better news. >> me too. i'm still woied. >> it's got be done. >> i love u. >> i lovyou too, baby. >> we've been maied 30 years

and we've alys worked. ronnie's worki two jobs. he's working for a merchanding company, and then he's gunds keeper for an apartmt complex. >> i make a ttle over $14,000 max for the year we were ableo pay our bills and put little bit aside, too. of course, all of the stuff at we had put ade is lo gone now because wead to use it immediately whever she first got ill. we didn't havensurance. >> once you don't have insuranc you don't really know what the problems are r you.

about 15 years ago, back real started to rt. slowly iwas just bending and bending until got to where i , so i lost about seven inch. my wife tes me, "let's go to the park tplay with the kids." i just cannot play with them because it's just... painful

>> 25 years o when i came to the united states, i felt ry happy to become a u.s. citizen. ght now, i am a chef working r a french restaurant. year i make $45,000. manyears ago when i had surance, they were giving me... it was just medicati thatou can buy over the counter. and expenses is stting to go up, rent it went up, so got to the poi that i just needed that moneyhat i was paying for the insurance in order t pport my family. so had to discontinue the insurance.

what i didt realize was that when i was takinall this dication for my back pain, that i was, like, bleeding inside of me. >>ne time you had some health insurance, but you cld no longer afford the... t premiums. is tt right? >> that's ght, yes, that was. >> carlos ca to this health fair six monthago. he looked very pale, bause he was missing almo 70% of his bloo and when we saw yoin september you were taking tylel, and motrin, and the other thing u re taking... >> naproxe >> naproxe how ma of those a day? >> was taking 10 pills. so the medicine you take fo pain caus ulceration, so you'd alst bleed to death.

we said you need to go the hospital right away. was that correct? >> and i said dr. dowling, "but it goi to cost to go a hospital, besides i have to go to work." andr. dowling tell me, "no, i don't think you're going to workright now you're going to go to e hospitalbecause on your way to work you canie." i s scared. it really scared m >> we ccessfully convinced him to go to the hostal emergency room, wherhe was admitted and transfus. so the bleeding waall due to the medines he was taking for his chronic pain i wondered if you uld stand up foa minute. just wanted to see your back that's okay? >> yeah, it's fine. >> althoh his bleeding has solved now, he's still very worried about his backroblems. we don't kw what the reason is, but it'sery painful. and he's sti without health

insuranc so he's got some real challenges down e road. >> h i'm doctor smith. , good to meet you. >>onnie dove. >> thas my husband and my mom. >> got any plans? >> i hope. i hope we're going to get is over wit >> well, l's go in there, let's get it out and fix you all righ see you backhere. all right. thank you,octor. >> it'time for a hug and a kiss.

>>an i have a marking pen please? it is cancer. 's cancer of the ovaries. it's spread the upper abdomen. in a couple of weeksshe'll get six cours of chemotherapy. it's given oneay every three weeks, uil she's done six of them. >> how far advced was it, as far as stage one, o, three? >> it's stage 3c. and most people with this age of cancer die of their canr. most people... >> karen had bn sick for several monthsefore she nally got the diagnosis.

even though, you know, ithe back of my mind i lt like i knew whawas going on, you still can't be prepared for when it's someone th close to yoas... as your wife. >> that oks pretty good. the hardest thing was being diagnosed. i had a canc specialist and he knewomething was wrong, but he just didn't wa to follow through with more stly tests. had i d insurance, i really believe it wouldave been diagnosed a lot earlier. it pbably would have not been in stage tee. if we had someind of medical system where everydy could get in there and be teed, they could stop some of this heartache.

they could stop a whollot of it. we were doing a lot better financially until e cancer hit and all thdoctor bills started comi. i've racked up some prettyood ze bills, and i have no idea wh the hospital bill will be. and th's twice a day. take 14 pills a day. potassium that'shree times a day. and the medication alone i $2,500 a month. for a while i was desperate t my medicine because i didn ve any. and i did go to mexicond buy someedicine. that's once a da with my inrance, when i had

it, that medicinwas $50. in mexico it was4.95. >> oh, they do keep cong, huh? >> yeah. >> of course, i'scared. i'm scar about the chemo. i realize that i've still goa battle ahead of . it's been rough. i've lost about 40ounds. you just can't seeto get the strengthhat you used to have. you sure you don't want som eggs? >> this is all i can d >> you got questions forhe doctor? >> yea

how soon before can start hitting on you again? >> rig. >> do you have to donything else to get ready to go? >> coverp my bald head. >> you need another nausea pl? i'm sorry. >> i'm tiredf not being able to hold do food. >> the hdest part is just seeing what karen has go through on a dly basis. it's rl hard to keep from rrying. >> hi. how are you? >> i just threw up >> she's been throwingp while you were out.

>> now if yoget over to the hospitalnd you don't feel beer and you're still vomiting, i'going to ask you to stay ther 're still at a very touch an go time. >> do you want to ta care of that now >> no, i'll have tput that on my bl and pay it out. >> all right. >> the financialart of this has been very diicult because you think out owing thousands of dollars that you ner expected to owe, and thoughtou might own a house one day, b co to find out it's all going to gon medical bills, and yore not going to have anything for oldge either. >>ecause joe has liver disease, joeas edema. and he's filli up with fluid. this iabout the fourth time

we've gone to the hospit this year wh this problem. >> i'm hoping that youome home soon. >> i hope , too. we have... i havto come home. actually, you take 12, 13.. there are 14 medicationsere that you're suppe to take day. >> daily, ye i don't en know what i'm going to do whene come out. we have no mey to pay for this medicine. >> i know. and i don't know how we' going pay for this hospital bill. >> ii paid for the medicine, i wouldn't have beenn the hospital to begiwith. i'm gointo have pain in a minute. >> it's okay. you wanto hold my hand? breathe through your nose, out your mth. coun remember count, focus on your finrs. well, i'm hong that they can figure out what's wrong th you d get this water out. >> why am i so blownp? >> wel you're blown up because

you know that you have t cirrhos of the liver. >>es. >> and wn you're on your mecine, the diuretic regimen, thatelps prevent the fluid build-up. so i tnk if we can keep you on these medicines, wll try, 'll get you out of trouble. >> i know, but have no money for the medines, which gets me into trouble. >> there are people that a dying, because they caot afford tir medication. i don't want my husbanto be one of those vicms. when i come home ande's not here at night, is hard. it causes me anxiety it causes a lot of stress. and we already he these bills that we are not able to y.

ery time joe is in the hospital, yore thinking, "oh god, h much is this costing? how am ioing to pay for this?" it's just really hard. >> f the last 15 years, i have never seen a speciist. i just wish that see someone at can really give me, tell me, what ieally have. >> unlesyou're a trauma case or you're in a carccident,

there going to have to tage people. it's a crisis situatn with people waiting and waiti and waiting. >> if i see a speciast, at least it wilbe a chance that the doctor will sathat the pa will go. that will be rlly a miracle for me. >> loong at your x-rays, you've got ankylosin spondylitis. >> uh-huh. >> so, like, on your hipight herethis used to be a clear linelike this. there was a joint here your body responds by turng yo ligaments and your tendons into bone. that's t underlying disease. but ateast we know what you have... i mean, this is the re deal. now, the pblem is it's a disee that continually progresses. the most important thing is ha to keep your head looking forward. carlos is not at the pnt where he requires surgery. if he were fused in a bad

position we can in and we cut the spine, realign theand get them to heal a n position. but it's a very largscale surgery, very highisk. if he can avoid a surgy of that magnitude, i'm alfor that. that's pretty dangerous. as long he can look straight ahead, we're not goingo touch you. veryood. let'see him back here in a year, okay? >> okay. >> i was kind ofisappointed. i am in a lot of pain anit's going toust get worse. think it all matters about t money because we're taing about mae $150,000 for a rgery. my cousin in mexo, she's a nurse,nd she's been telling me to go wn to mexico, to see if

rgery can be done.

>> t doctor in mexico, he gave me a lot of hope. $40,000 will cover the wle surgery and a month inhe hospital. and the door says there's going to be no more pain

>> when you dot have

insurae, you have to worry about how long is youresources going to las >> now what about medicatis? e you... >> i have some nausea medines and hopefully won't have to get anymore of that because e them is $1,100 a month. >> what are u taking for pain? >> jussome tylenol. >> tylenol usual doesn't do it for cancerain. >> yeah, it doest, but i just trand bear with it. the main pn is in my hands and feet. >> no, that's not good, ren. if you're hang more pain than at tylenol will cover, i wan you to go to dr. smi and ask her what s would give you. >> okay. >> but don't want you walking around in pain. >> all right >> okay? >> yeah. i really never knew how much cancer patient hado deal with, until it was put in my fe. >> ma'am, stevs health care haplaced you folks in our office for a pasdue bill

$578.08. this cl is an attempt to collect. any information will be us for that purpose >> all i can do isome in and start king some payments. >> okay. >> but i can't pmise more than $20 a mont i'm trying to pay t several people. >> okay. i can't secure it for at low. >> the cancer nter did have to finally turn us into the collecon agency. i rn off my phone because the collecrs calling so often that you can'even rest. it removal of ovary tubes, but th charge you for each tube. well, so far wstill got all of these. it's $,775.89.

i'ready to pull my hair out, what hair i' got left. i can't std it no more. it's dring me crazy. r full debt is probably $80,000, and we on made $16,000 last year. >> you're going to sell the? >> yep. we have to get rid of as mucas we can so we can pay the bil and try and make iuntil we can get moved. i think we canet some pretty good money on th. >> it's got to stay, bab >> how often do you play it ronnie? that's how we'reoing to get moy. we've thought about poibly ling bankruptcy.

if we can pay off e bills, we would pref to pay them off. think the stress and strain has finally hime, you know. but just have to keep reminding self things could be worse. >> sprise! >> hi, i didn't expe all y'all here. >> the lasyear and a half it's been pretty streful. >> happy birthday! >> thank you. >> you're welcome >> it has gottenetter knowing that the cancer is in remiion. still it's always in t back of my mind, what if it doesn' st? what are we gog to do then becauswe still don't have inrance. is is something that i'll ha to think about as long as i'

lucky enougho have karen with me. >> ♪ happy birthday to y! happy bihday dear karen! ♪ hap birthday to you! ♪ oh, those are cool. i think that was my nior year picture. the baldeaded one, of course. well, i'glad to be 50, and i'm glad to still be here. fe is to be lived to die and at's just the way it is. everybody'going to be there one day. i st look at it i got another day, i'm happy

>> joe is getting althis expensive treatmen but honestly it esn't make any sense. if he'd st had basic care and e medication that he needed, don't think joe would ve been this sick. this is the worst i've ever en joe. this suld be the best time of our live i meanwe've been together over 20 years, we shoulbe enjoying each other. this should have beeour time, and it's not. wee supposed to be the richest untry in the world, and yet

live t poorest life, and my husband worked all his le and paidaxes, so could somebody explaithat to me, because it doesn't make nsense. >> you're looking at m >> i love you. >> i love u, too. what? are you going to tell me something? tell m >> i'm finishe >> you're finished that's not true. i love you. yocan't leave me. >> i'm finished. >> no. >> i c't walk. >> don't make a fference. i'll take you any way i coul ta you. i alys told you that. >> yeah. >> don't leave me,oe.

when i drove homthat night, there was a peace with me that id it was okay, dale, to let joe . that he was suffing; he was in pain a couldn't even tell you he was ipain. and at i had covered everything of l the years we d spent together, and he kne when his time came tt i really d love him. two days beforjoe passed away, joe was approved f medicaid. i figured, "what's t point w?"

>> i was trying too back to mexico and have the suery done, t $40,000 dollars for me is impossible toome up with. when iealized that it was not going to be possiblei was sad. i wasn't expectinguch from li really. >> just relax w. if carlos had heal insurance something would ha happened by now. so we do rion care in this country. people don't likto hear that, they don't like say that, but the trh is, we do ration care bad on abilityo pay. i want youo breathe in and out through ur mouth, okay? whenever you're ready.

okay, deep breath. public hospils in los angeles e overwhelmed, and in the prive system things move quicker. and rlos? he's just a nice guyith three kidsnd he needs a break. so i'm trying to get him thrgh with the private stem. well, the goal ito evaluate you and then refer you tthe orthopedic surgeonat u.c.l.a. d see whether the surgery would be merited. if they feel they can lp you, they've agreedo do this all for fr because we know there's no way you cou possibly afford it. th will give you their honest opinion. >> right. >> and we'll go from the. and i don't know thenswer. i don't, i don't know. >> the lumbar curve , uh, is compsating quite a bit. can you bend forward

okay, all ght, very good. straighten bac he's gotuite a significant kyphosisere. >> 80 degrs maybe. >>5 degrees here. so this is eight yrs later, and it's progressed fromn 85 to a 97 degree curve and what wlook for to deteine whether anything surgical can be done ia few things. ether the curve is progressive, whichn your case has been, anthe other thing is in.... >> oh, yeah... >> ...which you'veeen experienng. so the two rsons are good reass to have surgery. this is a surgy we do for patients who... this conditi affects their li. the facthat carlos is getting th care for free is only a testament to t fact that he was lucky, nothing ee. he's lucky because hmet the right people at e right time,

and so this is a vy unique situation. >> everything ing okay? >> very well.... >> and for carlo i think, being a part othis documentary, he's gettg a lot re attention than the averag patient. >> i'm very pleased thate are able to help ts one indidual out, but what wee really talking about is 47 milln americans whhave no public o private insunce. we can't do endlessurgery on uninsured ople. it begs a national solion. >> andhen gradually increase yourctivity. >> for me, it ans a lot. that means, th you know, the pain is going to sto that maybe iill not have to deal with pills anymor it mea a lot, maybe my whole fe.

>> i know you've givenhis a lot of thought. and i wa you to be aware that this is big surgery. whene straighten the spine, the nerves can be retched and that can damage the spin cord and it may make you paralyd. because it is such aig suery, there is about a 10% risk of dying from this surgy. we're ing to do our best for that not to happen obvioly, t we can't predict the unexcted. >> okay, here go. this is where you say,i'll see u later." >> carlos' case isertainly in the ra of one of the worse

i've seen unfortunately. the worse the cue, the higher the risk involvewith this surgery. give me the screwdriver plea. if carlos had insuranc we could'verobably inrvened and addressed his deformity bere it got asevere as it is today. i think if we just comprs down here a little bit,hat might help us out. if carlos were to pafor his surgery, it uld cost $200,000 to $300,000. tough angle. this is a big operation. ú÷

>> heydr. shamie. >> nicto see you. how e you? >> gd to see you. >> you look more upright!

u look great. >> yea yeah i look better. >> how you feel? >> i can breathe a lotetter. yeah. fantastic. >> yea i told my wife, at least, u know'm at the same height as you now. because i was shorter u know? >> don't aertise that cause when you're gointo have people comingn wanting to get taller, anit's a big surgery for that. >> right, ght. >>ou gained a little over three inchesn three weeks. >> which ireally good, yeah. >>o this has been a remarkable journey. >> it has been. >>or you and your family. >> a i thank you so much. i have no words to desibe how much i feel. you haveractically saved my life. >> dr. dowli you started our dream, and dr. shamie you end it. >> ironically, it all starte two years o this past weekend. >> y, exactly, two years ago. >> at the medical stent health fair, ich we had again this weekend, and we stilsaw throngs of people wi health problems with no heah insurance. so thas part of the bigger

issues is how doe care for everybody in this country? after 15 years of having a lot of pain, i feel th i'm new. i can be a better fatherith my kids, be better husband. >> say chee! >> cheese! >> and i feel like i'mery lucky. >> moyers:ince producer roger weisberg first repord on the families in "critical condition," here's what ha happed to them. in the aftermath of e's death, his widow dale has been struggling to raise their granddaughter one. she stl receives collection notices for outanding medical bills and contins to blame joe's passg on his lack of

insurance. carlos benitez is thout great pain for the fir time in years and ur inches taller since his surgery. he returned his chef's job at that frencrestaurant, but stilhas no insurance. en if he could pay, his pre-existing condition probly mes no insurance companyould cor him. he tak pain medication that he ys much more cheaply in mexi and he has a st tiss lump on his chest, which remai undiagnosed. can't afford the x-rays he needs. six mont after "crical condition" was completedkaren dovead a recurrence of her cancer. she opted r an oral drug procol, but a serious side effect of the treatmensent her back to the hospital, where e contracted pneumonia andied, only 50 yes old. her husbd ronnie is living with his daughter. he got a job at a grocy store that has an surance plan. but the medical billfohis wife's treatme keep coming.

they m pe up to as much as $150,000. ronn, o lives from paychk to paycheck, h only been able to pay baca tiny fraction of wh he owes. you want to find out more abt the families and producer rog weisbers work, log onto pbs.org and click on "bill mors journal." we'll nk you to p.o.v.'s "critical condition"ebsi and some oroger's her cuntaries. contra these real-life experiences with the wheelin and dealing in washiton, where the al care negotiatns now rn on such arcane factors as "bendinghe curve," "advanc informn technology," and "actuarial projections meanwhe, on e airwaves, fans of every stripe are hammering eh other in0 and 60 second spots, each characterizing t other side in the health cardebate as evything fmauding sh... >> let's ta on the real predat health insurae companies. >> moyers: ...to dr. frankenste.

>> now we face his most ngerous experiment of all, governmeake overf healthcare. moyers: and on thground, the ressional wn hall meetings have beenijacked by yeing, jeeri, and belligerent shock trps of protest who ha turned the media spotlight on themselves, away from the issue of howo get health care to theeople who need, but can't afford i when all thela and fhave rned to ash, here's what remains: o present syste ts medicine as a profi center instead of a hun need and public svice. next wee we'll hear om some doctors whthink that's a scandal. the oscar-wiing filmmaker ex gibney has td up with producers petebull, ris tonti, and director andy edericks to oduce a film based on mage mahar's powerful book "money-drivenedicine." take a look. >> theurrent medical system is not designedo meet the health needs of theopulation.

it's designed to turn a ofit. it designed to meet the needs of the people in per. >> the worsthing that could happen to the director of hospitals that everybodyall of sudn woulbe healthy. whathey're selling is hospital beds. >> many pele thinkhey know what'srong wh the healthcare systemn this country. millions opeople are uninsud, and sure that's part of the problem, t that's not the whole problem. e whole problem is bigger th that. hey, this is somebody's mother. this is somebody's fher. th is somebody'srother, and if i don do right by them, just understanthat people die in my pression. >> when you have ia system built byevenue and that money is not bng put back in the systemo help people. we've lostur way. >> moyers: join next weor "money-driven medicine."m i'bi . e you then.

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