Sicko (documentary)
Movie Review
"Sicko (documentary)"
Review by Eric D. Snider
Grade: C+
Rating: PG-13
Released: Friday, June 29, 2007
Directed by:
Cast:
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 screwed up? 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 customers' 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 sloppier 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.
Enabling them are their hundreds of lobbyists, whom Moore says outnumber members of Congress 4-to-1. Billy Tauzin (R-La.) helped get the Medicare Prescription Drug Bill passed, which helps the pharmaceutical companies make more money. Then what did he do? He left Congress and took a job as the CEO of the drug industry's main lobbying organization. Hey, he knew the real money was to be had in pharmaceuticals, not Congress.
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! So what are you Doubting Thomases so worried about?!"
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 -- and this is coming from a guy who generally agrees with Moore.
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 -- let's see if we get better help in a Third World country than we do here -- but he behaves like a jackass in the execution of it. His first stop is to take his people to Guantanamo Bay and shout into a bullhorn that they'd like to receive the same expert healthcare that the prisoners are getting, please. And for some reason, Guantanamo DOESN'T open its doors and let them all in! Huh!
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 (maddeningly) 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. Sadly, all Moore has provided is a placebo.
Grade: C+
Rated PG-13, a little mild profanity, an F-word visible on a document, brief medical partial nudity
2 hrs., 3 min.
Copyright © Eric D. Snider.
This work may not be transmitted via the Internet, nor reproduced in any other way, without written consent from Eric D. Snider.
This item has 102 comments
June 29, 2007 at 5:53 am
You say that Moore smartly addresses the anti-socialism sentiment by pointing out the areas of our society that are already socialized. I can't deny that the areas mentioned in your review are indeed socialized, but these citations hurt Moore's argument more than they help. Our socialized school system turns out some of the most poorly-educated students in the world. The countries that turn out the top students all have overwhelmingly privatized education. The postal service does OK with letters, but ship a parcel with them (even a small one like a single DVD in a standard DVD case) and it's as likely as not that somewhere along the way your package is handled by a private carrier. Even the post office knows that it's more cost effective to hire a private business than trust things to the government. Government-run fire departments don't even cover many areas. If my house were on fire, it't the local volunteers who would put it out. They don't charge for their services; they go door-to-door asking for financial support and they stand at intersections holding out fire-boots for drivers to drop money into. Their means are limited and their expenditures are therefore frugal, as they can't just raise taxes for more money. As for the police, that is one area the I believe must always be government-run, just as the military must always be government-run. I also have no comment on libraries, as they seem to me to be the most efficient government-run entity in existence. But then, we don't have reformists shouting that we need to "fix the public library system," prompting the government to throw more money at it.
Barring the military and police, allowing the government to do what a private business could do will always result in more cost, lower quality of work, more waste, and fewer benefits for everyone involved (except the congressman and his pet lobbyists).
Advocates of socializing everything should reflect upon this one question: Can you name a poor country in which the free market is allowed to operate?
June 29, 2007 at 5:56 am
OF COURSE the Americans got the care they needed in Cuba. The Cuban government knows a photo-op when they see it, and Moore was their willing accomplice.
June 29, 2007 at 6:33 am
I'm really glad Eric mentioned the paucity of facts in the film. I never expected him to say it just like I would. I wrote more about it here:
http://blog.spotd.net/2007/06/real-sicko.html
I do disagree with characterizing any government service as free. To call it that, even while acknowledging that they are paid by taxes, kind of prmotes this idea of the benevolent and caring state, doing what we can't do. To me it is the bloated and inefficient state and the idea of putting my healthcare in the hands of the govrnment is terrifying,
June 29, 2007 at 6:42 am
Good point about not being convinced by mere anecdotal evidence. That's also how many questionable "cures" are sold to us. It's not hard for the medicine man to find a few people who think his product was the cause of the improvement in their health, so he publicizes their testimonials rather than the negative results of clinical trials.
June 29, 2007 at 7:38 am
So in Sicko, Moore makes some good points, but ruins things by not sourcing information, ignoring evidence he doesn't like and portraying the rest in a dishonest fashion.
Sounds like the rest of his films.
June 29, 2007 at 9:47 am
Our socialized school system turns out some of the most poorly-educated students in the world.
It also turns out some of the most brilliantly educated students in the world. We have a wide range. As does every other country in the world. The trouble is that people tend to compare our worst students with their best students.
June 29, 2007 at 10:04 am
Once again, another Moore film that millions of Americans will feel like they don't need to see in order to criticize it vehemently. The single, most consistent message of Sicko is (and I've SEEN the film) that the ONLY way for a health insurance company to "maximize" its profits is....what? To either charge you more for your health care or else deny your claims. Period. Moore's films rely on anecdotal evidence to tell a story that is compellingly urgent. So what? If Americans applied this same criticism to our government on Iraq, even half-assedly, we would certainly not have the Bush administration in charge. Hey, we might even have universal health care!
So PLEASE don't dismiss this film with off-handed casual remarks like "sounds like the rest of his films." The U.S. is the ONLY developed country in the world where universal health care is a conservative vs. liberal issue. Everywhere else, it's a GIVEN. No liberal or conservative would dare touch it!
Even if the claims about waiting months and months for chemo in Canada were true, guess what? There are about 33 million people in Canada, and they ALL have health care. In the US there are almost 50 million people with NO health insurance at all. If you could choose between a small wait for treatment or no treatment at all, which would you choose?
Folks, do NOT dismiss this film without seeing it.
June 29, 2007 at 10:22 am
I haven't ruled out watching this film yet (though with kids at home I will not use my precious babysitter nights when I could go see Transformers or Ratatouille), but I also don't think that I have to watch it to understand Moore's point and realize that we do have a problem. The problem is that Moore's prescription, and he has stated on the record that his preferred outcome is government-paid health coverage, is one that I think would be disastrous.
Our health care problems are at least partly a result of our current level of government involvement in it. I just don't think that more government involvement is the answer.
And to respond to #7, read this article by a Canadian-born doctor who is licensed here and in the US (http://opinionjournal.com/editorial/feature.html?id=110010266)
Then ask yourself that question again from the perspective of a person on a waitlist for Chemo.
June 29, 2007 at 11:04 am
Of course, Moore is romanticizing a type of system that would also have its problems. But again, if the 50 million Americans who had NO health care could at least get Canada's level of health care--why would that be so "disastrous"?
The problem with thinking about insurance as though the "free market" were a glorious catch-all is that, again, insurance is not something that some new capitalist entrepreneur can invent something new for. It's not something that gets better with free-market innovation. The ONLY way for an insurance company to make its share-holders happy is to make more money, and the ONLY way for an insurance company to make more money (currently) is...well, I said that already.
To accept a priori that it would be "disastrous" for the government to get involved in insuring all Americans universally--that presupposes quite a bit. But of course you won't have to worry about it because most Americans will also probably prefer spending the night watching Transformers too. And it won't matter to them until they get sick and Kaiser finds a way to declare their illness a product of some "previous condition."
To focus on this film as nothing but a series of biased anecdotes (without seeing it) is pure close-mindedness. Eric says nothing about the VERY compelling bits about Nixon and Kaiser in the film, or about the 1996 testimony of a former Medical "expert" for the insurance industry. But he's given everyone a few moments where Moore characteristically focuses on individual stories rather than distant statistical evidence--and that's enough to dismiss the whole idea altogether. Wow.
June 29, 2007 at 11:18 am
That was a really interesting article, Lowdogg. I know of a few examples of how socialized medicine can be dangerous: my aunt in Canada having to wait months to get the necessary test to determine if she had bone cancer (fortunately she didn't); my friend having to go to the emergency room two days in a row before she could see a doctor for her broken foot; even I was advised, two weeks before I was due to leave London, not to try to see a dentist for a toothache because I wouldn't get in anyway. Another interesting point: England has private hospitals, and they are known to be much better than the state-run. One of my friends, an American who was there when she had her first baby, said she paid to deliver in the private hospital because no one in their right mind would have a baby in the state hospital if they could afford not to.
I think the real problem is the drug and insurance companies, and the hold they have on Congress.
June 29, 2007 at 11:26 am
Oh, there's a problem with healthcare? You mean it's not perfect? Thank you, Mr. Moore, for making me aware. What's next, an expose on the amount of luggage lost by airlines?
June 29, 2007 at 11:57 am
"Folks, do NOT dismiss this film without seeing it."
I prefer not to take my political advice from a 2 hour sound bite. I'd rather do my own research and formulate my own opinion based on what I discover.
Therefore, I can dismiss this and every other "documentary" trying to sell me some belief or other. Until Moore learns how to produce a real, unbiased, documentary he will always earn the quoted "documentary."
June 29, 2007 at 12:11 pm
"Therefore, I can dismiss this and every other "documentary" trying to sell me some belief or other. Until Moore learns how to produce a real, unbiased, documentary he will always earn the quoted "documentary.""
And until you actually see the film (which, for some reason cannot be counted as part of your "own research"), your opinion will always earn the quoted "opinion." Your whole premise does not even make sense: Until he makes an objective documentary you won't see it--and the only way you would know that he had made an objective documentary was....what? See the friggin film! But I know, you can trust Eric to tell you all about it.
Honestly, I just cannot GET how so many people are experts on this film without seeing it.
June 29, 2007 at 12:31 pm
I haven't seen this movie, and probably won't. But when I talk to people from Taiwan (with universal health care) they praise it when all they need is a check-up for colds, bumps, and bruises. However, when they need something important like surgery or giving birth, they have nothing but praise for the US health system and horror stories about their own system. This is anecdotal, but I don't trust the government. I do find it strange how everyone loves the government as long as they like the people in power, but as soon as someone they don' t like is in, they have nothing but bad things to say. For you people who love big government/socialism, you are saying you want Bush in charge of your health care. I personally like Bush, but I don't want him, or Bill Clinton, or Hillary Clinton, in charge of what care I can get at a hospital. People like George W. and Bill Clinton will be elected in the future, so think about that when you want them in charge of your doctors. I personally don't trust the government to do anything right EVER. Definitely not medical care.
June 29, 2007 at 12:53 pm
One doesn't need to see this film to debate the merits of socialized medicine. To criticize the movie itself (whether it's objective, whether it's persuasive, etc), yes, definitely. But the arguments concerning our medical system aren't new; one person can decide that Moore is wrong for wanting a socialized system--and his opinion has been made plain in other forums--without seeing Moore's film.
June 29, 2007 at 1:25 pm
One very common arguement that I see in discussions of film and media is "If you didn't see it (or experience it) then you have no right to disagree with me." This is absolute nonsense. I have never done a lot of things about which I hold very strong opinions. Should we only allow congressmen who have used heroin to vote on passing laws against it? (How can they have an opinion if they have never personally experienced it?) How about theft or murder? (Well, theft might include a majority of congressmen anyway.) Anyway, please don't use the argument "Since you have not seen the film, you have no right to have an opinion."
It reminds me of angry letter writers saying "He makes more money than you -- so you can't disagree with his films." Just bad logic.
June 29, 2007 at 1:35 pm
I rarely disagree with Eric Snider's movie reviews, but I most definently disagree with this one. This is Moore's best film by far and I think his most disciplined, and thus, least controversial (from a "shoving it down your throat" sort of way).
You can read my full review of SiCKO here: http://thisdividedstate.blogspot.com/2007/06/im-feeling-sicko.html
Anyways, I guess I also feel weird about Eric Snider giving my film a better review than Moore's latest film.
June 29, 2007 at 1:39 pm
As for health care, sure our health care system isn't perfect. But it does have its strengths. For example, new innovative medical procedures are encouraged in private medicine, but discouraged in sociallized systems. If you can't make money from it, why spend the R&D dollars on it? Sure the Government could spend more on it. But look at how well our defense dollars earmarked for R&D are spent. How much waste is there? How much does politics come into play in assigning where those dollars are spent? Do you want that for our medical system?
Also, it has been estimated that up to 20 percent of the funding claimed from medicare is fraudulent. That's what the insurance companies are trying to avoid. The public system has little incentive to fight fraud, since it can just raise taxes to compensate. Insurance companies raising their rates will lose business to their competitors, so they try to eliminate fraud. This makes lots of paperwork for claims, and very occasionally denys people valid procedures (which Moore is quick to capitalize on).
Now think about how hard it is to fire a bad teacher. Do we want our medical system to be run like the education system? There is that disctinct possibility if we switch to a public system.
I think that there are dozens of other models for fixing health care that are superior to a public system. Besides, where will the Canadian and French health care system get its innovative medicine if the US goes public?
June 29, 2007 at 1:54 pm
"As for health care, sure our health care system isn't perfect. But it does have its strengths. For example, new innovative medical procedures are encouraged in private medicine, but discouraged in sociallized systems. If you can't make money from it, why spend the R&D dollars on it?"
This is precisely the problem that people are confused about. Medical research--drugs, methods, etc.--all of that you can make a strong case that privatization and competition leads to greater innovation, and new fancy ways of curing sick bodies. But INSURANCE??? Shouldn't we distinguish between insurance companies and the business of medical research? When people conflate the two (and think that to universalize "health care" means to socialize both the way care is administered and the way care is researched), then the insurance companies are sooooooo happy with that conflation. Insurance companies just LOVE it when we think that by keeping their business away from the government that we are somehow encouraging more innovative ways of helping people. But name one thing that an insurance company has "invented" that actually helps people!
June 29, 2007 at 3:12 pm
The benefit of hte documentary is seen in this discussion here...it doesn't matter whether he was innacurate or boarish. We are more likely to come to some good decisions if we discuss it as a real problem in need of a solution.
I am against universal medicine. Health means such different things to different people, we need choice and a free market.
Now if we can look at education in a free market environment...
June 29, 2007 at 3:54 pm
Ding ding ding, we have a winner. Mommy, you hit the nail on the head. That's the point of an exposé, to expose a problem and spark discussion. People always whine about Moore shoving things down their throat, and then whine when he doesn't tell them his solution? Make up your minds, people.
June 29, 2007 at 5:30 pm
We pay so much in health care expenses every year. I'm at about $1000 a month for my little 5 person family. Problem is, if a couple people have minor health issues, their denied coverage from most insurances. That forces us to use government programs at huge rates.
It's a really bad deal. America really needs a change to this and soon.
As for the callous insurance companies. I wish there were a way to bring justice and give them some of, well, their own medicine.
June 29, 2007 at 5:32 pm
The funny thing is that nobody actually wants to pay for health care. And, I'm betting that people who are actually for socializing health care don't want to pay for it, either. If they do, then I would ask them when the last time was that they charitably paid for someone else's health care. AND I would ask them if they have been absolutely 100% honest in the payment of their taxes according to the laws that we currently have. Because that's what we're talking about here: adding the burden of everyone's health care onto the honest taxpayers.
June 29, 2007 at 5:48 pm
Mail is delivered to your house for free? What the heck are these "stamp" thingies for?
June 29, 2007 at 5:57 pm
My brother would love socialized medicine, considering that on his salary he is unable to insure his entire family, despite all of them needing medical attention. He has to ask the state to insure his children while he pays the unearthly premiums to have his wife insured. He has none himself, despite chronic conditions. If it weren't for the offer of the state to insure the little ones, they would get nothing. And yes, he is a very good citizen, a hard-working employee of his company, and an honest tax payer. He simply can't afford what his bosses' insurance co. are asking for payment and survive. So enough with the generalizations.
Also, a good reflection of how socialized medicine in this country is run, just look at the military. If you are active duty, you never pay for anything, not even prescriptions. Ever. Yes, you go to military doctors, but if necessary, and if there is no space for you, you are referred to private doctors and hospitals instead. I've never had any complaints about the doctors I've seen with the Army, but then, I've probably been lucky that those in my path were dedicated and competent. I've heard of others who are neither, but given my experience in the private world too, you'll find that kind every where.
Now, if we take a look at the recent Walter Reed Hospital scandal we see what happens when a normally excellent health care system becomes overwhelmed with patients. Patients do get excellent care when they actually see a doctor, but the beaurocracy/red tape involved with the increase in numbers of patients needing help results in patients getting forgotten, records being lost, people denying proceedures for things they have no authority to deny even though they have been ordered by the doctors, people are denied seeing the doctors they need to see in the first place, and general neglect becomes the predominant feature in the system. When there is enough personnel to cover the increase in patients, the system works. When there isn't, it becomes a disaster. And I imagine trying to treat every single citizen in the U.S., not to mention every illegal immigrant on top of that, will result in much of the same on a much grander scale. And the more personnel you hire, the greater chance you have of running into unhelpful, incompetent people taking care of your medical needs.
June 29, 2007 at 6:00 pm
You're generalizing. My brother can't afford it for his family (only half of his family is insured because of it) and yet is a very honest tax payer and good citizen all around. I'm sure he'd much rather have socialized medicine than risk something happening to the family that he later couldn't even afford.
June 29, 2007 at 6:08 pm
You don't have to pay anything to have mail delivered TO you. It's absolutely free to have all your mail delivered to your house.
June 29, 2007 at 6:15 pm
Steve said;
"Our socialized school system turns out some of the most poorly-educated students in the world. The countries that turn out the top students all have overwhelmingly privatized education."
That's a bold assertion, Steve, you got anything to back that up? In my quick online research, I discovered that the nation credited with the #1 education system is Finland;
http://news.bbc.co.uk/2/hi/uk_news/education/4073753.stm
You'll note that the other nations ranked ahead of the USA are mostly EU countries, all of which have socialized education. I'm not sure about the systems in Japan, South Korea, and Hong Kong, but it would not surprise me to learn that these are all socialized systems, too. My own, admittedly anecdotal experience, is that Russians are also more well educated than Americans, and their system is heavily socialized, moreso than ours. But at least we're far ahead of them in health care, according to the World Health Organization;
http://www.photius.com/rankings/healthranks.html
The point is to ask, "How do you know what you know?" If we go around chiding Michael Moore for lack of sourcing, should we not hold ourselves to the same standard?
The larger issue is really that every side of this debate is populated with propagandists who have an agenda. They seek to prevent the rest of us from learning anything but their view. But it's possible to research or counter-research assertions and decide if there's any merit to them, based on facts. The facts themselves, in this health care debate, are very confusing and really go into a degree of depth that few of us have time to contemplate, or in some cases, even understand, for example on issues that require real medical knowledge most of us don't have. So we have to do the best we can, and try to figure out the big picture issues we can comprehend. On that basis, I personally come down on the side of socialized health care, even though it's imperfect.
And let's not forget -- the first major American politician to suggest universal health care was a Republican, Theodore Roosevelt, although he was running as a Progressive Part candidate at the time;
http://www.medicalnewstoday.com/medicalnews.php?newsid=69456
June 29, 2007 at 9:19 pm
"The funny thing is that nobody actually wants to pay for health care. And, I'm betting that people who are actually for socializing health care don't want to pay for it, either. If they do, then I would ask them when the last time was that they charitably paid for someone else's health care."
The last time I helped pay for someone's health care was when I paid my premiums for Pacific Care and didn't end up needing the amount of money I gave Pacific Care for my own health care. That meant that part of the money I gave to Pacific Care went to someone else who needed it more than I did (I hope)......Oh, and a nice fat $200 million bonus also went to the CEO.
See, card, what the difference is here? A government-run health care has to do basically the same thing--but no WAY could a government official walk away with a gigantic multi-multi-bulti-million-dollar retirement bonus. The difference with the insurance company is that the it's the insurance company's GOAL to make money.
June 29, 2007 at 9:32 pm
we all pay for things we don't need... my taxes pay for schools that other people's kids go to (i don't have kids)... they pay for roads i never drive on... i've never had to call the fire department for anything... i don't use the public library much... no, nobody *wants* to pay for other people's health care or other people's anything else... nobody *wants* to pay taxes at all. but it's necessary, and we accept it because these things are for the good of society in general.
June 29, 2007 at 10:46 pm
#26: "The difference with the insurance company is that the it's the insurance company's GOAL to make money."
I think that this isn't necessarily a bad thing, since this motivation will drive the insurance company to eliminate waste. What needs to be done, in my opinion, is to develop some really clever regulations that keep the insurance companies from making money by screwing over their customers. However, even if these regulations are theoretically, economically possible, the medical lobby would keep them from ever being codified into law. So I say that's where we start: lobbying reform. And then we can follow up quickly with a plan to get everyone insured, Ã la Massachusetts' medical plan.
Also, I would like to point out that some companies in England offer private insurance to their employees as benefits. I thought that was kinda funny.
June 30, 2007 at 12:12 am
I just watched "Sicko" this evening and I must say that I am entirely impressed with Moore's savage indictment of America's medical mafia. You all tout, "Where are the facts?! I want to see numbers?!" If you want pages and pages of data, get out of the theater...go to the nearest library and read. If you want to watch a movie about the system....then stay right there and listen. THIS IS A MOVIE NOT AN ESSAY. All the evidence I needed to hear was that you can get a $120 inhaler in Cuba for a nickel. If you can't understand that you are being screwed....I pity you.
June 30, 2007 at 3:17 am
With universal health care, you get three things: government bureaucracy (which means 20% of the people do 80% of the work); government control (people crossed an unknown body of water and gave their lives to establish a limited government, and now so many Americans’ core cause is for near total government control); and institutionalized theft (see below).
If your contribution to society would be insufficient to fund your health care, that of your spouse, and that of your X children, then you would be taking money from someone else under a universal system. That someone else is a real person; that is, when someone else would have to subsidize your health costs, that would reduce their ability to provide for their family and themselves. You would be taking their money, that they earned, using their skills, that required their dedication to acquire, and requires their time to utilize. Amazing.
June 30, 2007 at 3:30 am
If you can't understand that the cost of living in a third world country is far less than that of the United States, then you are being brainwashed by the government. The cost to develop, test, manufacture, certify, package, ship, bill, receive, stock, and sell an inhaler might be slightly different.
I still can't understand if there could EASILY be a system where all the members get quick access to outstanding healthcare, it doesn't cost a lot to each member, and everyone still makes a reasonable profit, then why doesn't a private group of investors put it together?
June 30, 2007 at 3:35 am
Turkey: I agree that your brother would probably rather have other people pay for his health care insurance. I would rather have other people pay for my car payment and auto insurance. I NEED my car. So why shouldn't the government socialize the auto industry? Plus, I have a wife and three kids. So I need more than a Nissan Sentra. I need a big SUV. But heck, since it is socialized, via tax money, maybe something better than a Ford or Chevy. Don't you think my family should get the best?
June 30, 2007 at 1:58 pm
A few interesting things that Moore left out of Sicko (and yes, for those Moore defenders I have seen the film):
- Wait times for anything over simple flu shots range in the period of months to years in Canada and in many parts of Ontario the concept of a family doctor is unheard of. Here in Ottawa most stopped taking new patients about 2 years ago. The Ontario government even has a web site just to look up how screwed you may be (http://www.health.gov.on.ca/transformation/wait_times/wait_mn.html). You can look up anything such as life saving treatments such as breast cancer surgery (3 months) or common diagnostics (MRIs 4 months). Once you move out of what's considered life threatening the times tend to just get longer and longer.
- England has a two-tier health system in which those who can afford it can opt for private insurance and pay for their own care. And from stories you can find online those dependent on the public only system face much the same wait time issues as Canada, just a little less so because a lot of the strain is removed through the private providers.
- And if you listen to the 'average' French family they claim they make roughly 8000/month. Usually when asked how much you make in a month people answer with the net amount, rarely their gross. Adding France's amazing 54% income tax onto their admitted income means this 'average' family could actually be making in the neighborhood of $200,000/year. Even with France's 19% sales tax, if you can't afford some nice things with a salary in the 6 figures then that would have been a story worthy of it's own film.
- One story worthy of it's own film is how the amazing French medical system allowed 15,000 people die in just a two week period just 4 years ago when no other neighboring country experienced more than 10% of that number.
- And as for the Cuban hospital he visits, I'm sure those doctors we treating them exactly how they treat everyone else that comes through their doors. The problem is that hospital is in the center of a tourist zone and unlike the hospitals the vast majority of native Cubans get to go to, it actually has bed sheets and medicine. A simple google search will show you images of Cuban hospitals that will make you feel the need to get your immunizations updated and start drinking bottles of antibiotics.
This, like all of his other films, is simply a highly bias ego trip for Moore. If you doubt that just ask yourself, how many other documentaries have as their poster a picture the director, who with the possible exception of Roger and Me, is not a central character to the story? None of the stories are about Michael Moore's experiences with guns, or health case, or the Bushes, but yet almost every publicity image for his films feature him front and center. Its that same ego driven personality that cause someone to make an anonymous donation only to feature that fact in a major motion picture (and if you look up the MooreWatch website you'll see he's even dishonest in the way he portrays the circumstances of that donation in his film).
For a whole 30 minutes Sicko looked like it could have been good but Moore just couldn't hold himself in check and ended up turning what could have been a serious look at flawed system into just another piece of fiction, no more realistic than 'Live Free or Die Hard'.
July 1, 2007 at 12:22 pm
"how England suffered 9/11-size losses every day during the Blitz" - is this what Moore actually says? It was eye-opeing to check Wikipedia are realize 43,000 civilians lost their lives. I would have guessed it was less. But that was over 8 months, and you can do the math...
July 1, 2007 at 7:46 pm
agreed - movie was light on statistics (undoubtedly the same dectracters bitched about the boring number in An Inconvenient Truth), so have a look at some of these below. I note that the America-firsters also fail to appeal to evidence in favor of inflated and unsupported rhetoric who can forget the LA-congressman's impassioned defense of loving his (but not necessarily my) mother!
Good health to you, especially my fellow Canadian Bic who has my full support in opting out of OHIP and traveling to the US to pay for his health care needs on his own dime. Oh, you might have missed all those free flu shot clinics in malls and hospital lobbies - maybe you can check that out next time.
For some stats (and authoritative sources)
http://www.huppi.com/kangaroo/L-healthcare.htm
July 1, 2007 at 9:34 pm
This is a brilliant film that shows how the excessive and inappropriate application of capitalism values to health care contributes to the decay in America. That people get rich by denying basic health services to others is a moral blight on our country. More shameful is that many who support this travesty of a health care system duplicitly pretend to espouse Christian values.
July 1, 2007 at 10:58 pm
Your main criticism seems to be that Moore does not provide enough empirical data. Please notice that virtually all of the people dissing the film in the forgoing comments likewise provide nothing but personal stories, opinion and invective. That includes a good many who haven't even seen it.
The fact is that most of the empirical data has been reiterated countless times. Moore's purpose is to put a human face on it. Unless I saw a different film from you, he doesn't make a specific proposal about how to remedy an outrageous situation. His purpose, as it was with Farenheit 911 to provoke discussion.
July 2, 2007 at 12:27 am
John Williams is heads and shoulders above everyone else in this debate, imo. There is surely a way to counter his arguments, but I'm not hearing them here.
I saw the movie, it is the only Moore film I have ever liked. He pushed his luck in France for sure, and frankly I thought the obesity of himself and the other Americans was an elephant in the room when lifespan came into play. But it's incredibly obvious that the traditional capitalist arguments don't work for healthcare at all because sick people cannot bargain. Footnote prediction on my part: many of the people attacking Moore on these points will eventually wish to god they had socialized medicine. This is the kind of thing that seems completely irrelevant until it runs over you like a cube van.
July 2, 2007 at 1:59 am
All of the terrible (largely anecdotal, I'm noticing) details about Canadian or English universal health care--that you have to wait longer periods for treatment, that you have higher taxes, etc. etc.--all of that remains entirely beside the point when nearly 50 million Americans have no health insurance at all.
I'm not romantic enough to believe that some day the rich and poor will have exactly the same health care. Even in a universal health-care system, I am sure the rich will find ways of accessing better care. That's life. But I really do believe that until we can provide every American with at least BASIC health care, our capitalist-run health-care system will continue to be an exploitative, irrational, and completely inhumane way of doing things.
Even if the ONLY fact Moore got right in his film was that that many Americans have no recourse for health care. That alone is enough to indict us as savages. Even for libertarians, you’d think the health and safety of our bodies is one area that the govt. needs to be involved. You red-staters can have your guns, and your transnational capitalism, and your irrational wars—fine. But if you trust the government to send our troops into the firing line, you could at least trust them enough to keep us healthy.
Remember Bush’s logic about the troop surge? That we should just “give it a chance to work� Well, why not apply that to saving lives now? Let’s TRY socialized medicine. And if it doesn’t work, fine, we can go back to a world where insurance CEO’s walk away with hundred-million-dollar bonuses while basic health care gets denied to good American families. But if it turns out, as it has in every other developed country where universal health care is a given, that the majority of the people actually like it—that we come to realize it makes sense to help take care of those who need our help….well, would that be so bad?
July 2, 2007 at 10:56 am
The trouble with your argument, John Williams, is your asking people to sacrifice a lot. Of course I agree that it is a travesty that so many Americans have no health insurance (which is different to no access to health care, by the way). But my family has health care. We have access to immediate attention when one of us is sick. In a socialized system, that would change, and frankly, I'm not willing to sacrifice my children's health. I am sorry for the uninsured, I really am. But I care more about my own family. I agree that something needs to be changed, but socialization is not the answer.
July 2, 2007 at 11:01 am
In comment 29, John Williams hits the problem on the head. He says that the way the government would run health care is not much different from the way that Insurance companies do it now. If that's the case, and if our current system is so horrific, how can you support "fixing" the problem by replacing the current system with one that you yourself claim will not be much different? And no fair saying that the current system isn't that different from a socialized system and later decrying the "capitalist" insurance system.
In comment 41, Mike Stevenson said that the capitalist system doesn't work for health care because sick people can't bargain. This completely misses the boat. I wasn't sick when I bought my health insurance. That's like saying that auto insurance doesn't work under a capitalist model because people with wrecked cars can't bargain. The problem is not that sick people can't bargain; it's that under the current system, NOBODY can bargain. With the way things are set up now, medical insurance companies do not have to compete with each other, as most Americans cannot choose their carrier. We have lots of choices for car insurance, for life insurance, and for many other kinds of insurance. I don't hear systemic horror stories about these other insurance systems. There are the occasional anecdotes, but if Moore had tried to do an expose on the auto insurance industry, he would have been laughed out of town. My car insurance company doesn't tell me what kind of car I can drive or how often I can drive it. My premiums may be affected by such things, but the insurance company isn't telling me, "sorry, we don't cover that. You're just out of luck." That is the beauty of capitalism. If one insurance company becomes notorious for denying claims, or for having high premiums, or for having limited coverage, they lose business immediately. The claim has been made here that the capitalist model fails in the case of medical insurance because there are no innovations to be made. But this argument (which is weak in itself) ignores capitalism's greatest strength, which is natural price control and better service through competition. If the medical insurance that your employer has chosen for you is lousy, you have no recourse, and the insurance company therefore has no incentive to do any better. Because of this inability to choose your provider, our current system is (again, as stated by John Williams) already very close to a socialist system. And all of the problems that people complain about in our system stem from that socialized element. The great power from on high dictates what treatments you are allowed. You think the federal government would do better? What, because they're not as greedy?
Seriously, John, you say that the difference is that it's the insurance company's goal to make money. What, as opposed to the altruistic congressman who only cares about the well-being of his fellow country-men and not about his own campaign coffers or personal power? Frankly, I'd much sooner trust the greedy CEO over any politician, because the CEO is at least honest about his motives.
And to Kyralessa, who posted comment number six, you were right to call me out on my statement about our socialized education system. Just because some of the worst students in the world pass through our system, that does not necessarily mean that the system is bad. So here is some data: http://4brevard.com/choice/international-test-scores.htm
The US isn't doing so hot in education. Do a little digging on the education systems of the countries that are the top performers. What do they have that America doesn't? (Hint: it's not money, it's the same thing we lack in our health care, and it's a six-letter word beginning with 'C').
July 2, 2007 at 11:15 am
I feel this was Moore's weakest effort to date -- it just felt lazy, self-serving and formulaic. You could feel his passion for his subject has faded and that the situations he constructed were probably produced in a board room.
The topic he chooses to work with is rich for exploration and exploitation. As a Canadian I sympathize with the plight of the Americans and their health care system. I lived in the states for a few years as a student and I felt the paranoia from my healthcareless peers and also the apathy that it was beyond their control. This film will allow the healthcare to be a topic of debate again and that alone is valuable, but it would also be valuable as a viewer of "Sicko" to feel that the filmmaker is really feeling it too.
July 2, 2007 at 11:35 am
The funny thing is: for the most part we DO have an ability to choose our provider. If our employer who offers the health plan doesn't have a provider that we like, it is always an option to get and pay for a policy that we do like. It seems to me that socialized medicine would actually take our choice away with regard to health care. Now, certainly it needs reform (I know people who insurance providers WILL NOT cover), but I don't believe that socialization is the answer. Perhaps a private charitable entity would be a better option.
We currently have another choice in our health care system: we can choose to prioritize our own health over our cars, our 4-bedroom homes, our eating out, our clothes-purchasing power, and our entertainment. If there is a person who doesn't have the health care that they desire and are choosing some of these other options above their own health care, then that is fine. So be it if going to see documentaries or taking their family to dinner or whatever they choose is a higher priority to them. I would rather that the choice in that case is theirs.
July 2, 2007 at 12:00 pm
Ayn-Rand Steve says: "The claim has been made here that the capitalist model fails in the case of medical insurance because there are no innovations to be made. But this argument (which is weak in itself) ignores capitalism's greatest strength, which is natural price control and better service through competition."
Again, the problem with thinking that capitalism works in the case of health insurance is that it's your BODY we're talking about, not some car. Steve claims that if you find out that your insurance company is "lousy" (like you discover that they won't do anything for your cancer), and you had true capitalist recourse to some other competing insurance company, then that insurance company would be suddenly motivated to do better. But you're missing the point of how health insurance works. A health insurance company WANTS you to go somewhere else if you have bad health. They only want healthy people, because THAT'S what makes them money. COMPETITION IS COMPLETELY IMPOSSIBLE in this case. If you discover that you have some terribly expensive disease---who wants to be competitive for your business? Maybe I’ll just say that again: If you have bad health, insurance companies do not want to “compete†for your business. It’s the moment where capitalism completely turns against you!
What Steve thinks, I guess, is that just initial word-of-mouth discussions about which insurance companies really do provide good health care for people in expensive, dire situations--that, coupled with freer opportunities for people to switch companies, would really encourage "better service" among health insurance companies. But that's a dreamy thought, one easily countered by wistful-music ad campaigns, and occasional testimonials (which, you'll notice, is what these insurance companies are doing already). It's time to realize that capitalism is not the answer for everything. For improving price control and service on widgets, etc., sure. But not health insurance.
Steve says, "You think the federal government would do better? What, because they're not as greedy?"
Yes, the govt would do better, precisely because 1) no one in a government run system would be allowed to make $20 million dollars as an annual salary. 2) there would be a means of investigating and prosecuting any such abuse. Under the current system, not only can we not investigate and prosecute a CEO who walks away with billions---he's actually encouraged to do it!
The point is not about which members of a society are more greedy. Politicians and CEO's are equally greedy, I grant you that. But the difference is, the current system allows CEO's (and a lot of other officials in the insurance companies) to reward their greed.
And, as I’ve already said, to compare health insurance to car insurance is a bit specious. If I get burned by a bad car insurance company, I end up paying a bunch more for my wrecked car, etc., but I can just quit it and move on to some other car insurance company. If I get burned by a bad HEALTH insurance company, I might just DIE. So, where's my bargaining power then?
July 2, 2007 at 12:11 pm
Hopelessdoom, comment 28: You chide me for not backing up my statements. Then you assert that Finland and all EU countries have socialized education. And your source on that is?
(by the way, "more well" is not grammatically correct. You should say "better.")
July 2, 2007 at 12:15 pm
Having read all of the comments to date, I sit stunned by the delusions people have about "socialized" medicine. I will attempt to address them.
1: the bureaucracy argument. All bureaucracies have inefficiencies and flaws. Private ones are no better than government ones. "Would you want Bush to be in charge of your health care?" Obviously not, but a public health system would be at arm's length from politicians (as it is everywhere in the world).
2: Freedom of choice. I don't know of a public health system where physicians are not permitted to choose the nature of their practice or where patients cannot choose their doctor. Such restrictions are not a necessary component of a public system.
3. R&D. As has been nicely answered previously, the issue of medical research is a separate issue. I would point out to whome that there is plenty of pharmaceutical research going on outside of the U.S.
4: The free market way: the argument that competition in the health insurance business would solve everything simply fails. The unregulated marketplace is largely an illusion in the 21st century. Yes, there are tons of examples of successes on both individual and national scales but this is all too often offset by the alliances between multinational corporations and government resulting in a near total elimination of real competition (the facade is carefully retained).
As for the film itself, Moore himself comes off as oafish (intentionally, for some reason), but this film is hopefully performing a great service to the American public. Yes, it's anecdotal but if it weren't it wouldn't be a film anyone would want to see, regardless of how accurate it might be. Does he propose a solution? No, that's not his job. Bottom line: Moore is a skilled filmmaker who is using his talent to stimulate his viewers to think about serious public issues. Good on him.
July 2, 2007 at 12:18 pm
Follow-up: Singapore, Netherlands and Sweden, who topped the international tests, have flexibility and choice in education, unlike America:
http://www.mackinac.org/article.aspx?ID=6840
http://www.moe.gov.sg/corporate/yearbook/2006/flexibility/index.html
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/exclusions/thinklocal/nosplit/swedenlocal.xml
July 2, 2007 at 12:30 pm
I agree with Card. I wonder how many Americans who cannot "afford" health insurance are nevertheless living with a lot of luxury items. We Americans feel we "need" a lot more than we actually do.
July 2, 2007 at 1:10 pm
John Williams says that capitalism works for lots of other stuff, but our health is too important to trust to anyone but the government. If that's the case, John, do you support the idea that the government should run everything else? After all, if you trust only the government with something as valuable as your health, does it not naturally follow that the government would also do a better job of manufacturing cars? Or computers? I realize that you have stated time and again that your body is different from a widget, but If the government does better in taking care of your body, why shouldn't it do everything else better as well? Please don't tell me that you trust them with your body but not with your watch.
July 2, 2007 at 3:15 pm
Steve,
Your response does not address my basic critique. To distinguish the power of capitalist competition between a body and a watch is crucial. I cannot throw away my body. I can throw away my watch. If I get sick with an expensive disease, I cannot start over with a healthy body and decide to take my business to some other insurance company who will magically be more amenable to funding my expensive illness. If no one got expensive illnesses, then this would not be a problem. But under the current system, the very minute I get sick, I CANNOT TAKE MY BUSINESS ANYWHERE ELSE! Insurance companies aggressively prohibit people with "previous conditions." That's how they do business. Your sickness effectively takes away your consumer power. Then where is your glorious capitalist "price control and better service"?
If you were to take a class in logic, you'd learn about what's called the "slippery slope" logical fallacy. That is, you set up a completely irrational argument that goes something like, well if we grant socialized health care, then isn't that just opening the doors to socialized EVERYTHING? But I've repeatedly stated that that's not where I'm going with this. Capitalism remains the order of the day in ALL developed countries where health care is universal.
But notice how Steve has cleverly shifted his response from a claim of how capitalism, if left truly unfettered, would create better health insurance (which, as I've illustrated, is totally crazy) to a discussion of how it's all about whether or not we "trust" our government with our bodies. This is a rhetorically specious move. If you were to ask anyone on the street in Canada: "Do you trust the government with your body?" the answer would invariably be "No." But, if you asked them, "Do you trust the universal health care system you have to provide coverage for people, even though who might not be able to afford it on their own?" The answer would invariably be "Yes."
So let's not turn this into a FOX-news scare hour, where it's all about the "GOVERNMENT CONTROLLING YOUR BODY!" Please. Go back to telling me about how unbridled capitalism forces insurance companies to provide better service and "price control."
I stand on my original point: Insurance companies do NOT want to compete for sick bodies. They want to compete for healthy bodies. That is a system explicitly designed to hurt sick people and benefit CEOs. Period.
July 2, 2007 at 6:15 pm
First of all, while the insurance industry and the health industry are different, there is no way that you could socialize insurance without also socializing medicine. In fact, that's what Moore is arguing for: socializing medicine to eliminate insurance.
I look at how much I pay for insurance, and how much my employer contributes, and I am absolutely astounded. When we had our last two children, we did not break even for those years; the insurance company still took in more money from our family than they paid out. Of course, my employer is not willing to give me their portion of the insurance payment if I opt out, so I stick with my employer's insurance plan.
Of course, medical insurance is not really insurance. Insurance is a way to subsidize rare but costly problems. For example, most people do not have many car crashes in their lives. They are rare, so a lot of people get together and contribute to the plan and it covers the occasional crash. On the other hand, dental insurance is merely planned savings with a middle man to pay as well. Since almost everyone who has dental insurance goes to see the dentist twice a year, and gets regular cleanings, fillings, and other treatments, the insurance company simply charges enough to pay the dentist and take home a little for themselves.
The laws dealing with insurance are stupid -- they have been heavily influenced by the insurance lobby. For instance, employers can offer a flexible savings account (FSA) to pay for medical needs with pre-tax dollars, but any money you contribute to your account that is not used by the end of the year is forfeited. Who does this help? It makes the account useless. If you have a medical need right after the year end, your account is empty. If we allowed the money to roll over in these FSAs, we could get people medical insurance with high deductibles, but that could be covered by the FSA. People would see exactly how much they were being charged for their medical needs and make the medical industry more accountable. Medical insurance would change from planned savings to a real insurance model. But since nobody in the insurance industry wants to lose the cash cow of corporate plans, this option is not available.
I realize that the insurance companies create problems. And I think that congress could create laws that would help to alleviate many of those problems. But I think that the problems from a system of socialized medicine are far worse, and harder to deal with.
I know that other countries have medical research programs, like pharmaceuticals. But they still get their money from patenting the drug in the US. They can't get enough money from the university systems in their own countries to justify their spending; and their local socialized medicine doesn't allow such patents, in many cases. And look at the volume. What percentage of major medical breakthroughs (including drugs, technology, methodology) come from countries that are not the United States of America?
July 2, 2007 at 8:13 pm
whome - There's also such a thing as an HSA, which is like an FSA (pre-tax dollars), only you don't lose it at the end of the year. It's a savings account.
Maybe if we treated health insurance more like car insurance it would actually be more effective. Instead of using it for the $35 prescription or the regular check-up at the doctor's office, maybe the insurance should be for major crashes. People don't use their auto insurance to get their oil changed.
Also, in my opinion people should not seek health care coverage from a company that pays its CEO 20 million in one year. If that were my company, they would definitely be hearing about it from me, even though that probably translates to about $2 per person covered.
In addition, with company health plans, health providers can't reject the coverage of a person based on previous conditions. It's only with individual health plans that it makes a difference, and even then if a person maintains health insurance prior to that condition, then switching providers should be possible for them. And, there are already organizations that help financially-unstable people to pay for the health coverage that they need.
July 2, 2007 at 11:25 pm
Wow - these HSA's were signed into law over 6 months ago and I didn't notice. I'm really interested to see how well they work and if employers start migrating to these plans. There are (of course) a bunch of restrictions. But it seems to me like an attractive alternative. You can even invest your HSA in mutual funds in the same way an IRA is invested. Thanks for pointing it out to me.
July 3, 2007 at 6:39 am
To John Williams:
I concede the following points:
Once you are sick, you cannot realistically switch insurance companies.
Insurance companies want to compete for healthy, not sick bodies.
The point I do not concede:
A government-run system would do a better job of ensuring that every citizen receives the care that they need.
In order to be convinced of this, I will need to see lots of data (no anecdotes or opinion surveys) comparing the US with other countries in terms of average wait times for critical procedures, numbers of deaths or severe disabilities caused by delay or denial of care, and any other comparison points that I can think of. I am going to take a few days to research this. Of course you may suspect that I will cherry-pick data to support my opinion, but I will make an effort to be unbiased in my search.
A final point before I go off to look for data: You have stated that the government would do a better job because there is no $20 million CEO involved. I counter that with the government running things, there would be waste of at least that much per year, because at least in the US, government programs become bloated with middle-management-type positions that contribute little to the effectiveness of the program. I offer as evidence a couple of the same programs cited by Moore: the postal service and the education system. So regardless of any potential merits of a government-run health program, we can be certain that it will at least cost more per person than the current system. And when problems arise with the new government system, what will be done about it? Look at our history. We will pass legislation to throw more money at it. We'll hire oversight committees and special inspectors. And when that doesn't fix the problems, we'll throw more money at it. You cannot deny that this is the modus operandi of the US federal government, and there is no reason to believe that this program would be any different. And where does all this money come from to support the "free" health care system? It comes from you, and it comes from me. People who are astounded by their current health insurance premiums ain't seen nothin' yet.
PS - this isn't FOX-style scare tactics. It's a logical projection based on history. Because with the federal government, past performance IS an indication of future results.
July 3, 2007 at 12:53 pm
MP, so your counter to my points displaying how Moore plays hard and fast with facts is "Ontarians get free flu shots, so there" (a service not even offered in most other provinces or territories I might add).
Well a quick google search shows that free flu shots are being handed out all across the US too, and there would have been more except for a shortfall of the vaccine due to production problems, so how does that even help your cause of demonizing the American system; a system I'm not even actually defending.
And statistics, without any real context are meaningless though it is ironic that one of the few Moore chooses to use in Sicko, the Health Care Rankings, if actually looked at hurts his case as much as helps it. The blessed Cuban health care system which Moore is so quick to praise is actually ranked two levels lower than the US on those rankings (not that those rankings are worth the cost of the paper they're printed as each country is actually ranked as to how they match up against a theoretical image of themselves and not any real standards).
July 3, 2007 at 1:19 pm
Bic says:
"And statistics, without any real context are meaningless though it is ironic that one of the few Moore chooses to use in Sicko, the Health Care Rankings, if actually looked at hurts his case as much as helps it. The blessed Cuban health care system which Moore is so quick to praise is actually ranked two levels lower than the US on those rankings (not that those rankings are worth the cost of the paper they're printed as each country is actually ranked as to how they match up against a theoretical image of themselves and not any real standards)."
Bic, you might find interesting this letter from sociology professor John Hammond to NPR: "Your correspondent said that Michael Moore’s comparison of the U.S. health care system to the Cuban system was not a good one (the U.S. came out ahead of Cuba on the World Health Organization survey; the U.S. was in 37th place, and Cuba in 39th). But that comparison is not exactly favorable to the U.S., with a per capita GNP many times greater than that of Cuba, we have a health-care system that is only marginally better. What Cuba shows is that even a poor country that uses its resources wisely and systematically can do almost as well as the richest country in the world."
THAT's the real context here. Honestly, as rich as we are in this nation, we should EASILY have the number 1 spot in that WHO survey, hands down.
July 3, 2007 at 1:24 pm
And a sincere kudos to Steve, for being open-minded about this at least.
July 3, 2007 at 8:13 pm
#11 G: I think that a documentary about lost airline luggage is just what this country needs. Do it Michael Moore!
July 4, 2007 at 4:06 am
I only mentioned the ranking to point out how Moore uses selected data to prove his points and he's not even consistent as to how that data is used. If you watch Sicko there is absolutely no indication that Cuban health care is anything less than amazing.
As I mentioned above, the study itself is highly flawed and next to meaningless in comparing one country to another. One of the key factors in determining a countries ranking is based on a "fairness in financing" formula which by it's very nature puts socialized medicine countries above user pay ones, thereby handicapping the US from ever reaching a high rank. It basically puts a heavy weight on who pays for the health care as opposed to what level of care is available.
Check out David Hogberg's, Paris General article for more.
July 4, 2007 at 7:34 pm
John Williams – You assert that free market competition doesn’t apply to health insurance, because unlike with other industries, health care deals with insuring human bodies, which are subject to illness over time. Yet life insurance also deals with human bodies, and life insurers are equally driven to sign healthy people who won’t get sick and die prematurely. This has motivated many people to lose weight and quit smoking to decrease their premiums, and although there are always some who do die early and thereby generate claims which increase the total cost, as a general rule life insurance in the USA is price competitive and equitable and widely respected. Insurance need not be used to cover routine costs; it’s meant to be a rarely-invoked protection against some unforeseen future calamity, and insurers can and do offer policies which protect people who contract future illnesses that neither they nor their insurance companies could foresee. It’s natural that people with worse health should have to pay more for such protections; we can’t realistically expect insurance companies to operate at a loss in order to keep premiums low for people who are certain to end up costing a lot, can we? The real demon in health care in the USA is not the greed of insurance companies; rather, the problem is that the industry is largely insulated from free market competition, mostly because of the policy errors committed by a few well-intentioned but very misinformed people.
True market competition could (and WOULD) fix American health care, and it would be relatively easy for us to get there; four simple steps would take us most of the way. First, the FDA and the various state licensing boards would have to allow anyone to practice medicine however they chose, without regulation or restriction. We “consumers†would be free to continue to choose to go only to AMA-accredited doctors and institutions. Or not. We could go to shamans or witch doctors, for that matter, and we would have access to drugs or surgery or care of any type, regardless of how we chose to obtain those things, without forcing every practitioner and procedure to be AMA-sanctioned and FDA-approved. Consumers would quickly become wiser in our health-related choices, and medical establishments competing for our individual business would tout their reliability and reputations.
Second, we would have to set a $500,000 cap on medical malpractice lawsuits, obviously to cut down the prohibitively high malpractice insurance costs many doctors presently face. Third, we would have to make a tax law reversal. Currently, businesses can write off employee-related medical costs, up to 7.5% of adjusted gross income. We would have to eliminate that loophole entirely, and instead pass those savings along to individuals on their personal income taxes, so that as individuals we could deduct health care expenses, rather than through our employers. This would result in a fundamental shift from employer-provided care, which has largely eliminated the consumer-driven price competition the industry so badly needs, to a market driven by families and individuals shopping for their own coverage. And finally, to truly have a free market, we’d have to eliminate Medicare, Medicaid, Bush’s prescription drug benefit, and the various other governmental regulations and requirements that exist, such as the rule that hospitals treat everyone who enters, irrespective of their ability to pay.
Such changes would not result in universal care, it’s true. But the cost of health care would plummet so dramatically that your 50 million uninsured Americans would dwindle to maybe 50,000, and those of us who consider ourselves Christian and/or giving, caring people would be happy to help those uninsured people ourselves, through the tens of thousands of churches and charitable organizations which already exist and which would undoubtedly be in a better position to help after health care costs had dropped to a small fraction of what they are today. And the beauty of the free market is that even after prices went down so much, the various businesses within the industry – insurance firms, drug companies, hospitals, doctors’ offices, etc. – would have to compete so directly for more market share that the quality of care and customer service would go nowhere but up.
July 4, 2007 at 8:31 pm
(1) Health insurance and health care are NOT synonymous;
(2) Bush/troops/war is off topic and is not germane to the discussion;
(3) Whether Mike Moore actually cares about health insurance coverage, a discussion on said topic, or is only out for the paycheck is all speculation;
(4) I think most would agree that exorbitant CEO bonuses/stock options need to be curtailed (btw, it is an issue not unique to the health insurance industry), but…
(5) GAO estimates one out of even seven dollars spent on Medicare is done fraudulently – considering that annual Medicare expenditures are in the +/- $300 billion, that is a lot of money. Multiply that times 7 (300 million people total in USA/42 million people currently covered) to get a real estimate of how much waste there would be (three orders of magnitude greater than your CEO bonus).
July 4, 2007 at 9:10 pm
My current employer offers three health insurance plans: I selected (and pay more for) the most comprehensive one. I made this decision PRIOR to getting a disease, because that is when it should be made. I have (and pay for) life insurance. I made this decision BEFORE I died (which I haven’t yet). Finally, I carry (and pay for) disability insurance. Once again, I made the decision to get this BEFORE I became disabled (which I'm also not). I value my health and the future of my family regardless of what my health might be. I don’t believe that the 50 million uninsured Americans place any such value on these.
July 4, 2007 at 10:00 pm
Comment 39: Please explain how someone is being denied basic health care services? As for “getting rich,†competition is the biggest motivator. If there were no incentives for the CEO/company, then why would they bother? I agree that there needs to be CEO compensation reform, but absolutely not socialization of the industry.
Comment 40: See me previous post regarding fraud. Also, please post the CEO’s justification for his $20 million bonus. I doubt it was because he had the snappiest power tie and suit combination…
Comment 41: It is not obvious to me that the capitalist argument doesn’t work. As I stated earlier, it is left up to the free will of the individual to make their health care decisions PRIOR to getting sick. I cannot understand why others can’t understand this. You do not ask for auto, homeowner’s, flood, renter’s, or any other type of insurance AFTER the event has occurred.
Comment 42: All Americans have access to basic health care, regardless of whether they have health insurance. If they have a health care need, they must pay for it. Just like those who have health insurance, but they don’t have to pay the premiums for all of the times they do no use the insurance. I think trying to convince Libertarians to accept government controlling their health care decisions is pointless. I do agree with the seemingly excessive corporate bonuses, but that is separate from the core issue (unless you believe it is these bonuses that make insurance that would be affordable to the uninsured unaffordable - I’m not doing the research, but I doubt this is the case).
Comment 47: You are combining arguments and making assumptions. I think we all concede that already sick individuals who are uninsured will find it more difficult to obtain insurance compared with those who are healthy. But, how many of the 50 million uninsured Americans does this apply to? How many are currently diagnosed with a chronic illness or disease? You subtly imply (or at least as I am interpreting it this way) that some WERE insured, then became ill, and were dropped prior to or during treatment – if this is an argument, please indicate how many people fall into this category (and why they didn’t sue!). Also, you assume that one with an illness is forever ill. Some conditions will be fully cured or easily and inexpensively managed. Please identify the CEOs of health insurance companies that are currently making billions of dollars – there’s a huge difference between a $20 million bonus and “billions.†If you want billions, or more to the point hundreds of billions, see my previous post about Medicare fraud. Your last argument works against you: with a government plan, you have no bargaining power at all prior to, during, and after an illness; why do you make the huge assumption that with the government plan, you won’t “might just DIE.†Finally, your entire approach to this issue is based on the individual taking a passive role in his or her own health. I find this completely unacceptable. As you stated, this is not a watch or a car. There are 50 million Americans who currently do not understand this.
July 4, 2007 at 10:36 pm
Comment 53: I couldn’t care less whether the average Canadian trusts his system, but I do know that my healthcare service is better than that of the average Canadian, average Cuban, average Iranian, etc. and this due to the fact that our system gives those who value healthcare the choice to have superior service over a system without choice. It doesn’t matter whether socializing healthcare would lead to socialization of other industries, it is still a bad idea based on the facts and reasonable assumptions. Speaking of logic, you continue make a straw man argument concerning the current “unbridled capitalism†method of insurance – this is not an unregulated industry.
If your original point is that insurance companies do no want to compete for sick bodies, then your original point does not apply to the entire group (i.e., 50 million people). I don’t believe the system hurts sick people – please explain how health insurance companies go around and make people ill/cause disease. The reality is that the system provides medical care for sick people who chose to PAY for the service. Speaking of pay, why shouldn’t CEOs benefit? When you take away the financial incentive with a government system, you do not then somehow then operate under one based on morals.
July 5, 2007 at 10:33 am
Huh?, your characterization (65,66) of the 50 million uninsured is as ignorant as it is offensive. Do you actually believe all those people don't care about their health? That is just a ridiculous assertion. It is much more likely that these people:
A) Don't have jobs that offer health insurance
B) Have employer subsidized health insurance that only offers prohibitively high premiums; this also could evolve into a discussion of people being underinsured, but I'll defer that for now
C) Have previous conditions which make them uninsurable
D) Have other problems which makes health insurance seem unattainable
I have worked for a public health office and continued to work with the less privileged in our communities. I can assure you that these people are aware and concerned for their health. There are real barriers, usually having to do with cost or employment situations.
At this point I'm not advancing any solution, but I could not let your asinine comments go unchecked.
July 5, 2007 at 5:29 pm
A close friend of mine contracted some kind of skin rash while we lived in Vitoria, Spain. We got a free doctor's visit, and very very cheap medicine. Too bad it was the wrong medicine for his rash. We went back again, misdiagnosed again. The THIRD visit produced results.
In Spain they have private practices as well, I got dental work done at a private practice and it was as good or better than any visit I've ever had here in the states.
If theres any way to go after the insurance companies without forcing socialized medical care on the general public, I'd like to hear it.
July 5, 2007 at 6:00 pm
I've been reading these comments with some interest, and while I don't claim to have all the answers (or any, because my own opinions are still evolving), I do have several thoughts/beliefs:
1) I believe that anyone who thinks they have the obvious solution to this problem is wrong. If the solution was obvious, it would be espoused by the majority of logical people, and probably even in place already. Since the system in place is widely criticized and it's hard to find two intelligent, logical people who agree on the best solution, I think it's safe to say that there is no obvious answer.
2) I believe that if there wasn't such a need in the U.S. to make everything a political issue, people would be more able to compromise and work to find one of the countless solutions that would be better than what we have right now. People will compromise with their spouses, their bosses, even strangers on the road when they both get to the stop sign at the same time. But if you ask a Republican and a Democrat to compromise on something, you're asking for trouble.
3) I believe that there IS a certain percentage of uninsured citizens who probably have within them the ability to fix their own problems. Whether it's getting more education, using the education you have more wisely, improving your health/lifestyle to qualify for coverage, etc., certain people CAN improve their situations.
4) I believe that this quote... "I value my health and the future of my family regardless of what my health might be. I don’t believe that the 50 million uninsured Americans place any such value on these." ...is one of the most ridiculous things I have ever heard. I personally have good insurance for myself and my family, and I feel very blessed to have a job that provides it at a relatively cheap cost to me personally. But my point is that I feel blessed, because I know other people who have at least as much education as I do, who work just as hard as I do, and who are just as good at what they do, who (for one reason or another) do not have the affordable health insurance that I do. Oh yeah, and they care just as much about their health and their families as I do about mine. To say that they don't have insurance because they don't care is just ridiculous. Or, as HoosierDaddy said, it is "as ignorant as it is offensive." I am not offended by it, but I certainly think it is stupid.
5) I believe that with the current system, it is impossible for everyone to have adequate health insurance. The fact is, you have to have either a) a good job that provides insurance, or b) a good job that pays well enough for you to pay for private insurance. And the fact is that there are not as many good jobs in this country as there are people who need health insurance. What it really boils down to is this: is affordable health care a right or a privilege? The more I think about it, the more I think maybe it should be a right.
6) I believe that a completely socialized medical system would be a bad thing. I don't think the government has what it takes to efficiently run such a huge project. I also don't think a government-run medical system could/would meet the standards that my current insurance meets. If all health care were socialized, so we all received the same health care as everyone else, my standard of health care would go down. I don't know what the perfect solution is, but I have to think it lies somewhere in the gray area where we can provide at least the basics for everyone (especially children) while not "punishing" those who are doing fine right now by lowering them down to the socialized level.
7) I believe that Michael Moore is a two-edged sword. On one hand, he has the name recognition to make a documentary like this one that will get people talking; on the other hand, he further politicizes an issue that I don't believe has any place in politics. Health care is not a political issue, but it is one of many issues that have become political in our system. It makes me sad that there are people who consider themselves Republicans or Democrats or Libertarians first and Americans second, and base their judgments of other people on those criteria. For my money, we are all human beings first, Americans a little lower, and our political party somewhere way down the list. And from that standpoint, I can't stand to have my fellow human beings in my country suffering because of lousy health care through no fault of their own. This is not George Bush's fault any more than it is George Washington's fault. It's not really any single person's fault. It is a flawed system, and the people in charge of our systems (regardless of political party) need to step up and work together to find a solution.
July 5, 2007 at 6:05 pm
Sorry, one clarification on my last paragraph. I am not saying that Michael Moore is making this a political issue -- I haven't seen the movie yet, so I don't know. When I say that "he further politicizes an issue that I don't believe has any place in politics," I mean to say that the mere fact that it's him making the points will cause a lot of people who dislike him politically to disagree with him in knee-jerk fashion. (I'm also not saying that everyone who disagrees with him is doing so knee-jerkingly.)
July 5, 2007 at 6:48 pm
I currently work for the government and I know first hand how much paperwork is involved in everything. Every decision has to be justified and signed off by at least three people. There is no way I would want this system to be applied to health care. While I agree that heath care needs work, I do not agree that it should be taken over by the government.
July 5, 2007 at 9:05 pm
Perry says: “Insurance need not be used to cover routine costs; it’s meant to be a rarely-invoked protection against some unforeseen future calamity, and insurers can and do offer policies which protect people who contract future illnesses that neither they nor their insurance companies could foresee. It’s natural that people with worse health should have to pay more for such protections; we can’t realistically expect insurance companies to operate at a loss in order to keep premiums low for people who are certain to end up costing a lot, can we?â€
John: What exactly is “natural†about people with bad health having to pay more for the right to live? If, as you seem to imply, all diseases were brought on by our own bad living, then yes, this might seem “natural.†But the idea that it is “natural†for someone with cancer to have to pay more for their life than someone who does not have cancer—I completely reject this (it relies on an assumption---it is NOT just clear logic). It is only “natural†by the logic of corporate capitalism. If “we can’t realistically expect insurance companies to operate at a loss" it is only because they exist only to make a profit. Perry might be surprised to learn that in every other developed nation in the world, it is not considered “natural†that someone who gets sick should be forced to pay more for the right to live than someone who is healthy. Why on earth should I accept that as “natural.†To me, it sounds absolutely draconian, ugly, anti-humanist, just bad, bad, bad.
Perry says: “You assert that free market competition doesn’t apply to health insurance, because unlike with other industries, health care deals with insuring human bodies, which are subject to illness over time. Yet life insurance also deals with human bodies, and life insurers are equally driven to sign healthy people who won’t get sick and die prematurely. This has motivated many people to lose weight and quit smoking to decrease their premiums, and although there are always some who do die early and thereby generate claims which increase the total cost, as a general rule life insurance in the USA is price competitive and equitable and widely respected.â€
John: Clearly, this is a very poor analogy to health insurance. Life insurance operates under a fundamentally different logic than health insurance. With life insurance, there is a one-time event (your death) and a one-time payout (the amount you were insured for). This makes the entire system extremely simple, and it tends to work just fine (although it is still a system that privileges people who are healthy over those who are not—but okay, fine). Health insurance, on the other hand, is not so simple. Any number of things can go wrong with your body—and some of them will be easily treatable, and others very expensive. But there is no telling how expensive or how long they will last beforehand. That is, you might get a sore throat, or you might get cancer, and you might need something routine, or you might need something experimental. So there is no one-time event or one-time payout. It’s enormously more complicated than life insurance.
Perry says: “ The real demon in health care in the USA is not the greed of insurance companies; rather, the problem is that the industry is largely insulated from free market competition, mostly because of the policy errors committed by a few well-intentioned but very misinformed peopleâ€
John: this is a largely conjectural hypothesis. And, again, the notion that true free-market competition will somehow “trickle down†to everyone but about 50,000-odd poverty-stricken souls (to be taken care of by the Christian largesse of American goodness)—well, to me that constitutes a faith in Ayn Rand that I just cannot fathom. The inevitability of the corporation, its proposed role as the salvo to every evil, all of this has become such a tight ideology that it appears completely “natural†that some people pay more for the right to live than others. But will someone explain to me, please, what is “natural†about that?
July 5, 2007 at 9:32 pm
I really want to see what happens with the health-care reform that just went into effect in Massachusetts. They are requiring all citizens to carry health insurance, much as you are required to carry auto insurance in most states if you own a car. The govt. is subsidizing some cheap plans for the low-income folks, to make it less burdensome.
It sounded like a good compromise and (from preliminary reports) wasn't supposed to cost the state much more than they were already paying to hospitals, to reimburse them for treating uninsured patients.
Here are a couple news articles about it:
Signonsandiego.com
Washingtonpost.com
July 6, 2007 at 2:21 am
> John Williams: “What exactly is “natural†about people with bad health having to pay more for the right to live? . . . will someone explain to me, please, what is “natural†about that?†People with crooked teeth have to pay for braces; people with bad eyes pay for glasses; people who aren’t natural born athletes pay for gym memberships or personal trainers; and so on. It doesn’t seem like such a stretch to say that it’s natural for less healthy people to have to pay more for care. You’ve got to be careful when you say that we have a “right to live,†because you’re clearly not just implying a right to not be killed by someone else, but also a right to have the government do whatever it can to prolong our lives, regardless of the cost. If there were a limit placed on the cost, then we’d only have a “right to live†as long as the cost didn’t exceed some previously-defined amount, right?
If we really had a right to live, we could demand that the entire gross domestic product be devoted solely to pursuing the medical means of prolonging the lives of all 300 million of us, because we would all share in that “right.†This obviously would never happen; somebody, at some point, would have to draw the line and say “we’re not going to spend any more time or money on that particular patient,†even though the patient, or his family, might disagree. It’s a judgment call that cannot be avoided; but who is qualified to make it? The president? Congress? Doctors? You indicated earlier (42) that you’d like to see government-provided “basic†health care for all Americans. Who defines “basic?†Who makes the judgment call as to where basic care ends and the patient is released, if not the price-benefit, maximization-of-personal-utility model derived from the free market?
There’s nothing draconian about the marketplace charging more to a person with cancer than to a person without it. After all, it costs a lot to treat cancer, of course. No one can accurately say whether a person’s cancer was brought on by poor choices or by genes, but that doesn’t mean that all of society must be compelled to financially support everyone with cancer. If medical costs in general were radically reduced from their present state, then even though people with cancer would still pay more, everyone would be paying so much less overall, that it wouldn’t really matter so much. If you think the government’s role is to try to force us all to have exactly equal opportunities, to aim to correct Mother Nature’s mistakes by compensating for those people who are born with disabilities or illnesses, to compel us all to live with whatever problems others are born with even when we ourselves weren’t born with those particular problems, I’d have to question your sanity, just a little. (wink, wink)
> John Williams: (on whether life insurance is analogous) “Clearly, this is a very poor analogy to health insurance . . . (which is) enormously more complicated than life insurance.†That fact that health insurance seems more complicated to you in no way weakens the analogy. You proposed that health insurance was uniquely immune to capitalist forces because unlike other industries it deals with your body, and that you can’t always shop around for a better policy if you’re mistreated because you might die (47). Life insurance fits neatly into these parameters, and without all of the onerous governmental regulation that has plagued health care, it seems to work very well. The analogy works, complexity notwithstanding.
> John Williams: “If you have bad health, insurance companies do not want to “compete†for your business. It’s the moment where capitalism completely turns against you!†Absolutely untrue. Insurance companies, unobstructed by governmental regulations and restrictions, will be happy to take on customers with bad health, not at the same rates as those with good health of course, but if health care costs have radically dropped overall anyway, then even the higher-cost “bad health†customers will be able to afford their premiums.
> John Williams: “If I get burned by a bad HEALTH insurance company, I might just DIE. So, where's my bargaining power then?†Your personal bargaining power isn’t the only factor that will make the health insurance company not want to “burn†you. Every insurance company understands the importance of reputation; if there were no governmental regulation, private ratings groups like the Consumers Union (Consumer Reports) would become a lot more important, and insurance companies would vie for optimum ratings. Burning customers wouldn’t get them very far, needless to say.
> John Williams: “. . . this (that the industry doesn’t currently experience free market competition because of some specific governmental policies) is a largely conjectural hypothesis.†I’ve listed four concrete policies (or categories of policies) which hamper or eliminate market competition in health care, none of which you attempt to refute. That these policies exist and that they are not conducive to free market competition is neither hypothetical nor conjectural.
> John Williams: “. . . the ONLY way for a health insurance company to "maximize" its profits is....what? To either charge you more for your health care or else deny your claims. Period.†Nonsense. In a free market, if you raise prices too much (“charge you more for your health careâ€), you lose customers to the competition. This results in a wide degree of price parity between competitors in typical markets, forcing companies to do other things to attract new customers, because if you can’t raise prices, the way to maximize profits is to increase sales volume by winning people over. You mention only prices and denial of claims. If in a free market an insurance company raises prices and denies too many claims, they won’t be around for long.
> John Williams: “. . . the notion that true free-market competition will somehow “trickle down†to everyone but about 50,000-odd poverty-stricken souls (to be taken care of by the Christian largesse of American goodness)—well, to me that constitutes a faith in Ayn Rand that I just cannot fathom.†Free market competition doesn’t trickle down; it lowers prices and raises quality and service. And it doesn’t just “somehow†magically do this; it does it openly, elegantly, and powerfully. You personally benefit from it every minute of every day in countless ways, in spite of your efforts to ridicule it. Can you make a credible case to prove that making the four reforms I proposed in (63), which would bring market competition to the health care industry, would not result in significantly lowered prices and improved quality and service, which in turn would enable many millions of Americans to be able to once again afford good health insurance?
The faith in Ayn Rand which you “just cannot fathom†is misplaced; Rand was neither a Christian nor an advocate of charitable giving to the poor. If, however, you’re convinced that Americans aren’t charitable enough to be willing to help the needy without being compelled by the government (especially after everyone has more money to spend because health care costs have gone way down), then it’s apparent that what you really lack is faith in the American people themselves.
At any rate, John, I’m obviously not going to win you over, but I’m hoping other people who are reading these posts might realize that while Michael Moore was correct in pointing out that American health care is in need of an overhaul (he’s kind of stating the obvious, isn’t he?), it’s important to realize that his proposed solution - government-run health care - is based on the faulty assumption that our current system represents a failure of the free market. It doesn’t.
July 6, 2007 at 2:50 am
Perry, I confess, I'm really tired, and your post seems really smart. Give me some time to think it over.
July 6, 2007 at 11:31 am
It may be that I’m fighting a losing battle here (just in this thread, I seem to be one of maybe 2-3 people who actually think the govt. could do a decent job of providing health care for even the poorest among us). I also confess that I don’t entirely understand Perry’s proposed solutions, or how they would work. Perry says, “Or not. We could go to shamans or witch doctors, for that matter, and we would have access to drugs or surgery or care of any type, regardless of how we chose to obtain those things, without forcing every practitioner and procedure to be AMA-sanctioned and FDA-approved.†But you are already free to go to witch doctors or shamans, if you want, right? The difference is that Perry’s solution seems to be that our insurance companies would be paying for whichever doctor we want them to. Is that right? But I’m so confused by that. What’s to stop me from saying that my wife is a doctor (she’s not), and that she needs $2 million to treat me from the emotional damage suffered by reading Eric’s review of “Sicko� Perry’s second and third options seem like good ideas. And if we absolutely must have a capitalist insurance system, then they are probably good ways of fixing the problem.
But the central premise of Perry’s suggestion relies on the question of an insurance company’s “reputation.†As he says, “Consumers would quickly become wiser in our health-related choices, and medical establishments competing for our individual business would tout their reliability and reputations.†And again later: “Every insurance company understands the importance of reputation; if there were no governmental regulation, private ratings groups like the Consumers Union (Consumer Reports) would become a lot more important, and insurance companies would vie for optimum ratings. Burning customers wouldn’t get them very far, needless to say.†The idea here is that if an insurance company gets a bad reputation, and we were absolutely free to take our insurance business wherever we want, then prices go down, quality goes up. Now, as I’ve already shown, this is a fix that requires the exploitation of a significant number of people. As I’ve pointed out several times, if an insurance company burns me, then (because I’m sick) I cannot take my business anywhere else. I’m screwed. But of course just one person getting screwed is not enough for an insurance company to get a bad reputation. They have to screw a LOT of people, and THEN, they get the bad reputation. Which is great if you’re one of the people who finds out afterwards, but really bad if you’re one of the thousands (tens of thousands?) who find out in the meantime and have no recourse for health care at that point. And never mind that most people currently using their health insurance are in precisely that position.
But what is to stop Perry’s free-market insurance solution from simply drowning us in corporate insurance advertising? I can think of a LOT of things that Americans choose to buy simply because they have been persuaded by advertising—not because the product is in fact the superior one.
In the end, I’m not someone who will ever have a say (beyond my vote and in random blogs like this) on what really happens with health care. And I’m willing to hope that even if a government-run health care system is not ever going to happen, that we at least reform the current system we have.
July 6, 2007 at 11:41 am
Jeff (70, 71), I think you confuse political with partisan. Wikipedia (which is usually a reasonable source) defines politics:
Politics is the process and method of making decisions for groups. Although it is generally applied to governments, politics is also observed in all human group interactions including corporate, academic, and religious.
So this is definitely a political issue. We should all be very involved in politics. What you meant was the issue is becoming partisan. And definitely, support for fully socialized medicine is favored by some parties, and not by others. However, I don't think Moore is anywhere close to the mainstream in his desires. Neither major party wants or believes in socialized medicine. Although some minor parties like the Green party may.
One of the schools I attended did not provide or require insurance. With a wife and two children, I felt that we needed insurance. So I went to an agent, and saw that there were a large number of plans accessible to our family, even on our meager income. They had high deductibles, but they would protect us from medical bankruptcy if it ever came to that. The plan did not have maternity coverage, so we had to be creative to pay for our third child when he came along. But we made it work. We lived well under the poverty level and almost certainly would have qualified for medicaid, but we felt like we did not need to depend on the government for a handout, and were able to make due.
Most of the people we knew who didn't have insurance were really worried about it, but didn't really know what to do about it. They put off solving the problem until after they needed it, and then were stuck, and had to rely on government social services. It was really sad. If they didn't have insurance from work, many of the currently insured with plenty of money to afford insurance would have put it off until it was too late. That's human nature. So maybe Massachusetts has it right. Requiring everyone to have insurance is really the first step. They we can deal with those who really can't afford it.
July 6, 2007 at 11:47 am
Sorry -- I think it should have been "make do" not "make due". Or am I wrong?
July 6, 2007 at 2:13 pm
> John Williams: “I seem to be one of maybe 2-3 people who actually think the govt. could do a decent job of providing health care for even the poorest among us.†Whether government could do a decent job is not the issue; it’s whether our current health care system fairly represents the unrestricted power of the free market. I’d be fascinated to see someone try to make the case that it does.
> John Williams: “But you are already free to go to witch doctors or shamans, if you want, right?†They can’t prescribe medicine, perform surgery or other routine medical procedures, or even legally claim to be legitimate doctors, because they’re not licensed by the state. So if you want your neighborhood shaman to set your son’s broken arm or remove your mother’s appendix or perform an ultrasound or prescribe Ritalin or Zoloft, or maybe give you a note for antibiotics for your daughter’s stuffy nose, you’re out of luck. What is the shaman left to do? Acupuncture, herbal remedies, naturopathy, and other forms of “alternative†medicine. Why can’t he diagnose Johnny’s cold and send you to the pharmacy for penicillin? Because the FDA is “protecting†us, the vulnerable consumers, from accidentally getting Johnny the wrong stuff. But there’s a cost for this protection: instead of having an uneducated, unqualified shaman charge me five or ten bucks for his time, I have to sit with Johnny in a waiting room and then meet with someone with at least eight expensive years of college and an additional four years of a rigorous residency under his belt, not to mention a med-school-related personal debt easily exceeding $100,000 (and a 4.0 GPA and top percentile MCAT test just to get into med school in the first place). It’s no wonder that AVERAGE doctor salaries ranged in 2004 from $133,000 to $322,000, depending on the specialty and the experience (www.bls.gov/oco/ocos074.htm).
Why do medical schools cost so much, and why are they so hard to get into? Because there aren’t enough of them. The demand for medical schools exceeds the supply. Many more people want to be doctors than can get into med school every year. Why is this? Aren’t there more universities which would like to open their own medical schools? Sure, there are tons of them. But the American Medical Association won’t let them; it won’t accredit them. Why not? The AMA claims that if there were more med schools, people with lower GPAs and test scores would be admitted, and the overall quality of care in America would be reduced. This approach lucidly demonstrates that the AMA is comprised of doctors, not economists. Yet maybe they’re not as clueless as they appear to be; there’s a definite cause-effect relationship between limited supply and higher prices. If there were more medical schools, more doctors would be competing for the same pie, and prices (and doctors’ salaries) would certainly go down. To allow for more medical schools, state licensing boards would have to permit normal people to do what doctors do without having attended an accredited school; this alone would dramatically reduce health care costs in America. (In fact, state licensing boards serve no useful purpose other than to drive prices up; they should be abolished entirely.)
My two-year-old developed a lump on the side of his neck last year. We took him to our doctor, who ordered a test, prescribed an antibiotic, and referred us to another doctor. The antibiotic worked fine; the lump was nothing. The cost for this treatment was $800. Even when insurance “pays†for these kinds of costs, it all ends up coming back to us in the end. Society pays, one way or another, when industry is inefficient. I’m not saying that I’d rather have visited the shaman; I’m just saying that there’s got to be a happy medium for relatively routine checkups, exams, common ear-nose-throat ailments, etc. I don’t need a personal visit to someone whose credentials rival those of the Surgeon General every time my kid gets the sniffles.
> John Williams: “What’s to stop me from saying that my wife is a doctor (she’s not), and that she needs $2 million to treat me . . .†Typically, when you first sign up with an insurance company or HMO, there’s a list of approved doctors you can check. If your wife isn’t on the list, the HMO isn’t obligated to pay the $2 million, right? So if one HMO or insurance company only allows AMA-approved doctors on its list, another might compete by allowing witch doctors, shamans, and your wife, but when you sign the contract, the HMO can certainly include language limiting the amounts it will pay out to such people, and ways it can determine whether their bills are legitimate. It’s then up to you, the consumer, to decide whether to go with that particular HMO or not. Keep in mind, though, that if we all shopped for insurance as individual consumers, rather than leaving that job to the Human Resources specialists at our places of employment, the insurance companies would quickly change their approach to cater to what we would be looking for, in order to attract us to them, right?
> John Williams: “. . . if an insurance company burns me, then (because I’m sick) I cannot take my business anywhere else.†I assume that by “burns†you mean it illegally denies your claims. You still have recourses; if they violated their contract, you can take them to court. You can still shop for insurance elsewhere, though it will cost more because now you’re sick. You can contact the Better Business Bureau. And because these options are open to you and the insurance companies are aware of this, it’s unlikely in a totally free market that they will illegally “burn†you at all, given the potential for negative repercussions and press. Still, if getting burned is a concern, you can choose to begin your coverage with a longer-established, more reputable company. If you’re young and healthy and a risk taker, on the other hand, you can buy a cheaper policy from an up-and-coming company and probably be just fine. I’d like to know what guarantee is in place under socialized, universal government-run care which stipulates that no one will ever get “burned?â€
> John Williams: “But what is to stop Perry’s free-market insurance solution from simply drowning us in corporate insurance advertising? I can think of a LOT of things that Americans choose to buy simply because they have been persuaded by advertising . . .†This puts a smile on my face, John. I, too, hate the obnoxious advertising which permeates our society. One of the free market’s failings, to be sure! But to suggest that Americans will make poor health insurance choices because they’ll be duped by false advertising is to once again show no faith in the intelligence and wisdom of your neighbors and friends. It’s ironic to me that fans of big government typically see American citizens as being idiots when it comes to making personal decisions (Which product to buy? How to ensure that such-and-such is safe? Whether to wear my seat belt? Etc.), who cannot be trusted to make good choices unless the government intervenes in the process. Yet when it comes to complex questions about international relations, foreign wars, trade issues, etc., these same lovers of centralized authority bow to the sacred shrine of democracy. If a survey shows that a slight majority of Americans thinks that a such-and-such trade deal will result in unemployment, it must be so, because democracy is never wrong. Go figure.
It’s true that insurers will continue to advertise, as they do now, but you’ve got to give Americans credit. When it comes to maximizing my own personal utility, no one – not you, not my congressman, not even my wife – knows better than I do how I best want to spend my time and money. No one. I’m not an idiot consumer. There ARE some fools out there, to be sure, but the less that government tries to protect them, the wiser they’ll naturally become, and the stronger our society will be.
If government were completely removed from the health care industry, prices would be radically lower, virtually everyone would be able to afford insurance, the quality of care and the level of service would be improved, and you and I wouldn’t even be talking right now. If, on the other hand, we were to nationalize health care, the current inefficiencies and bureaucracies would only increase, costs would continue to steadily climb, and someone would have to pay for that. Given the current populist trend in our country, I’m sure the brunt of the cost would be borne by the individuals and companies which have the most money. A hidden yet potentially devastating result of this is that the increasing money these people would spend to support nationalized health care would begin to deplete their bank accounts, loans, and other assets, decreasing the amount of capital available to businesses. When the supply of available capital shrinks, the cost of whatever capital is left goes up. In other words, if you wanted to start a new business or grow your existing one, when you went to the bank to get a loan (or sought private equity investment in other forms), you would find that the interest rates would be too high, so you wouldn’t start the new business or invest in the expansion after all. This, of course, would do nothing but hurt the economy and launch us into recession, so that even though the lower income populists might think they really stuck it to the rich man by nationalizing health care, they’d be mystified to discover that the economy wasn’t robust enough to support the low unemployment rates they needed to be able to hold onto good jobs. But hey, they shouldn’t worry; the government can always fix that for them too, right? We’ll just create a bunch of new TVA or CCC-style jobs, and print out a lot more money (or borrow it) to cover the costs. Surely the ends justify the means?
July 6, 2007 at 3:23 pm
Hey John, I'm with you - I think the government would do a serviceable job with this. I'm not saying there wouldn't be other problems, but I think it would do away with many of the worst problems of the way things are now.
Perry, I'm liking the sound of your ideas to an extent, but I can't really agree with them. Maybe I'm not following your ideas completely, but from what I've seen your argument basically boils down to letting a free market run with this. It's a great theory, but I don't see it working. If all men and women were virtuous, completely free markets would be great, but that's not the case. That's much of the reason why government has to interfere with the market in the first place.
I also find it curious that you paint the AMA as some sort of shady institution. They set standards for a profession, just like many professional organizations. When it comes to health care I don't see anything wrong with those standards being set very high. If you want to lower costs for treatment of routine illnesses you can go to a nurse practitioner, who can prescribe many medications. I would suggest that calling the AMA unnecessary is not as solid a point as you seem to think.
The discussion about being "burned" is also very interesting. John didn't define this, but I think I know what he means. In any case, I don't think it necessarily means that the insurance company has done anything illegal, it means that they've ripped you off in some way. A big business can have their lawyers and policies interpret laws in many ways that are devious and not at all fair to the consumer. The consumer can always bring up a lawsuit as recourse, but who wants to do that? That's not that easy, and winning is not assured.
There's a story I could relate here about how one time AT&T stiffed me out of $50 several years ago. Seemingly not a lot of money, but it did put a dent in my family's finances when it happened. I still don't think I should have payed them, but my recourse was a lawsuit that would require me to hire a lawyer ($300/hr) and spend a lot more time (I'd already spent 2 months trying to get them to give me my money back) and energy in a cause that just wasn't worth it. Their recourse? A staff of lawyers specializing in contract law and crushing people like me, and threats to ruin my credit rating. I'm getting mad now just thinking about this. $50 didn't put me in the poorhouse, but it seems like a multi-billion dollar company could just refund me that amount without blinking an eye, right? And because of the free market I could switch providers, to Verizon in this case, but, you know, I'm sure they would have done the exact same thing in a similar circumstance. The experience made me more careful in choosing my long distance carrier. It also made me very wary of big business, in general, too.
Also - You know what I hate? Having to think really long and hard about which freaking long distance carrier to choose!
Ok, that was a bit of a tangent, but there are some analogous elements, too. Big businesses are big businesses and they want to make money, and they don't necessarily have the best interest of the consumer in mind.
I can understand being suspicious of big government, but why do you have so much faith in big business doing the right thing?
I had more, but I'm tired just now. Maybe later.
July 6, 2007 at 4:50 pm
I am wondering, Perry, what your answer is to the thousands of children that are insured through Medicare/Medicaid. They would have absolutely no recourse to purchase their own health insurance, and if their parents didn't do it for them--and let's face it, there are many, many parents that are failing at their job as parents and probably wouldn't--what would they do? My own parents didn't take me to the dentist regularly because we didn't always have dental insurance--and we had plenty of money! Right now, the government offers something for children via Medicare/Medicaid. If they didn't, who would? What is your solution?
I do not agree with the idea of socialized medicine, but I highly doubt a free market would take care of the most vulnerable--especially because I share HoosierDaddy's suspicions of big business. There are plenty of ways we could improve the system we already have. As Perry mentioned, tort reform would be a significant first step.
As a side note, Perry: when my kids are only mildly sick, I either call and talk to a nurse, or see a nurse practitioner. Most medical practices I've encountered are set up this way. I think your "happy medium" already exists. Also, I am glad there are such high standards for who can prescribe medicine and treatment, considering the mind-boggling plethora of ailments and drugs and tests out there. It's interesting that you used penicillin in your shaman example since that is one drug to which many people have severe allergies. Even for most-likely-not-serious health issues, it is in our own best interest to have the most knowledgeable among us be the ones calling the shots. If there is a lot of "unnecessary" cost associated with seeing a properly trained doctor, how much will those costs go up when all the undereducated shamans and witch doctors out there make people worse because they aren't competent to diagnose or treat patients? Certainly insurance companies would pass those costs back to the consumer. Or there would simply not be any insurance companies willing to insure non-MD health practitioners, and then things wouldn't be that different from where they are now. So I'm not sure how getting rid of the AMA and FDA would help any.
I think Massachusetts' system shows a lot of promise. Why not make it a state-by-state issue, meaning each state is required to make sure all of its citizens are insured? That way, some can do a socialized system, some can do a free market, some can do a hybrid. In any case, there would be many more options, the governments involved in a hybrid or socialized system would be much smaller and thus (hopefully) more efficient.
July 7, 2007 at 12:40 am
I did not see sicko and i Agree we need universal Health care. But read my blog post on this very subject. http://utahconservitivedemocrat.wordpress.com/2007/05/25/universal-health-care-my-thoughts/
July 8, 2007 at 1:56 am
Wow, way to many comments to read. Let me just add a few comments from a doctor's point of view.
1. I would never let anyone in my family be treated at a VA hospital.
2. Two of the biggest problems in health care in the USA right now are illegal immigrants and lawyers. We need tort reform and immigration law reform.
3. The uninsured have access to basic health care. I operate on them every week. I see them at free clinics. They fill the ERs of America (usually for routine, non-emergent issues). They get basic health care.
4. I hate insurance companies too, but refer to #1.
July 11, 2007 at 11:11 am
In (84), Surgeon touches on an issue that, unfortunately, has been mostly overlooked in this discussion: private charity.
Consider the fact that, for example, children born with cleft lips or club feet will almost always be able to receive corrective surgery ANYWHERE IN THE WORLD regardless of how poor they (or their country) are. It is not anyone's government that makes this possible (aside from the fact that the governments allow it by getting out of the way). This happens because those rich, greedy CEOs (and most other decent people) make substantial financial donations and doctors donate their time and abilities, because we all agree that being poor should not be a reason not to receive such care.
You may respond by saying that relying on private charities leaves it up to chance and the whims of donors, while a government program would guarantee results. My response is to look at the data. Private charities have consistently and reliably done a far superior job of caring for those in any kind of dire straits than any government program you care to name. I challenge anyone to prove this statement wrong. Name one government program that does its job better than - no, make that even as well as - a private business or a private charity. And by doing the job better, I mean comparable results with less cost. Oh, and don't feed me that line about universal care being free. I am a taxpayer.
Would anyone support a government program that provides one last wish to a dying child because the Make a Wish Foundation is unreliable due to its reliance on the whims of donors? Is it not obvious that such an attitude is patently ridiculous?
Also, private charities do not have the sort of waste that is guaranteed in any government program. This is because donors will choose other causes to donate to if they feel that their charity is being squandered. And that, John Williams, is how the free market system (specifically, the freedom to choose how much to donate and to whom) will always do a better job of meeting the needs of those who cannot afford to pay doctors than any government program ever could. You can't argue with results.
This is a hard pill (ha!) to swallow, because it sounds like I am suggesting that the government simply turn a blind eye to the problem and say, "that's not my job." People don't like that. It sounds cold and draconian. It doesn't make you feel good because you're "doing something." It doesn't appeal the people's irrational emotions. It appeals to the cold logic of data analysis.
I am not suggesting that the government turn a blind eye to the problem. I am suggesting that the government make a realistic (rather than political or emotional) assessment of the situation, and say, "hey, those guys are doing a really good job of taking care of people. In fact, they could do even better if we got out of the way." That is the charitable and humane thing to do. In this case, as in so many others, it is less government, not more, that will result in a better situation for everyone.
July 13, 2007 at 6:20 am
Some comments here mention that the socialized healthcare system would mean that no one would get help on time and thus would not work, well... I don't pretend to know anything about the American system or the British one (which, I guess, are dominantly discussed in here) but where I live in (Finland, Northern Europe, next to Sweden, Norway and Russia, just in case you didn't know... ;) ) our healthcare, just like education, is free to everyone. One might need to wait a while if you're going to go for a routine checkup or to have your teeth cleaned up, but if you have a serious illness and are about to die, there's no way they'll put you on a line. Plus, for those who cannot wait for 15 minutes to get their fever measured, there are private clinics, which do charge for their services, but from those also you get a certain percentage payed by the government (if you apply). Certainly we pay taxes for all our free services, but they're not in the end that much that we couldn't bear them; what is a little money compared to a happy nation? Maybe it's a question of the mentality of the people in question: do the Americans value their bank account more than their health? So our doctors aren't millionaires, but do they really need to be? You seriously think that if they were, they'd do their jobs better? Maybe Finns just aren't greedy enough then, that we rather have a country where everyone has the same opportunities to live and educate themselves, than a country where the biggest goal in life is to be a millionaire and drive a maybach (or whatever) and god forbid if anything would keep you from doing that (like those damn taxes! How can one possibly live after paying them?!). But someone will probably point out to me that comparing a system for (only) 5,5 million people and one that's supposed to take care of 300 million isn't really noteworthy. And I accept that, but the point I guess I'm trying to make here is that paying taxes isn't "the great evil" but letting your fellow countrymen die just because they can't afford to pay for an insurance is. I also apologise for my terrible language and writing skills and all the possible mistakes I've made so far, but this isn't my native language and all the mistakes I make are because of that damned terrible socialized schooling system! :)
July 15, 2007 at 12:05 pm
To 68 and 70, I don't doubt that you find my comments ridiculous because it is quite clear that neither of you are capable of holding people accountable for their own lives as well as for the many poor choices that they might have made. To think that health insurance coverage is "arbitrary" or some special privilege is completely absurd. I find it supremely offensive that you believe a certain classification of people is incapable of the thoughts and activities necessary to comprehend and ultimately manage their situations.
I challenge any of you to identify a country, now or in the past, where its citizens have a better chance to succeed in life (which includes goods, services, and freedoms) than in the present day United States. This coupled with the fact that that +/- 250 million people can handle something makes me feel that the other 50 million are failing in their personal responsibilities. Considering their current employment situation and lifestyle of those who cannot afford health insurance, they need to add to their income or reduce their other expenditures.
I'll throw another curveball at you: health insurance has CO$T$ associated with it. People who are covered pay for it. The argument, "My employer pays for it/offers it affordably" is not a luck of the draw. When an employer pays a portion or the coverage, that is part of your entire compensation (just like ESOP, 401k, vacation, company car, etc.). Positions with "full benefits" actually compensate about 1.6 times what the dollar salary is.
July 15, 2007 at 12:15 pm
70: Concerning your "health insurance is a right" statement, my discussion concerning the "right to have an automobile" should be sufficient for you to retract this disturbing and absurd argument. To help, I use a car just about every day of my life. I use my health insurance probably once per year, usually for routine check-ups.
Your universal health insurance system operated by the government will do this to me:
* Reduce the quality of my health care;
* Increase the time it takes for me to receive appropriate health care;
* Reduce or eliminate the health care choices I currently have;
* Significantly increase the costs I currently pay for the services;
* Do all of the above for my family.
If four out of five dentists agree that Crest is a good toothpaste, using the arguments of the pro-socialized system, it is really bad for you...
Rights of people should never require one individual to subsidize another.
July 15, 2007 at 11:10 pm
Huh? said:
"To 68 and 70, I don't doubt that you find my comments ridiculous because it is quite clear that neither of you are capable of holding people accountable for their own lives as well as for the many poor choices that they might have made. To think that health insurance coverage is "arbitrary" or some special privilege is completely absurd. I find it supremely offensive that you believe a certain classification of people is incapable of the thoughts and activities necessary to comprehend and ultimately manage their situations."
I find your comments ridiculous because they are. Your statement, like most absolute statements, has no chance of being true. (How'd you like that absolutely statement?) You said every single uninsured person in our country is that way because they don't value their own well-being. I'm not sure exactly what you find "supremely offensive," but I assure you that I didn't say anything offensive. If you really believe that every single person has what it takes to get a good job with good insurance, you are hopelessly out of touch with reality. Some people are less intelligent than others, not through a lack of hard work, but due to sheer bad genes or bad upbringing or whatever. Some people will never, no matter how hard they work or how many years in a row they flunk out of college, be qualified to do a job that has good health benefits. So unless employers start offering benefits with lousy jobs, those people are out of luck. (And for that matter, as long as small businesses are put at a huge disadvantage in offering benefits to their employees, the people who work for those small business are out of luck, too.)
If I were one to get supremely offended about something an anonymous moron on the Internet said about me, I might take offense to the idea that you think "it is quite clear that [I am] capable of holding people accountable for their own lives as well as for the many poor choices that they might have made." I believe very strongly in holding people accountable for their choices. My entire argument was with your assertion that every uninsured person is that way because of their choices. I apologize if this is blunt and supremely offensive, but it is a stupid opinion to have. I don't generally strongly disagree with people's opinions, but when they are demonstrably untrue and coming from a seemingly intelligent person, I just have to say something. I assume (based on the fact that you have a job with good benefits) that you are a reasonably well-educated person, and it baffles me that an educated person can believe something that is so obviously false, and believe it so strongly that he is willing to make himself look like a complete buffoon in public about it. (Of course, you aren't taking much of a risk with a name like "Huh?," now are you?)
I also am a big fan of your comment #88, where you refer to MY "universal health insurance system operated by the government." It reminds me of that time when I said, in the VERY COMMENT you were responding to, the following:
"I believe that a completely socialized medical system would be a bad thing. I don't think the government has what it takes to efficiently run such a huge project. I also don't think a government-run medical system could/would meet the standards that my current insurance meets."
I guess you only read far enough to get supremely offended, then you decided to start spouting nonsense again. Well played, my friend. Commenting is so much harder when you actually have to respond to the things people actually said.
July 16, 2007 at 5:26 pm
89: I was using hyperbole to mock/make notice of the statements you and the other supporter of the universal/government-run health insurance system made (which used absolute comments). You fail to provide any evidence for any of your arguments (e.g., "I find your arguments ridiculous because they are."). Outstanding. I find it strange when unsupported arguments use absolutes such as in your posts, but then get offended when others do the same in response. I think that we agree on this, though I imagine one of us will continue to do this as support for their arguments.
Please read the last part of Comment 87. An employer provides a total compensation to an employee. They aren't just going to, "Throw in benefits." This has a bottom-line cost associated with it. As for the people, they are certainly not out of luck. They don't need to stay with their current employer if their current position does not have benefits and this is something they desire or feel they need. They chose to stay in their current situation or do an inadequate job of advancing this situation. I believe that all people can better themselves and their situations; people have free will, have choice (in this country), and have many opportunities. Please explain how that is:
* demonstrably untrue;
* a stupid opinion to have; and
* so obviously false.
You do state that you do not want a completely socialized medical system; however, consider the following: "The more I think about it, the more I think maybe it should be a right." How is that NOT in support of a universal/government-run health care system? I read your ENTIRE post and chose to address words you wrote. My take is that rights are either given by one's maker (we will not get into that argument) -or- by the government.
It is clear we disagree as to who wants/can get health insurance in this country. My interpretation of your views is that 5 out of 6 Americans can afford health insurance, but everyone is really striving to have it. My take is that 5 our of 6 Americans have it and the vast majority of the other 1 out of 6 value other things in life to a greater capacity and/or they are not willing to work extra to have this benefit.
July 16, 2007 at 5:38 pm
"My take is that 5 our of 6 Americans have it and the vast majority of the other 1 out of 6 value other things in life to a greater capacity and/or they are not willing to work extra to have this benefit."
Yeah, but that's not what you said before. What you said before was, simply, that the 50 million Americans without health insurance just don't care about their health. That's the statement -- the obviously untrue, unprovable statement -- that Jeff and others were responding to.
Your newly clarified position -- that the vast majority of those 50 million (rather than every single one of them) have different priorities ... well, that's still debatable. But at least it's not as obviously laugh-out-loud ridiculous as the idea that all 50 million of them just don't care about their health.
July 16, 2007 at 10:49 pm
91: No, I didn't "simply" say what you typed. I said that I don't believe they place a significant value on it (as part of an argument concerning health insurance, where I discussed how I actively take responsibility for myself and my family). This was in response to the "the uninsured cannot get insurance when they have an expensive illness" topic. I concurred, but with the caveat that I believe this applies to only a small portion of the group. I was trying to point out that the time for insurance is prior to needing it. Thank you for the straw man, though.
I don't believe I had an old clarified position or a different position. I made the clarification because I recognize that a small subset of the 50 million are probably incapable of improving their situation; however, I hold the vast majority responsible for taking care of something that they obviously value.
What is laugh-out-loud ridiculous is cherry-picking a portion of a statement, taking it out of context, and then modifying it.
July 16, 2007 at 11:43 pm
No, I didn't "simply" say what you typed. I said that I don't believe they place a significant value on it (as part of an argument concerning health insurance, where I discussed how I actively take responsibility for myself and my family). This was in response to the "the uninsured cannot get insurance when they have an expensive illness" topic. I concurred, but with the caveat that I believe this applies to only a small portion of the group.
Here's what you originally said:
My current employer offers three health insurance plans: I selected (and pay more for) the most comprehensive one. I made this decision PRIOR to getting a disease, because that is when it should be made. I have (and pay for) life insurance. I made this decision BEFORE I died (which I haven’t yet). Finally, I carry (and pay for) disability insurance. Once again, I made the decision to get this BEFORE I became disabled (which I'm also not). I value my health and the future of my family regardless of what my health might be. I don’t believe that the 50 million uninsured Americans place any such value on these.
I am glad that you recognize, as you pointed out in your most recent comment, "that a small subset of the 50 million are probably incapable of improving their situation." What I was pointing out, however, is that you didn't say that originally. What you said originally, quoted above, is that you "don't believe that the 50 million uninsured Americans" place as much value on their health as you do on yours. You didn't say "most of them" or "some of them"; you said "the 50 million uninsured Americans." THAT'S the hilarious idea -- that EVERY SINGLE ONE OF THEM doesn't care about his or health as much as you do about yours. Since you have clarified that you didn't mean ALL of them, just most of them, that's a much more reasonable position, and one that can be discussed.
July 17, 2007 at 12:12 am
So Huh?, since you agree that "a small subset of the 50 million are probably incapable of improving their situation," what should be done with them? When I said I lean towards thinking health care is a right, I had in mind those people -- the ones who CAN'T improve things on their own. The percentage of the 50 million uninsured who fit this category is debatable -- I probably think it is quite a bit higher than you do -- but as long as we agree that the percentage is higher than zero, your attitude of "screw you, dude, I HAVE insurance" is unfair to at least a few people. I am really interested in what you would do for those people.
I have no desire to engage in a silly, petty argument about who's a bigger dooty-head, and I'm sorry if I came across overly caustic. The part of your argument that I said was ridiculous, stupid, demonstrably false, etc., was that part that you have since admitted you didn't really mean -- that EVERYONE without insurance is without insurance because they don't care enough to have it. So now that we're past that one sticky issue, I want to know what you would do to fix health care in our country. Or do you not think it is broken?
(One other little sticky issue, just to clear my chest so I can have a mature discussion with you without any lingering annoyance: You say you just addressed the words I actually wrote, but you have now twice blatantly disregarded the fact that I specifically said I am not in favor of a completely socialized health care system, instead focusing on other things I wrote that you INTERPRETED to mean I was lying when I said what I said. You also ignored the fact that I specifically said that I do NOT get offended by things said in comments on the Internet, instead implying that I am a hypocrite for getting offended by your unsupported arguments. So yeah, if we're going to discuss this, I need you to stop implying that I am a liar. And remembering my very first statement -- that I have no answers because my opinions are still evolving -- would probably help, too.)
July 17, 2007 at 9:27 am
93: I stand by, "I said that I don't believe they place a significant value on it (as part of an argument concerning health insurance, where I discussed how I actively take responsibility for myself and my family)." It isn't hilarious, laugh-at-loud, absurd, etc; I think it is clear, though I can see how some with a bias can take it out of context (even without changing or adding text). I'm sorry if you can't see the entire argument.
I didn't say they didn't care, I said they didn't value it as much. Caring has immediacy to it (knee-jerk, emotional response) where valuing is more of an honest critique with a time factor involved; I think one's cares can change quickly and drastically whereas values take a long time to move significantly. I have health insurance in part because I value it. There are 250 million Americans who also have it; I believe most of them value it. I'm sure the other 50 million "care" about it, especially if someone else gets to pay for it or if they have an immediate health care situation.
94. Life is unfair. It is interesting that your evaluations involve people being passive (people have health insurance, people are lucky, people are more educated). I disagree with approaching the discussion in that manner. Part of my argument has been that I don't believe some people are active in taking control over this situation. Those with insurance do not inherit or somehow luck into their situations. People EARN what they have through hard work, dedication, perseverance, planning, concessions, choices, and tough decisions.
I don't have a, "screw you dude" attitude. If I were proposing that someone else fund something that I am not paying for, then I would say that is true. I value people's ability, independence, and free will; I challenge them to empower themselves to work towards obtaining health insurance. I think very highly of them because I believe they can do it and I hope that they do it.
Health care and health insurance are two different matters.
Is the health insurance system broken? No, I don't believe so. Is their room for improvement? Absolutely. Does the improvement somehow involve the government forcibly taking money from me to give to others without a tangible benefit to my family or me? No, I don't believe so. I don't believe the onus has been put on the uninsured to challenge them to take the many (sometimes difficult) steps to obtain and maintain insurance. The easy and emotional view seems to be find who has money and take it from them.
I understand that you said you don't believe in a fully socialized system, but you also said you believe it might be a right. I was looking for clarification (and yes, badgering you a little). Who is going to provide or guarantee this right if it is not the government? Health insurance is not an intangible such as free speech or the right to bear arms; it has a monetary value attached to it. I think I could agree that there is a right to receive equal access and equal treatment - I believe we have that. Should taxpayers fund people who want to have their own newspaper but cannot afford it? Should taxpayers pay for firearms for citizens who cannot afford to bear arms? (There' a good counter argument, btw, I hope you find it).
In addition to personal responsibility (I will not beat this dead horse again), I think the solution also involves those who are crawling all over each other to take my money. There are a lot of activities that they could do that would improve the situation (other than lobbying for increased taxes/a government system). Since I value your independence and freethinking ability, I let you come up with some of the solutions. I’ll present one though: I’ll call it Mike Moore Health Insurance (MMHI). It provides basic health insurance coverage and costs $20 per month per member. I think we can agree that many of the 50 million uninsured can afford $20 per month. I’ll be charitable and say half can (I believe almost all can). So, 25 million times $20 is $500 million per month. MMHI has quite a lot of money to cover its members. Seriously, I do believe that there is the opportunity for this type of system.
I do ask though, I wonder if Mr. Moore provides health insurance for those who work on his films?
July 17, 2007 at 12:22 pm
Huh? said:
"It is interesting that your evaluations involve people being passive (people have health insurance, people are lucky, people are more educated)."
Are you really saying that getting an education -- and therefore being qualified for a job that has health benefits -- is a passive process? Let's look at those three "evaluations" that you paraphrased from what I wrote: "people have health insurance" is neither passive nor active, just a simple fact; "people are lucky" is also a fact, and one I backed up with a personal account that I personally know people who are just as educated as I am and work just as hard as I do, but they don't have as good a job as I do, and I feel that I owe that, in part, to luck; and "people are more educated" is definitely an active process, not even remotely passive.
Huh? also said this:
"I understand that you said you don't believe in a fully socialized system, but you also said you believe it might be a right. I was looking for clarification (and yes, badgering you a little). Who is going to provide or guarantee this right if it is not the government?"
For a guy who keeps drawing the distinction between health INSURANCE and health CARE, you sure do keep insisting on misinterpreting what I said when I said I believe "affordable health care" is a right. If you can't see that there is some middle ground between "a fully socialized system" and "people who have no ability to improve their own health care situation are screwed," I'm note sure you're making any attempt at a reasonable conversation. You seem keen on arguing, but you are making no attempt at addressing any of the specific questions people ask you in response.
You accuse those of us who misunderstood what you said of having a bias that caused the misunderstanding, when really all we did was take what you said literally. You can say all you want about the distinction between "care" and "value," but all it does it change the percentages. It DOESN'T change the fact that there are some people who VALUE their well-being but have no ability to improve their situation. Or that there are some people who don't even have the mental capacity to VALUE anything -- I believe it is our responsibility to take care of them, too.
I stand by what I said in my original post, that under the current system, even if all 300 million Americans valued their well-being, they would not all be able to have affordable health care. If one person takes the initiative to improve his situation (through education or whatever you consider an "active" process), then when he gets that job that either offers health insurance or pays well enough for him to cover his family some other way, some other poor schlub is going to lose his job to make way for Mr. Active Values. So if it is literally impossible under the current system for every American to have affordable health care, even if they all valued it as much as you want them to, then the system is broken.
October 23, 2007 at 3:53 am
I live in Israel. I pay some ten to fifteen dollars per month of medical insurance. It's universal, and it's good. I never waited more than 40 minutes anywhere. When i could not get my regular Troath doctor, I asked for another one through the centralized appointment system, and I got one. And I know that Israel is still pretty behind if compared with Western Europe. Now I'm going back to live in Argentina (my original contry). Health-care there is also universal, but public hospitals are very poor (but are better than not-receiving any care, and the level of the doctors is high). Nevertheless, if you pay private insurance, you get ALL what you need. I don't know about NOT APPROVED claims in Argentina.
November 30, 2007 at 10:55 am
I’ve just seen this movie. All of you people who criticize this film without having seen it should not even be able to comment. You can not judge a film without having seen it. You can make an educated guess on what it may be like via the film maker’s previous films but to dismiss a films contents which you have only heard about would be like choosing to hate a candidate because of what a third+ party person tells you…pure stupidity. This movie phenomenally hits all the things wrong with American healthcare. It shows the hardship many Americans with and without healthcare face due to the revenue focused healthcare companies. Simply put, this film makes any person brought up in America with those “America is the best, most caring, intelligent nation” ideals will just be completely degraded and sick...
December 9, 2007 at 4:58 am
I just saw the movie, too. Thought I'd say something for posterity. I really liked the film. I delayed seeing it for such a long time because of Eric's review. I usually agree with most of them, not this one.
Universal health care is a tide that raises all ships. It's better for society as a whole. America should stop making it a damn political issue and just do it.
December 20, 2007 at 10:22 am
Am I nuts or does it seem like the reason we can't throw money at universal healthcare and education is because we have the most bloated defense budget in the history of the planet? And even then we manage to privatize our war resources so we can cut taxes for the very rich. The whole system is rotten. Call me a commie dreamer but I would rather my tax contributions go to healthcare for my fellow citizens than funding this global meliorism that fuels anti-American sentiment.
May 26, 2008 at 5:16 am
Ken Kirk said:
"And even then we manage to privatize our war resources so we can cut taxes for the very rich. The whole system is rotten. Call me a commie dreamer but I would rather my tax contributions go to healthcare for my fellow citizens than funding this global meliorism that fuels anti-American sentiment"
What tax cuts do you speak of specifically?
May 19, 2009 at 9:14 pm
I recently had to have shoulder surgery & am now dealing with my insurance company over them nitpicking what they will & will not cover. Before I went into surgery, I was told that I was near my deductible & therefore wouldn't have to pay for the majority of my surgery. Now I am getting all my bills & seeing thing that the insurance company claimed they would cover, are not, & I will have to pay for them myself. I have had my insurance for nearly 15 years & in that time this is the first time I have had to use it for something major. I have never hit my deductible ($300) before, & usually end up paying for the majority of my doctor visits & anything else I need. I had to go to the emergency room & ended up paying for the whole thing myself, because I didn't go to the "approved" hospital on my insurance. I don't make alot of money & consider myself lucky to even have insurance, even though I pay for almost everything anyway. Yet the CEO of my insurance company got a $100,000 bonus, & my rates are going up when I renew my insurance later this year. I don't understand why the money I pay for insurance can't be held, like a trust. Then when I need it, the insurance company has to just pay my bills out of it, no questions asked. I don't understand why everything has to be "approved". If my doctor says I need it, why does the insurance company think that they're smarter than the doctor & I don't? My surgery ended up being more invasive, due to a complication that didn't show up, until I was on the table. But the insurance company won't pay for it, because I didn't get it approved with them before I went in. I know there need to be some guidelines in place, because otherwise the insurance company could be scammed, but at the same time, the "rules" the insurance companies come up with are outrageous. I honestly believe that this country doesn't really need socialized medicine. What it does need is some housecleaning of the insurance companies. They've become bloated money grubbers, more concerned with their next bonus, than with taking care of the people they insure. I don't claim to be an expert on any of this, but when I see friends & family, & myself all paying money we really can't afford, to cover things that an insurance company should, it kind of makes you wonder why we even need insurance companies. Can someone enlighten me as to why we couldn't clean up the companies, without compromising the health-care system?