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Excerpts from Michael Moore's 'Sicko'

by marco Thu May 14th, 2009 at 01:48:03 AM EST

I was living in China when Michael Moore's Sicko came out in 2007, so I hardly heard anything about it or how it was received when it came out.

I just watched it on cable TV, and was pretty struck by it -- even as I expected over-the-top sensationalism and bias.

The US really comes out looking like a quasi-barbaric society, an also-ran in the community of civilized countries.

One of my favorite parts was the interview with British Labourite former member of Parliament Tony Benn, which you can see and part of which is transcribed below the fold.

Well, if you go back, it all began with democracy.  Before we had the vote, all the power was in the hands of rich people.  If you had money, you could get healthcare, education, look after yourself when you were old.  And what democracy did was give was to give the poor the vote, and it moved power from the marketplace to the police station, from the wallet to the ballot.

If you can find money to kill people, you can find money to help people.

... choice depends on the freedom to choose, and if you are shackled with debt you don't have the freedom to choose.

People in debt become hopeless and hopeless people don't vote.  They always say that that everyone should vote but I think that if the poor in Britain or the United States turned out and voted for people that represented their interests there would be a real democratic revolution.

See, I think there are two ways in which people are controlled.  First of all frighten people and secondly, demoralize them.

An educated, healthy and confident nation is harder to govern.  And I think there's an element in the thinking of some people: 'We don't want people to be educated, healthy and confident, because they would get out of control.'

The top 1% of the world's population own 80% of the world's wealth.  It's incredible that people put up with it!  But they're poor, they're demoralized, they're frightened, and therefore they think perhaps the safest thing to do is take orders and hope for the best.

Another clip I like a lot shows Moore walking through the streets of Paris filled with embracing lovers and picnicking familes (to the somewhat incongruous accompaniment of Serge Gainsbourg and Jane Birkin's "Je t'aime... moi non plus") after having spent time learning about the French health care, day care, work and vacation system.  He reminisces:

After seeing all this, I began to wonder: Was there a reason our government and our media wants us to hate the French?  Are they worried we might like the French?  Or like their ways of doing things?  It was enough to make me put away my freedom fries.

Here is the clip (through 1:00; what follows that first minute is jarring anecdotal scenes involving people who are refused hospital care in Los Angeles):

And I began to wonder: What impact, if any, did this movie have in shaping the dialogue about healthcare and in making healthcare more of a priority among the U.S. public?

I wouldn't say it had impact other than helping some medical professionals organize during the movie's premiere.

The American public has been heavily in favor of a universal health insurance plan by a ratio of 2 to 1. The politics of it is just noxious however as the Pharmaceutical and Insurance industries are huge. The opposition in congress is frightening. These industries employ millions.

Consider this: George Bush PREVENTED the gov't from trying to negotiate medicine purchases at a discount. Medicare pays top dollar for medicine.

by Upstate NY on Thu May 14th, 2009 at 07:47:40 PM EST
Upstate NY: The American public has been heavily in favor of a universal health insurance plan by a ratio of 2 to 1.

Not sure what you mean by "universal health insurance plan" but regarding a "single-payer plan":

Julie Rovner [health policy correspondent for National Public Radio, author of "Health Care Policy and Politics A-Z," and contributing editor for National Journal's CongressDaily]: ... The thing about single-payer is, it's like abortion:  People who believe in it believe in it very very very strongly.  Single-payer has, does continue to have fairly strong support, but it's not a majority.  It's somewhere between a quarter and a third, so it's big, but it's not a majority.

And like abortion, the people who oppose it also oppose it very very strongly.  And I think that's why it's really not on the table in Congress, because there are people -- I mean, it could not pass with just Democratic votes, because there's not a majority of Democrats in Congress who support it.  And in fact it's simply a recognition of political reality that, you know, it's one of those conundrums, even though there is a very strong and fairly large contingent who support it, it is not large enough to get passed, and the people who oppose it oppose it extraordinarily vehemently.  If you look and see how many Republicans are saying that simply having a public plan option is a show-stopper, the idea of going to a single-payer is obviously a non-starter.  And I think that that's why that even among Democrats who are trying to craft a bill and come up with a compromise, and working very hard to get a bi-partisan compromise, certainly they have ruled out single-payer for political reasons.


Len Nichols [director of the health policy program at the New America Foundation]:  Well, I would certainly agree that the majority of the American people don't support it.  It does poll very well in California, by the way.  It's in the high 40s there, and Julie's right, nation-wide only in the 25-35 range.

But I think the fundamental deal here is that most people don't really want as much change as single-payer would entail.  And therefore, in a fundamental sense, they don't trust the government enough to turn everything over to them.  They clearly want the government to do some things, but not everything.  And the fear of single-payer is that if you gave the government total power, then there would be in a sense no recourse -- it's very difficult to go back, once you make that choice.  And that's where Stuart [Butler, Vice President, Domestic and Economic Policy Studies, The Heritage Foundation] and I actually really agree.

The Diane Rehm Show: "Update on Health Care Reform"

Truth unfolds in time through a communal process.
by marco on Fri May 15th, 2009 at 10:06:08 AM EST
[ Parent ]
Universal health coverage refers to a national policy which provides medical care to every single American and covers every necessary medical procedure without fear of rejection.

So, it's not single payer. The term "universal" in the USA refers to a host of pay points, whether they come from the federal government or one's employer or directly from health insurance plans.

The vast majority of the populace in the USA is for total coverage. Obviously, there are many countries in the world, some of which appeared in the Moore documentary, which also adopt a multipayer health care system.

by Upstate NY on Fri May 15th, 2009 at 11:15:13 AM EST
[ Parent ]
What are the main points in the single payer plan? And why would it not be universal?

Sweden's finest (and perhaps only) collaborative, leftist e-newspaper Synapze.se
by A swedish kind of death on Mon May 18th, 2009 at 03:12:47 AM EST
[ Parent ]
Single payer should be universal, but there are other ways to provide universal coverage, such as in Germany. Single payer probably makes sense for the U.S., as they already have lots of experience with it (Medicare, VA).
by gk (gk (gk quattro due due sette @gmail.com)) on Mon May 18th, 2009 at 04:02:57 AM EST
[ Parent ]
I think I was unclear. What I meant was I do not know what this "single payer plan" is. Please explain it.

Sweden's finest (and perhaps only) collaborative, leftist e-newspaper Synapze.se
by A swedish kind of death on Tue May 19th, 2009 at 03:18:51 AM EST
[ Parent ]
I don't think there is a specific "single-payer plan". It's used in the U.S. more as a general term for health care (or at least basic care) paid for by a single organization (usually the government), as opposed to having many insurance companies working under government guidelines.
by gk (gk (gk quattro due due sette @gmail.com)) on Tue May 19th, 2009 at 04:41:42 AM EST
[ Parent ]
Ah, thank you.

Sweden's finest (and perhaps only) collaborative, leftist e-newspaper Synapze.se
by A swedish kind of death on Tue May 19th, 2009 at 08:30:51 AM EST
[ Parent ]
Won't physicians' incomes have to be decrease -- or at least, the top physicians' incomes -- in order to make health care in the United States affordable enough both to be sustainable and to be universal (in the sense Upstate NY explains below)?

Put another way, are the high compensation levels of U.S. doctors a significant reason why health care in the U.S. is so expensive?

Moore touches on this in Sicko where he interviews a very young doctor in the UK who owns two cars (one a BMW, I believe) and owns a $1 million, large house in one of the poshest parts of London.  The doctor assures Moore that he makes plenty enough as far as he is concerned, but that if doctors wanted to make two, three, four times as much, then yes, they would probably have to move to the U.S.

(I heard this point made recently on a radio program (I thought it was the same one I quoted in this comment), but I can't find it now.)

Truth unfolds in time through a communal process.

by marco on Fri May 15th, 2009 at 11:31:32 AM EST
Some doctors will certainly have to take a haircut. But then again, those doctors make too much already.

But the big haircut will be to the insurance companies and other unproductive overhead. That's where the American system's costs explode compared to the rest of the industrialised world.

But you are right that American doctor's remuneration is higher than comparable salaries in Europe. This may in all probability be attributed to the American tradition of for-profit higher education saddling American doctors with onerous student debts that have to be repaid. So you could argue that it remains to be seen whether universal health coverage is compatible with a a for-profit educational system.

Of course if it turns out not to be, there is a simple solution to that problem...

- Jake

Friends come and go. Enemies accumulate.

by JakeS (JangoSierra 'at' gmail 'dot' com) on Fri May 15th, 2009 at 02:54:26 PM EST
[ Parent ]
I haven't found physician fees to be the primary culprit in health care costs, but rather the cost of hospital stays including use of their equipment, supplies and facilities by the patient and the attending physician.  For example, I had a complicated procedure last year for which the well-known and highly skilled attending physician was paid a couple of thousand dollars.  However, the hospital billed $40 thousand to my insurance of which the insurance paid a negotiated amount of about $20 thousand.  I stayed one night in the hospital. There was a small army of hospital employees, medical professionals doing prep and followup care, but I doubt they were paid much of the billing.

I can swear there ain't no heaven but I pray there ain't no hell. _ Blood Sweat & Tears
by Gringo (stargazing camel at aoldotcom) on Fri May 15th, 2009 at 11:22:27 PM EST
[ Parent ]
From the San Diego Union-Tribune web site April 26, 09. Story by Dean Calbreath.

It's been nearly three decades since White House Chief of Staff John Ehrlichman floated the idea of creating a health care system based on health maintenance organizations.

President Richard Nixon at first balked at the idea. "You know, I'm not too keen on any of these damn medical programs," he said on June 17, 1971, as recorded by his secret White House taping system.

Ehrlichman, who would later serve jail time for his role in the Watergate affair, patiently explained that privately run HMOs could be profitable, since "all of the incentives are for less medical care. Because the less care they give, the more money they make."

"Not bad," Nixon replied. The next day, he proposed "a new national health strategy" based on HMOs, saying that "the purpose of this program is simply this: I want Americans to have the finest health care in the world."

Why are our health care costs so high? Why aren't we getting broader coverage, considering the amount of money we're putting into the system?

There are a number of reasons, ranging from our fondness for CT scans and MRIs to the high profits of the drug industry. But some critics recently have focused on two other major factors: profits - as Nixon alluded to - and paperwork.

and for profit institutions may be the reason we don't receive the better health care. From the Harvard School of Public Health:

The researchers found that on average, quality of care was lower in for-profit health plans on all four clinical measures studied, with for-profit plans scoring 7.3 percentage points below not-for-profit health plans on breast cancer screenings, 14.1 percentage points below on diabetic eye exams, 12.1 percentage points below on beta-blockers administered after heart attack, and 18.3 percentage points below on follow-up after hospitalization for mental illness.  After adjusting for sociodemographic and geographic variables, for-profit health plans still underperformed in three of the four clinical services.

But maybe people are starting to wake up.

From the AFL-CIO Now Blog site:

March 10, 2009:

A wide range of approaches and proposals mark the debate on health care reform. The insurance industry group, America's Health Insurance Plans (AHIP), has a pretty "simple plan" says Ethan Rome, deputy campaign manager for Health Care for America Now! (HCAN).

They get the profits and we get the shaft.

Rome and some 100 union, health care and community activists, including members of the California Nurses Association/National Nurses Organizing Committee (CNA/NNOC) and Working America, rallied outside AHIP's National Policy Forum at Washington, D.C.'s Ritz-Carlton hotel this morning.

Calling for "real reform and not rhetoric," the group denounced AHIP's "astroturf" health care reform campaign orchestrated by private, for-profit health insurance executives that is masquerading as a grassroots initiative.

Rome told the crowd that during the past five years, health insurance company profits have soared by 1,000 percent while health care premiums for working families have risen five times faster than wages.

They raise our premiums, they raise our deductibles, they raise our co-pays each and every year and now they're conducting a fake campaign for reform.

I can swear there ain't no heaven but I pray there ain't no hell. _ Blood Sweat & Tears
by Gringo (stargazing camel at aoldotcom) on Sat May 16th, 2009 at 11:45:08 AM EST

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