Though it doesn’t explain some important aspects of the health-care system, "Sicko" certainly highlights many of the issues our company deals with every day on behalf of the employees and retirees of our clients.

One scene shows a woman holding a denial letter from her insurance company — received because her ambulance ride to the hospital after a car accident wasn't pre-approved. A father shows the denial letter he received for a second cochlear implant for his daughter. Their insurer had paid for the first implant but considered the second "experimental."

Anyone who says all of these examples aren't true has great insurance coverage and has likely never been very ill. As most of you know from both personal experience and from managing health benefits, these situations occur all too often.

The article on Debbie Yungman in this issue of The Advocate is another example of the system's flaws. Her husband Tim's health plan had a limit on how much it would pay for his gastric bypass surgery. Sadly, he suffered severe complications and died two months later after being on a respirator in intensive care. At first, the insurance company balked at paying anything beyond the initial surgery — leaving Mrs. Yungman with bills of more than $450,000.

After many weeks of research, requesting medical records and negotiation, we convinced the health plan that although the complications were a result of the initial surgery these bills should be considered separate and apart from the initial surgery and paid under the normal plan provisions.

Had we not understood how health insurance works, how to file appeals properly and how to negotiate with carriers and hospitals, Mrs.Yungman would have faced a financial crisis.

Incidentally, effective in October 2008, Medicare will stop paying hospitals for charges resulting from preventable complications such as falls, objects left in a patient during surgery, blood incompatibility, air embolisms, certain infections and bedsores. And the hospitals won't be able to bill patients for any charges associated with these hospital-acquired complications. Expect private health insurers to follow Medicare's lead.

Some of the examples highlighted in “Sicko” are much like the Yungman’s case. The movie is not about those with no health insurance which is itself a tragedy. Instead, it’s about those of us who are fortunate enough to have good health insurance, but don’t always receive the benefits paid for.

In the film, Moore clearly questions the profit motives of American health-care system but unfortunately doesn’t also explore the tax implications of universal health care. As I’ve said before, America needs to find a balance between the two systems — private and government. He also omits a very important element missing in the health-system crisis: the importance of taking personal responsibility for your health.

Yet the film does illustrate tragic examples of how the health-care system can get things very wrong and includes trips to London, France, Canada and Cuba. A mother's daughter dies because of the delay produced when an out-of-network hospital refused to treat her. Moore takes 911 volunteers with respiratory problems that New York won't pay for — because they weren't city employees — to Cuba where one woman finds her $125 inhaler costs a nickel.

There are lighter moments as well — a British public health doctor who Moore assumes lives in a bad part of town and drives a beat-up car pulls up in front of his million dollar townhouse in an Audi. A doctor in Paris makes house calls in a small Volkswagen bug.

While some may consider Moore and his craft extreme, "Sicko" depicts an American health system in crisis. We may not want to duplicate the Canadian or Western European systems, with their long lines, rationing and black-market treatment options. But we need to stop being so arrogant and look and learn from others to improve the quality, access and compassion of care here for all Americans.