Health care in the United States

Michael Moore’s last two films were based on opinions that many people vehemently opposed: that America has too many guns, and that George W. Bush is a bad president. It didn’t matter how persuasive the films might have been, because half the population disagreed with them before the opening credits even rolled. But with “Sicko,” Moore turns his attention to the American healthcare system, and his central theme is that it needs to be reformed. I think that’s common ground, don’t you?

We can argue about what remedies the system needs, and the best way to go about it, and plenty of people will think Moore is off-base for suggesting socialized medicine. But Republican or Democrat, liberal or conservative, don’t we all agree that the current system is wrong?

Let’s use that as the starting point and let the discussion evolve from there. There are 50 million Americans who have no health coverage at all and “Sicko” is not about them. “Sicko,” Moore says, is about the other 250 million Americans, the ones who have health insurance yet STILL get a raw deal. This movie is about how American health insurance companies exploit every means possible to avoid actually paying for their customer’s medical needs, and how people sometimes die because of it.

The “lucky” ones live, and are stuck with astronomical medical bills, you know, the bills that were supposed to be taken care of by the insurance company. This topic is fraught with anger and emotion, and someone needs to stick it to the ruthless corporations that deny funding for life-saving operations due to loopholes and technicalities, or that tell a man they can either sew one of his severed fingers back on for $60,000, or the other finger for $12,000.

When an insurance company refuses to pay for a woman’s ambulance ride because it wasn’t pre-approved, even though the woman was unconscious at the time and couldn’t call for approval. That’s the kind of outrageous profiteering that needs to be dealt with. Too bad, then, that Moore is only getting excessively casual in the way he presents his arguments. Having been chided in the past for getting his facts wrong, this time he just doesn’t present very many, at least not in the way of statistics. He relies mostly on anecdotal evidence, which is a great way to convince people who already agree with you, but not very compelling to skeptics.

The first half of the film details the despicable way health insurance providers weasel out of paying claims, and how requests for treatment are denied for whimsical, capricious reasons. (One woman was denied an operation to remove her brain tumor because the insurance company said it was “non-life threatening. ” Then she died. ) Moore put out a call for Americans to tell their healthcare horror stories, and he shows us enough of them to convince us (if we needed convincing) that the healthcare industry is a maze of blinding bureaucracy and callous indifference.

So what’s to be done? Moore takes us to several foreign countries that have universal health care, where citizens (and even visitors! ) get everything for free or almost-free, paid for by the government. The hope is that we will see the merits of these systems and create something similar for ourselves. And they certainly do seem appealing. Moore regales us with eye-opening factlets. In England, not only is your hospital stay free, but they’ll even reimburse you if you had to take a bus to get there! In France, doctors make house calls!

In Cuba, prescriptions cost a nickel! In Canada, everyone has their own personal doctor assigned to live in their house, and the average citizen lives to be 150! OK, I exaggerate. Moore is enamored of these foreign systems, and he presents them in a very positive light. He is aware of the criticisms, though, and he anticipates the concerns many Americans will have. And how does he answer them? Shiftily, that’s how. For example, the most common complaint we hear about the Canadian system is the wait. Don’t people have to wait hours and hours in the emergency room?

Aren’t there horror stories about waiting nine months for chemotherapy or other desperately needed treatment? Moore’s answer is to talk to a handful of Canadians including two of his own relatives all of whom think the Canadian system is perfectly delightful. In France, he takes up the question of whether a government-funded healthcare system means burdensome taxes for the citizens. He answers it by talking to one family, a family he describes as “middle-class,” even though their income is about 96,000 U. S. dollars a year. And nope, they’re getting by just fine!

Taxes don’t worry them! In England, he addresses another concern: Don’t doctors make a whole lot less money when they’re paid by the government, rather than operating in private practice? His answer: They get paid very well, thank you … or at least this one doctor he interviewed does. This is all anecdotal. It may well be representative of how the average Torontonian, Parisian, or Londoner feels but without some actual data, we have no way of knowing.

For all we know, these people are in the minority. For all we know, Moore found the only 10 people in all of Canada who like the healthcare system. How about a poll of 1,000 Canadians to see what their average wait time is? Why not ask 1,000 French if they feel they pay too much in taxes? And surely it would be easy enough to find out at the average salary of a British doctor, or at least a ballpark figure, and compare that to the average U. S. doctor’s income.

That would be much more convincing to a skeptical audience than, “Hey, I found this one guy, and he thinks it’s awesome! One subject Moore does address smartly is the reason a lot of Americans don’t want universal health care: because another term for it is “socialized medicine,” and if we allow socialism to infiltrate any part of our society, then the next thing you know we’re marching through Red Square with hammer and sickle flags.

Americans, as a rule, don’t like anything that sounds like socialism, and Moore has the amusing clips from an old anti-socialism educational film (narrated by Ronald Reagan! ) to prove it. The problem with that argument, as Moore explains, is many elements of American society already ARE socialized. You get mail delivered to your house for free, you send your kids to school for free, you can call the fire department for free, you can borrow books from the library for free, you can call the cops to investigate a crime for free.

Everyone has access to those things, and no one has to pay for it, except through their tax dollars. Socialized medicine works exactly the same way. If we trust the government to hire teachers to educate us, and firefighters and cops to protect us (and there are private alternatives we can pay for if we don’t), why don’t we trust them to hire doctors to cure us?

Moore loses points for forcing 9/11 connections into the film, including one very condescending lecture about how England suffered 9/11-size losses every day during the Blitz. His tone of voice in that particular segment is infuriating.

There’s more eye-rolling when Moore takes a squad of ailing Americans, all of them betrayed by their insurance companies, to seek treatment in Cuba. As usual with Moore, the premise is useful but he doesn’t know how to execute it. Yet there’s that underlying kernel of legitimacy. As it happens, these sick Americans do get excellent treatment in Cuba.

Some of them are given procedures and prescriptions that they’ve been needing for months, but that their insurance companies refused to pay for. That’s why it’s hard to just dismiss “Sicko” and Moore altogether: because a lot of what he says makes sense. It’s the way he says it that needs work. Despite its flaws, I still think people should see the film, if only to start a discussion about how we should fix our healthcare system, and to make the health insurance companies sweat a little. The movie itself is not important, but its ideas are. The U. S. healthcare system needs medicine.

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David from Healtheappointments:

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