The Big Heist, a documentary film now in pre-production, will lay the blame for middle-class economic stagnation on healthcare executives.
"For fifteen thousand years, fraud and short-sighted thinking have never, ever worked. Not once. Eventually you get caught, things go south. When the hell did we forget all that? I thought we were better than this, I really did." – The Big Short
The healthcare industry has largely escaped furious documentaries that blame it for substandard quality, bankrupting people, and general economic malaise.
But that's about to change.
The Big Heist (working title) is a film that takes square aim at what might be called, with apologies to Dwight Eisenhower, the healthcare-industrial complex.
The film, now in production and set to be released next Fall, is being bankrolled and executive produced by Dave Chase, an author and venture capitalist. He founded Microsoft's healthcare business unit and Avado, a cloud-based patient relationship management solution, acquired by WebMD in 2013 for an eight-digit price tag.
Chase calls the movie a cross between The Big Short (a feature film) and An Inconvenient Truth, (a documentary) and hopes that by "following the money," the movie will expose the perverse incentives that maintain the status quo: a far from optimal healthcare experience that harms people and costs way too much money.
He hopes the film will catalyze change in the way healthcare is paid for and delivered.
Much of the film's satirical focus will be on how the status quo remains so, from federal lobbying to the construction of the employer-based health insurance model, to the broker-insurance dynamic, which Chase insists is completely disincented to reduce healthcare costs because profits depend on a getting a share of the cost pie. The only way to grow profits is to grow the pie.
"The disaster of the middle class is the employer-based health insurance model," he says.
'The Math Stops Working'
To employers, healthcare for decades was a nice benefit to offer employees, but not a material part of a company's expenses.
But with the power of "somebody else is paying" and the lack of focus by CEOs on getting value for their healthcare expenditures, costs blew up. Then companies started pushing costs directly onto employees through high deductible health plans.
High Deductibles Could Backfire on Insurers, Employers
"If you wanted to separate a company from its money, this was the perfect storm," he says. "Healthcare is made to be very complex and certainly is medically, but the financial side has been made so because of the convoluted system we have for a host of reasons. So what happens is they shove what they won't pay onto the employees' plate and then the math stops working."
Contributing to the problem is that the insurance companies aren't interested in lowering costs for healthcare despite their protestations, because it's against their self-interest, he says.
"The misconception is that health insurance companies have an interest in cost control where the opposite is true," he says. "It's easy to scare and bamboozle people when there are not a lot of employers around them who appear to be doing any better.
Executives need to recognize that this isn't a passing problem, Chase says.
"Dollars have gotten to breaking point and clinical teams are also incredibly frustrated," he says. "You would be amazed at the plotting that's going on right now to break free of these organizations and create new things."
Other healthcare luminaries who are funding and advising on the project include
- Doug Barry, founder of Digital Riot Media
- Zubin Damania, MD, a former Stanford physician who's known as the "Weird Al" of medicine through his alter ego, ZDoggMD
- Jonathan Bush, the bombastic CEO of Athenahealth
Meghan O'Hara, who worked on Michel Moore's Sicko and Bowling for Columbine, will produce and Nick McKinney, who worked on The Daily Show, will direct. Right now, Chase and his team are finalizing the narrative, casting and filming a promo trailer, while simultaneously raising capital to produce and distribute the film, which they expect to release next fall.
"Most people won't watch a wonky documentary, but if it's entertaining, they will," says Chase.
"The absurd and outrageous make good satire and the only previous attempt I know of was Sicko, almost 10 years ago, but half the country won't listen to Michael Moore. This is not a right or left deal. In fact," he says, "the best way to preserve the status quo is to politicize healthcare. But when the country pulls together, big things can be accomplished."
Philip Betbeze is the senior leadership editor at HealthLeaders.