Money-Driven Medicine: Interview with the Filmmakers

"We have in the United States of America the greatest health care system in the entire history of the world.

Text: Do we?

"There are at least a dozen countries with lower rates of preventable mortality than the United States, and not one of those countries spends 60 percent of what we do on health care."

Text: Why?

"We're not treating medicine as if it were an industrial product. Through put, how many units of care can you deliver, the idea that you're going to see a patient for between 12 and 15 minutes, no matter what their condition."

Text: Everyone is talking about health care

President Obama: "A plan that makes sure that it is affordable to get health care that is as good as the health care that I have as a member of Congress."

Text: Are you listening?

Alex Gibney, Film Producer; Maggie Mahar, Film Author
"Money Driven Medicine"

Text: What is the inspiration for the film?

Alex Gibney: "The film came about because I had read Maggie's book Bull, about the bull market of the late 20th century. I was floored by it. And then read Money-Driven Medicine, and Rob Johnson—one of the executive producers—and I were floored by it. We thoughts, we've got to make a movie about this. This is tremendous. So, We turned to Maggie. One of the things that intrigued me about what Maggie had done is that Maggie, in a way, was like a detective. She went and talked to doctors, and the interesting thing about this whole process is that doctors were telling Maggie that the system was broken, that they want to provide a different kind of health care than they were able to under the current system. So, everybody talks about how we don't want to get the government in between the doctor and the patient. The fact was that doctors were frustrated because the current system doesn't allow them to do the kind of work that they want to do."

Text: How can the film inspire health reform?

Maggie Mahar: "I think it could have an influence on the debate in Congress right now. But I also think that no one's planning on rolling out health care reform until 2013. So, for the next three years and three months, we are going to be fleshing out the details of what health care reform will mean. That means intense further debate about all sorts of things, including how we use comparative effectiveness research, how we change the way we pay providers, how we change the way they deliver care so it can be more collaborative and more patient-centered. So I think that the film is going to be part of, I hope, that ongoing debate for more than three years."

Text: "What is the film really about?

AG: "It's really a film about doctors, and their frustration with the system. And we always talk about that relationship between the doctor and the patient, and this is film that asks the doctors: What's wrong, and how can we make it better? And everybody talks about this thing in terms of the new health care debate from a policymakers standpoint. And what about the doctor, and what about the patient? Everybody uses them rhetorically, but I think this film can be extraordinarily valuable because it talks to some of the doctors, and indeed some of the patients."

Text: What is an important fact about health reform?

MM: "More care is not necessarily better care, and about a third of our health care dollars are wasted on unnecessary, ineffective, sometimes redundant, often unproven, sometimes unwanted tests, treatments, hospitalizations, drugs, and devices. And that's not just a waste of money. The problem is, whenever a patient's exposed to a treatment he doesn't need or is ineffective, he is exposed to risk without benefit."

Text: What's next for the film?

AG: "On October 27th, I believe, there will be a screening at the Capitol, and that's going to kick off a watch in. Now, we remember the "be in," all sorts of other things from the 60s. This is all about trying to stream it live on a website all over the country, and to get people to look at this film and use it as a tool to understand some of the things that they really didn't know were broken about the system."