Monday, July 02, 2007

Sicko is Healthy

There is a lot of knee-jerk reaction against Michael Moore's latest indictment of the US health care system, Sicko. But, overall, the experts pretty much agree that he gets the big picture right. Here's the New Republic's Jonathan Cohn, who writes extensively on health care:
"As Sicko rolled, it did little to allay my fears. I spotted plenty of intellectual dishonesties and arguments without context--enough, surely, to keep right-wing truth squads (and some left-wing ones) busy for weeks... Still, by the time the final credits ran, it was hard to get too worked up about all of that. Because, beyond all the grandstanding and political theater, the movie actually made a compelling, argument about what's wrong with U.S. health care and how to fix it. Sicko got a lot of the little things wrong. But it got most of the big things right."

CNN (taking a short break from incessant Paris Hilton coverage, so it seems) also got their fact checkers on the job, no doubt expecting a bonanza of error-laden propaganda. But it was not to be:
"Moore covers a lot of ground. Our team investigated some of the claims put forth in his film. We found that his numbers were mostly right, but his arguments could use a little more context. As we dug deep to uncover the numbers, we found surprisingly few inaccuracies in the film. In fact, most pundits or health-care experts we spoke to spent more time on errors of omission rather than disputing the actual claims in the film"

I've already laid out many of the problems with the US health care system in my argument in favor of a single payer system last week. The analysis backs up what I was saying, including the fact that the US spends far more for health care than the rest of advanced world, and attains far less in return. Perhaps the most pertinent statistic is the one from the World Health Organization, showing that the US is ranked only 37 in the world in terms of health care outcomes (while both France and Canada make the top ten). They also show the relative inefficiency of private insurance: while Medicare eats up about 1 percent on overhead, private insurance companies waste between 10 and 30 percent (as I noted in my post last week, this is because so much effort is put into screening people). In criticizing Moore, Andrew Sullivan puts forward the most bizarre argument I've seen yet: the anti-US health care position ignores the fact that much of it is under the auspices of the government anyway. Since this is the most efficient part, the obvious conclusion from Sullivan's thought process is "Medicare for all"!

Opponents of single payer systems usually retort to two tactics: they play up waiting lists, and they argue by anecdote. And yes, in some universal health care systems, there are waiting lists for non-emergency elective surgery such as hip replacements. But that is not true everywhere. France has no waiting lists, allows free choice of doctors, and offers access to highly advanced medical care to those in need. And, in fact, the absence of waiting lists for elective surgery in the US has a dark side, as it reflects an over-supply of specialists relative to primary care physicians. This is not too surprising, given that specialists earn a whopping 300 percent more that primary care physicians here, as opposed to a norm of 30 percent elsewhere. Clearly, something is amiss.

So bear that in mind next time some smug free-marketer talks about waiting lists for hip replacements in Canada, or how Canadian doctors are trying to enter the American market. And keep some of these figures in mind too:

Health Spending per capita: US-- $4,497; Canada-- $2,483

Healthy life expectancy: US-- 68.1; Canada-- 70.5

Standardized death rate (per 100,000): US-- 670; Canada-- 561

Infant mortality rate (per 1,000): US-- 6.9; Canada-- 5.3

Child mortality rate (per 1,000): US-- 7.6; Canada-- 5.7

Maternal mortality rate (per 100,000): US-- 10.5; Canada-- 5.8

Number of uninsured:US-- 45 million; Canada-- 0

The question is, though, will people be able to see the big picture, and the basic truth in this movie, or will be they blinded by the minor inaccuracies, the stupid visit to Cuba, and the personality of Michael Moore himself?


Steve Bogner said...

Great perspective - thanks! Something indeed needs to be done to make sure everyone has their medical needs addressed. I've seen way to many cases where people need care but choose not to get it due to cost - and that's just not right.

Anonymous said...

The question is, though, will people be able to see the big picture . . .

Or will they be scared off by New And Improved "Harry & Louise" advertising sponsored by the Health Insurance industry (naturally!) who will be spending hundreds of millions to assure the very profitable status quo.

If the American public is foolish enough to be suckered yet again (think: '04 election) then they deserve what they get.

Antonio Manetti said...

I saw the movie today. I was plenty mad over the blatant injustice in the current system when I went in. I was twice as angry when it was over and in the mood to rant.

My wife, who's quite familiar with the health care industry, pointed out another less obvious strategy by which provider's game the system by giveng palliative care through medication rather than treatment, not because of patient care concerns but because medication has less impact on the provider's bottom line.

That being said, what really made me angry was the sight of indigent patients being kicked out of hostpitals and dumped on skid row.

If, by some miracle, any measure claiming to be universal health care is passed, I expect a repeat of the medicare drug scam, where everyone in the food chain profits except the so-called benficiary.

No matter what elegant or clever rhetoric it's couched in, the bottom line in this Calvinistic, free entereprise system of ours, is that individual worthiness (or dignity in CST terms) equates to one's market value -- and nothing more. By that measure, of course, someone with the ruthlessness and greed of a Tony Soprano is a saint.

IsaacnotIshmael said...

I've got a question for you guys: Will I be able to opt out of your system? I mean, thanks for your consideration and all, but I really don't think I'm interested. Will I be able to keep my money?