Topics

> How Good Is Your Healthcare?

The quality of America's health care is one of the most hotly debated topics in America today. Many people tout America's trillion dollar healthcare system is the best in the world, yet millions of ordinary Americans complain that they do not get the care they need when they need it most. In two major PBS programs, Hedrick Smith and his production team hae traveled the country talking to doctors, patients, HMO executives, government and academic experts and quality gurus to get an in-depth evaluation of the state of America's health care. These programs and supporting materials provide not only a white paper report on what's working and what is not - but also how to become your own best health care advocate.

PBS Frontline: Dr. Solomon's Dilemma
In the new economic crunch on America's health care system, doctors find themselves trapped in the middle - caught between their commitment to patients and the tightening vice of medical cost control. "Dr. Solomon's Dilemma" goes inside one of Harvard Medical School's famed teaching hospitals to depict the struggle between the patient-firsters and doctor-managers focused on the bottom line. Hedrick Smith follows Boston-based physician Marty Solomon as he grapples with the issues of cost versus care - navigating the fine line between patients' needs and financial realities which can spell death or survival, not only for patients but for the hospitals that seek to provide their care. Dr. Solomon and his partners in his "pod" or medical practice find themselves having to calculate whether to keep providing care for group of senior patients or having to fork out money from their own pockets to pay back the HMO when their costs exceed their share of health care premiums.

Critical Condition with Hedrick Smith
With Americans more anxious about healthcare than ever before, we all want to know if the right care will be there when we need it most - in emergencies or when we or our loved ones developed chronic conditions that require years of expensive care. Hedrick Smith and his team scour the country, visiting cancer clinics and children's rehabilitation centers, filming open-heart surgery and talking with diabetic patients and their doctors, capturing the aching choices of the uninsured and the medical centers committed to caring for them when dollars are short. And everywhere, Smith seeks answers to the critical question: "How good is your health care in a crunch?" PBS devoted an entire three-hour evening of prime time, two weeks before the 2000 Presidential election, to this in depth report on the challenges facing our facing our modern medical system and some of the daring efforts to improve the quality of American health care.

One major finding: A huge quality gap between normal medical practice and best practice. Careful medical students and health experts report that medical errors kill tens of thousands of people each year - more than car accidents, breast cancer and AIDS. The 45-minute segment on "The Quality Gap" focuses on a new breed of crusaders that are tackling this issue - and cycle of official silence and denial that often follow medical errors.

Living with chronic illness is a grim reality for over 100 million Americans. The cost of caring for these patients is more than $760 billion a year, posing a major challenge for commercial health insurers. The 45-minute segment on "The Chronically Ill" looks at those who need care the most, from infants to seniors, the struggle of their families to get them the health care and the insurance they need for necessary treatment, in today's cost-conscious health care market.

"The Idealist HMO" examines the pioneer HMO, Kaiser Permanente, the non-profit giant that began in northern California, and how it differs from many managed care companies. Kaiser Permanente started as a radical experiment of social mission of lifetime care and doctors, not executives, making big financial decisions, but came under fierce competitive market pressure in the 1990s to changes its ways and cut corners to maintain its market share. Kaiser nearly got blown off course and suffered setbacks, but then began battling back to its core commitments. The most visible symbol of Kaiser's commitment to healthcare for all: a public ad campaign touting its extensive HIV program - despite the fact that people with HIV and AIDS are among the most costly patients - often costing far more than $20,000 a year in drug costs alone. But even when Permanente's social commitment outdoes its rivals, Kaiser faces financial trouble, and it remains to be seen whether its efforts to regroup, cut costs and win customers through their emphasis on quality care, will pay off in the long run.

Roughly 40 million Americans are without health insurance. The majority are employed, but work in jobs that do not provide health insurance benefits. Because of their uninsured status, many put off seeking routine medical care until their health concerns reach crisis proportions, a trend that actually costs America's health care system more in the long run since emergency treatment is often much more costly than preventitive care. The program's segment on the "Uninsured" looks at the problem of both individual patients, and the effect the uninsured have on the health system as a whole. It explores innovative state efforts to extend medical coverage to those who need it most from Tennessee to California.