| Ambulances | Siren/ Music | 01:00:00 |
| Casualty section of Texas Medical Center | BOWDEN: It’s another Friday afternoon and staff at the Texas Medical Center are gearing up for a hectic night ahead. | 01:00:21 |
| Holcomb. Super: | DR JOHN HOLCOMB: We had a guy who had part of a house fall on his leg and we did an amputation on his leg just about an hour ago, and we’ve had three seriously injured patients come in, in the last twenty minutes or so. | 01:00:30 |
| Aerials from helicopter | Music | 01:00:38 |
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| BOWDEN: This is the largest medical complex in the world, a virtual satellite city near downtown Houston. But one in three Texans don’t have any kind of health insurance. The only way they can make it in here is if they’re sick enough to be sent to emergency. | 01:00:54 |
| Patients from helicopter into emergency | Music |
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| DR JOHN HOLCOMB: I enjoy trauma because when the patients come in, I don’t have to inquire their insurance status. It’s irrelevant. And so | 01:01:30 |
| Holcomb | it’s one of the segments of the health care system where we have open access to everybody. |
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| Emergency montage | Music |
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| BOWDEN: Forty-seven million Americans can’t afford insurance and as the economy gets worse, that number is expected to rise. Even if you are insured, it still may not get you into the hospitals at the Texas Medical Center. | 01:01:47 |
| Lisa an d Sam Kelly walk | That’s what happened to the Kelly family. | 01:02:08 |
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| LISA KELLY: You have no idea when you go to the hospital what you’re looking at, what their charges are and plus | 01:02:17 |
| Lisa Kelly | our insurance is so expensive we couldn’t afford it. | 01:02:24 |
| Photo. Lisa and Sam | BOWDEN: Three years ago Lisa Kelly and her husband Sam were looking forward to a comfortable retirement. | 01:02:30 |
| Lisa and Sam sit on bench | Like many Americans they had basic health insurance. Then the bottom fell out of their world. Lisa was diagnosed with leukaemia. | 01:02:36 |
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| LISA KELLY: The very first day is the most emotional. | 01:02:49 |
| Lisa | You’re just kind of in a daze, you’re in shock, you have no idea. | 01:02:54 |
| Ext. University of Texas cancer centre | BOWDEN: After Lisa Kelly’s diagnosis, doctors told her that this was the place she needed to come to for treatment – the MD Anderson Cancer Center in Houston – about an hour and a half’s drive from her home. But even before the first appointment, it became clear that the family was facing not just a medical crisis but a financial one. | 01:03:03 |
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| LISA KELLY: I called and made an appointment, gave them my insurance information, they called me back, “I’m sorry you’re going to have to have the money for us to make you an appointment”. | 01:03:24 |
| Lisa | BOWDEN: How much money? | 01:03:32 |
| Super: | LISA KELLY: The very first day I had to go up there with a cheque for forty-five thousand dollars before they would give me an appointment. | 01:03:33 |
| Lisa takes tablets | BOWDEN: They managed to pay it but it didn’t stop there. | 01:03:45 |
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| SAM KELLY: I mean even the doctor came out and said this could cost you anywhere from a quarter of a million dollars to half a million dollars to get your wife well. I said okay. | 01:03:49 |
| Sam. Super | You know I would give up everything I’ve got to keep her. | 01:03:57 |
| Chemotherapy montage | Music |
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| BOWDEN: On one occasion as Lisa Kelly waited with a drip in her arm in the middle of chemotherapy treatment, staff said the appointment would only continue if her husband went and made yet another payment. | 01:04:06 |
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| LISA KELLY: My machine was beeping because it was empty and I needed another bag, and she said | 01:04:22 |
| Lisa | “One of you are going to have to go down to the business office before we can take you to the back and re-hook you”. It was one of those rough days. | 01:04:26 |
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| SAM KELLY: Yep, one of those rough days. | 01:04:33 |
| Sam | BOWDEN: What kept you going on the days when it was really difficult? | 01:04:35 |
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| SAM KELLY: [Upset] Just to keep her going. | 01:04:43 |
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| BOWDEN: Just to help her get through it and get better. | 01:04:46 |
| Holly on phone | HOLLY WALLACK: [On telephone] Good morning. My name is Holly Wallack and I’m from Administrative Solutions Plus and I’d like to speak to you about the account of Lisa Kelly… BOWDEN: As they faced the prospect of having to sell their home to pay medical bills, Lisa Kelly heard about someone she hoped could help - billing advocate Holly Wallack. | 01:04:53
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| HOLLY WALLACK: [On telephone] Her total self-pay charges come to one hundred and forty-three thousand. BOWDEN: Holly Wallack lives and works in Florida, | 04:05:13
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| spending her days contacting the billing departments of hospitals across the nation, trying to get a fair deal for her clients. |
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| Holly takes notes | Now Lisa was under-insured, was she being irresponsible? | 04:05:33 |
| Holly | HOLLY WALLACK: No I don’t believe that she was not responsible. I think that she was under-insured and I think that there are a number of companies that are selling this type of insurance and 25 million Americans have it. I think it’s not sold properly, I think that people believe that they’re buying adequate coverage, and none of these 25 million people realise that they’re under-insured and the only way they’ll realise it is, God forbid, if they get ill. | 04:05:36 |
| Ext. Medical centre | Music |
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| BOWDEN: Management of the MD Anderson Cancer Center refused our request for an interview, but the hospital’s policy of up front payment is not unusual as US hospitals face growing bad debt from the massive number of uninsured patients. The cost, complexity and failures of its health system have grown over time to become America’s most profound domestic policy problem. | 01:06:14 |
| Hillary Clinton archival footage | Hillary Clinton for one tried to change the system back in the 1990s.
HILLARY CLINTON: [1993 address] Nothing is more important to our nation than ensuring that | 01:06:46
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| Super: | every American has comprehensive health care benefits that can never be taken away. BOWDEN: Her plan was killed off by the powerful interest groups including insurance and drug companies. |
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| Jennings. Super: | JENNINGS: The opponents of health care will always use words like government takeover, rationing, socialisation, communism, you know, you name it. They use terms of art that have no relevance to the current debate. They try to scare people. They know that in the past fear has beaten hope. | 01:07:09
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| Archival. Freeze frame. Jenning behind Hillary Clinton | BOWDEN: Chris Jennings was ‘the health care guy’ in the Clinton White House and is now advising the new administration. CHRIS JENNINGS: I can tell you when President Clinton and Hillary Clinton would travel | 01:07:27
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| Photo. President Clinton and Jennngs in White House | around the world, the one question they could never answer all the foreign dignitaries was |
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| Jennings | how can you be a great, and you know, and the economic power that you are, and you say you are, and leave so many people behind? | 01:07:45
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| BOWDEN: He’s heard all the arguments against change but says this time it’s different. | 01:07:53
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| CHRIS JENNINGS: Everyone sees that the current system is absolutely unsustainable and they see that failure to act could create more problems than acting. | 01:07:58
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| The president’s commitment is to develop a system that does cover every single American. |
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| Super: | It will include specific financial support for people to be able to afford health care through tax credits and direct financial assistance, both through the private sector and the public sector. | 01:08:15 |
| Pennsylvania Ave sign | BOWDEN: Unlike Hillary Clinton, President Obama is managing to keep the insurance companies on side with the promise of increased market share. | 01:08:28 |
| Jennings | CHRIS JENNINGS: We have a crisis and that’s the only time this country does big things. We have an economic crisis, it’s linked to health care and when we have these type of environments, people look toward the Federal Government to do and take more of a leadership role. | 01:08:38 |
| Inauguration footage | SHALONDA FREDERICK: I watched the election coverage and I was so into it. He knows what it is to not have that insurance and to need the help and no one will help you. | 01:08:58 |
| Shalonda | BOWDEN: Shalonda Frederick believes President Obama will provide that leadership and she needs it. | 01:09:13 |
| Super: | SHALONDA FREDERICK: It’s totally unbelievable. It is like you know they tell you, you know no child left behind, you go to school, you go to college and have a career, you be productive… well, I did all that but no child -- I didn’t get left behind as a child but I’m getting totally screwed as an adult. It’s just unbelievable. | 01:09:19 |
| Shalonda at home | BOWDEN: Shalonda Frederick lives less than an hour from the decision makers in Congress. She did all the right things, worked hard, paid her taxes, had health insurance but now she can’t afford the medication to slow the cruel progression of Multiple Sclerosis. | 01:09:38 |
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| What difference does it make when you actually get the medication? | 01:09:56 |
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| SHALONDA FREDERICK: It just makes you feel better. You feel like the MS isn’t winning. | 01:09:59 |
| Shalonda | It’s a total different way of life. I can, you know, play with my dog, I can focus on doing what I’m doing. It makes your mind clear ‘cause you don’t have to worry about am I going to fall? | 01:10:06 |
| Shalonda dresses dog | BOWDEN: Like most Americans, the thirty-three year old’s health cover was provided by her employer, so when she lost her job because of her illness, she also lost her insurance. | 01:10:18 |
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| So you simply do not have the money to buy your medicine? SHALONDA FREDERICK: Yeah. BOWDEN: How much would it be? | 01:10:30 |
| Shalonda | SHALONDA FREDERICK: Whatever the shots you may need or the treatments you can do, that can be three to five thousand dollars per month or every three months depending on how often you do them and I mean there’s just no way, it is just not possible. | 01:10:35 |
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| BOWDEN: When did you have your last lot of medication? | 01:10:48 |
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| SHALONDA FREDERICK: The last week of July, last year. The last week of July. | 01:10:50 |
| Shalonda with dog | BOWDEN: There is government assistance for the poor called Medicaid but in Maryland where Shalonda lives, you can’t earn more than $360 a month to qualify and her disability pension puts her over the limit. So she has to wait until April next year before she qualifies for government funding for her medication. | 01:10:58 |
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| SHALONDA FREDERICK: April’s not even in my vocabulary right now. My point is, do you even know if any of those medicines are going to work? My fear is that I’m going to be too far gone. You know, | 01:11:19 |
| Shalonda | I’m not a give-up, whiney type person and for this to happen, I am terrified. It’s like at the end of the day I am thirty-three. I’m thirty-three years old and there’s just no… I’m sorry… there’s just no… there’s nothing there. It’s like I didn’t do anything, and apparently it doesn’t matter. You see people very day that do bad stuff and they get over and I’m the dummy that chose to live right and there’s like…. no….. there’s nothing there. It’s like I’m being penalised because I chose to do the right thing. | 01:11:30 |
| Driving to Kentucky | Music |
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| BOWDEN: As unemployment grows there are sure to be many more Shalonda Federicks. In some parts of America, whole communities are suffering. | 01:12:19 |
| Kentucky people lining up for medical care | It’s the middle of the night in the middle of winter but people are lining up and waiting for their number to be called. This weekend the sports stadium outside Hazard Kentucky has been turned into a free medical clinic, by a charity originally set up to help people in the remote Amazon jungle, until they realised people in the world’s richest country need their help just as much. | 01:12:40 |
| Ava in queue | AVA SLOAN: We got here at about six thirty yesterday evening and I am here for my heart and a cancer screening and then my husband… he’s here for glasses and he really needs them. | 01:13:09 |
| Daniel | DANIEL SLOAN: I’m thirty-nine years old. I made it this far. If I get them today I’ll be fine – if I don’t I’ll be fine. What can you do? | 01:13:20 |
| Ava in queue | BOWDEN: Ava Sloan has no teeth and hopes to be fitted for dentures today. AVA SLOAN: I couldn’t afford dentures. They’re like thirty-four hundred dollars and I don’t have that kind of money. I don’t have no money. | 01:13:28
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| Inside stadium |
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| Craig having dental exam | BOWDEN: Craig Evans lost his job two years ago when the company he worked for relocated to Mexico. Today he’s finally getting an infected tooth extracted. | 01:13:48 |
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| CRAIG EVANS: Since we lost our jobs, we just couldn’t afford the medical insurance. | 01:13:59 |
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| If a clinic like this wasn’t here, we wouldn’t even have got these things today. | 01:14:04 |
| Linda Evans tries spectacles | BOWDEN: Craig Evan’s mother Linda is choosing a new pair of glasses. After losing her job and her health insurance, this is the first time in her life she’s had to rely on a free service. LINDA EVANS: Congress and all them | 01:14:11
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| Linda Evans | should take notice of what us Americans have to do anymore, which we have to lower our pride and all this… and it’s good but it’s also bad for us, you know? ‘Cause we’re independent people. | 01:14:24 |
| Kelly family watch superbowl |
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| BOWDEN: Back in Texas, Lisa Kelly and her family are gathering to watch the superbowl. | 01:14:52 |
| Lisa goes to front door to greet Holly | And they’re expecting a special guest. | 01:14:58 |
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| Holly Wallack has arrived from Florida and it’s the first time the women have met after two years of phone calls and emails. | 01:15:08 |
| Holly looks at Lisa’s medical bills | She’s come to Texas to visit the MD Anderson Cancer Center and to challenge more of the Kellys’ bills. With the advocate’s help, Lisa Kelly’s been able to afford a stem cell transplant to fight her cancer. | 01:15:26 |
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| HOLLY: [Looking at bills with the Kellys] This is your nine thousand dollar shot, remember this shot? | 01:15:42 |
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| HOLLY WALLACK: The bills are egregious, some of them. | 01:15:45 |
| Holly and Lisa | Some of the charges for instance for sodium chloride, you take a bag that costs a dollar and a quarter and they’re charging sixty-five dollars for it. Every company, every business is entitled to make a profit but to mark things up by three and four thousand per cent is outrageous. | 01:15:49 |
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| BOWDEN: And Lisa what difference has Holly made for you? LISA KELLY: A huge difference. It’s like a load has just been taken off. | 01:16:06
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| Lisa’s neighbourhood | Music |
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| BOWDEN: In this home, like so many across America, there’s hope that Barack Obama’s health reforms will make a difference – and soon. | 01:16:25
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| Lisa and Holly | LISA KELLY: It just makes you angry because you’re thinking this is America. Why is this happening in America? It’s not like we’re Africa. | 01:16:38
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| Lisa | I don’t know what it would take to fix it but I know there’s something better than this. | 01:16:48
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| Shalonda with dog | Music |
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| SHALONDA FREDERICK: I have to believe that it’s going to happen. BOWDEN: Shalonda Frederick too is putting her faith in the new President to change a health system, which is crippling the economy and millions of Americans. | 01:16:59
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| SHALONDA FREDERICK: If there is anybody that can get this, that has the power to change it, | 01:17:19
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| Shalonda | I have to believe in him. I don’t have a choice. | 01:17:24
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| Reporter : Tracy Bowden Camera: Dan Sweetapple, Louie Eroglu ACS Editor: Simon Brynjolffssen, Woody Landay Producer: Mavourneen Dineen |
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