Sicko

We went to see Sicko last night. I really dislike Michael Moore and his movies. He's a jerk and his movies are boring and repetitive. It's like he is trying to hit us over the head so hard that we'll listen to him. Whatever.

But the premise behind the movie is spot on. Why does the US resist universal health care when countries like Canada and the UK have shown that it works? I have no idea but I think this coming election will see universal health care be a vote getter, big time.

Comments

[John]

Kind of ironic that you ding Moore for making "movies [that] are boring and repetitive. It's like he is trying to hit us over the head so hard that we'll listen to him," . . .

but then in your own post about Sonos you say: "I know I've said that many times on this blog and am now sounding like a broken record. But it's true."

Maybe the motivation is similar.

[Douglas Karr]

The fear that insurance companies have spread is real. In a conversation at work, one of my fellow employees actually got irate at me for mentioning national healthcare - stating that it would cut treatment to her mother with Parkinson's.

What Americans fail to recognize is that we currently HAVE socialized medicine. That is, you and I DO pay for people that don't have insurance. The cost is passed on in our insurance premiums, healthcare costs, and taxes.

What National healthcare brings the country is a sense of safety. No longer do you have to rely on an employer so you don't risk going out on your own. I would be self-employed tomorrow if it weren't for the high premiums.

People don't realize that we also pay for malpractice, malpractice insurance, litigation, courts, pharmaceutical suits, pharmaceutical profits, insurance profits, insurance bureaucracy... granted, not all of that disappears with National healthcare - but Europe and Canada have shown that it improves significantly.

Doug

[MacMic]

As a Canadian, I can tell you both that public healthcare works, and that it is still a flippin' hard thing to get right!! So you are trading one set of problems off for another. But you should still do it, because compared to the problems in US-style private health insurance situations, it is *way* better to have the problems facing public health insurance programs!!! Peace of mind is invaluable, especially when you are sick and vulnerable.

[Nik]

I am not an expert on any healthcare system but I have worked with both payors and providers as a consultant in a previous job and things can definetely be improved. I also believed that its a shame that US, as rich as it is, cannot look after its people. I also looked at the UK and Canada as good examples...

Until the time, when another friend (who was a fellow consultant, very liberal, until a few months ago a big supporter of universal/govt backed healthcare went to the UK for a project. Here is what she wrote in an email,a few months ago, to me when I asked her why she changed her mind:

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First of all, I went to the dentist, and instead of doing a teeth cleaning the dentist took one X-ray, said everything was fine and sent me on my way - I got to pay £15 for this supposedly FREE NHS dental service. I managed to get a different appt for the cleaning, which lasted all of 10 minutes. The hygienist didn't wear gloves and cleaned like 2 teeth. I got to pay £30 for this. Before you see any doctor you first have to register with them and the government, which takes about 2 weeks. If you get sick during this time you have to go to free clinics and wait in the huge queue to be seen. This happened to me and I ended up taking 4 hours out of my working day.

As for the doctors, everything has to go through your GP. I don't even know how to go about finding a dermatologist etc if I needed one. Secondly, I got blood taken and the nurse not only didn't wear gloves, but she didn't swab my arm with alcohol first either. If she doesn't want to wear gloves that's her risk, but I could get sick because she didn't wipe my arm first. On top of that I had to wait about 2 hours at a hospital for this since my GP doesn't do simple tests like blood tests, throat cultures etc. All testing has to go through the hospitals, and you have to call between 12:30 and 1 to get your results. Thirdly, if I want to make an appointment I have to wait until the day I want to have the appointment, then call the office between 8 and 8:30. I called at 8:36 one morning and was told I was too late and would have to try tomorrow or go to the open clinic where I waited for another 2 hours. If I want to speak with a doctor or nurse for advice or to get a prescription, i have to call between 12 and 12:30. Of course everyone and their mother calls during this time so the line is always busy. It took me months and months to figure out all these rules

That's the extent of my knowledge of the NHS, but all in all it has not been pleasant. In general there is too much red tape and I can't decide if the poor quality is down to budgetary problems or a lower level of medical training of the staff. I have a feeling the answer is both and that they are interrelated.

By the way, the government is now trying to figure out how it can afford to keep the NHS in light of the huge deficit it runs and the aging population. Sounds a bit like the Social Security mess...!

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[Rogel]

I don't like Moore's movies as well, mostly because of his disregard for minor things like facts and truth. The problem is that even when he has a valid point, and when debating on Health Care system he might have some, the fact that he insist on propaganda instead of documentation make his movies unbearable.
It isn't that a movie must be objective, it is practically impossible, but I would prefer a movie that at least tries to be intellectually honest.
That being said, I completely disagree with you about the universal health care solution, but this is not the place to develop this debate.

[carl rahn griffith]

a spot-on review in the new yorker, recently ...

http://www.newyorker.com/arts/critics/cinema/2007/07/02/070702crci_cinema_denby

[Adam]

In traditional Michael Moore fashion, he only presents his side of the arguement. While it's true Canada does have Universal Health Care, the system is plagued with problems of overcrowding, ineffeciencies, and general underperformance, and will need to be heavily overhauled in the not too distant future

[Charlie Gower]

I live in the UK and I can tell you the system only half works. You can get appointments but you have to wait so damn long people tend to go private (if you can afford it). All the workers are foreigners who come here for a few years to travel around. This is because the NHS can't afford to pay proper wages, so nationals can't afford to do the job. It's a bit of a joke.

[Terry Jones]

I've always thought a big part of the reason why Michael Moore is important is that people who think hard about issues, who weigh evidence and try to be rational, etc. have a hard time with his movies. If Michael Moore made movies on the same subjects but which people like us (whatever that is exactly) found really appealing, honest, balanced, etc., I think they would be a hell of a lot less successful (i.e., boring to the average consumer).

Given a choice between A) someone who's sensationalist, who glosses over issues and paints them in a sometimes one-sided way, who's overly ironic in a bit of a stupid and annoying way, BUT who has an important message and pitches it at a level that gets millions of people to watch, listen, think a bit, etc. and B) someone who's intellectually pure, balanced, unsensationalistic, scientific, quantitative, with an equally important message BUT who can't reach the average consumer, I'd take A any day.

What if you had to choose, between Michael Moore and Noam Chomsky, who's the most important for social awareness and change? My vote goes to Moore. And I think it's a good thing, a very good thing, that people like "us" find his movies very hard to bear. People like us are a tiny, tiny, minority. People who have thought little about some of these issues and who might find resonance with a Michael Moore movie may even be a majority.

That's why Michael Moore is so important.

[Justin]

People like us are a tiny, tiny, minority. People who have thought little about some of these issues and who might find resonance with a Michael Moore movie may even be a majority.

You nailed it, Terry. My thoughts exactly. To "us," those that might be trained to spot a half-assed argument, it's clearly one-sided and not deep enough into the other perspectives and issues.

He hits us over the head in a hugely intentional fashion. Then sits there all smug and says, "fact-check it." He knows what he's doing. He has a sense for how the media spin will play out. He knows intelligent bloggers will debate this movie till the cows come home. I personally respect the man. Here here, Moore.

[Terry Jones]

A few more quick thoughts:

People like Michael Moore, Al Franken, and Greg Palast choose to present their messages with a certain style, to pitch them in a certain way. I find Greg Palast's writing style hard to bear. But these people are providing something important: an accessible way to start thinking about politics.

These are intelligent people. You have to suspect that they know what they're doing in choosing their style, their pitch, their tone, etc.

Fred - you think Michael Moore is a jerk, but you also think (I guess) that health care is an important issue and that it will be a "vote getter, big time" this time around. I agree. We will have Michael Moore and Sicko to thank for a good part of that. You should join me in be pleased that he's so annoying :-)

Terry

[Fraser]

Canada's health care system is in a terrible spot. It's broken, but hardly anyone is working towards fixing it.

The problem is that as a nation we view the US system as the only alternative when Europe has some progressive/interesting health care models. I suspect that the same is true for Americans. Another issue is that political parties seem to be unwilling to invest in the long-term commitment that's required to change the system. They're more concerned with reelection and so they simply throw good money after bad at election time.

I'd say that Canada has shown that a model is possible, but we're far from showing that it works.

As a Canadian court recently wrote in a ruling on the public/private debate: universal access to a waiting line does not equate to universal access to health care.

[hey]

Socialised medicine doesn't work. It eats government budgets, is untouchable from a political standpoint, and is more unequal because it rations based on time and connections instead of cash.

The people who get A1 service in the US get the same service in Canada. If you know large numbers of doctors, are well versed in medicine and the system, then you can get morning appointments, home service, and can skip any line that exists. The regular person with insurance in the US would get horrible service because they would be stuck on the back end of MULTI-YEAR waiting lists.

The Canadian system is very short on diagnostic machines (hardly any PET scanners and very few MRIs) and in general is very, very slow to adopt new devices and practices. The "customer" is the provincial (state) health service and is worried about total cost rather than outcome. New treatments aren't approved for years to keep the budget down, rather than being introduced early as a profit center. Every patient is a cost center, rather than a profit center, and you can imagine what that does to service.

Another problem is that a unified system enable union capture of support staff. A major reason behind the revival of MRSA in Canada and the UK is the great reduction of maintenance staff and practices thanks to union work rules and wages. It's wonderful for the few janitors that get paid very large amounts of money for their jobs (we shouldn't be encouraging people to do that as a full time career) and have to do very little thanks to work rules, but it is horrible for patients and health outcomes. Socialised medicine turns the entire health system into one bargaining unit, and completely submerges wage disputes into political ones. Given the repsective sizes of the labor pool (and thus voting power), this ends up with the service union taking the lions share of the cash and controlling health policy, with nurses getting some additional pay (as a group), and the doctors getting the shaft.

Healthcare is a market good like any other. Trying to make it free at the point of use is just as stupid as a universal foodcare system or a universal clothing system would be. The problems in the US stem from employer paid plans and the facially unconstitutional intrusion of the states into determining what health insurance covers. Moving to a system with true insurance (i.e. for catastrophes only) and tax free HSAs where every customer paid at admission is by far the best solution. You get everyone questioning the cost and quality of their care, because by god they paid cash for it. You get people comparing cost vs quality of hospitals and evaluating the benefit of a given procedure or test at an individual level. The same control or evaluation by a bureaucracy not only requires Soviet levels of tyrannical inspectors, but you get away from the idiosyncratic evaluation that every individual has. Some people are going to want to spend money to be active again, because their passion or key family activity is sailing or skiing, while others would be fine saving money and spending more time on the couch. One rule for the state or country doesn't capture this, but giving everyone the ability to choose does.

Fred, would you be happy if the government had the power to decide whether or not comscore provided a valuable service for enough people? If a bureaucrat could set your prices? If a bureaucrat could decide that one company would get the business for the whole country?

So many critics attack the waste of our system, saying that all the me-too drugs are useless, and that the me-too devices are just wastes of money. This betrays their inherent ignorance of medicine as well as their inherent love of a tyranny they run. Every single person's combination of biochemistry, genetic profile, past history, body shape, and lifestyle makes for a unique set of values. A drug that is fine for one patient could be completely inappropriate for another, even though they are superficially "the same". How hard a drug is on other internal organs could rule it out, depending on your history. Effects on fertility can be very important if you're a young patient, but not all that important if you have cancer or arthritis in your 70s. Thalidomide is a very bad thing to give to pregnant women, but it is an effective treatment for some leprosy symptoms and for multiple myeloma. Accutane is also a VERY BAD THING for pregnant women, but helps many young people who have severe acne problems. Going to a single provider means that these smaller decisions and tradeoffs are less likely to happen, with the bureaucratic preference for one general rule.

To echo a recent court decision, the way to solve government intrusion in the health care system is to reduce government intrusion into the health care system. Stop the distortions from employer provided insurance, stop mandating cadillac levels of "insurance" as the base level available in a state. Stop having the government pay for things so that decisions are made based on the size of the staff cohort and their political power rather than the best health outcomes. Finally, stop lauding socialists who act as sycophants to a mass murdering tyrannical dictator who throw journalists, librarians, and gays in jail at a whim. Michael Moore is just as guilty of the ongong crime against humanity that is Cuba as Fidel, and they should both be punished accordingly. Duranty was a willing accomplice of Stalin, and while Fidel doesn't have the base to work with, he is doing his best to continue to live up to his role models.

[Michael]

Let's take a look at this statement:

"Why does the US resist universal health care when countries like Canada and the UK have shown that it works? "

The problem here is that you are making a huge assumption before asking the question. The assumption is that "Canada and the UK have shown that it [universal health care] works"

That assumption is very much your opinion. Many, many (millions) of people would disagree with your statement for a huge variety of reasons.

Ironically, you are making the same mistake that Michael Moore constantly makes. Moore has an opinion on something and goes about creating the argument for the opinion. He doesn't investigate with the goal of learning, analyzing, and then arriving at an opinion. He has his opinion already, and then just finds things to back it up. He makes this logical fallacy intentionally, which is probably why he seems so obnoxious to you. I will assume that you made it by mistake.

[charlie crystle]

I am one of the leaders of the universal healthcare movement in Pennsylvania, and as a business owner, I have to say that the insurance industry is a waste ot time, resources, and money for all businesses except the insurance industry and the financial sectors that benefit from them.

More from the Pittsburgh Post-Gazette:

"Single-payer is Good for Business"

http://www.post-gazette.com/pg/07108/778752-109.stm

[simon]

as an Australian - we have public health care an i couldn't imagine this country without it. its just bizarre that usa does not provide this service.

[fewquid]

Fred, for once I disagree with you. I grew up in the UK and the NHS is APPALLING. The early comment from Nik above is just the tip of the iceberg.

I had an elderly neighbor that waited SIX YEARS for a hip replacement, and that was not unusual at the time. A good friend of mine had large knee shaped bruises on his chest after having wisdom teeth removed. Mistaken identities are common, as are anti-biotic restistant infections. My Grandfather was left shivering after brain surgery because the ward sister REFUSED to provide an extra blanket (in January in a prestigious but old London hospital).

The GPs can be incredibly out of date and unbelievably arrogant. I personally was witness to a GP stating someone was "perfectly heathly and had nothing more than a mild cold" only for the person to be dead within 24 hours from heart failure. The GP concerned did not even apologise and there were NO options for any kind of recourse or complaint.

The NHS is one of the MOST beaurocratic and incompetent organizations on the planet. High level adminstrators make a lot of money with ridiculous perks while basic services are left unprovided. Does anyone really need a new BMW every 12 months? (Again, personal experience). My favorite was the incredibly expensive patient computer system. It didn't work well at first, so they kept the paper system. When it did work, they still kept the paper system. So now data ends up in multiple places and is sometimes on paper and sometimes in the computer...

The basic concept of healthcare for all is an ideal I absolutely subscribe to. But surely there must be a better way forward than the NHS.

I totally agree that healthcare is expensive here (and health insurance doubly so). But I would favor a free market system over a state run nightmare any day. Just making health insurance companies compete across state lines would make a BIG difference in the costs for the average person.

Sorry for the rant, but having been brutalized first hand by the NHS, it's something I would hate to see here.

[Dave]

Your comment that nationalized healthcare "works" is stunningly naive. Remind me never to ask you to invest in anything I am associated with.

[carl rahn griffith]

less is more. people, KISS please.

honestly, who here reads umpteen paragraphs of diatribe (no matter how noble) from any poster, unless a known, credible, poster?

d'oh.

[jackson]

I wonder which Aerosmith record Michael Moore thinks is best.

[Andy Swan]

If you could pick one government service that the national-healthcare system should be modeled after (in terms of efficiency, innovation, quality and customer service), which one would it be?

Public Schools? The DMV? The IRS?

[David]

I've lived in Europe (Germany, Czech, Switzerland) for about fifteen years now and the healthcare is amazing. The models are simple, over a hundred years old and they work. It always made me sad that the US finds it so difficult to look abroad and say, "Country X is doing it better." It's that way with old, tired corporations too.
XEROX, change? Why we're the biggest and best! You can't stay competitive without some humility, and the US has a big ego problem.

So kudos to Michael Moore for bringing it to the table and making it something we debate about. If he feels obvious, well, the issue has been sitting there, obvious, for a long time now. The US has long paid twice as much for healthcare yet ranked towards the bottom of all developed countries. My friends in healthcare have long scratched their heads and wondered how strange it is to watch the proverbial frog boil when it could simply jump.

[Hockeydino]

Are you kidding me? Yeah just what we need is more government intervention. Friggin socialism DOES NOT WORK.

The government can't get your taxes right, they can't manage pretty much anything right, and you want it to manage your health care?

The reason why it's a mess is because they have their hand in it in the first place with all their regulations.

Does anyone really think Michael Moore is going to wait in line for months to get medical treatment? No, he'll fly on his jet to Austria and get first class treatment.

Come on people get real. There's a reason why doctors in Canada try to come to the U.S in droves.

Listen to TB MAN!

[ellen]

(I posted this on the gotham gal first as I read her blog before yours. I enjoy reading hers first for her recipes, rest. review, book reviews and the next new best thing etc.)

The really horrible thing is that you can pay health care premiums all of your life and never have a hospitalization and then when you need services the insurance companies want to deny you the benefits that are clearly stated on your policy. My sister needed to be hospitalized in April and she pays $1400 a month for Blue Cross, an induvidual plan and has been on Blue Cross for all of her life. When you have to buy individual plans, they can be costly. Anyway, she was very sick. You cannot believe the static I got from the Hospitalists, in hospital primary care physicians to send her to a nursing home to die, while the specialists had a treatment to save her life. Every day, the hospitalists would put pressure on me to virtual kill her. I wanted to battle her illness not the primary care physician's group on her case , the ApI group at Beth Israel Hospital in Boston. I wonder what secret provider benefits they were receiving to NOT want to treat her? If anything we need a more transparent system so we know WHY doctors don't treat or order tests or needed drugs. My sister also had a raging infection where I would put cold packs on her head for hours. The hospitalist doctor did not want to give her i.v. antibiotics, because if you are taking two different i.v antibiotics at the same time, then they can't boot you out to a nursing home that quickly. (Finally, her boss gave my sister the needed drugs, but this waiting caused her much pain and suffering.) When I decided that my sister should have a chance at life, the hospital rushed so many tests at once, because the in- patient allowable clock begins ticking that they ordered a test(field vision test) that my sister was obviously incapable of doing and as they pushed her to sit up, the staff banged her leg causing such a major wound that she needed an operation, then a debriding where they nicked her vein causing her to spend the weekend bleeding in her bed from her leg that she needed 6 blood transfusion and cardiac care( she had heart failure from loss of blood) and plastic surgery and a skin graft. If they did not rush so quickly this could have been avoided. The subscribers are the ones that lose with our present system. The hospitals get paid no matter what and I must say they are paid well from the bills I have been getting. If doctors did not agree to being paid to not treat back in the early 1980's than this present system would not be in effect. Managed care came about because doctors agreed to it. It sounded good that they would get money not to treat a patient from the patient's insurance company. We, as the insured, are paying the premiums to fuel this charade

[charlie crystle]

Amen, ellen. The incentives in the system are not to provide healthcare, but to make a profit.

I've got an answer for the guy asking on what system do we model national healthcare after: Medicare. The admin costs of private insurance is over 16%, while for Medicare it's only 3.3%. Ask anyone on Medicare what they think about losing it.

Now which of you unbelievably smart capitalists (I'm a capitalist too) thinks the costs of private insurance administration, not to mention the cost it foists on our businesses, not to mention the 40% marketing, sales, advertising, and executive pay costs we have to pay--tell me which is the better way?

Health insurance is a drag on true capitalism. The market system for healthcare failed. Drop the ideology and get this: as businesses, you'll save 40% by going to a single-payer system, right off the top. And everyone will be covered. Drop the ability to sue and go to a no-fault system, and you get rid of defensive medical practices, which makes up a good chunk of costs(though awards do not, only 2.5%).

Get a clue. Our system is an economic nightmare, and it's only good for those who can afford it or who don't get denied their coverage because of the profit motive. And it's a drag on truly capitalist, innovative, value-providing businesses.

And I'm sick of it, after another 27% raise ion our premiums, and I'm sick of the bullshit arguments against it. Selfish, short-sighted sons of bitches.