…and this is a 
Moore v. Gupta: Truth v. False Doubt
Category: Politics
Posted on: July 14, 2007 2:00 PM, by PZ Myers
As Revere points out, Michael Moore gave Sanjay Gupta a whomping. What I missed in the Moore-Gupta match, though, was the big picture. Basically, they argued over details: Gupta put together a "fact check" that claimed Moore fudged various numbers, while Moore showed that his numbers were legitimate. What appalled me, though, was the spin put on it, the spin that Gupta did not acknowledge.
Here's the argument: Moore says the US spends something under $7000 per person per year on health care; Gupta says it's 'only' something over $6000. Moore says Cuba spends $251 for the same thing; Gupta says it's $229. Moore points out that we're ranked 37th in the world for the quality of our health care system; Gupta claims Moore was hiding the fact that Cuba is 39th.
Look at the message CNN is sending. They are saying Moore is a sloppy researcher who is fudging his numbers, and giving ammunition to all the people who want to close their eyes and dismiss Moore's movie and the problems in the American health care system. Moore is charging in and ably refuting the claims that his data isn't backed up, but he's fighting against CNN's dishonest, sneaky, corrupt story.
Ignore the little variations in number: both cite different sources, accounting for the slight differences. Here's the bottom line.
The US is spending several thousands of dollars where Cuba is spending a few hundreds of dollars to get roughly equivalent (that is, poor) healthcare.
Further, the media, including Sanjay Gupta, are mounting a spin campaign to cast doubt on the real problem and give cover to those who want to bury efforts to change the system.
Michael Moore sees that, although I don't think he expressed it as well as he should. That's where the outrage at CNN is coming from: this is a media outlet that sees their role as one of commissioning hatchet jobs on anyone who challenges the status quo, doing their best to hide an uncomfortable core of truth in a blizzard of irrelevant details. They will gladly paint Michael Moore as a truth-challenged liar on the basis of their selective reading of the facts, but give the Bush administration a complete pass on years of bloodshed and waste. They couldn't even muster a single Gupta-style querulous whine against the lies behind the Iraq war.
Comments
PZ, did you forget the omni-present "liberal bias"?
Posted by: mndarwinist | July 14, 2007 2:14 PM
Great post, which I will be linking in a listserv discussion about Moore! Thanks.
Posted by: Daisy | July 14, 2007 2:26 PM
I have a friend who travels to Cuba frequently and knows a bit about the Cuban medical system from talking to people in Cuba. While everyone supposedly gets coverage the lack of medicine and supplies to treat the illness means that they often aren't treated. It would be interesting to hear from people with a little credibility about their experiences with the Cuban medical system.
Posted by: Anonymous | July 14, 2007 2:36 PM
Yep, it is quite amazing the incredible amount of straw man and ad hominem attacks that Moore is getting slammed with.
Yet, overall on the macro level, aside from little details, and wait times in Canada, Moore's case is airtight. That is private for profit insurance companies make their profit by doing their best to deny and limit coverage.
They go over Moore's film like he is submitting it to a peer reviewed journal article. Frankly, I don't expect Moore's numbers to be exactly correct, because they don't matter to the case being made.
As for Cuba's healthcare, a relavant comparison would be how it stacks up against Haiti or the Dominican Republic's health care system. For sure, the comparison with Haiti's would indeed make Cuba's health care system utopia!
Posted by: Sheldon | July 14, 2007 2:40 PM
The problem with Moore is not the facts. Anyone can "check facts" and regurgitate them, and most (although not all) of Moore's facts in his movies do check out. The problem with Moore is the way he puts those facts together. Moore is a propagandist, muck raker, and rabble rouser, not a documentarian, and he tends to cherry pick those "facts" in order to support a predetermined viewpoint. The facts that he leaves out are as important as those he emphasizes.
The best example of that is probably his handling of the Unocal pipeline issue in Fahrenheit 9/11.
Posted by: Orac | July 14, 2007 2:41 PM
The viewpoint that he's supporting in this film is an eminently reasonable one with plenty of data to support it; indeed it's virtually a truism to anybody even moderately familiar with serious international comparisons of health care systems.
Posted by: Steve LaBonne | July 14, 2007 2:49 PM
The problem with Moore is not the facts. Anyone can "check facts" and regurgitate them, and most (although not all) of Moore's facts in his movies do check out. The problem with Moore is the way he puts those facts together. Moore is a propagandist, muck raker, and rabble rouser, not a documentarian, and he tends to cherry pick those "facts" in order to support a predetermined viewpoint. The facts that he leaves out are as important as those he emphasizes.
The best example of that is probably his handling of the Unocal pipeline issue in Fahrenheit 9/11.
**************************************************
He is a good framer got to give him that though ;)
And there isn't a problem with the American health care system?
Posted by: ponderingfool | July 14, 2007 2:50 PM
The real problem is that there just isn't a source for the truth anymore. If I check a government source, I picture the current administration's abuses of science fact to "spin" ideological issues. If I listen to CNN, I'm thinking about the advertising debts that a giant media source ends up owing to its sponsors. Even if Moore is correct, he's just another head waving a sheaf of papers that support his statements.
Trouble is, this time around, I'm not entirely sure I believe him. Don't get me wrong, I can tell that our medical system is f'ed up-- I think anyone can tell you this. But the examples he uses seem extraordinary, and maybe even false. How about that baby that died when the mom was asked to transfer to a different hospital? Are we to believe that she couldn't have just said she'd pay the bill herself later, and let her kid be treated there? I've never seen a hospital demand payment first-- looks to me like she was holding out for a place where her insurance was good, and she waited too long. Or how about the "average" French couple who were making $100,000 a year? That didn't seem quite right either, not when I see news reports about the big unemployment problems in France.
There's also an underlying theme that bothers me, something that I'm sure most of you will totally disagree with, not being poor folks yourselves-- and I'll use the guy who got his two fingers cut off as an example. My take on this? Get your damn fingers put back on, and just say "yeah, no sweat, I'll pay you, sure thing"... you know this guy didn't pay that $12,000 up front, he's probably doing it in installments or something. Shit, drop the other finger right on top of that bill. It's just money. Even if you can't pay, they're not going to repo your finger! Sounds like people are more worried about money than their own health, which is ridiculous. It's this push-over mentality that allows a system of $5 aspirin and $5000 ambulance rides to exist.
Posted by: DaveX | July 14, 2007 3:01 PM
DaveX, I haven't seen the movie so I don't know the specifics of your examples, but my brother had planned surgery on his face some years ago. The hospital demanded a cashier's check for the entire amount up front before they'd do anything. We delayed the surgery three months because the hospital and insurance kept going back and forth trying to make us pay immediately; eventually, we did. Others in my family will go to the ER and hand over a credit card because otherwise, it takes too long to figure out what kind of cast is allowed or not.
Posted by: Diatryma | July 14, 2007 3:08 PM
That may be so. However, all I can say is that I've been to the emergency room more than my fair share of times, intending to essentially use it in place of a proper doctor visit, simply because I had nowhere else to go. I was always up front about not having insurance, and that I'd be expecting a bill. I never got turned away, so my experience isn't all that bad.
Posted by: Diatryma | July 14, 2007 3:11 PM
"Moore is a propagandist, muck raker, and rabble rouser, not a documentarian, and he tends to cherry pick those "facts" in order to support a predetermined viewpoint."
In some cases and contexts, none of those things are neccessarily negative.
Can anyone give me an example of a documentary film that does not cherry pick some facts in some way, that does not arrange those facts to make some type of argument? Honest question, not just rhetorical.
Moore for certain is making a different kind of documentary film, loosely speaking, that does not meet the standard of other documentary films. And he tries to make them entertaining, funny, and appeal to a wider audience that would not sit and pay to see a documentary.
Being a defender of Moore, I will concede that sometimes he makes statements that I would not defend without caveat or clarification. However, because Moore's films and arguments are threatening to certain elite interests, he is held up to a higher standard. I would like to see Moore's critics in the media held up to the same standards that they hold him to. They wouldn't fair to well either.
Posted by: Sheldon | July 14, 2007 3:14 PM
I thought Moore made his most telling point in the interview with Keith Olbermann. He claimed that in the US, people were losing their homes or going bankrupt in order to pay for medical care, people were dying because insurance companies would not pay for treatments and doctors were put in the invidious position of having to obtain insurance company approval before carrying out courses of treatment they believed were necessary on medical grounds. That simply doesn't happen on the NHS in the UK.
Yes, there are longer waiting lists in the UK but, as Moore comments, keeping over 45 million people out of your private healthcare system will help to keep waiting times down.
Yes, there are shortages of more expensive treatments and equipment in the UK. Rationing happens but at least it's done on medical grounds rather than on whether the patient can afford it. Again, keeping over 45 million out of private heathcare does help to ease the pressure on resources.
Having now had personal experience of both systems, I can affirm that the US healthcare system undoubtedly provides an excellent service for those who have insurance coverage. The general standard in the UK may not be quite as good but it is still an immense relief to know that, whatever happens, you will have access to good treatment without worrying about whether you can afford it or not.
The caveat about higher taxation in order to pay for universal healthcare systems is a red herring. One way or another you have to pay for healthcare, whether through taxes or insurance premiums. That isn't the problem.
The question is whether healthcare should be available to everyone or only those with the most money.
The answer should be obvious to all but the rabid free-market fundamentalists - or viewers of Faux Noise.
Posted by: Ian H Spedding FCD | July 14, 2007 3:25 PM
If you want to know the truth about the Cuban health care system, go to:
www.saludthefilm.net
IS MICHAEL MOORE RIGHT ABOUT CUBA?
NEW DOCUMENTARY ¡SALUD! PROVIDES INSIGHTS ON CUBAN HEALTH CARE SYSTEM
Atlanta, GA - For Americans curious about Cuba's health care system after seeing Michael Moore's SiCKO, the new documentary film ¡SALUD! sheds light on how such a resource-poor country can provide its people with universal health care.
¡SALUD! is directed by Academy Award nominee Connie Field and was produced with support from Atlantic Philanthropies and the Rockefeller Foundation. ¡SALUD! is the first film to examine the results of Cuba's health care system and the island's global cooperation program, which sends 30,000 health professionals abroad. The documentary was filmed in Cuba, South Africa, The Gambia, Honduras and Venezuela, and includes testimonials from former President Jimmy Carter, Harvard University's Dr. Paul Farmer, and George Washington University's Dr. Fitzhugh Mullan.
"The biggest lesson we learned filming ¡SALUD! is that no matter how poor a society or a community is, accessible, affordable health care is possible," said producer Gail Reed, international director of Medical Education Cooperation with Cuba (MEDICC), the Atlanta based organization that works to enhance global health cooperation. "Cuba's experience in delivering health and training physicians to provide good primary care is an example that we in the United States could learn a lot from."
"The Cuban system of health care and medical education have a great deal to teach us about how to provide medical care - we can't adopt it wholesale here by any means but it provides lessons we can learn from," said Dr. Mullan.
In an interview in ¡SALUD!, former President Jimmy Carter says, "Of all the so-called developing nations, Cuba has by far the best health system. And their outreach program to other countries is unequaled anywhere."
Cuba provides free universal health care to all of its citizens, with a community-based focus on prevention based on a network of neighborhood clinics. In a December 2006 Gallup Poll, 96% of Cubans said they have regular access to health care, no matter what their income level. Despite its limited economic resources, Cuba's infant mortality rate, life expectancy and other health indicators are comparable to those in the United States, yet the per-person expenditure is only about $230 (compared to over $6,000 in the U.S.).
Cuba has also been a world leader in the development of new vaccines, including one for meningitis, which are not available to patients in the United States because of the U.S. embargo against Cuba.
Despite shortages and hospitals in need of refurbishing, the strength of Cuba's health care system lies in its workforce. The country has more than 70,000 doctors, 20,000 of them serving in poor communities abroad (mostly elsewhere in Latin America and in Africa). The 50,000 working at home still give Cuba the best patient-doctor ratio in Latin America, nearly twice that of the U.S. Cuba's Latin American Medical School provides full scholarships to over 10,000 low-income students from around the world (including the U.S.) who make a commitment to work in under-served communities in their own countries when they graduate.
For more information, please visit the ¡SALUD! and MEDICC websites:
www.saludthefilm.net
www.medicc.org
#####
Posted by: Stephen Rivers | July 14, 2007 3:28 PM
To DaveX,
"....not being poor folks yourselves"
Of course being "poor" is a relative thing. I am an educated guy, married with one child, in debt, without insurance, employed, and looking for that job that is going to get me out of this mess. If something happens to me that leaves me with a huge medical bill, then I am history! So don't come out with this BS about "its just money", easy for you to say when you have it.
No, they won't repo the guys finger, but they might garnish your wages. There was a study out recently that basically had the conclusion that quite a few bankruptcies were due to people losing everything because of medical bills they couldn't pay.
Posted by: Sheldon | July 14, 2007 3:31 PM
Of course Michael Moore is a muckraker, but that does not mean people take less heed of what he has to say because of it. Where do you think a more balanced, less emotional, less entertaining documentary about the healthcare system be shown? In the movie theaters, primetime network television? Of course not.
If he had been lucky, he would have had gotten one mid-evening showing on PBS with viewing figures barely into the hundreds of thousands and a passing mention in the TV columns of some of the more responsible newspapers. That's just about it.
Instead millions of people have seen and will see his movie (and been informed and entertained at that same time) and it has sparked a national debate that has continued for several weeks. Sure some people have dismissed his work as just another liberal-biased polemic, but at least people are noticing and discussing the issues addressed in the movie. That, in itself, is a public service that few people are in a position to deliver.
Posted by: tacitus | July 14, 2007 3:31 PM
Ugh, it's just idiotic math. CNN is complaining about a 10% error when the whole point is that the costs differ by a factor of 28. At this point I don't care what argument they're trying to "debunk", it's a lie to claim that this is significant.
Posted by: Colin Slater | July 14, 2007 3:32 PM
I thought the biggest elephant in the room was Gupta himself. Gupta agreed with Moore's basic premise, but rather than use his own considerable megaphone to do something about it, he decides to balk over numbers. What was that nonsense argument of Gupta's that "for those who care deeply about this issue, it weakens their position for you to exaggerate or misstate things." Who is making the case for overhauling U.S. healthcare? Certainly not Dr. Gupta.
Doesn't that seem odd to anyone else? Why isn't the host of a CNN segment devoted to healthcare not making Moore's point on a daily basis? Why is he not trumpeting the 'figures' rather than waiting for Moore to do so and then bicker with him over it?
To wit: Why is one of the principal voices in medical journalism eight steps behind an overweight documentarian? Why would he rather grant the premise and haggle over the details rather than grant the premise and, hell, do something substantial about it?
Posted by: Marci Kiser | July 14, 2007 3:38 PM
What is also interesting is that the common theme of most of MM's movies is a critique of American exceptionalism. I think THAT is truly what rubs people the wrong way: the demonstration that, no, America is not number one in everything and there are things that could be learned from other countries. But it feels like it would be a huge disaster if people actually realized that some other countries have better health care systems or better correction systems or whatever. Who's afraid of Michael Moore indeed.
Also, there is a big double standard: who else has ever been subjected to the same kind of scrutiny? No one. All of a sudden, there is a need to fact-check Moore's movie, but that never happens when it comes to corporate or government claims. My guess is Robert Greenwald's films would get the same treatment if they made it to the theaters rather than distributed directly on DVDs.
Posted by: Frenchdoc | July 14, 2007 3:46 PM
"Are we to believe that she couldn't have just said she'd pay the bill herself later, and let her kid be treated there? I've never seen a hospital demand payment first"
LOL!!! Treat me now and I'll pay the bill later...now THAT'S a good one. This is not just an anecdotal case. Trust me, such things as shown in Moore's latest documentary happen in US hospitals every single day. For the good of all of us, I think some need to put away their political ideology and see things for how they really are. If you have no health insurance in this country, you're screwed. If one is lucky enough to have health insurance, you're still screwed, just not as badly.
Posted by: paleotn | July 14, 2007 3:50 PM
But the examples he uses seem extraordinary, and maybe even false.
Don't you read the news? It was barely a few weeks ago that a woman died in the emergency room of a hospital because they refused to treat her condition -- refused to take it seriously at all in fact -- even though her history showed it was a real problem. The people with her even called 911 to try to get her help, but they refused to send help since she was in an emergency room at the time. Which ordinarily would seem to be reasonable logic, except that the emergency room people just let her die instead of helping her.
We've lately seen one of our lefty bloggers die due to not having insurance.
Things as horrible as those shown in Moore's movie happen all the time in the USA; if anything he understated the problem. Our system is insane and badly in need of intervention.
Posted by: QrazyQat | July 14, 2007 3:51 PM
The system is broken.
Tort reform is a spectacular failure.
What is your next solution, and how are you going about implementing it?
Or, are you like every other average physician that doesnt care what happens, and long as it doesnt happen until after you retire?
Posted by: ERV | July 14, 2007 3:55 PM
"Doesn't that seem odd to anyone else? Why isn't the host of a CNN segment devoted to healthcare not making Moore's point on a daily basis?"
Why, because he doesn't want to lose his job and health insurance! Besides, he probably doesn't decide what to put on anyway.
Posted by: Sheldon | July 14, 2007 3:55 PM
I'm a foreign businessman living in Cuba with a Cuban wife. I have had a lot of experiences with Cuban friends/family and the medical system here. There is a two-tier system, one for foreiners (that is on par with industrialized countries) and one for Cubans. However, it is ridiculous to compare a Cuban hospital and available medicines/treatments to a 1st world for-profit hospital in the US. That being said, access for Cubans to medical care is quick and the doctors well trained and professional. Appropriate treatment is always available, however more traditional treatments and medicines are usually used(like penicillin) as opposed to newer techniques and antibiotics. Healthcare is more than accessible and adequate as evidenced by the life expectancy equal to the 1st world. I've lived here for 8 years and I do not know any Cubans that I would say have health issues that are not being appropriately addressed. There will always be anti-Cuba naysayers that will find examples that will make the Cuban system look bad, but they are missing the point of this paticular argument. For the level of per-capital GDP of Cuba, what they have accomplished in health care is amazing.
Posted by: Paul King | July 14, 2007 4:03 PM
"What is also interesting is that the common theme of most of MM's movies is a critique of American exceptionalism. I think THAT is truly what rubs people the wrong way: the demonstration that, no, America is not number one in everything and there are things that could be learned from other countries."
Exactly, Frenchdoc -- this is why he's often referred to as a traitor, even when he's not addressing American foreign policy directly. I know this is way off topic, but isn't it interesting, the way Americans have projected this myth of exceptionalism onto Israel?
Posted by: Robert Edwards | July 14, 2007 4:03 PM
There was a study out recently that basically had the conclusion that quite a few bankruptcies were due to people losing everything because of medical bills they couldn't pay.
quite a few = half of all bankruptcies in the US, in fact.
Posted by: cleek | July 14, 2007 4:22 PM
Orac:
Well, politics aside recent history w/r/t the Unocal pipeline seems to me to have yanked that particular carpet out from under you.
Posted by: Marion Delgado | July 14, 2007 4:44 PM
For all you bitching & complaining about the health system in America:
Go ahead, with the next coronary you have, go to Cuba, Haiti or another country of your choosing.
See how you like it.
In the end, there is no 'perfect system', and American medicine is near the top.
Sure, the U.S. government could set up some basic system, put the taxes through the roof - but it would still be mediocre since it's not profit-driven.
Do you really think Richard Dawkins uses his national health care system? I doubt it - I'd be willing to bet my life he pays for private medical care.
Do you really think PZ Myers uses public aid? I doubt it.
Why? Cause he knows it sucks and always will.
When Michael Moore gets a heart attack with that fatty, male heart of his, he'll use his insurance that he pays for by making ridiculous movies that liberals just eat up and actually pay for.
And why do people have the audacity to EXPECT free health insurance???
Pay for it yourself, like some people and you'll have no problems.
Can't afford it? - not my problem.
Granted, withstanding the handicapped and disabled, why should the government take care of other's laziness and lack of drive/education?
Complain all you want about that lost finger but you had the choice to not pay health insurance or take out a loan.
Posted by: philos | July 14, 2007 4:48 PM
re: #27
So, philos, how is the insurance in La-La Land?
-- CV
Posted by: CortxVortx | July 14, 2007 4:55 PM
I wrote a post about it too.
http://www.inoculatedmind.com/?p=201
Gupta just had a noninvasive rectal implant performed on national TV. The only argument he has against Michael Moore now is for performing that on-air surgery without a license to practice medicine!
Posted by: Inoculated Mind | July 14, 2007 5:05 PM
philos--
I have, supposedly, *good* health care now. I recently had a bit of a medical emergency, but not emergency enough to go to the EMERGENCY room.
The *good* doctors I can go to wouldnt see me for a month. The *poor people* clinic could see me that day. I LOVE the care I got at the *poor people* clinic. I go there exclusively now.
Posted by: ERV | July 14, 2007 5:06 PM
Inoculated Mind... "noninvasive"... I thought it was pretty aggressive, and without anesthesia too! Even Blitzer had to cringe. :-)
Posted by: Frenchdoc | July 14, 2007 5:09 PM
philos, get a clue. US taxayers are already paying more per capita (out of their taxes) than some countries, like the UK, where there is universal healthcare coverage. The US healthcare system works for those who can afford it. For the rest, it ends up being an even greater burden on the public purse--including your own pocket book.
And since when does having universal healthcare coverage require everybody to use it? People in the UK, including Richard Dawkins, are free to fund their own healthcare if they so choose. You may be surprised to hear this, but having a universal health care system doesn't turn a country into a Stalinist state.
The British people may never be entirely happy with the NHS, but not even Maggie Thatcher dared abolish it. We are very proud of the system, desipte its flaws, and both my parents owe their lives to the prompt, professional, and worry-free care that the NHS provided them--and all at a lower cost (including decades of paying taxes) than you have been paying for the past couple of decades.
Posted by: tacitus | July 14, 2007 5:29 PM
I think philo's statement about the handicapped serves as another excellent-but-overlooked aspect of the debate. He grants that the handicapped and disabled should receive medical care - prefaced, of course, with his comment that such care (since we can easily assume he is referring to Medicare and Medicaid) is 'mediocre'.
Therefore, it is okay that those most in need receive 'mediocre' care, because they were too lazy or dumb or communist to stay perfectly healthy.
I'm also somewhat astounded, as a doctor, that there is the a priori assumption in his head that those of us in the trenches need a profit motive to care for the sick and the dying. In the small, old-fashioned little village of Boston where I grew up, all you needed was some basic compassion. Maybe his big city values make mine look naive.
In re: to his very small and sad reality, a brief overview of the not-for-profit mediocrities:
The 82nd Airborne never is never grounded because the pilots have just had their pensions stripped away and are on strike.
The New York Police & Fire Departments didn't wait to have their actions pre-approved by insurance companies before rushing into two tall burning buildings.
The Library of Congress does not conspire to raise the price of books across California and then declare bankruptcy - after making sure all of the librarians have sold their library cards.
The Boston Metro never stops dropping off at Cambridge because its wheels aren't compatible with a rival's subway tracks.
Yellowstone National Park is first-class beauty, even if you can only afford coach.
Are any of them perfect? Not as long as they're run by human beings. What they are is excellent reminders that human beings are more than the tiny factories of greed philos thinks we are.
Posted by: Marci Kiser | July 14, 2007 5:36 PM
Galileo warned of those who "fasten upon some saying of mine that may want a hair's breadth of the truth, and under this hair seek to hide another man's blunder as big as a cable." Always a convenient tactic for the dishonest interlocutor.
Posted by: "Q" the Enchanter | July 14, 2007 5:37 PM
Philos -
People like you think that healthcare is something like HD TV, or a Lexus or some other material thing that comes as a privilege after having made money.
Did you know -
People without insurance are the ones who are working, not the ones on government aid. People who make the minimum wage are in jobs in which employers can't afford to provide health care plans (or like Wal-Mart, who tells their employees how to get government-paid healthcare instead.)
And here is how it is your problem:
People without healthcare insurance don't get treatment for communicable diseases until their symptoms get so acute that they have to rush to the emergency room, which are all ready overburdened by other people using the emergency rooms in the same way.
So, while they are sick, they are working and passing communicable diseases to their co-workers, who follow the same path. Consider the economic impact of that state of affairs.
As to wait times in countries with universal health care: what is the wait time for care for all of the people that don't have the means to pay for care?
Posted by: Mike Haubrich | July 14, 2007 5:54 PM
Regarding the hospital care
You must remember that in America there are two types of hospitals, NOT-for-profit and FOR-profit. For-Profit can make rules and regs pretty much as they please when it comes to coverage and payments. The only thing they MUST do is stabilize anyone in an emergency situation before shipping them out to a NOT-for-profit hospital.
I work for a NOT-for-profit hospital, who luckily was very forward thinking when it comes to getting things paid for. If it is an elective surgery without insurance (plastic surgery comes to mind) payment is expected up front. Emergency surgery is done per the doctors evaluation and any worries about payment are dealt with by financial counselors who will work specifically with the patient and any programs available to get whatever coverage they can.
Many of our oncology patients without prescription coverage are evaluated (medically and financially) and will have their drugs given to them for free by the drug manufacturer (its a tax write off and good will gesture) These are the sort of things NOT-for-profit hospitals do. FOR-profits don't need to, either you pay, usually up front, or you go somewhere else. Pity the patient who has no other option of where to go.
Posted by: flame821 | July 14, 2007 6:03 PM
Philos,
I hope that does not stand for philososphy, because if so you ought to review the fallacies chapter in some of your books. Start with "Strawman" in the index.
Posted by: Sheldon | July 14, 2007 6:04 PM
DaveX (#8)...
I cut off the end of my finger with a circular saw earlier this year. I spent 5 days in hospital with it reattached (but it didn't take). I came back a week later to have it removed.
After that I had hand therapy to get the use of the hand and finger back, and several post op hospital visits to check on my progress. After a while I felt I was ok and needed no more therapy - the therapists gave me an open invitation for future visits.
Total cost to me (apart from pain killers for use at home) was...
$0
My wife was admitted to hospital several times during both pregnancies for extreme morning sickness, requiring rehydration - total hospital time would have been 3-4 weeks.
Both my children were born prematurely - the first spent 1 week in intensive care, and 2 weeks in a humidicrib. My 2nd spent around a week in a humidicrib.
The total cost to us for all of this was less than $100, again all this happened as public patients.
This all happened in Australia, where the costs of medical care are said to be low by world standards. Michael Moore would have done better to include something about Australia in his docco to show just how cheap -excellent- health care can be.
Posted by: Dale | July 14, 2007 6:08 PM
Go ahead, with the next coronary you have, go to Cuba, Haiti or another country of your choosing.
I'd like to try Australia or New Zealand myself.
fork over the airfare and I'll let you know how it turns out.
you'll have to give me the cash BEFORE i have my "next coronary" though, as I'm not going to have the time to hunt you down at that point. Is your offer valid for other illnesses? what about if I break a leg or an arm?
about $2000 should cover it. shouldn't be a problem for you, right?
would you like my snail mail addy to send the check to?
Posted by: Ichthyic | July 14, 2007 6:26 PM
Philos,
Maybe you could explain why it's not your problem if other people can't afford health care. Is it the sort of thing like where it's not my problem if the government decided to tax you at 60%, but not me at all? Or the same way that it wouldn't be my problem if someone car-jacked you and put a bullet in your head? Or maybe it's the kind of thing how it's not my problem that some terrorists decided to drive airplanes into a couple buildings. It's not like I live in New York. I'm dying to know how the health of 300 million people living and working around you isn't your problem.
Posted by: Dahan | July 14, 2007 6:43 PM
"They go over Moore's film like he is submitting it to a peer reviewed journal article."
hehe. So for all thier aversion to science they still are willing to use it's tools.
Posted by: Bob L | July 14, 2007 7:05 PM
I had a problem with both hands, dated from spending a lot of time with a graphics tablet during my PhD. Basically the joint between the trapezoid bone and my second metacarpal moved too much and I was wearing away the cartilage. I could work, just, on a lot of NSAIDs. I could go into the lab and do maybe 24 minipreps before my forearms would inflate as the muscles noted the strain the drugs were just about keeping from me. Then I would go home.
I had an understanding boss, just about, and good labour laws about sick leave and unjustified dismissal too. In the 6 months I waited (in London) to see a specialist surgeon I got tested for just about every systemic bone disorder including having a bone scan, that saved time with the surgeon. He gave me my hands back*, which is why I can type this, providing I don't do toooo much ;-)
It cost me nothing more than prescription charges and my GP was generous with the NSAIDs so that was little enough. Three cheers for the NHS.
* basically they go in to the hand, chop the joint services off, take a chunk of bone out of your iliac crest (front top of the pelvis), drop that in the gap and hold it temporarily with a pin. Worst thing? getting the pin out. I didn't faint on the second one, just.
Peter
Posted by: Peter Ashby | July 14, 2007 7:12 PM
Sanjay Gupta is a doctor. Would one expect anything less than an attack on Moore? Of course Gupta wants to preserve the for-profit health care system in the US.
Posted by: thickslab | July 14, 2007 7:13 PM
Orac, where do you and so many other people get the idea that "real" documentaries are fair and objective? I've never seen one of these mythical documentaries in my life. And whether you realize it or not, neither have you.
Posted by: HP | July 14, 2007 7:30 PM
Michael Moore's written an Open Letter to CNN. I think it addresses the spin PZ talked about. Here's a taste:
http://www.michaelmoore.com/words/message/index.php?id=216
Posted by: jimmy | July 14, 2007 7:41 PM
Health is a material issue, just like everything else.
And in healthcare, just like everything, you get what you pay for.
Again, except for the disabled / physically handicapped or mentally disabled, most people really don't need to be on a national health care system, but I can see a need for basic emergency services for those in between the cracks of life. Many people that don't really need to be on the system abuse the system and if they didn't swamp it, it would be even greater for those that truly need it. If we continually act as a crutch for the lazy butts of the world, and pay for everything, it's basically free, so people don't appreciate it and take it for granted. Then they clog the system and guess what - poor service.
Life is full of choices.
Posted by: philos | July 14, 2007 8:34 PM
A few years back I gave a talk at a Redstockings event on the wider corporate agenda behind efforts to privatize Social Security. (Essentially, to tighten
the corporate noose just a little tighter around citizen necks.) They had a table set up with some of their brochures and I bought one on the health care
situation in the US vs the rest of the industrialized world. I was stunned when I read it a few days later. I recall thinking that if this could be publicized to a broad audience, the US govt would likely be shamed into offering universal health care for two reasons: (1) to avoid appearing backward in relation to the UK, Germany, France and Canada and (2) to prevent a flood of
expats exiting for affordable health care.
Moore has built on the public shame that any health care comparison between the rest of the industrialized world and the US reveals. And he has dramatically jump started a national dialogue on the issue. But he has done
something potentially even more important: he has made people come out of their fog and question a corporate model that glorifies profit while trivializing human
life.
And that is dangerous to the corporate masters. Very dangerous. If Moore can get people to question this corporate model, what's to prevent people from
questioning other corporate models: like denying court access to workers (mandatory arbitration); like secretly
buying corporate life insurance on our lives (COLI); like controlling the people's elected representatives in the people's government.
Moore is now Public Enemy Number 1 to the corporate masters. It's my guess that CNN's Sanjay Gupta was fed the script for his attack on Moore and Sicko by those very same corporate masters. (Could a guy who's a practicing brain surgeon, TV celebrity and columnist actually find the time to "fact check" a Moore documentary that is loaded with thousands of facts?) And it's heartening that Gupta is feeling the heat from people posting on his CNN web page, from scrutiny of his remarks on Moore's web site, by FAIR and throughout the blogosphere.
I plan to do my part to focus attention on Gupta's corporate masters and I encourage everyone who wants to stop the devolution of the US into a corporate fascist state to do something in support of Moore and Sicko.
Posted by: Pam Martens | July 14, 2007 8:34 PM
Life is full of choices.
yup, and you should have chosen to go to a respectable college, because your education seems horribly lacking.
Posted by: Ichthyic | July 14, 2007 8:45 PM
Philos -- You make an excellent point. The reason that Canada's waiting times are just slightly longer than the US probably does not have to do with the fact that they are covering every single Canadian citizen. No, it's probably an open secret that the real reason is people abusing the system. The free market dictates that the items with the highest price are the most desirable, by definition. Therefore, if medical services were free, everyone would naturally be lining up for free chemotherapy, free bone marrow transplants, free open heart surgeries, etc.
I'm glad geniuses like you have such a prominent voice in the health care debate. I would rather spend $550 a month on my limited COBRA health coverage than spend $300 a month for total care for life but have to risk some dirty lazy brown person getting free care.
Cheers.
Posted by: inkadu | July 14, 2007 8:46 PM
Philos's "Lazy people will break the system by going to the doctor all the time" is what's called the moral hazard argument. Among the conservatives' favorite forms of American exceptionalism is the argument that Americans are less moral than other people, which justifies the size of our prison population and the quality of our health care.
Posted by: Josh | July 14, 2007 8:46 PM
It's my guess that CNN's Sanjay Gupta was fed the script for his attack on Moore and Sicko by those very same corporate masters.
then, we should be extremely happy that the best they could do was quibble over minor details.
Moore's argument essentially remained untouched.
Frankly, I'm very pissed at Clinton not jumping on this and making it her primary focus in her campaign (especially considering how gun-ho she was during the early Clinton white house years).
even if she doesn't get elected, it's one of the major issues in the US right now, and she simply couldn't do more benefit to all of us than by focusing HARD on this.
Posted by: Ichthyic | July 14, 2007 8:50 PM
This is the same CNN, let's not forget, in which Larry King interviews a politician like Clintion yesterday and then today has that charlatan Sylvia Browne on, legitimising in the eyes of unwary viewers all of her unsubstantiated claims to be able to talk to the dead. CNN isn't about the news; CNN is all about the ratings. Only when viewers realise this and protest loudly and in droves will the status quo change.
Posted by: Kimpatsu | July 14, 2007 8:56 PM
Something worth remembering here is that Sanjay Gupta is heavily invested in the US medical system as it is.
I mean, forget the obvious -- he's a well-paid MD whose current lifestyle derives from taking advantage of the existing system. And we know he does work on CNN, and that's all well and good -- CNN isn't inherently evil or corrupting.
But I happened to be at the doctor's office this week, and my doctor's practice has a new LCD HDTV on the wall. The TV is tuned to CNN's "AccessHealth" channel, which stars... Dr. Sanjay Gupta!
If you've never seen CNN's "AccessHealth" channel, it consists of short minor stories with a heavily pro-corporate-medicine slant followed by truckloads of drug commercials. The TV in my doctor's office is part of a display posted by a group of healthcare advertisers, so there's a ton of advertising slapped all around the TV itself.
So don't tell me Sanjay Gupta represents balanced and honest reportage on any of these subjects.
Posted by: Jim Kiley | July 14, 2007 9:08 PM
"If we continually act as a crutch for the lazy butts of the world, and pay for everything, it's basically free, so people don't appreciate it and take it for granted."
There is a real easy answer to this argument about the dangers of people abusing their free universal health care. Like many private insurance plans, people are also charged a co-pay when they visit the doctor. So charge a reasonable and do-able copay. $20.00 or so per visit, less for the truly destitute. I wouldn't mind that, I just can't handle paying $300 to a $1,000 dollars per month to cover me or my family.
Posted by: Sheldon | July 14, 2007 9:13 PM
It isn't just individuals who are paying for America's overpriced, underperforming health care system. Our corporations are paying for it as well. Compare GM in the US and Toyota in Japan, or GM in the US and GM in Canada, or Boeing in the US and Airbus in the EU and what you won't see is foreign business executives struggling with soaring health care costs.
We are at a distinct competitive disadvantage. This disadvantage is worst in the high value, knowledge intensive businesses that should be our strengths. If some crazy Belgians wanted to build EU-gle, to challenge Google, they'd start out ahead by the cost of medical care. This is actually silly.
Corporate executives are not blind to this problem. They'll often go on about rising medical costs, and how wonderful it would be to get them off their balance sheets. They have good, solid, old fashioned motivations for backing universal care. Unfortunately, ideology prevents them from taking the next obvious step and coming out in favor of nationalized health care. Ideology is very powerful. It destroyed the Soviet Union, and it might well destroy us as well.
Posted by: Kaleberg | July 14, 2007 9:47 PM
Having universal health care is useless if the system is corrupt.
Its not suprising that many people doubt that hiv causes aids when 99.9% of animals injected with hiv dont get sick, its only present in a small % of t cells, 1/1000 or so and most viruses cause the most havoc BEFORE antibody protection and once you have antibodies youre safe, thats the entire logic behind vaccines.
Many credible scientists have questioned the hiv hypothesis at some time.
Like kary mullis nobel prize winner
walter gilbert nobel prize winning harvard bio professor
duesberg retroviral expert
shyh ching lo cheif of the infectious unit of the armed forces institute of pathology
etc etc
This film hiv fact or fraud summarizes their views.
http://video.google.com/videoplay?docid=5064591712431946916
There is another microbe called mycoplasma incognitus that sickens/kills every animal injected here's the peer reviwed evidence http://www.aegis.com/pubs/atn/1990/ATN09501.htm
It's found by pcr(antibody testing is useless bsc the animals that died only showed a weak reponse when near death) in CFS/AIDS etc read Project Day Lily www.projectdaylily.com to find out how it was part of the biowarfare program.
http://www.projectdaylily.com/
Posted by: cooler | July 14, 2007 9:53 PM
Having universal health care is useless if the system is corrupt.
or if it's run by idiots who think there's valid reasons to doubt that HIV attacks immune cells.
You should ask Mr Mbeki in South Africa how well his HIV denial played out:
http://www.guardian.co.uk/aids/story/0,,1933873,00.html
I wonder how many people might still be alive if that idiot had not been an HIV denier.
good thing cranks like you won't be running any kind of health-care program, anywhere.
Posted by: Ichthyic | July 14, 2007 10:10 PM
I'm Canadian. Philos' post sounds like something from another planet to me... I honestly can't think of anyone I've ever met, of any political persuasion, who would state things so coldly and in such an inhumane manner.
To quote the Wikipedia page on Canadian Medicare: "Polling data in the last few years have consistently cited medicare as the most important political issue in the minds of Canadian voters... the CBC ran a poll that found medicare to be one of the most defining characteristics of Canada."
What's the story? Why are Canadians, British, and French, and every other developed country, so different in their philosophy of collective responsibility when it comes to healthcare? In these countries, it's not the just hippies, progressives, and moderates that champion universal healthcare, it's the opinion of the vast majority that accessible coverage for everyone is right.
My mother's in the hospital at the moment, with cancer, and when it was recently diagnosed, one of the few things I could come up with to try and find a "bright side" was that at least she's lucky enough to live in a country where she doesn't have to worry about how to pay for treatment, or pre-qualifying, or using only an approved doctor or facility, or any of that other nonsense. It's worth noting, also (although anecdotes are not statistics, I know) that there was ZERO waiting time for anything.
Posted by: Paul K. | July 14, 2007 10:17 PM
Isn't Yellowstone being severely damaged by the compromises made to get more and more people into the park?
For that matter, my understanding was that the entire national park service was in dire straits.
Posted by: Caledonian | July 14, 2007 10:34 PM
"If we continually act as a crutch for the lazy butts of the world, and pay for everything, it's basically free, so people don't appreciate it and take it for granted. Then they clog the system and guess what - poor service."
So you're worried about lazy butts getting something they don't deserve, huh? What about rich bastards getting richer due to no bid contracts? It's o.k. to rebuild New Orleans by giving the job to the rich so they can do an inept job, not pay a decent wage and skim millions off the top? Better yet, let the rich hire undocumented workers and then not pay them wages they deserve due to their illegality.
You seem to worry about the undeserving getting what they haven't earned. I seem to have the same concern. It's just that I hate it when the rich get over on the rest of society and you worry about the poor doing the same.
Think about it. The rich can take care of themselves. They don't need a handout. The poor, and as others have pointed out this includes much of the middle class too, walk a fine line between health and destitution. There is a need for health care that hasn't been skimmed by the rich in the same way that other government projects have.
We were born with certain human rights. I would suggest that one has the right to be cared for when sick and not to be extorted.
It's funny though, it's people like philos who suddenly change their tune when they or ones they love get sick or injured and the expense devastates them.
Posted by: Rick T | July 14, 2007 10:52 PM
I love people who insist that the US healthcare system is the best on the basis of mostly incoherent "principles" (usually a reference to "responsibility") regardless of its performance. They might as well be insisting that bumblebees can't fly.
Posted by: Azkyroth | July 14, 2007 10:55 PM
Paul K, 64% of us in the U.S. supposedly think "the federal government should guarantee health insurance to every American," 60% would personally pay more in taxes, and apparently 90% want "fundamental changes" or "to completely rebuild it". New York Times link here. They don't necessarily hold this view consistently, but the questions about national health care for all seem to assume that citizens couldn't buy additional health insurance. And that still gets more support than the current system (47 to 38).
Posted by: hf | July 14, 2007 11:14 PM
Some knee-jerk freemarket-is-best espouser said: Sure, the U.S. government could set up some basic system, put the taxes through the roof - but it would still be mediocre since it's not profit-driven.
...or you could stop spending a quadrillion dollars per second killing people in Iraq. Think about it next time you hear someone say the money just isn't there for healthcare or education. Money's there. It's just not for healthcare or education.
Anyways, to the point. The problem with running healthcare (or a transport system, or prisons) or anything else as a for-profit is that the healthcare/transport/prison/etc. service becomes secondary to profit. Why do people think a private system will work best? The reason in the US you have this situation is because you allowed govt to pull the feet out from under national healthcare in the first place. I used to live in Japan -- capitalist country, but with universal healthcare, which works pretty well and taxes are not through the roof. I now live in Canada, where taxes are pretty high, but again universal healthcare. It's scandalous that the richest nation on earth doesn't give a crap about its citizens to the point where so many of them have no safety net as far as health is concerned. Hell, even Thailand, an "emerging economy", has some form of coverage for most people
Oh and Gupta said that MM said Cuba spend $25 per person...that's a pretty big margin of error considering he actually said $251, which is a lot closer to the supposed accurate figure of $229.
Posted by: AlanWCan | July 14, 2007 11:15 PM
I am Australian, have worked in our health care system (at the clinical level), know a shit load about a small bit of medical science, and of course have also been a user of the universal coverage system we have here, with all its flaws.
I loathe the corporate model of health insurance, and reject it out of hand. It is basically inhumane and very inefficient theft. If individual folks want to pay directly out of their own pocket, that is fine by me, but my vote remains firmly with a single insurer system (ie the government via the tax system), however much of an evil socialist that makes me in the eyes of some.
And Orac, what exactly is your proposal to fix clearly expensive failure that is the corporate model of health insurance? Cheap shots at Moore for imperfectly pointing out the problem don't cut it. Putting on my sceptical cynic's hat (something you should appreciate), I could be excused for thinking that you have done a little too well from corporatised health care to want to shoot it down. I am happy to be proved wrong about that, as I otherwise generally respect your views on health care and medical science.
Posted by: Obdualntist | July 14, 2007 11:22 PM
My father worked his ass off all his life. Hard, manual labor in his own business, usually 12 to 14 hour days, six days a week. However, he never really made very much money, and at the age of 50 he had a massive heart attack. He only put in 9 hour days after that. My parents didn't make any terrible money decisions (except giving to their church) but still cannot now pay for all the medications my dad needs to stay alive. He's not technically "disabled / physically handicapped or mentally disabled" using most of the traditional definitions of those terms. I guess under Philos plan he doesn't need health care. Yep, sure makes sense to me.
Posted by: Dahan | July 14, 2007 11:29 PM