Sicko
“If elected, I vow to retire the term ‘limousine liberal’ from the English language indefinitely!”
I like Michael Moore’s work. Do I think he presents the facts on his chosen subject with arid objectivity? No. Do I think the documentarian standard to which he’s held is fair to any documentarian, even ones with less florid or obvious points of view, given that the very editing of a documentary indicates a bias — in favor of some materials over others, at the least? No. If you want a transcript, call a hearing and have one made; a documentary is not a court proceeding. It’s up to the audience to think critically and to ask questions of the content, and if you base your opinions about certain political and historical matters on a filmmaker’s presentation, there is a risk that he or she, a human being just like you, is either incorrect or has slanted the facts to get at a truth s/he finds preferable. Or more valuable from an entertainment standpoint.
I’m not saying Moore doesn’t twist things around to get what he goes in looking for. I’m saying that to some extent, all documentarians do this, even on the level of pressing for something beyond a yes-or-no answer; that Moore is by now a known quantity in the culture, and if you do find his methods or presentation unacceptable, you’re free not to consume them, but to expect different from him is a bit disingenuous after nearly 20 years; and that Moore probably gets pounded to the extent he does because he does get what he goes in looking for a lot of the time, and what he gets is uncomfortable and embarrassing to people in power. Naturally, you won’t have a huge job finding a liberal who thinks Moore is an albatross to our arguments; they’re thick on the ground, and in a lot of ways, he is. But Errol Morris doesn’t come in for nearly the low pH of vitriol Moore does; while I doubt The Thin Blue Line won the man any popularity contests in Texas law enforcement, I also doubt that he’s ever been loathed as widely or as loudly as Moore. Who, like him or not, like his work or not, is an important filmmaker, if only because he incites so many dust-ups.
All that said, Sicko is a subpar effort. The health-care industry in the U.S. is a big problem, but…you know, duh. Moore’s take had no depth; holding up the European model as a shining example is all well and good, and looking to Moore’s film for a sincere effort to see the other side is a mistake, as I said above, but the only mention of the taxes that pay for that sort of thing is a glancing one. I don’t know how the income-tax/social-services flow is set up in Canada, but I know what their tax brackets look like, and “free” is a misnomer. Is it worth it to Canadians? I can’t say. Would I pay more every year so that I didn’t have to worry about this shit? Probably. The logistics of fixing the problem aren’t the issue; it’s that Moore’s subject is a dunk that’s already been slammed, and then he brings no nuance or investigative interest in the solution to it, and as a result, the film feels gimmicky and cutesy throughout. The current administration is selfish! Kids can’t get x-rays! I know all this, and don’t particularly want to spend my free time thinking about it in the same old ragey way, so you don’t have to suggest fixes, but you do have to say something new. Oscar-worthy, this ain’t.
Tags: movies
Our tax brackets aren’t anything like what I’ve heard (and not from Michael Moore; I slept through most of Sicko) an individual in the US has to pay MONTHLY for health insurance. I’ve said it before and I’ll say it again: I think the health care system in the US is inhumane.
I saw a one-man show about Tommy Douglas night before last, Canada’s “father of medicare”, and while I’m sure it was biased too (him being a politician and all, and the show portraying him as a shining light of goodness) I agree with him entirely that basic health care for all should be an essential of any civilised society.
I agree. In fact, my father and I went to see this movie and walked out because we got bored with about 30 minutes left. It was repetitive, and boring. Good to know there wasn’t a surprise ending that we missed.
I’m a Canuck who’s married to a doctor, and it’s true that our health care is not “free,” but it is (as you know) offered to anyone who needs it, the same way (I think) that public education is offered both here and in the States. The revelation for me about Sicko was not that there isn’t universal health care in the States; it’s that the people who are paying for health insurance still aren’t getting good care.
I suppose you could make the same analogy here; we Canadians all “pay” for heath care through taxes, but given the doctor shortage and wait times for care, we’re not getting great care either. That being said, no-one is ever turned away from an ER or a walk-in clinic (as my husband, who has been woken in the night to treat a HANGNAIL, can attest), and there’s no bill presented upon departure. So no matter what you’re paying in taxes, you can still be seen and assessed by a doctor without having to think about which finger to reattach or whether the insurance you’ve paid good money for will cover it.
I actually haven’t seen this yet, for the reasons you stated: I already know all this stuff. I don’t need help being outraged about it. I’m outraged every time I have to deal with this insane system we have here in the US.
I used to live in France, which has (according to the World Health Org) THE best health care system in the world. Though my experience is limited to only a few different systems, I’d say it’s the best one I’ve seen. Yes, we paid taxes each month for it — but those taxes were FAR lower than any US health insurance premiums I’ve ever paid — amazing, considering it wasn’t just covering us, but helping to cover the poor who paid no taxes but were equally entitled to services.
No, it wasn’t perfect, and I could give you a laundry list of areas for improvement. But geez, I had a kidney stone and the doctor came to my apartment, then arranged an ambulance to take me to the hospital, and I never for one second worried about whether the ambulance or the hospital was covered by my insurance or not. Between the house call, ambulance, hospital, doctors, MRIs, morphine, and prescriptions, I paid a few measly Euros — co-pays on the prescriptions.
Whenever we needed to see a doctor, we had an appointment within a week’s time (sometimes the same day). The whole process was seamless. Everyone has the same card. Every provider is set up to accept it. No one goes bankrupt from medical bills. Everyone can get care. We desperately need a system like this in the US.
I’m with Cheryl: Sicko was actually more revelatory than I was expecting, since I thought it was going to be about the people who don’t have coverage in the U.S., not about the insurance companies’ desperate attempts to avoid, y’know, insuring people.
That said, “gimmicky” is the right word and “facile” would be another one. The great thing about the Canadian system is that no one gets turned away, even people who don’t pay taxes at all. But there’s a huge doctor shortage, leading to people going to walk-in clinics or the ER for things like hangnails. And there’s an argument to be made that user fees would stop people from going to the doctor for every little thing, thus costing the govenment money and using up valuble time and space. I can’t speak to how well Moore covered the French health care system, but his portrayal of the Canadian one was about as accurate as his depiction of our “slums” in Bowling for Columbine, which is to say, not very.
I haven’t seen Sicko, in large part because I do feel familiar with the ridiculousness of our system. But a lot of people in this country somehow aren’t and I think they do need to see it. They need to see that when you get knocked over in the street and your head is bleeding, the first thing you think about shouldn’t be “If I call an ambulance, or go to urgent care, how much will I have to pay?”
I went home, and called the doctor the next day instead. And I still have to pay out-of-pocket charges for the X-rays. Not exactly a tragedy of massive proportions, but — why is that the first thing I have to think of when I’m injured?
I’m an American who has been living in England for six years. I’ve also had asthma since I was a little kid. No system is perfect, but long story short, I find it vastly preferable to live in a place where I’m not under constant stress about whether or not I’ll be able to afford the inhalers I need to prevent me from suffocating in my sleep. And, if I am drowning in taxes, I guess I’m just to busy enjoying my free-breathing life to notice.
Alexis is right; I don’t think enough Americans realize the severity of the problem because they take it for granted that that’s just the way life is. They don’t understand the purpose of the insurance companies, how the system works, how they make money, etc. I’m also not sure many Americans realize there are other, much more humane approaches to health care in virtually every single developed country except their own. So yes, for the more educated American, Sicko probably seems redundant in a lot of ways, but it was definitely needed, I think.
But that raises an interesting question: Is the American who doesn’t realize the breadth of the problem, or the alternatives, the American who went to see the movie?
Moore isn’t required to penetrate all demographics, like I said above, and it’s not that the uninsured don’t go to the movies; nor is Moore required to educate the moviegoing public on the issues affecting it. But if he isn’t doing that, he should hit an entertainment standard, which I felt he didn’t do here.
Saying that we don’t realize the severity of the problem because we’re just used to it is perhaps a little condescending. We have a whole satchel of severe problems around here that, in spite of various degrees of agitation on the part of the voting public, have not improved in the last 6-8 years, and even the disenfranchised know what the word “company” implies. Does a disquietingly large proportion of the electorate not know or care about these issues? Yes — but it’s proved impossible even for those of us following said issues to get any traction with them.
If the U.S. economy goes into the shitter in the next 3-6 months, you’re going to see an increasing awareness on the part of the voters and a lot more anger about the ways various U.S. systems have failed to make taking care of the citizenry their priority, but then there’s still a fundamental conflict at the heart of it, whether you’re talking about FEMA or health care or foreign policy, to wit: taking care of the citizenry, focusing on health care and poverty outreach and disaster management and educational funding, has a price. And so does maintaining status as a superpower. And there isn’t enough money to do both even in boom times. And until a government is in place that wants to scale back our foreign involvement to more of an aid-only position and reroute those tax dollars into social programs — until politicians start running on that platform and fed-up voters start putting them in office — we’re going to keep running up against that conflict, that the subsidized day care we think is a fantastic idea and a solution to a lot of problems is unworkable in practice, because the money for it got spent on radar systems and stealth tech. (Not on veterans, though. Never that.)
For my money, now that the Cold War is almost 20 years dead, it’s time to let other countries police themselves and focus on humanitarian intervention, abroad if necessary, but at home first. Make sure everyone under 18 is fed and has enough notebook paper, and if you can’t do that you got no business toppling foreign regimes.
One of the things that may get overlooked when thinking about re-doing the US healthcare system is the role of industry. Most of the health insurance in this country is paid for by employers. (My own company shells out more than 10k per person, and our coverage is on the bare-bones side of things.)
If we switch to single-payer, a couple of things could happen: 1) employers continue to foot the bill, but since everybody’s in the same group, costs for employers go down. 2) Government foots the bill, which means withholding goes up, but employers no longer have that expense, freeing up all kinds of private industry dough to either plow back into their companies (and maybe spend at least some of that 10k on giving me a damn raise!) expanding the economy or take the money and run. 3) some hybrid of the two.
Anyway you look at it, there’s more free money around, not less.
In fact, the only segment of the economy that looks to take a hit is the health insurance company. And for me, well, I don’t miss the once omnipresent blacksmith industry either, you know?
I need only spend 2 hours at the DMV to remind me personally of why I believe putting healthcare in the hands of the government is a bad idea. And believe me, I don’t recite that as a boilerplate conservative rebuttal. While I’m a fiscal and nat’l defense conservative, I’m a huge liberal in terms of human rights. I’m a man without a party in most every conceivable way and don’t for a second defend the issues raised in “Sicko†as in any way “OK”.
Per usual, I didn’t have time to do the actual intellectual legwork myself and found this article interesting on the topic.
http://www.slate.com/id/2169454/
Me, I loved this movie, but I like the Moore. I thought he made it humorous when it got too heavy & yet made his points. I would like to see what the tax levels are for those who do have national health care because that wasn’t addressed in any way…but I *like* the man’s sarcastic & biased style.
Cheryl, do you have to pay a lot more in taxes for your health care?
As a Canadian I think the odd thing about the US system (from what I understand it) is that if a person with no health insurance walks in to an ER at a US public hospital having a heart attack, gets treated for a few days in ICU and then dies, then the health care system, and in turn the tax payers absorb the cost (which are usually pretty high for that type of emergency care). Now personally I would much rather my taxes go to making sure that person is able to get a yearly check-up so that the odds of him having a heart attack are significantly decreased, and the health care costs are lowered.
The Canadian system is, on the whole, cheaper to run over the American private medical system. There are innumerable economies of scale available in a single-payer system, not to mention far less administrative work required sorting out who pays what to whom.
Also, our taxes aren’t significantly greater: you’re paying nearly as much, but seeing most of it funnelled into offence…er, defence…spending.
But yeah, the Euros have it better still.
Dave, although I understand your point about the DMV, I would assert that the government already does a perfectly able job in running healthcare — Medicare. Sure, there are improvements we’d like to see, but Medicare is hardly a broken husk of a program incapable of doing anything right.
All we need to do is expand it to cover us all.
Oops…I definitely didn’t mean to sound condescending, though I see how that came across. I was basing the “it doesn’t change because people are unaware” assertion on my own experience, which was going through a world of pain at the hands of the U.S. system and then moving to England, 100% ignorant, and being totally gobsmacked that there was ‘another way’. In retrospect, basing a generalization on my own intellectual laziness was probably…er, intellectually lazy. I certainly didn’t mean to imply that the majority of people are as in the dark as I was.
And I do agree that Moore didn’t seem to focus at all on possible solutions apart from “let’s be more like France/England/Canada!” That was frustrating, since there was a world of opportunity to explore different ideas and ideologies instead of rehashing a lot of the problems that everybody already knew existed. And it certainly wasn’t his most entertaining piece of work (that would be “The Big One”.) But if even one druken college dork (me six years ago) saw the movie and said, “…ooooh!”, then I feel that Moore accomplished his objective.
I think that you (Sars) hit the nail on the head when you said that the United States can’t maintain its superpower status whilst overhauling its domestic humanitarian policies. And bravo to your whole last paragraph in your comment.
Attica,
That’s a fair point. Or is it? I dunno. I honestly have no experience with anyone that could paint me a visual picture of “Medicare – Easy?â€. I’m willing to buy your premise as a jumping off point.
My thinking was more open-ended than maybe my post conveyed.
Ask yourself this. Has there ever, in your whole life, been a time in which you thought to yourself, “Thank GOODNESS the government came in here and streamlined this for us!â€
I have not. I think most can agree that free market solutions force companies to be more nimble, efficient and user-friendly than something our government dreams up…and that stands to reason. If I don’t want to lose you as a customer, I’d better give you incentive to use my services over someone else’s. If it’s federally administered and you have no other options…you get sad workers in grey buildings who kind of shrug with that “It is what it is†mentality.
My analogy CLEARLY doesn’t hold true in this particular instance. Insurance is a minefield even for people who think they are covered. Do you need my policy card? No? My lab card? My flex plan card? Am I in network? Is this procedure elective? It is currently very convoluted and difficult to navigate in its current form. Not to mention patently unfair.
But if you think old Uncle Sam could really, and genuinely simplify matters, while not causing endless bureaucratic nonsense and redtape…then I guess we’ll have to agree to disagree. I can’t see it happening.
In that article I referenced earlier they do make some salient points about how tangled the whole thing really is. It isn’t just insurance companies; it’s pharm corps and doctor salaries and malpractice issues and R&D for cutting edge treatments too expensive to “offer†to the masses under a universal plan. Just because Canada or England cover your …say, broken arm, free of charge…doesn’t mean you can get the newest cancer treatment on the market for the same. You might not be able to get it at all. Whereas here, and you have means, you can go get that super-new treatment. Hopefully that works and trickles down to be the standard treatment for everyone in 10 years. I know…I feel stupid making that point. Talk about cold comfort.
If you permit me to make another floundering reach of an analogy. SOMEBODY had to buy that $25,000 36†plasma TV 10 years ago in order for you to buy a $1,000 50†one today. I think the current system is something of a house of cards like that. Pull one out and watch the ripple effect as it changes various parts of the system. We can’t have free care for everyone (for anything they choose to seek treatment for) AND still have the best, highest paid doctors leading the way.
I do like the notion of “pooling†brought up in the piece, that would maybe at least address the denials of service for the most at risk.
So anyway……yeah. “Sicko†huh? Haven’t seen it.
Okay, here we go. First up: Michael Moore himself.
The issue is not that he uses immensely misleading presentations to show off extreme opinions in a deniable manner. The issue is that he presents his opinions as though they were out-and-out facts, and then when he’s called on it his defense is to whine like a bitch. “Oh, well, if it wasn’t a true fact it was just my opinion,” he snivels when someone points out that, e.g., Charlton Heston did not actually say “from my cold dead hands” in response to the Columbine shootings.
The issue is that people look at his movies and say “oh, these are a documentaries! Therefore everything is a true and well-researched and objectively-presented fact!” Yeah, yeah, I know, they shouldn’t, but it’s not as though there’s a big disclaimer at the front saying “DON’T TAKE THIS AT FACE VALUE, I’M JUST MAKING SHIT UP HERE, DO YOUR OWN RESEARCH BEFORE FORMING AN OPINION ON THE MATTER”.
*****
Health Care: Lots of people cite lots of statistics about this. Infant mortality pops up a lot, but nobody seems to recognize how radically different Europe and America are when it comes to that statistic. For one thing, Europeans are much less likely to include inconvenient immigrants and poor brown people in their numbers. Infant mortality is pretty well correlated to income; I’m fairly certain that rich white people have a much better mortality rate than poor Mexicans trying to have anchor babies. Beyond that, American doctors are much more likely to go to heroic measures to save premature babies; European doctors often won’t even try for anything earlier than the third trimester, and even a full-term baby with significant birth defects might be listed as “nonviable”–meaning that it’s a miscarriage, and therefore not counted in the mortality statistics.
“per-capita spending” is another big one. The problem here is that the person citing the statistic usually just takes “total spending” and divides by “total population” and comes up with a number. America’s number is higher than Europe; therefore America is bad. Except that this simple total-population average ignores demographics. In America, less than a fifth of the population is elderly, but they spend more than a third of the total health-care dollars. Take out everyone over sixty-five and the per-capita spending is reduced by a third; take out everyone over fifty and it’s cut in half, leaving it in line with other countries’ per-capita numbers. And it just so happens that the elderly have already got their own UHC system–Medicare. So the group in the United States with the biggest per-capita spending has 100% of their needs covered by a single-payer government-run UHC program.
One thing that no UHC advocate ever seems to suggest is that Americans be allowed to “buy in” to Medicaid, with Medicaid premiums set based on income and blind to “pre-existing conditions” and the like. That seems like that would address everyone’s concerns.
One thing (of the many!) that drove me nuts about the State of the Union was Bush’s assertion that providing universal health care means taking health decisions out of the hands of individuals and their doctors, and into the hands of Congress. Sicko made me aware of the depths of a problem I had only been vaguely aware of — namely, that insurance companies, and particularly people who are tasked with denying as many petitions as possible to satisfy their stockholders, are the ones making a great number of health care decisions. And that seems messed up to me (although if you look at the Terry Schiavo case, I’m not sure I want Congress making my health care decisions, either. But that’s another story.)
As with all of Moore’s documentaries, I was a pleased at the way he undercut a lot of the arguments to the contrary (e.g., nobody will want to be a doctor, everyone will have to pay super-high taxes), and disappointed at the ones he failed to deal with, presumably because he couldn’t come up with something clever or convincing to say (e.g., whether making health care public would actually inhibit medical innovation, which I’m not convinced about but haven’t seen much to suggest what would happen either way).
UHC in this country would fail for the same reasons insurance companies charge high premiums–the cost of healthcare is outrageous here. (And when I say healthcare, I mean healthcare–doctors, ambulances, hospitals, labs, etc. I get SO sick of politicians and the media calling health insurance health care!) And one very big reason it is so outrageous is the litigiousness culture we have become.
I would actually concur with KMSD. I didn’t realize what a mess it can be until I was paying for, and trying to be covered under, my own health care plan. And the contrast with my experience in the UK (which occurred pre-job-with-healthcare) was notable for me. For one thing, I wasn’t shelling out $300 a year there for birth control.
One interesting thing that I haven’t seen much discussion of is non-profit vs. for-profit healthcare. Even if we can’t agree on who should do the insurance for healthcare, it seems obvious that the profit motive is a big problem in insurance denials. They should be paying people to figure out how to cover everyone cost-effectively, and maybe that would happen if insurers had to be non-profit. Or maybe not. But is it under discussion?
I have a different perspective, since I work in an insurance company, and am sort of in a weird department, namely one that liaises with finance and claims, since usually they have little contact with anyone else.
I work internationally to get travelers care, and through my experience have come to really understand how completely messed up our system is. Right to the core. So, when Moore did his documentary, I have to tell you all, I really liked it, because I think it really showed people the how deeply we are all screwed if something really goes wrong with us health wise.
Above, there was an argument about how we shouldn’t trust government services to run our healthcare, but the simple truth is that we wouldn’t be anyway. Working with public healthcare centers in say Europe, is much like working with ones here. The only difference is that the insurance “company” is really the government and every citizen is given the same set of benefits for being a citizen.
And believe me, having worked in this industry coming on three years, I would be grateful to throw my lot in with the government. Because as inefficient as it can be, it’s not maliciously driven by profit. Which, every domestic, for-profit insurance company is. They are not there to help you, they are there to take your money. And those stories about the brain tumors that were denied, and the cancers that wiped a family out financially, well, every insurance person could tell you stories of denied claims and deathbed denials that would make you yearn for EU citizenship.
“Because as inefficient as it can be, it’s not maliciously driven by profit.”
I’m not deliberately missing your larger point, but government is made up of people — people like Dick Cheney, who I suspect is entirely maliciously driven by profit.
Government in the abstract, as a concept, is not malign or corrupt. The *current* government is not one I would trust to dress a skinned knee. Whether my reaction is proportionate or not, it’s one more issue facing the U.S. with any proposed move to universal coverage — that the federal government has a huge perception problem.
I’m in the UK and just popping my nose in to say, we don’t pay grinding income tax – you can actually see our taxation bands for each income level at http://www.hmrc.gov.uk/rates/it.htm
In terms of earning potential across skillsets, and purchasing power, my US friend tells me that a pound works out about the same as a dollar, at the moment.
Trying (and failing) to claim back pet insurance when my lovely dog died of an illness that should have been covered (but they found wiggle-room, because he was a rescued dog, and so didn’t have backdated records) showed me, very painfully, that even when you think you’re covered you often aren’t.
How people can cope with making decisions about healthcare for their child or parent, when funds are limited or the company doesn’t pay up, is beyond me – it must be a total nightmare.
I think there is something else that needs to be thought about in this instance, and that is the fact that the US healthcare cost is increased by lawsuits. I’m not saying that there aren’t many justified suits, but I know that the money paid out for frivolous ones is much more than in European countries. If something isn’t done about these law suits I guarantee that our health care system will continue to flounder.
Health-care companies don’t actually make all that much profit. It’s typically on the order of five percent. Profit is not the reason that health care is expensive.
Heck, I’d claim that insurance itself is what makes health care so expensive. If the consumer doesn’t pay anything for care, then there’s no incentive to shop for the best price, and no reason to choose anything but the maximal amount of care possible. I’m not paying for anything; why should I care that I’m getting two MRI’s and three months of physical therapy for a bruised ankle?
It’s the same thing that you see at auto-body shops. If the customer is paying out-of-pocket, then your door ding will be popped out with a vacuum pump and then buffed out with some rubbing compound. If the customer’s insurance is paying, then it’s suddenly a two-week job that involves stripping the door and the two adjacent body panels down to bare metal, replacing all the plastic trim on that side of the car, using computer-analysis equipment to exactly match the paint shade…
But if the consumer is paying for health care, is she going to get that lump in her breast checked out if money is tight? Probably not. So she’ll wait and she’ll wait until she’s terribly sick and has to go the hospital. And then there will be intense amount of medial treatment to have, and pay for.
There are a lot of health problems that can be, not necessarily fixed, but mitigated with regular, preventative health care. If I had to pay for all my tests out of my own pocket, I can guarantee you I wouldn’t be at the dentist’s office every 6 months, or at my general physician’s office each year. And there’s a chance I’d be worse off for it.
I totally agree with what Katy above me said. As far as the Canadian system goes, I also like the reassurance of knowing that if I am in an elevator there is logically a lower chance of the guy next to me having some contagious disease since if he has a cough he can go see a doctor without worrying about having to pay a bill. Or if I am driving down the street there is less chance that the cab driver behind me is going to have a fatal heart attack and cause an accident because he is able to get his yearly check-up.
As far as lawsuits go I think if people didn’t have to directly pay for medical services out of their own pocket you would see these go down. I mean if a family member goes in for surgery that costs $100,000 and still dies, I would think there would be a much higher chance that the surviving family would sue the doctor, than if the surgery didn’t cost anything.
I beg to differ on the profit that insurance companies make. The CEO of Aetna has his own private helicopter (does that kind of excess cut into profits? you betcha.). These for profit insurance companies are doing just fine for the guys at the top and the shareholders, and that’s all that matters for a corporation.
As for lawsuits – well, that’s actually not what’s driving prices up, because no insurance company pays the actual rates that doctors charge. If you pay out of pocket for a delivery, it can be up to $20,000 and they’ll blame it on rising costs. Big Box Insurance would probably pay about $3,000 for the same care because it’s in the contract and the hospital can deal with it. They are not paying what people pay out of pocket, and hospitals are not getting paid for what it costs to care for people, so prices go up. Add in the shameless amount we allow Big Pharma to charge for lifesaving drugs and you have a recipe for disaster.
As for trusting the government: well, there are good administrations and bad ones. But not even the worst ones refuse to give their citizens liver transplants until right before they die. One person wouldn’t be in control – it would be an organization that simply pays the bill based on whether you are a citizen or not. The NHS in England and the DHB in New Zealand have had lots of different governments run them, but they still manage to arrange care for all their people. We are not a society like Zimbabwe where one cult of personality will mean the difference between life and death.
And again, the government wouldn’t actually have a hand in taking care of us: that would be left to doctors and other medical professionals. Government would simply foot the bill.
I have not seen the movie — I find I pretty much have an idea about what Moore is going to say before he says it, so why bother — but as the Slate review upthread mentions, Moore is being awfully coy about his lauding Cuba’s (!) healthcare system. What, I ask, is the penalty for complaining?
And, a doctor shortage in Canada? Imagine.
It’s a homily, but worth repeating: if you think the current mess is expensive, wait until you see government-run health care. The biggest problem we have right now is layer upon layer of federal intervention into the medical care market, the biggest of which is the deductability of medical bills on personal — not corporate — income tax. Changing that would go a long way to fixing the current problems with medicine by getting the insurers out of the way.
As a Canadian, i found the movie to be interesting mostly because healthcare up here is beneath notice – literally. You don’t even think about it because there’s no stress associated with accessing healthcare, except for whatever is actually wrong with you.
It’s a very well established principle that stress makes you ill – higher BP, loss of sleep, immune system problems, mental health issues etc etc.
Imagine NEVER having to think about your health insurance. I don’t mean having excellent insurance and being comforted by that. I mean never ever thinking about it. Not when you’re 3 and your parent gets worried about paying for the broken arm, not when you’re having a baby and hoping he/she is OK so you can keep your house (over and above the stress of having a sick baby).
That’s what it’s like in Canada. Yes, we have to wait for care in certain situations, like ER visits and certain tests. But here’s the thing – triage is performed at every stage so that if you’re really sick, you get seen pretty much immediately. Finances are not an issue – not for you or for your doctor.
And get real, folks. Only hypochondriacs and Munchausen’s enjoy going to the doctor. People don’t abuse the free system up here just because it’s free. Actually, because it’s free, it’s not intrinsically valuable – it’s like oxygen – I really don’t care if you breathe more than I do, as long as there’s enough to go around.
I also find it amazing that some Americans say they don’t want UHC because they don’t want some faceless beaurocracy telling them which doctors they are allowed to see. Um, isn’t that what a lot of you have, right now? Once again, this is simply not present up here.
The only government intervention that I as a consumer of medical services have ever seen is a letter from the gov’t asking me to confirm that I did indeed receive certain care from a certain doctor, as part of some random QA process to make sure no-one overcharges.
As a single woman with no children I am not entitled to any healthcare assistance (or any other kind) from our government. This month I had to forgo part of the mdications that my doctor (Who charges $75.00s an office visit) prescribed for me. As one of the thousands of unisured in this country, I believe that any effort at an UHC system would be greatly applauded. I have not seen Michael Moore’s mockumentory (Though I have seen enough of his work to figure how it went) but I think that he does make some valid points in his own messed up style concerning the system, or rather lack of in this country and other countries.
I would actually take it one step further than what IgnorantBystander said. Even if people are going to the doctor when they probably don’t need to if that is the trade off you have to make to assure that a guy having chest pains can get medical treatment before he has a serious heart attack without him having to worry that he might be spending a bunch of money on something that could be indigestion then I am fine with someone going to the doctor too much.
I feel the need to point out that Canadians DO pay for health insurance, and not just through our taxes. The provinces administer their own medical programs and pay for them with a combination of federal funding and provincial taxes. In Ontario, the healthcare premiums are rolled in with the taxes, so citizens don’t have a specific bill for it, but that’s only one province (and those of us in other provinces are rather heartily sick of Ontario hogging the spotlight, too!).
In Alberta and BC, the two places I’ve lived, people pay premiums on a monthly or quarterly basis. The premiums are indexed to household size and to income – I didn’t pay any as a student, and when I was working it was about $40 a month. This is for *basic* care – doctors’ appointments, hospital care, lab tests as needed, that sort of thing. It does not cover ambulance fees, any dental care, or prescriptions, although seniors and those on social assistance (welfare, EI) get some help there.
There is extended health insurance available through most employers that does cover ambulances, prescriptions, and usually dental care, and if you are lucky you get coverage for optical care too (as someone with a $400 glasses prescription, that’s important…). Often these plans are rolled in with an insurance policy that covers sudden disability or dismemberment. We pay for that too, again about $40 a month for the plans I have had. Most universities and colleges offer similar plans to their students for low prices (mine was $45 this semester), but some student plans are limited in the specific prescriptions they will pay for (mine is generics only, which actually left me out of luck for my birth control).
So we DO pay for our system, but not at the crippling rates that seem to be so common in the States. I’m just a bit sick of the “Canadians have FREEEEEE health care” schtick, because no, we don’t. We have reasonably priced, government subsidized care that is administered by offices that run similar to corporations – just without the profit part.
Doctors make a reasonable amount of money and have choices regarding where and what kind of medicine to practice; there are incentive programs to bring doctors to smaller or more remote communities, but by no stretch of the imagination is any doctor “forced” into specific practice. Individuals can choose which doctor to go to – yes, there is a shortage of doctors in several cities, but that’s because the cities are growing quickly, not because of any nefarious plan. The problem is that a lot of people don’t look for a doctor until they are sick, at which point you do get them coming to ERs and walk-in clinics, and bitching that there are “no doctors”; but if you are reasonably patient and persistent, you can find a general physician to see for checkups and such.
Someone mentioned having health care costs as tax-deductible expenses was a strength of the US system – we can claim out of pocket medical costs here too (prescriptions, glasses or contacts, dental work, etc). Our income tax returns work a bit differently int hat we can’t get more money back than we paid in tax, but we can reduce the amount owing.
I guess I have perspective on both systems as I am a Registered Nurse that is Canadian but I have worked and lived in the US(Kentucky) for two years.
To those that think Canada is some kind of back water that offers no innovative care you couldn’t be more wrong. We spend billions in research here and are a world leader in research and treatment.
Many years ago during the height of the AIDS epidemic hospitals in the US were caught doing what is called patient dumping. A patient with no insurance and a very expensive disease process was bundled up in an ambulance and dumped at the county hospitals door. The US government created in turn a law that made it illegal to refuse anyone emergency treatment EMTLA…this law is the mother of unintended consequences. This means ER docs and the hospitals are literally forced into providing completely free services for anyone that walks in the door. And because of this hospitals are going bankrupt or they cannot find any doctors willing to work in the ER. Doctors do not like working for free…would you?
So the political delusion that socialized medicine doesn’t exist in the US is just that, a delusion. Remember what Bush said…anyone can get medical care, just go to the ER. He wasn’t kidding.
The US runs one of the largest single payer programs in the world. And it makes me laugh every time I hear the protests. Have a look at the population of Canada, the total population. We have less people living in our country than you have in Medicare/Medicaid. You already have our system. Combine that with the EMTLA and you have a system no different than any other “socialized” medicine country. Of course no politician is going to tell you this. Makes you guys all worry about that red commie menace coming to take you over.
The biggest threat to a total single payer system is the US has nothing to do with politics or what the people want. It’s all about what your doctors are willing to participate in. Docs want no part of single payer, just ask anyone with Medicare. Medicine is the only career choice that takes at minimum thirteen years to qualify and your pay drops every year.
Because reimbursement rates are set by medicare most private insurance companies set their reimbursement rates by the same scale. Every year the reimbursement rates are being rolled back. Do you wonder why the doc never spends any time with you? It’s because he gets paid about fifteen dollars a patient. He has to go for volume. It’s also why he doesn’t want to look after patients with multiple complicated problems. It eats into the time he needs to make a living. The days of docs making two to three hundred thousand are gone. So of course they don’t want more single payer. They will never be able to pay off the two hundred thousand dollars of student debt and how can you justify studying for half your life and gross debt for no return and a chance to get sued and lose everything?
In Canada the program is still as long but the debt is a quarter and your income is steady. No roll backs, a steady pay raise, all things that make the system tolerable. No doc is getting rich here but they aren’t at risk for going broke either. Our docs continue to buy in.
The moment we fail in this we will have the same problem you have.
Health care professionals don’t have to do what they do. At any time we can all quit and take up real estate or dog grooming. There is no law that says you must be a doctor just because you went to med school.
So, if the system in the US continues the least of your worries is going to be insurance. How about trying to find a doc to work in the ER?
For Canadians and non-Canadians alike, I think it’s worth pointing out that health care (I hate it when Canadians call it medicare: there is no such program in Canada) is a Provincial responsibility, not a federal one. While the federal government does set standards and provide transfers of money to the provinces to pay for it, managing and maintaining the system, including paying for hospitals, nurses and doctors is up to the provinces.
As someone who has lived for long periods of time in both the US and Canada, I’d like to offer up a choice to those who are wary of a government bureaucracy providing healthcare in the US: would you rather have a commercial insurance bureaucrat deciding if you get treatment based on maintaining profits and shareholder returns, or a government healthcare bureaucrat deciding when you get treatment based on maintaining efficiencies in the system?
The thing to remember is that Canada’s system ensures access to everybody who is a legal resident (not citizen) of Canada on a rationed care model. That means that, for instance, if you have a bad knee or need a hip replaced, you wait – sometimes for admittedly unreasonable amounts of time – for a spot to open up in a surgical ward (hospitals don’t like paying too much overtime for surgical nurses). You will get the surgery, just not as quickly as you would like.
Our system is not ideal by any definition, there are many cracks in the floor and people do fall through them. But by and large it does work, people are treated appropriately and successfully and in a more or less timely manner. To answer my own question, I would rather have a bureaucrat deciding when, not if, I get treatment.