Moore v. Gupta: Truth v. False Doubt

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.

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PZ, did you forget the omni-present "liberal bias"?

By mndarwinist (not verified) on 14 Jul 2007 #permalink

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.

By Anonymous (not verified) on 14 Jul 2007 #permalink

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!

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.

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.

By Steve LaBonne (not verified) on 14 Jul 2007 #permalink

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?

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.

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.

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.

"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.

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.

By Ian H Spedding FCD (not verified) on 14 Jul 2007 #permalink

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

#####

By Stephen Rivers (not verified) on 14 Jul 2007 #permalink

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.

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.

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.

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?

By Marci Kiser (not verified) on 14 Jul 2007 #permalink

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.

By Frenchdoc (not verified) on 14 Jul 2007 #permalink

"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.

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.

{snip Orac}

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?

"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.

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.

By Paul King (not verified) on 14 Jul 2007 #permalink

"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?

By Robert Edwards (not verified) on 14 Jul 2007 #permalink

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.

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.

By Marion Delgado (not verified) on 14 Jul 2007 #permalink

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.

re: #27

So, philos, how is the insurance in La-La Land?

-- CV

By CortxVortx (not verified) on 14 Jul 2007 #permalink

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.

Inoculated Mind... "noninvasive"... I thought it was pretty aggressive, and without anesthesia too! Even Blitzer had to cringe. :-)

By Frenchdoc (not verified) on 14 Jul 2007 #permalink

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.

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.

By Marci Kiser (not verified) on 14 Jul 2007 #permalink

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.

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?

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.

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.

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.

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?

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.

"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.

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

By Peter Ashby (not verified) on 14 Jul 2007 #permalink

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.

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.

Michael Moore's written an Open Letter to CNN. I think it addresses the spin PZ talked about. Here's a taste:

I bet you thought my dust-up with Wolf Blitzer was just a cool ratings coup, that you really wouldn't have to correct the false statements you made about "Sicko." I bet you thought I was just going to go quietly away.

Think again. I'm about to become your worst nightmare. 'Cause I ain't ever going away. Not until you set the record straight, and apologize to your viewers. "The Most Trusted Name in News?" I think it's safe to say you can retire that slogan.

http://www.michaelmoore.com/words/message/index.php?id=216

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.

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.

By Pam Martens (not verified) on 14 Jul 2007 #permalink

Life is full of choices.

yup, and you should have chosen to go to a respectable college, because your education seems horribly lacking.

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.

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.

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.

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.

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.

By Jim Kiley (not verified) on 14 Jul 2007 #permalink

"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.

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.

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/

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.

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.

Yellowstone National Park is first-class beauty, even if you can only afford coach.

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.

By Caledonian (not verified) on 14 Jul 2007 #permalink

"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.

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.

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).

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.

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.

By Obdualntist (not verified) on 14 Jul 2007 #permalink

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.

Philos old boy you are on to something. I will follow you on the health care issue if you will be on my bandwagon on the fire and police department. Here we are paying taxes for
lazy, lowlifes to use when their dwelling catch on fire or somebody is trying to commit a crime. It makes me boiling mad. Lets do the for profit thing and cut out the excessive abuse of these systems.

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.

Same question I ask every sociopathic quasi-Libertarian. What evidence, other than the fact that it helps you sleep at night, do you have that any significant fraction of people in need of social assistance are "lazybutts" (or, in general, somehow responsible for their condition and therefore undeserving of assistance).

(Not that I really expect an answer; it's an Article of Faith. It's like asking a Fundamentalist to justify their belief that the Bible is inerrant.)

Its not suprising that many people doubt that hiv causes aids when 99.9% of animals injected with hiv dont get sick,

That's the funny thing about viruses (and, in fact, many other pathogens); their range of possible hosts tends to be limited. I suppose you think the fact that humans injected with Tobacco Mosaic Virus don't manifest symptoms of the disease indicates that it doesn't cause the characteristic blight on tobacco plants?

All a "free market" does is set the price of goods and services arbitrarily close to the "natural price" of said goods and services. In a majority of cases, this is a wonderful way to do business, as the things in question are apportioned to the consumers based on both desire to have them and their availability.
Some goods and services, however, are so closely tied to a nation's well being that they must be seen to by governmental bodies. I submit that these services include education, basic utilities, security (both national, the army, and individual, the police/firemen/et al.) and health care. Health care is costly. The natural price of health care is beyond all but the wealthiest of people. Because of this, if left to the market, health care is largely unaffordable. Giving in to the market argument against universal coverage leads directly to the question of why insurance companies exist at all. If you can't afford to pay market price for health care without insurance, why do we allow these socialist (many pay, few use) insurance companies to exist? It is impossible to logically argue that private insurance is good while national insurance is not. According to the market, any person who can not pay for the full price of health care is S.O.L.

Also, while we're throwing around anecdotes, I have a friend who is a lawyer, and not the good kind. He loves Reagan (I refrained from punching him in the face) and has a job where he "makes sure that the rich stay rich, and that they don't have to share". He is all for national health care, and he used the example of Ireland, I think (could have been somewhere else), where the corporations realised that the tiny increase in their taxes to fund a national system were much less than the giant decrease in their taxes resulting from them not having to pay for a small group of people exclusively. Taxes on business plummetted, he said, and health care got better for everyone.

I wonder if anyone here even knows that Michael Moore outright admitted on national TV that his portrayal of U.S. health care in "Sicko" was from the "worst-case" POV and his portrayal of other countries' health care was from the "best-case" POV. How exactly is that fair and honest?

It is truly amazing what people can do with statistics. My favorite example in this debate is the repeated claim that Cuba's infant mortality rate is comparable to that of the United States.

The basic reason for this "disparity" is that in Cuba, they follow the World Health Organization's recommendation as to how to record births---that is, a child born weighing less than 1000g (1.1 pounds) is simply not recorded as a birth. (Most European countries follow this method as well.) In the United States, all live births are counted as live births, regardless of baby weight.

Thus, when 30-40 percent of those under-1000g babies die the same day they are born, those births and deaths are counted against the infant mortality rate of the United States, but not against the rate for Cuba and the other countries that follow the WHO's recommendations.

This statistical difference is illustrated by the fact that in the U.S., 1.3 percent of babies weigh less than 1500g at birth. while in Cuba, only 0.4 percent weigh under 1500g. The babies under 1000g are simply excluded from the count in Cuba. while counted in the U.S. So a comparison of the two rates as a measure of the quality of the system really is apples and oranges.

I am not arguing the superiority of either record-keeping method---just pointing out that they are not comparable on the surface because they simply are measuring different things. I also am not arguing universal vs. private health care, because it's obvious from the comments that everyone who knows anything on the topic has already made up his or her mind and no one is going to change.

For more on the specifics of infant mortality and the varying recording policies, check out:

http://www.overpopulation.com/articles/2002/cuba-vs-the-united-states-o…

I do, however, like Tim Slagle's description of the Cuban health care reporting differences, in a review of "Sicko":

"Cuba, of course, has free health care for every citizen, no infant mortality, and no malpractice. That's because the Cuban government controls all medical information. Whereas, in America, we use technological advances and complex modern pharmaceutical products to raise our standard of health care, Cuba is able to surpass us using only a little bottle of Wite-Out."

By cureholder (not verified) on 14 Jul 2007 #permalink

Steven Rivers, I was going to mention Salud!, thanks for doing it.

Here is another article about Cuban health care.

http://www.yesmagazine.org/article.asp?ID=1733

"Recently, Cuba extended the offer of free medical training to students from the United States. It started when Representative Bennie Thompson of Mississippi got curious after he and other members of the Congressional Black Caucus repeatedly encountered Cuban or Cuban-trained doctors in poor communities around the world.

They visited Cuba in May 2000, and during a conversation with Fidel Castro, Thompson brought up the lack of medical access for his poor, rural constituents. "He [Castro] was very familiar with the unemployment rates, health conditions, and infant mortality rates in my district, and that surprised me," Thompson said. Castro offered scholarships for low-income Americans under the same terms as the other international students--they have to agree to go back and serve their communities.

Today, about 90 young people from poor parts of the United States have joined the ranks of international students studying medicine in Cuba.

The offer of medical training is just one way Cuba has reached out to the United States. Immediately after Hurricanes Katrina and Rita, 1,500 Cuban doctors volunteered to come to the Gulf Coast. They waited with packed bags and medical supplies, and a ship ready to provide backup support. Permission from the U.S. government never arrived."

It would be interesting to see what kind of health care ALL Cuban refugees in Florida get, not just the rich anti-castro CIA employees.

1. Moore should not have included Cuba in the documentary. It was the equivalent of handing a gun to his opponents.

2. Gupta's report was distorted but Moore didn't help. In the interviews I saw with Blitzer and Olbermann, he spent all his energy attacking the reporter and CNN when he should have just laid down a bunch of statistics. What I found particularly irritating about Gupta's report is the use of the standard Conservative complaints (e.g. waiting times) minus data. To take that complaint, for example: what are the differences like (months vs. weeks or two months vs. one month)and for what procedures? (Gupta mentioned, I believe, 3 elective procedures - something I've heard so often, I wonder if, perhaps, they are the only procedures where waiting times are shorter in the U.S.) Similarly, Gupta says that the U.S. has the highest percentage of satisfied citizens but, again (assuming he is right), how much lower is Number 2? And is the difference statistically significant?

3. Personal stories are interesting, often compelling, but they are a lousy way to judge anything. There probably isn't a health system in the world that doesn't have satisfied as well as dissatisfied citizens. One should note, however, that Western Europeans and Scandinavians all live in democratic countries and could always vote for lower taxes and no national health care if they were not, generally, satisfied.

4. Here are just a couple of stats I picked up recently. NationMaster.com will show you where the U.S. ranks on a wide range of health-related statistics. It's first in cost per person and plastic surgery but not much else.

Examples of stats from other sources:
1. The U.S. has the second worst newborn death rate in
the modern world (only Latvia is worse) and ranks 43rd
in the world. (CNN -
http://www.cnn.com/2006/HEALTH/parenting/05/08/mothers.index/index.html)

2. In the U.S., childbirth kills 1 in 7,000 women;
it's 1 in 30,000 in Sweden. (Newsweek, 7/4-11/07
issue)

3. Life expectancy? The U.S. ranks 38th; Jordan is
higher.

PZ,

It is not a fair comparison that Cuba gets the 'same quality' health care as the US for much less. I'm sure housing in Cuba is far cheaper than here in the Bay Area.

Now that being said, if you were to charge every person in the US $7000, and then proceed to direct that money directly to the doctors, you could employ every doctor (I got a number at about 700,000) in the US for 3.5 million dollars/year. The average

That's without the cost of facilities, support staff, and legal team.

Do similar calculations for public school teachers (take spending per student (8000), and then multiply by students per teacher (30)) and you get $240,000 dollars per year (in California). Average teacher salary in California is about 55,000. So if we assume that the overhead of governmental run health-care would be the same as for public schools (something I'd be skeptical of) We'd expect the doctor salaries to be $700,000/year. It's around half to a third of that. So, it is at least somewhat plausible that we could be paying at around 2500 or 3500 dollars instead of 7000 but a 20 fold reduction seems highly unlikely without seriously reducing doctor pay.

Sources:
Number of doctors in US http://www.new-mind.com/Library/doctorsguns.htm
Class Size in California:
http://www.ed-data.k12.ca.us/Profile.asp?level=04
Doctor Salary:
http://www.bls.gov/oco/ocos074.htm

When debating universal health care and similar issues, I find it relevant to look at the numbers.

The facts are that the US is spending more on health care (both per capita and as a percentage of the GNP) than any other country, and get rather poor results for that money. I've written about this at great lengths in my post Is Universal Health Care Affordable in the US. The post contains quite a bit of number crushing, where I compare the health care spending in different countries as well as several health care indicators (life expectancy, infant mortality, and maternal mortality) as well as health care availability (number of hospital beds and doctors per capita).

I've also written about why I consider universal health care such an important issue in my post Universal health care as a progressive issue. One simple fact that I mention is the fact that there are 9 million uninsured children in the US.

I appologize for pushing my posts on those of you who have seen them before, but I think they are pretty good resources in this debate, since I have collected all the numbers together (with sources and all).

One of the more interesting things to do with healthcare costs is to consider how much Federal income taxes would need to rise to provide universal coverage, and if you are one of the people with a job that helps you obtain health insurance to ponder to yourself how much your federal income taxes could rise if at the same time your medical insurance premiums were taken care of.

A few years ago, I worked out that a 40% across-the-board increase in federal income taxes that also eliminated my health insurance premiums to provide me with the same level of mediocre care that I get now would constitute a net gain for me. I should re-crunch the numbers for this past year.

Here is Bush's attitude towards health care,

"The White House said on Saturday that President Bush would veto a bipartisan plan to expand the Children's Health Insurance Program, drafted over the last six months by senior members of the Senate Finance Committee.

The vow puts Mr. Bush at odds with the Democratic majority in Congress, with a substantial number of Republican lawmakers and with many governors of both parties, who want to expand the popular program to cover some of the nation's eight million uninsured children."

http://www.nytimes.com/2007/07/15/washington/15child.html?ex=1342152000…

"The proposal would increase current levels of spending by $35 billion over the next five years, bringing the total to $60 billion. The Congressional Budget Office says the plan would reduce the number of uninsured children by 4.1 million.

The new spending would be financed by an increase in the federal excise tax on tobacco products. The tax on cigarettes would rise to $1 a pack, from the current 39 cents.

Mr. Fratto, the White House spokesman, said, "Tax increases are neither necessary nor advisable to fund the program appropriately.""

OK, let's defend the healthful tobacco industry. Who would have thunk it?

It gets "funnier" if that is the right word.

"The proposal would dramatically expand the Children's Health Insurance Program, adding nonpoor children to the program, and more than doubling the level of spending," Mr. Fratto said. "This will have the effect of encouraging many to drop private coverage, to go on the government-subsidized program."

Besides the tobacco industry, let's protect the private insurance vampires.

Orac's comment shows exactly what the effect is of the Gupta-style hack job.

Orac leads with the ad hominem attack, which is the dominant meme passed around in discussions about Michael Moore. After conceding that Moore's facts check out, Orac says:

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.

I adore the sneering attitude taken toward fact-based argument. It's truly delicious.

But, of course, Orac includes one of the irrelevant bits of "fact-checking" from a previous film. But instead of noting that this error by Moore is uncharacteristic of Moore's work, a point that Orac has already conceded, Orac argues that this one mistake is the "best example" of how Moore works.

I saw Farehnhet 9/11. Unocal was not in any way a central point in the film. The central message of the film was that the Bush administration lied to start a war and the war backers were a cabal of military service-avoiding chickenhawks who were using propaganda techniques to advance their own agenda.

One would think that this story, which is the most important story of the new century, would get more coverage in media outlets that cover the news. But no, as PZ points out, the MSM reflexively discredits Moore at every turn. And viewers like Orac buy into the false equivalences and ad hominem attacks.

Ichthyic:

good thing cranks like you won't be running any kind of health-care program, anywhere.

Why not? Bush got elected, twice. Wouldn't he (or his successor) be the guy in charge of appointing the head of a national health care system?

Having re-crunched the numbers using 2006 data, I see that my health insurance, while getting more expensive in absolute terms, has gotten less expensive relative to the overall amount of Federal income tax I pay. Now, I would "only" win if Federal income taxes needed to rise 33% or less across-the-board to provide universal coverage. (As a percentage of the line labeled "Gross Pay", Federal Income tax withheld was 7.4% whereas medical insurance was 2.5% - if you throw in dental insurance and the vision plan, that goes up to 3%)

Note that a mere 5% across-the-board federal income tax increase amounts to something like $40 billion/year nationally, which last I heard was more than the estimated costs of a universal coverage program.

I wonder how much you have to make before your average medical insurance costs fall below 5% of your federal income taxes. Top 10%? Unlikely, since my numbers put me at 85th percentile by annual income already. Top 5%? Maybe - anyone making over $167K per year care to comment?

What makes you think that the US could do anything as efficiently as other countries?

Try instituting a national health care system, and I'll bet it would cost three times what you think and still be inferior to everyone else.

By Caledonian (not verified) on 15 Jul 2007 #permalink

DaveX: Hospitals do indeed demand treatment up-front. Unstable patients have the right to be stabilized without up-front payment, but the moment they're not on the cusp of death, they get outed unless they have insurance or a fat wallet.

Most (all?) surgeons demand a significant portion of their costs up-front; essentially all of the cost not covered by your insurance.

I've volunteered at a hospital for years where, if you're sufficiently stable to walk yourself into the ED, you will be asked your billing information long before you will ever see triage.

---(hospital volunteer and physician shadow for the past eight years, here).

People complaining that Cuba should not have been brought into the argument miss an important point, Cuba does what it does DESPITE the embargo which makes their accomplishments even more astounding. Of course it does not stack up technologically to the top developed countries - but this is a country where the vehicular fleet comprises largely cobbled together '50s era vehicles. It shows what can be accomplished when there is a will in the face of extreme adversity. So, what is America's excuse - besides lack of will?

And I'll extend that to Canada as well. Recent governments have bought in whole-hog to the taxes=bad political viewpoint prevalent these days, forgetting that services require capital. If we funded out health care system to the per-capita extent that the US does, we'd eliminate a lot of the wait-time problems and still have universal coverage. But no-one has the chutzpah to ask for the tax dollars, or to re-align other spending. Especially the current government who is pouring billions upon billions into a military shopping spree.

Odd, in my math courses a long time ago, I had been led to believe that

Moore says the US spends something under $7000 per person per year on health care; Gupta says it's 'only' something over $6000.

was about the same. Inequalities, you know, within a range.

I wonder just how much CNN is paying Gupta for this idiocy.

Some friends in Toronto recently had a baby, oops, well, it's been two years already. Anyway, while MOST of their hospital was paid for, they had to pay $11 for parking EVERY visit. While the wife was actually admitted, the husband would sometimes making 10 trips a day to the hospital, each at $11 a shot. That's what really broke the bank for them, he said.

The few hospitals I've been to which required paid parking would always validate parking for patients and immediate family. Not that this means the US is better, but there are little things that add up that Canada's system doesn't pay for.

Philos: I think you need a reality check. People may be able to pay up front for acute stuff, but when chronic illness strikes, that's when you absolutely need health insurance. (That's also when insurance companies drop you) When I worked for the DoD, I had health insurance, the so-called "Care"First (BlueCross/BlueShield). I needed a liver transplant (a genetic condition, not from my having behaved stupidly!). They paid all the bills, including transport to another city by ambulance. I was in the hospital three weeks, then came home. They paid for all the meds (running about $2,000/month) and subsequent hospitalizations/surgeries for complications. Then I got RIFfed from the government, and was able to convert my group policy into a private one. The premium started at $12,000/year just for me. It kept going up each 6 months until it reached nearly $20,000/year (not including that $12,000 for meds yearly) What kind of job do you have to have to be able to afford that outlay?

Fortunately, my husband was in the Navy, and I was able to transfer all my care to the military. All my meds are free, as is all the routine and specialized health checkups I need. I receive intravenous medications once a month for my conditions, also free. The premiums are a couple of hundred dollars a year. The downside is that I have to wait up to 2 months for a routine appointment. Urgent appointments are same day.

You should also know that when you are on the waiting list for an organ transplant the evaluation regularly includes a "wallet biopsy" along with the other checks.

My husband, a physician, jokes that the first words you should utter when entering the Emergency Department is "I have insurance" Everyone laughs, but it's true.

SG

By Science Goddess (not verified) on 15 Jul 2007 #permalink

While the wife was actually admitted, the husband would sometimes making 10 trips a day to the hospital, each at $11 a shot. That's what really broke the bank for them, he said.

Why in the world did he need to make ten trips a day to the hospital?

By Caledonian (not verified) on 15 Jul 2007 #permalink

In Cuba "more traditional treatments and medicines are usually used(like penicillin) as opposed to newer techniques and antibiotics."

So if antibiotics are less plentiful, maybe they have less antibiotic resistance?

By John Wendt (not verified) on 15 Jul 2007 #permalink

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.

...and that it's a right.

By David Marjanović (not verified) on 15 Jul 2007 #permalink

Bill Clinton spoke in San Francisco a few months ago, and we blogged the highlights of what he said. Very relevant to this discussion-see below-, and I agree with the comments above that this is the type of big picture conversation that Gupta should engage in more often, rather than focus on pretty irrelevant number controversies with Moore.

1) Clinton's overview of key data:

*16 vs 10-11: % GDP spent on health care in the US vs. other industrialized countries. This percentage difference equals around $800 billion annually
*84 vs 100: % population with some form of health insurance in the US vs. other countries
*34 and 37: ranking of the US system as measured by health outcomes and life expectancy, respectively
*34 vs 19: % health care costs spent on administration in the US vs. other countries

2) He outlined the 3 main problems with US Healthcare as follows-and empathized that any serious, long-term solution needs to address these 3 elements as a whole:

* immoral unequal coverage
* inefficient system: we pay more for less
* we still focus more on disease than on health. But he is hopeful about an increasing focus on wellness, absolutely necessary to alleviate future cost pressures

3) A couple of (aproximate) quotes

* "I am a testimonial for the best of American medicine. Given my heart problems, it is a miracle I am here with you today. These days I cannot stay more than 5 minutes in a bad mood, because I remind myself how fortunate I am simply to be alive"
* (when people were clapping and cheering to easy "sound bites" while he was still trying to make a complex point) "Please stop. I don't want you to boo or cheer, simply to think on your own"

What makes you think that the US could do anything as efficiently as other countries?

because americans, clearly, are all just so damn sucky and useless that it's pointless for them to even try to accomplish anything.

yeah, that's the american dream, right there.

By Nomen Nescio (not verified) on 15 Jul 2007 #permalink

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/

Philos is not inhumane -he clearly suffers from a thyroid condition .

autumn said:

Giving in to the market argument against universal coverage leads directly to the question of why insurance companies exist at all. If you can't afford to pay market price for health care without insurance, why do we allow these socialist (many pay, few use) insurance companies to exist? It is impossible to logically argue that private insurance is good while national insurance is not.

I must humbly disagree with each sentence of the above.

This to me seems like a misunderstanding of both markets and socialism. Insurance is a system for spreading risk around. Other people are willing to buy your risk, to gamble that things will go well for you, whereas you are betting against yourself. This type of contract, freely entered, can save your life. There is not a slightest thing that is socialist or anti-market about this type of insurance.

A socialist health insurance program is distinguished from this by a couple of features. Firstly, its usage is compelled by force. You cannot opt out of it, and if you try, men with guns will show up and put you in prison.

Secondly, it is by nature a monopoly. Who can compete with a service for which the fees are collected by force? In a monopoly, we don't have as many choices, nor as much recourse when we get screwed over. Legally-enforced monopolies tend close the door on innovation, because people with bright new ideas can't just go out and try them. A would-be innovator would have to push their ideas through a committee that could never have enough information to reason well about the idea. In contrast, the market system can allow all participants to employ their private information to help determine in a distributed fashion whether the new idea works. People with new ideas about health care can try them, and if people like the new ideas, they will prosper. And nobody has to use violence.

And do you think a government-run healthcare system is somehow immune to the immense temptation to cut operating costs by denying treatments? No matter how much tax money we allocate, planning committees will have to decide how it gets spent, and we will have to trust this small (and very bribable by special interests) group to wisely decide who lives/dies/suffers/gets cured. We all have to obey this one locked-in bureaucratic plan, since we can't just take our money elsewhere to try an alternative plan.

We do, however, have the vote. Yay democracy. But democracy in certain areas of health care policy might be a bit dangerous: legislators would have an incentive to favor cheap treatment of chronic conditions over expensive acute ones, because the same amount of funding can treat a whole lot of chronic patients (voters). A comparably smaller amount of acute patients may die, but this smaller group would be less important when trying to get votes. I find this a worrisome idea.

[I would note that the Founders wisely protected certain issues from direct democratic control via the Bill of Rights. The majority would often want to censor minority opinions or otherwise undermine their rights, so we have these difficult-to-change amendments in the constitution to protect minorities from mob rule. This type of protection is pretty handy if you're, say, an atheist like me.]

Lest you denounce me as a market fundamentalist of some stripe, I would like to point out that I am not a republican. I am a godless liberal democrat, and my heart, it bleeds. I am also not in a great financial situation, so I am not just trying to self-interestedly keep from having to share my wealth with poor people. I own DVDs of all previous Moore movies, even Roger & Me. And clearly we have problems with our current employer-centered approach (you have to get new insurance when you change jobs? wtf?), and we should be thinking hard about what to do to make things better. I don't have all the answers.

It sounds really great to stand up and say, "Health care is a human right!" and "Nobody should have to die because they couldn't afford health care!" But saying these things doesn't magically pay for them. Everyone wants better health care for more people. I certainly do. But I don't think socialism really delivers on this promise because it limits innovation and forces us to use less total information in our decision-making processes. It takes power out of the hands of the actual users of the health care system and places it in a rigid central bureaucracy which cannot understand our needs as well as we can ourselves. Let's look for a better idea than that.

It takes power out of the hands of the actual users of the health care system and places it in a rigid central bureaucracy which cannot understand our needs as well as we can ourselves.

Nathan,

I take it you haven't had a claim refused by your insurer lately?

Melanie said:

I take it you haven't had a claim refused by your insurer lately?

Not lately, but I am aware that it sucks and sucks deeply. I have seen it happen to friends.

Keep in mind, our choices are not limited to the binary status quo vs. full-on socialism. A positive function of SiCKO is to illustrate failures we're currently facing. Insurers who routinely f*ck people over should be publicly shamed for it. We need to build awareness of shady dealings so that companies have an incentive to be less shady.

Currently, most people do not really choose their insurers; they pretty much have to go with whoever their employer uses. I think we need to decouple this in order to foster more productive competition. If people individually had more choice in the matter, and we had some nice scorecards for who is the least likely to screw you over, then people will flock to the companies with the best records.

In this way, we provide incentive to health care providers to keep their customers happy, and we make insurers much more accountable to their clients than they are today. It is the paucity of direct accountability which allows them to pull the shenanigans they currently pull. They need to lose more whuffie when they do bad, and allowing people to easily move to alternative providers accomplishes that.

And by minimizing central planning, we also keep ourselves open to innovation, so new health care choices can appear which are currently un-dreamed-of. There's a reason we ended up with more goodies over here than in the USSR, and that reason is that decentralized systems can investigate more possibilities (just like good ol' evolution does) than rigidly centralized ones.

Isn't it about time for one-hit-wonder 'cooler' to go to the dungeon?

I've seen that same post several times today in scienceblogs.com.

step off punk son! "several times" liar! read and learn!

Liar? Do you know what that word means cooler? You've posted it twice in this thread alone. They were about 40 posts apart so I doubt you just hit the button twice. I'm not sure where else you have posted it, most of your longer posts on the topic seem to blend together but I wouldn't be surprised if I found the same post, or an almost identical one at aetiology and possibly even in other places.

So yes, several times seems like an accurate statement.

Wouldn't he (or his successor) be the guy in charge of appointing the head of a national health care system?

but he wouldn't be RUNNING it, now, would he.

even bush isn't an HIV denier, for that matter, regardless of his vast amount of ignorance of just about everything.

read and learn!

if only you could practice what you preach (redundantly).

another vote to send you off to the dungeon.

Irrespective of the state of the US health system, I can assure you that if I got sick tomorrow here in Ottawa, Ontario, I'd probably have to drive 45 minutes down the road to Ogdensburg, NY to get effective treatment, let alone timely treatment.

Yep, it would cost me, but the alternative is to languish on a waiting list, hoping that my doctor has a spare moment to see me and that I don't get worse in the mean time. Current wait time for an appointment with my doctor is 12-15 business days.

Of course, I could show up at the emergency room, but if I don't have my severed head in a bag with me, I can expect a good 6-8 hour wait and then get told to go see my family doctor (go back to the previous paragraph).

I was working in Caracas a few years ago and got ill. It cost me 40,000 Bs (about $80 US at the time), but I got to see the doctor that day, he was US educated, and the half hour consultation was better than anything I've ever had here.

Please, please do not hold Canada's health care system up as a model for much of anything. Maybe we don't have poor people dying in the streets, but I can assure you we have middle-class people dying on waiting lists for treatment.

nathan, "It sounds really great to stand up and say, "Health care is a human right!" and "Nobody should have to die because they couldn't afford health care!" But saying these things doesn't magically pay for them."

Just replace "health care" with "fire protection care" and "police protection care" to see the invalidity of that argument. Neither the police department nor the fire department ask for your Police Maintenance Organization or Fire Maintenance Organization authorization before they intervene. The same should be true for health care.

In fact both of those are aspects of universal socialized health care. Both the fire and police departments exist to protect people's health and lives. I don't know the statistics, but it might be interesting to see how many people die from fire and assaults with how many die from lack of medical treatment.

"But I don't think socialism really delivers on this promise because it limits innovation and forces us to use less total information in our decision-making processes. It takes power out of the hands of the actual users of the health care system and places it in a rigid central bureaucracy which cannot understand our needs as well as we can ourselves."

What evidence do you have that socialism doesn't deliver or that it limits innovation? The Soviet Union had a better health care system than Russia does now, as well has putting men and stuff into space. China's medical system seems to have quite a few weaknesses, but in other areas of development it seems to be doing rather too well for our taste.

That HMO's or whatever they are called now are rigidly bureaucratic is one of the points of Moore's film. The system gives a semblance of choice, not real choice. How many people really have and understand the information to make a choice. In fact the power is out of the hands of actual users today.

Why do you think that an insurance actuary, who is really the one that makes the decisions, understands our needs better than we, or the government paid system, would? Under "socialized" medicine, the doctors would decide treatment, not government bureaucrats or insurance actuaries. The government would pay for it, with our taxes of course.

Just as we pay taxes for fire and police protection, we should pay taxes for health protection and medical treatment.

Evolving Squid: Please, please do not hold Canada's health care system up as a model for much of anything. Maybe we don't have poor people dying in the streets, but I can assure you we have middle-class people dying on waiting lists for treatment.

Got any actual examples? Because this sounds like the classic US urban myth to me...

Evolving Squid, I don't know what sort of care you are finding in Ogdensburg, NY, (sounds like a for-profit minor emergency clinic) but in all my years in Texas, there is always a wait to see a doctor. And if you need to see a specialist, and can't afford it, then the wait is until you die or your family can raise enough money. Around here, you can't go into any business without seeing the signs for benefit dinners or dances for someone with a severe acute or chronic illness. There are no cash registers that don't also have one or more jars for donations to pay for someone's chemo or physical therapy. On any given weekend, you can be assured of finding a choice of $5 meals with all proceeds going toward medical expenses. So, tell me again how bad you've got it in Canada.

just as a note keeping 45 million out of the US population still vastly outnumbers the population of the UK and France. You can cherry pick examples against the socialist system of health care too. My biggest problem with Sicko was that he didn't tell you at all what the cost of Universal health care was. He doesn't say anything about the French tax rates of 68.2% total tax rate for medium sized businesses, and the income tax of 53.25% on incomes exceeding $49,365 (this is based on total household income too, so anything your kids make), the 19.6% sales tax, 33% capital gains tax, and a property Tax . Ouch. Personally, I dont know if im ready to have more than half my income gone before I start paying my bills.

http://www.internationalliving.com/france/taxes.html

http://www.doingbusiness.org/ExploreTopics/PayingTaxes/Details.aspx?eco…

Unocal/pipeline

Moore had good reason to raise this issue, though he failed to keep his audience up-to-date. As Michele Landsberg reported in 2003:

"Mohammed Razim, Afghanistan's mines and industries minister, told the BBC that "Unocal will be the lead company" in funding the pipeline. Unocal denied it. At the same time, a Unocal spokesperson told the Los Angeles Times that the company had no plans there for the foreseeable future, but that "I don't think it would serve me to say 'forever.'"

www.overcast.pwp.blueyonder.co.uk/f911

Evolving Squid: Funny, my SIL in Ottawa got urgent surgery the day she presented herself to a doctor, and my husband and I in Toronto can get appointments with our GP within a day. There are problems in some locations with lack of GPs, and I know there are issues with waits for some specific treatments, but generally the waits are for non-urgent care.

I guess media wants to compare socialized medicine of Cuba with private for profit medical industry of US to cover up the terrible health care system of the USA. I was once told by an american (who did not have health care insurance) that USA is the best for health care! In India where socialized medicine is falling apart because government wants to adopt the USA's model and sell the health care to private organizations, you can get perhaps somewhat better treatment than here. That is of course, if you have money, you can go to a hospital which can be compared to any of the first world country's hospital. Here in the USA, even if you have insurance you may not even get your doctor to come deliver your baby! Yes, that had happened to me - attending nurses deliver my child when the doctor (whose office was right next door) was busy in his office. My condition was critical and he never showed up even after many calls to his office. I do not know whether this would have happened in any a country like Cuba or in a private hospital like in India! Sanjay Gupta should know better - how the doctors here want to keep the number of admissions to medical schools limited to make more money and have less doctors per person than in Cuba! It seems like you can get a good treatment if you have cancer than child birth, if you have insurance! Although it may not be covered fully by your insurance and you have to pay $50,000.00 for it.

nathan said

"But I don't think socialism really delivers on this promise because it limits innovation and forces us to use less total information in our decision-making processes. It takes power out of the hands of the actual users of the health care system and places it in a rigid central bureaucracy which cannot understand our needs as well as we can ourselves"

You can't be serious. My brother has ulcerative colitis, which has several treatment options. In the US the most cutting edge seems to be Methotrexate, an extremely dangerous drug with limited effects. The two most promising treatments for colitis are from the UK and Germany. Neither of these treatments are drugs. In the UK they're experimenting with bacterial therapy, in Germany it's microscopic, parasitic worms. Therefore, your arguments that socialized healthcare restricts innovation are a load of crap.

Quite frankly the US system relies far too heavily on "innovative" drugs rather than truly innovative healthcare options.

Your arguments rely on the idea that profit is a good motive for healthcare innovation and that people receiving healthcare have choices. Get an HMO, see how many choices you have.

By Pygmy Loris (not verified) on 16 Jul 2007 #permalink

Moore should not have included Cuba in the documentary. It was the equivalent of handing a gun to his opponents.

I agree. The Cuba adventure was just an extended tangent.

On the other hand, bits like that are a Moore trademark: My sympathies line up with his, so I never go to one of his flicks expecting to be persuaded. Since 'Bowling for Columbine', I see them just to find out which bits are well-done, and which make me roll my eyeballs back into my skull. It's breathtaking how Moore can go from canny to maudlin within about three minutes. And for what it's worth, I liked this latest effort, but for my money 'Fahrenheit 911' is easily Moore's best so far.

Lotta good posts in this thread. For those folks who find philos' remarks disturbing and inhumane -- hey, the guy's not saying anything that your average Republican precinct captain doesn't believe. That's the party of family values for you, speaking plainly.

Cal:

What makes you think that the US could do anything as efficiently as other countries?

What makes you think we couldn't?

I think there's precious little evidence to support the government-is-always-inefficient mantra, and plenty of evidence to support the contrary position (e.g., compare the administrative costs of Medicare to those of any private, for-profit insurer).

But even if we stipulate the inefficiency of government for purposes of this conversation, what makes you think our government would be worse at running a healthcare system than our peer governments around the world?

Do you think U.S. healthcare management professionals are inherently stupider than their fellows around the world? Or that they would magically become stupider if their paychecks were drawn on public rather than private funds? Do you think something about our form of government, or perhaps something inherent in the American chracter, makes us uniquely incapable of operating public institutions effectively?

Personally, I don't see any evidence for these suppositions. I'd be curious to see whether you have anything other than your personal ideological assumptions to support this skepticism.

By Bill Dauphin (not verified) on 16 Jul 2007 #permalink

But I don't think socialism really delivers on this promise because it limits innovation...

Just look at Prosthetics - a German company invented the most adavanced artificial knee/shin system on the market today, The C-leg. They also developed and manufacture the one of the leading arm prosthesis - the MyoBock arm.
The next generation of advanced prosthetics are being developed by DARPA - a gov. agency.
Nathan, your comment shows a fundamental lack of knowledge in regards to medical research.

By ironicname (not verified) on 16 Jul 2007 #permalink

My biggest problem with Sicko was that he didn't tell you at all what the cost of Universal health care was. He doesn't say anything about the French tax rates of 68.2% total tax rate for medium sized businesses, and the income tax of 53.25% on incomes exceeding $49,365 (this is based on total household income too, so anything your kids make), the 19.6% sales tax, 33% capital gains tax, and a property Tax . Ouch.

The numbers are typically represented as a percentage of overall GDP rather than as a percentage of tax spending. The point is that we're spending it. Whether the government spends it or we spend it privately, it's still being spent, so the question should be, "What percentage of your GDP are you spending on health care?" rather than "How much public money is being spent on health care?" or "How high are your taxes?"

As Moore and others point out, other countries with socialized medicine spend a smaller percentage of their GDP on health care so presumably, any increase in public spending would be more than offset by a decrease in private spending (at least, that's the argument). Think of it this way: Should I really complain about $1 more in taxes if it saves me $2 in out-of-pocket spending?

By Troublesome Frog (not verified) on 16 Jul 2007 #permalink

Canadian citizen here.

Anecdotes- twice in for surgery in through emergency for a recurring problem. First time admitted, surgery done in 12 hours and a two nite stay. Second time surgery done within 1 hour. (Difference was anesthesia used. 1st general, second local).

But- with a child who had an adverse reaction to a shot- I did not take the kid in through emergency and had to wait 4 months for an allergist appointment, and almost a year for a neurologists appointment. Even though I had advised the health unit within 12 hours of hives. If it ever happens again I would suggest emergency, because there were long term repercussions, and they are an ongoing concern. Transient brachial neuropathy, numbness and a worry about ever getting this immunizxation again as allergy tests actually confirmed the allergy, much to the allergists surprise.

Extended family:

Heart problems- fast and done within a month and a bit for a valve.

Cancer- caught cut and radiation within two months. Had it been lymph node it would have been chemo or radiation ASAP.

Diabetes- not only caught and treated but classes held to teach how to manage- a couple days worth.

Another family memeber has had two liver transplants due to a chronic autoimmune disease. Lengthy hospitalizations of months for other issues related- NO ALCOHOL INVOLVED!!!

But- my lady family doc dropped a bunch of us as patients because she is too busy and we don't go often eough. (We are lucky that we have a decent walk in doctor here.) Our population has skyrocketed here and my lady doc is excellent.

I pay for my health care a bit- over a thousand a year for a family. Plus if I quit my job we could be without coverage for glasses and teeth and prescriptions. The Blue Cross here would probably be as crazy to access as your HMO dudes, as they have denied coverage for a family I know for certain things because of previous health history.

What else- all possible broken bones have been xrayed within two hours of incident. Mostly because of the initial wait for the walk in doc.

We have paid for an MRI with a very serious problem that we would have had to wait for. This allowed surgery to be booked almost immediately.

I dunno- I think that there is good and bad here- but I know that in the US some of my relatives would be dead, or broke.

I loved Sicko and am telling everyone I know to see it. The audience reaction is amazing here in canada. You have no idea how sheltered we are when it comes to knowing what it is like to PAY for health care or getting denied. Even though there may be a wait there still is hope that things will happen.

bernarda,
Just replace "health care" with "fire protection care" and "police protection care" to see the invalidity of that argument. Neither the police department nor the fire department ask for your Police Maintenance Organization or Fire Maintenance Organization authorization before they intervene. The same should be true for health care.

No it shouldn't. Police and fire protection are public goods. Health care systems are not.

Jesur,
Got any actual examples? Because this sounds like the classic US urban myth to me...

From the Supreme Court of Canada's 2005 ruling in Chaoulli v. Quebec:

The evidence in this case shows that delays in the public health care system are widespread, and that, in some serious cases, patients die as a result of waiting lists for public health care.

DSM, Sicko does not set itself up as an impartial and studious examination of every issue surrounding the health care debate. Michael Moore's starting point is that the US health-care system is fatally flawed and a well-funded socialised health-care system is the best all-round solution. He knows foreign health care establishments are not flawless (read some of his interviews). The main point of spotlighting and then cherry-picking the best working parts of other support systems is so Americans demand, and hopefully one day receive, the very best of treatment. His narration proceeds: "When we see a good idea from another country, we grab it. If they build a better car, we drive it. If they make a better wine, we drink it."

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.

...and that it's a right.

By David Marjanović (not verified) on 15 Jul 2007 #permalink