Jose and I watched Michael Moore’s documentary/mockumentary “Sicko” tonight. This was the first Michael Moore movie I’ve seen, and I went into it with a healthy dose of skepticism. While I think that the U.S. healthcare system is pretty much screwed, I still wasn’t prepared to swallow everything Moore said. After all, it is easy to paint a picture one way or the other when you have access to hours of film and an editing room.
Moore is obviously a fan of socialized healthcare, and he paints an incredibly rosy picture of what things are like in Canada, the United Kingdom, France, Cuba and (in the DVD extras) Norway. It’s difficult to watch the movie without wanting to immediately pick up and move to France. Having a baby? It’s free. Need medicine? Free. Get cancer? Treatment is still free. With the 35 hour work week and tons of vacation, France seems ideal.
Socialized systems. Public services. Moore does make a good point in saying that many things in the U.S. are already socialized. If someone breaks into your house, the police will come and help you, for free. You can go to school through 12th grade, for free. You can go to the public library and borrow a book, for free. If you need to send a letter across the country, you can do so via the postal service for a very small fee. If your house catches on fire, the fire department will come to put it out, for free.
Think about that. The fire department will do their best to save your burning house — at no charge to you. But if you fall down the stairs and break your leg while you’re running out of that same burning house and need medical assistance? Well, I hope you have insurance. We protect people’s property before we protect the people themselves.
Obviously socialized medicine does come with its own problems, and is not some kind of panacea. But if our goal is to provide a reasonable level of service to all people, instead of a high level of service to only those who can afford it, we will have to change the way our system is currently run. Jose asked if I thought the U.S. would go to a socialized healthcare system in our lifetime. After a moment’s thought, I was forced to admit that while I wasn’t ready to give a definite “no,” I don’t think we will see significant change anytime soon. Why? Because it would involve such a widespread and fundamental change in how the healthcare system is run, in the government’s involvement in such a system, and in the government’s ties to the large insurance and pharmaceutical companies. And, as Jose pointed out, those companies are not going to go down without a fight.
And yet the fact remains that being an American unfortunate enough to get a serious illness leaves you with only two options: foregoing treatment or a lifetime of debt.
Regardless of how we fix it, I hope everyone can agree that there is something wrong with that.
Jen says
Socialized medicine is nice in theory, but if I was ever really sick, I’d much rather be here than Europe.
laanba says
I enjoyed reading this post. Very insightful. I haven’t watched the movie yet because I think I may just get too depressed. Just this week I paid $90 for two, count them TWO, medications. I have a job, WITH insurance and the medications were for asthma and not something more serious. As you said if someone gets seriously ill it is a choice between foregoing treatment or debt. Unfortunately with so many different levels of insurance out there that is a choice that even people with coverage may have to make as well.
June says
i did a presentation on this in my pol sci class.
heres something i found to be completely crazy.
something like 80% of the people that are homeless or have filed bankruptcy are that way/have done so because of not being able to pay for medical costs. And they WERE insured!
while it is about those WITHOUT insurance, its even bad for those of us who do. you think you’re covered, but therein lies the bigger problem
Jen says
On the burning house – probably one of the main reasons putting out the fire is free is because it threatens your neighbor’s houses. It’s worth it to me to pay for public fire protection so that if my neighbor’s house catches on fire through bad luck or negligence, mine won’t burn too.
It’s worth remembering that repair of that house – much mor expensive than actually putting out the fire – will then be paid for by insurance — which by the way its mandated by law that you have as a homeowner. In fact, I would compare putting out the fire to receiving emergency room care (you cannot be turned away from an emergency room, in my understanding) and repairing the house to receiving all the other care AFTER the emergency room.
And the choice as far as I can tell is high level of service to most people (what we have now), substandard level of service to all people except the wealthy who will pay to get decent service ( Britain, Ireland ), or something different, like reglated health insurance and a law that everyone sign up for it and companies provide it ( what’s been done recently in MA ).
I’m a little bitter about socialized medicine. This bitterness comes from a story I’ve repeated often – my Irish grandmother dying after receiving substandard care for cancer. My Dad, who has lived decades in both countries, believes she would have survived if she’d been in this country. Also, watching my Irish aunts wait *years* in line to get cataract surgery – something my American grandmother got within months. Hearing about a scary life-threatening mis-diagnosis my wealthy Irish aunt got in Ireland before she decided to take matters into her own hands and pay for decent care – which probably saved her life. Most people can’t afford that.
And, watching the amazing care my decidedly non-rich (working class) American grandfather got in this country for cancer and heart disease. There’s no question in my mind that he wouldn’t have lasted as long overseas.
I don’t see what the big deal is. I think Mass has a great plan. 1.) Mandate companies 10+ employees provide health insurance 2.) Provide some regulation / guidance on what standard of care an insurance company provides 3.) Mandate that people above a certain income level pay for health insurance 4.) Provide free health insurance to the 10 – 20% of the country that can’t afford it.
becca says
Well, it depends on your income Jen. At our income level and working for an employer that has health benefits, if I was ever sick, I’d rather be here than in Europe or Canada. However, if I made half of what I did or had a home business or worked at a small company with no benefits, I’d far rather be sick in Europe or Canada than here.
And, yes, June, I have read that medical bills is the most common reason for bankrupcy filings in the U.S. So common in fact that the medical lobby is currently pushing legislation that is going to change bankruptcy law so that you can no longer get out of still owing payments on your bills through bankruptcy.
becca says
The other thing that is crazy is that a lot of people who do have insurance through their employer have capped coverage – like no more than $50,000 in coverage per year. That may seem like a lot BUT a major illness or hospitalization will exceed that by a good deal, so even with insurance, you could end up with $50,000 or $100,000 in bills that you could be paying for the rest of your life.
Gavin says
I’ve seen three of Moore’s movies, two of which were “documentaries”, and consequently had no desire to see Sicko.
Canadian Bacon was funny, and John Candy’s last movie. Moore should have stuck with fiction.
Bowling for Columbine was entertaining and had some interesting social questions, up until he started grandstanding with one of the Columbine victims in front of K-mart and when he blindsided Charlston Heston, who was displaying symptoms of Alzheimers, in an interview. Such shock ploys did nothing positive for anyone or any cause.
Fahrenheit 9/11 had several amusing moments, but I felt it had very little substance at all. Mostly shock and awe from a propaganda standpoint supporting the anti-war and anti-Bush movements. Which is fine, but, I wouldn’t classify it as a documentary. The one thing that stands out to me was where he’s standing in front of the Capitol building asking members of Congress if they support the war, and if they say yes, are they ready for their kids to go over there. One guy gives Moore an incredulous look which got a great audience reaction… and the movie cuts to another scene.
The incredulous congressman already had two nephews in the military, with one serving in Afghanistan. But Moore cut his response out since it didn’t fit with his satirical message.
Anyways.
Socialized medicine. In such a system there’s little impetus to make medical care better, or faster. This is why social care sucks in Europe. Is it better than nothing? Yes. Will it save more lives and improve the quality of life for more people than privatized care? That is the real question. I don’t know. I suspect not, but, I’m biased towards markets.
Jose says
The free market is a funny thing because it has no morality or humanity. It will only make Viagra a buck a pill and give the elderly a 2000 a year pharmaceutical bill. By definition it will never move opposite the direction of profit (unless there is more profit at the end). The free market is very powerful but it is a tool and not the answer.
The free market as it exists today puts no premium on minimizing disease, only on maximizing profit. It does this the easiest way it knows how: limiting procedures, limiting coverage, and denying coverage through various loopholes it has created for itself. We may have the best technology, pharmaceuticals and procedures as produced through the unchecked market but they are at a price. And for most of us it is unbearable.
Would a nationalized health care system have impetus to provide higher quality care? I don’t see why not. It would simply require the government to establish the specific needs instead of the willy nilly market. The military is a government entity demanding systems with almost no other market applicability and it is doing fine, with a few companies routinely fighting for the world’s next ridiculous weapon. Imagine what the healthcare equivalent of an F-22 is? There are a myriad of defense research programs that are producing impossibly complex and advanced systems. Why there is not equal or more funding for health care is beyond me. Of course nobody wants to touch that ripe worthless defense budget.
We could do it if we wanted, we just don’t want to. The public has had it drilled into their head that anything sounding socialist is un-American. We cling to the notion that anything that doesn’t go DIRECTLY to me is somehow going to be lost. Those huge multi-billion dollar companies with politicians in their pocket also think it is un-American to not make as much money as mathematically possible.
Any American denied health care is to me un-American. Americans who have worked hard their whole lives to go into massive life ruining debt because they get cancer is un-American. The fact that this has gone on so long is un-American.
Jon says
I worked in British Columbia for 15 months last year and this year. We had to build the hospital information system that the hospitals in one of their health authorities would use. Therefore, we needed to learn how they did business.
I specifically asked if their healthcare was free and I was told that most employers pay the premium to their healthcare; however, they did have a premium. And for most basic items, their care was indeed free. [If you wanted a fiberglass cast instead of a plaster cast, you paid a fee for that.] But they, despite incredible initiatives to facilitate change, still faced wait times for outpatient surgeries as well as emergency room care.
There was a very good article in the Wall Street Journal last week (the week of Nov. 26) about the capped amount of care issue.
The real issue is how changes in reimbursement by the government for the Medicare program – during Reagan’s watch – changed the way health care was paid for. It has resulted in a couple of decades worth of cost-shifting because you aren’t allowed to charge a Medicare patient differently than what you do a self-pay patient. [If you do, it’s fraud.] However, Medicare (Medicaid or most of your HMOs and PPOs) doesn’t pay 100 cents on the dollar like a self-pay patient does. It is about 35-40 cents on the dollar and Medicaid is even less.
In Canada, interestingly enough, they do allow for different prices for different patients. If you were from Alberta and got sick in British Columbia, you had one rate. If you were from out of the country, you paid the highest rate possible.
I do agree with the common sentiment expressed here that we must figure out a better health care delivery model in this country.