I just recently had a chance to see Michael Moore's "Sicko"
Admittedly, as a Doctor, I started the movie feeling defensive and a little worried that Moore would try to make doctors look bad---and suggest that we were the problem.
He did no such thing. Instead he focused a handful of unfortunate cases- first of the uninsured and then of the underinsured or those who had been jerked around by their insurance company or HMO. This was all a little sensational, but certainly highlighting issues we all know exist. There was, however, nothing very insightful, and even in some of his chosen cases it seemed that the insurance company was doing the reasonable thing.
Moore's solution for the problem is socialized medicine, or a single payor system. His evaluation of the current socialized medical systems in Canada, France, England, and Cuba mark a new low point in investigative journalism. He showed repeatedly that no one paid for their healthcare directly in these countries- which is sort of the point. He spent large portions of the movie monotonously asking patients and doctors what the bill was or where the billing office was.
Never did he mention that most who can afford it in these countries have private insurance so they can bypass the public system. He only addressed the issue of a waiting list for procedures by showing that there were not long waiting times in the Emergency Rooms in Canada. (No you didn't read that incorrectly---the logical flaw was in his movie not in my text.)
I lived in France and would never send a family member or friend to receive care in a public hospital there. To Moore's untrained eye, these places are the paragon of medicine.
The most amazing thing though was the trip to Cuba This segment was wonderful in its irony- but also truly bizarre. Moore shows that medicines are very cheap in Cuba- an inhaler for 4 cents- which is obviously not representing anyone's true cost. He also shows how wonderful the care is in Cuban hospitals- That’s right Moore really seems to believe that the care in Cuba's poor, decrepit hospitals which are well known to have huge shortages of almost everything (in part due to embargoes) are much better than the care in the US.
Having gone way too far, Moore obviously realized he was done, and ended the movie on that low point.
So all in all, Sicko is entertaining, occasionally clever, but misguided and just plain wrong about much. It’s worth watching, but not worth taking seriously.
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And the alternative is?
(Unregistered)
Although you did a fair critique of SICKO, you were less than fair in your critique of single payer systems and your views DO NOT represent the views of the majority of physicians. Given that you are a frequent poster on matters related to investing, it may be understandable that you would be opposed to moving medicine away from its profit driven, inefficient, and unsustainable current status. The US system is unaffordable for many and yet even the 47 million people who have no insurance and cannot afford health care at all are indirectly subsidizing the care of those who can.
Buying health care is not the same as buying a pair of shoes. The same market principles DO NOT APPLY, because the market conditions are not balanced. I know you know that by any objective measure, and there are lots of them out there, people in the USA are not getting what they are paying for. Not as a society, and not as individuals. So if you are advocating for a continuation of the system we have, you fail to make the case very well. Interestingly, you are silent about alternatives.
A single payer system is NOT socialized medicine. Do you actually know anything about the Canadian system? Sure some rich Canadians have private health insurance because they want their elective care the same day and a block away from where they live - with free parking.
But as a Canadian who lives in the US and also knows about health systems around the world, I am happy to set the record straight. Canadians are so upset about the quality of their care and their single payer system that their satisfaction with the system continues to be well over 90% (try matching that against the same survey in the US.) More to the point, people who know about public health and epidemiology also point out that the health and life expectancy of those in the US are not anywhere near what we should be getting for our money, since we outspend EVERY every other country by a considerable margin.
You missed another important point about SICKO: Moore's message was that the health insurance industry does not want people in the US to know the truth, because their is too much money at stake. Your equating socialized medicine with single payer system is one of their tactics, since they try to equate the term (socialized medicine) with impersonal, institution-like warehouse medicine with each patient treated as a number. Guess what, when I moved from Canada to the US, I went from a situation where I had my choice of ANY primary care practitioner in private practice to a choice of one, dictated by my US based insurance company. My comparative experiences on quality: For acute care, I feel the convenience is better in Canada and the quality is equal. For elective medicine, the US may have an advantage for THOSE WHO CAN AFFORD IT. And by the way, one reason I think reform has taken so long in the US is that few who are in a position to change policy experience the system's weaknesses. Docs get care from other docs, through a system called "professional courtesy", and politicians on the national scene get their care provided through a well-greased federal system in Washington. Ever hear from a Senator who experienced long waits in the Emergency Department?
Finally, you made no mention of one of the central themes of SICKO, which is that a population that worries about personal financial disaster due to illness or accident is under constant stress and those who know about immunology (or specifically, neuropsychoimmunology) appreciate that constant stress leads to chronic disease and premature death. How many people do YOU know who are staying in a job they hate because they need the health insurance benefits? And did you know that the majority of bankruptcies filed last year were due to financial calamity caused by health care costs? These facts cannot make any of us feel comfortable in a country that can do better, not just for a small segment of the population working on wall street or getting rich by it, but for all the people who travel on main street and work hard, pay their taxes, and deserve better than they are getting fron an overfunded system producing underperforming results.
Posted: Aug 27, 2008
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