What do you get when you mix one part Michael Moore with a preeminent health economist and the head of the American health insurance lobby? A very lively hour on the Oprah Winfrey Show.

Today’s Oprah show featured a heated discussion about health care in the U.S. The title of the show was Sick in America: It Can Happen to You. Oprah and the audience saw Michael Moore’s Sicko before the show was taped. Oprah confessed to her millions of viewers that the movie opened her eyes to the problems of access in U.S. health care.

A panel was convened to debate Sicko’s contentions. The panel included Karen Ignani, President of America’s Health Insurance Plans (AHIP, the health insurance mega-lobby); Uwe Reinhardt, health economics professor extraordinaire of Princeton; and Moore.

About 30 minutes into the show, Oprah got pretty heated with Ignani when talking about the denial of a young man’s insurance claim for a bone marrow transplant to treat leukemia. Ignani talked about how 5 billion claims are approved in the U.S. each year, and that there is ‘only’ a 3% denial rate. Oprah repeatedly asked, “Why wasn’t the bone marrow transplant covered?” The debate got more impassioned.

Reinhardt was his usual calm and collected self, asking the question that is now on Oprah’s website poll: “Should the child of a gas station attendant have the same chance of staying healthy or getting cured, if sick, as the child of a corporate executive?” He spoke about how Americans should stop using the phrase “socialized health care,” and instead talk about “social insurance.” After all, Reinhardt said, “When hurricanes or other natural disasters hit, the government steps in to help victims. That’s social insurance,” he explained. “It’s a natural disaster, and I would say if a lady in Mississippi has breast cancer, isn’t that a natural disaster, too?” That sentiment could deeply resonate in the heartland of post-Katrina America.

Poor Ignani, the definitive model for grace under pressure, was out-argued by the panel. Then the health insurance whistle-blower, Dr. Linda Peeno, joined the panel. Peeno’s segment was perhaps the most powerful on the program (as she was a formidable feature in Sicko, as well).

In 1996, Peeno testified to Congress as a medical director for an HMO. She said, “In the spring of 1987, as a physician, I denied a man a necessary operation that would have saved his life and thus caused his death. No person and no group has held me accountable for this because, in fact, what I did was I saved a company a half a million dollars for this.”

Fast forward 11 years, and Peeno told the Oprah audience that she could offer the same testimony today. Except, Peeno said, “The only thing I would have to add to it was that things are worse.”

hile the panel was not evenly stacked — Ignani had both hands full vis-a-vis the four-pack of Moore/Oprah/Penno/Reinhardt — the show did a good job trying to focus the debate on The Question we must ask ourselves as Americans: Should health care be a right or a luxury? Are you ready to make changes so that everyone can become insured in our country? What are you willing to sacrifice personally for healthcare to become a right for every citizen?

Health Populi’s Hot Points:
If the topic’s on Oprah, it must be reaching middle America. This is a good thing. It’s more than time to have the open debate about Who We Are Today — and Who We as Americans Want to Be going forward. This will not be the last Oprah sh

ow on health care. Stay tuned. Health Populi will be…