Contributors

Sunday, August 05, 2007

Let Us Begin

I finally got around to seeing the new Michael Moore film, Sicko. It is stunning. But rather than drone on like I am prone to do (and in the interest of being fair and balanced), I thought the first "volley" on this film should be from a conservative and, coincidentally my date for the evening when I saw it. Yep, that's right. We've all been anxiously awaiting his re-appearance. It's the Return Of Crabmaster Scratch.

Let the grand health care debate begin. Take it away, Crab.

Guest columnist this week is Senor Scratch who is still last in line. Thank you to Markadelphia for turning the reigns over for the time being. Moore makes entertaining pieces of work and I like his style of film making. There are very few documentary filmmakers nowadays who can open a film in a wide theatrical release and Moore is top dog at this point in time. The strength of Sicko is that he's arguing for most American citizens as opposed to his earlier movies when he was really arguing against any 1 narrow constituent of people.

Contrary to what many conservatives will say, this is not a left-wing propaganda piece. Everyone - liberal, conservative, and everything else - will come away outraged at the way insurance companies treat the people they claim to work for. Perhaps the coldest of capitalists will be able to rationalize insurance companies' practices as "good business sense," but one would have to be a seriously evil bastard to ignore how little sense those practices make from a medical perspective IMO.

Michael Moore takes aim at the US health care system, how damaged it is, some of the reasons why that came to be, as well as showcasing the successes of the universal systems in four other countries (Canada, England, France, and Cuba). If it works so well in Canada, England, France and Cuba, why can't it here? Well, the first answer would have to be that the insurance companies wouldn't allow it. The second would be that the lobbyists have all members of Congress in their pocket. Third may be lawyers. Mix and match to your heart's content. In my opinion, facts are indeed presented but it's not the whole truth. Did Moore even touch on the subject of the millions of dollars that illegal aliens cost our system? No, he just blames everything on drug companies and insurance companies. Illegals cost the system billions in unreimbursed care. That's not racism. It's common knowledge for those of us who work in the health care industry.

Moore reports that his research shows that Canadian, British and French citizens live longer, healthier lives than Americans but he doesn't say it is because a lot of people here are overweight, don't exercise, and have 15 things going on every night when they get off of work so the only time they find for dinner is driving their crumb crunchers through the drive-thru at McD's. Then you have the people who aren't happy with their lives for any number of reasons and many of those people look for the solution at the bottom of a bottle of booze or some pill. The only pill I ever take is a couple of Aleve if I am sore after a softball/volleyball tournament. Moore takes all the worst-case scenarios he can find in the United States and then compares them to all the best-case scenarios in all these other countries.

Imagine if you did a documentary on poverty and you found all the poorest people in America and then compared their situation to the most well-off people in, say, Afghanistan. I guarantee you the poor people would all universally say they'd rather live in Afghanistan.When Moore takes a look at the health care systems he loves in France and England, he interviews white, middle-to-upper class people (a common affliction of many Americans who travel to Europe - they tend to associate with people exactly like themselves). You wouldn't know that France has a very high unemployment rate or that there are thousands of Muslims burning buses in the outskirts of Paris or that, 2 years ago, the UK government "discovered" that about 1 million UK men had simply disappeared from the Island over a period of 10 or 20 years. That is 50,000 per year or 1,000 men per week moving to another country. When, just a couple years ago, a third of French voters demonstrated their willingness to vote for 80 year old Jean-Marie Le Pen's National Front - a party that makes the Ku Klux Klan seem like Human Rights Watch - all predictions of Europe going gently into that good night don't hold much weight with me. Europe has its own system of haves and have-nots and anyone who is saying otherwise is lying to you.

He shows protests in France where people are demanding free housing from the government. That type of garbage is where I draw the line...buy your own house/apartment because a government that is powerful enough to give you all that free stuff is also powerful enough to take it all away.Nope, only the upper-middle class in England and France get interviewed in this film. When he's in America, its working-class people, inner-city blacks, and one skid row patient who are interviewed. So America is seen right up from skid row, whereas when you go to England, you're now dealing with people who live in $200,000 homes. Yes, Moore found six people in the US who got denied health care. What about the six million who did get their care? I've never had a problem with an insurance company and no one in my immediate family has either. That being said, I know that if you deal with insurance companies often enough you will get burned eventually.All the Canadians, French and Cubans interviewed have nothing but praise for their national health care. There are no dissenting viewpoints, no investigations into the economics that make these systems possible. Moore interviewed the daughter of Che Guevara.she wonders why an impoverished island nation is able to provide free health care for its citizens while the United States cannot. Completely left out of this film was any mention of Cuba's massive Soviet subsidies in the 1970s and '80s of $4 billion to $6 billion annually, which kept the nation afloat and made this system possible.

Also not mentioned is Cuba's subsequent decline once these subsidies ended with the collapse of the USSR.

Go here - http://www.reuters.com/article/healthNews/idUSN1936307620070719?feedType=RSS&rpc=22&sp=true

See where it says "But the hospital where SiCKO's patients were treated is an exception in Cuba, where patients of many other hospitals complain they have to take their own sheets and food" in the middle of the article? Again, you aren't and never will get the whole story from Moore.The rose-tinted stories about all the benefits French citizens get like 1 year off for maternity leave and 35 hour work weeks.those type of things are only affordable in a wealthy, capitalist system. Hell many of those countries don't even have to worry about their military.let someone else worry about Iran or North Korea I guess.He goes to Cuba and gets inhalers that cost $120 here for 5 pesos. I'm all for cheap stuff but that fact remains that there is very little oversight or regulation in pharmacies in the third world regarding the medication they sell. Hell I could have walked into that exact same pharmacy and walked right out the door with hundreds of bottles of steroids that would kill me off in no time.

The state of Wisconsin has been trying to get a universal health care bill passed recently. I hope John Waxey will stop by to tell us what he hears about that issue in his home state. From what I have read thus far the plan would cost an estimated $15.2 billion, or $3 billion more than the state currently collects in all income, sales and corporate income taxes!! Looks to me like one big problem is that we are paying a whole lot for health care. Wisconsin would do well to look at Oregon, a state that has malpractice caps as well as a three strike law on doctors who are sued for malpractice. Under the Oregon Plan there are no malpractice lawsuits until a proposed case is reviewed by an Administrative Panel of Health care professionals as well as legal professionals to determine if this is a whiplash Harry kind of case. Under the Oregon plan (written by Democrats), it is illegal for a lawyer to take a percentage of the winnings, thereby taking away the carrot for abuse. Does anybody on here think it is a coincidence that they have the lowest health care premiums in the nation? More lawsuits drive up malpractice insurance, which drives up health care costs, which in turn drives up your premiums for insurance.

With tort reform there would be fewer claims since the frivolous claims would be disposed with, the lottery mentality broken, and just like in Oregon, the costs for premiums would drop. Thought should also be given to capping medical malpractice at $250k. It does not cap actual medical claims, just the difficult to define "pain & suffering". Victims of malpractice would have all of their medical needs taken care of, yet they would not be bankrupting the system while doing it.

I favor a limited universal health care plan for this country that I have posted on this blog before. The bottom line is that, right now, Medicare is the best system we have going right now in this country. IMO there needs to be more of a balance between medicare, private insurance, and co-pay. Congress passed a law some time ago (not sure when) that stipulates that Medicare cannot negotiate prices with insurance companies. I would reverse that so Medicare is allowed to negotiate for prices like everybody else.Therefore I favor a medicare-style plan that everybody is on...sort of a National HMO if you will. 2 ways to go about this, and I'm not sure which way is the best...one way is to have basic hospitalizations covered 100%. Really expensive things like transplants and prescription drugs would not be covered under this. Everybody would have the option to purchase supplemental private insurance from insurance companies to cover such things based on their own or their families needs.

The other way is to have all catastrophic things covered and have the option to buy private insurance for basic hospitalization or whatever else you want you and your family to be covered for. US companies would drop medical insurance as a benefit and they would get to keep that money for their own bottom line. Increase payroll taxes to pay for the plan.Regarding co-pay, it is at about 20% now...increase it to 30% over a period of time...say 10 years or so...don't implement that change right away all at once. You have the option to buy private insurance from private insurance companies to help you out with co-pays.In terms of implementing any new plan, the free market will determine the next great health care plan. When it will be successful will be when there is a market demand for it, sooner rather than later I bet.

Maybe it will be something along the lines of what I typed. Maybe it will be some socialists wet dream, I don't know for sure. Whatever it is will come about because somebody has found a way to work with the free market and will allow people in the free market to sell services for a profit and the market has found that it is cheap, efficient, and is preferable to the current system. People have to want it, not be guilt tripped into accepting it. In other words, it can't be forced. The main problem I still have is that US politicians and US government bureaucrats will be running the plan and the service we will receive and the implementation of the plan will be absolutely horrible and corruption will be rampant. I mean, look at the areas that the government controls now - the post office, Department of Motor Vehicles, VA hospitals, Public Education.areas like those are horribly mismanaged with bureaucracies, corruption, overhead and waste as far as the eye can see, not to mention a poorly motivated workforce who all know it is impossible for them to get fired.

In conclusion, I have learned to take all of Moore's facts with a grain of salt. Sure, there is a ton of truth to what he says, but there is also a lot of editorial discretion in how the facts are presented, ensuring that they back his vision. There always needs to be a "this is the truth, just not the whole truth" clause attached to his work. Fortunately, I do not expect, nor require, all sides of the issue to be contained in Moores work. My main focus is the entertainment factor, the thought-provoking factor - does it succeed? The answer is yes in my opinion. I just have a gut feeling that Moores cure may be worse than the disease.

31 comments:

Anonymous said...

Hey Crab, good to hear from you.

…OK, I’m going to be redundant here and lament on a couple of stories from my time in the UK.
a) My own experience... I have an unusual food allergy which can be quite serious. I went to the doctor in Hammersmith (W. London) and after reciting the symptoms, was asked what I thought it was and was invited to simply “stop eating that”. Upon asking for something a bit more definitive, I was told I could get put on a list to get an allergy test but that it’d be approx. 18 months. However, if I purchased additional health insurance like in t he US, I could probably cut that time in half. I was torn between feeling proud that I’m as educated as a UK Doctor and simultaneously cheated out of my health care benefit. Upon returning to the US and visiting my local provider, I didn’t even finish my list of symptoms before the doctor had a nurse in to draw blood. Two days later it was found to be inconclusive and I was immediately shipped to a specialist. Problem solved.

b) My friend’s experience... His boy has asthma and was having an attack when they took him to the emergency room. After waiting for a good while and going thru a cursory examination, they were informed that he had a cold/flu and would be fine. Never mind that he was turning blue before their eyes. My friend is from South Africa, is very big and is not shy. The doctor was a polar opposite. This was probably the only scenario that could have saved his boy because it took my friend also ripping this SOB apart before they even looked for, acknowledged and treated for symptoms of asthma.

c) General knowledge… Pick up the Times or any paper on any given Sunday morning and you’ll get at least 2 or three horror stories of patients on waiting lists, patients being examined in the hallways due to lack of beds, misdiagnosis, rats roaming the halls, etc, etc, etc. I don’t know the French system, but it got to be so bad in London that the UK gov’t actually made provisions for it’s residents on waiting lists which they’d not live out to get their medical care in France.

I see that you didn’t mention “motivation” until your 2nd to last paragraph. I would have thought this to be in the 2nd paragraph as it is of paramount importance. I’ve not experienced Dutch healthcare, but when one speaks of motivation or the lack thereof, I immediately think of Holland. I spent a lot of time there on business and with a friend from Minneapolis living in Emmen at the same time I was in London. He summed up their culture (in some respects anyway) as follows, “they just don’t care”… The gov’t pays for everything so there is no motivation to do anything or do it well. This is evident in professions high to low. Take a look at the service you get at the pub or in a cab or you name it; they don’t give a rip about providing quality service to you because there is no motivation or incentive. They can’t get fired and there’s no “professional” motivation because the gov’t evens out the pay scales so there’s no motivation to do well to move forward. It’s just a stagnant culture.

I don’t purport to have a solution. But I’ve seen first hand the socialized system and I can say that that is not the way to go. I do know that when someone is really sick or has the money to be treated anywhere, they don’t go to France, England, Canada or Cuba, they make a beeline for the Good ole US of A. I know that we can improve on what we have and tort reform seems like a good starting point.

Anonymous said...

What a joke. A conservative? Give me a break. This line

"I favor a limited universal health care plan for this country that I have posted on this blog before. The bottom line is that, right now, Medicare is the best system we have going right now in this country."

means that you are not credible. Medicare is the worst snafu in the world and is just another example of what the gubmint does when it interferes in our lives. Nice try, Mark, but having your friend "the conservative" post his view doesn't change the fact that you want communism

Anonymous said...

"I immediately think of Holland. I spent a lot of time there on business"...suuuuuure it was a business trip. haha, j/k

I hear you on A & B. I've heard similar stories from my friends in the UK as well as former co-workers from Canada. 18 month wait for an allergy test?? Like I said, the cure will probably be worse than the disease.

Dirty little secret is that a couple countries in Europe (France included) are beginning the process of looking into ways to privatize their health care system.

I heard about Dutch "motivation" from an American in the Amnesia coffeeshop in Amsterdam. He had been living there for 2 years and he mentioned that the work ethic is pretty poor, at least among the laborers he would hire. He said in his experience, employees would do just enough work to get by. Now I know that doesn't describe everybody in Holland but he said it was pretty consistent in his experience. I know they aren't as materialistic as we are...one of the strategies they use when it comes to their bikes is to ride the most ugly, broken down bike known to man so as to deter bike theives from stealing their bike. The Dutch are leaving their country as well.

I know that Hollands universal healthcare is so liberal that they pay for everything their citizens will ever need including cosmetic surgery, boob jobs, face lifts, even sex change operations, something us Americans would probably find incomprehensible. They have free needle exchanges for the drug addicts and even give heroin addicts free heroin so that they stay away from crime to get their fix and they allow Euthanisia.

Anonymous said...

Sarge, I deal with both medicare and insurance companies for a living as I work in the healthcare industry...in an area that deals with reimbursement nonetheless.

My universal healthcare plan is "limited" as I stated. The bottom line is that just 1 generation ago, our parents would go to the doctor and get a bill in the mail and pay it. That just isn't the case anymore.

Mark Ward said...

Dave, curious, when were you in England?

I lived in France for a year and it is the best health care system in the world. They still do house calls for crying out loud. People go there for health care as well as here. It has nothing to do with the type of system, it's more like who is the foremost specialist. A very wealthy man from my hometown, suffering from cancer made several trips to France and Switzerland to see specialists there. He certainly had the money to pay whatever he had to but since it was free, he didn't have to.

Anonymous said...

I lived in London from Spring 1999 thru Spring 2002.

Mark Ward said...

True, crab, the days of our grandparents and parents are long gone. The segment in the film with the Nixon audio was quite damning and really showed how it was really the plan all along to screw people over.

I wonder, though, what do you think Moore's cure actually is? From where I see it, I think he just wants people in this country--everyone--to be able to be cared for and not have to sell their houses to do it. Your solution is a good first step, though, I will give you that.

Anonymous said...

Mark,

In general terms, what's your definition of "cared for"? My primary opposition to universal health care is the wasted time, effort, and money on frivolous and ultimately futile procedures.

Mark Ward said...

Dave, your experience sounds terrible. I think there have been some changes since then...

http://www.nhs.uk/Aboutnhs/howthenhsworks/Pages/HowtheNHSworks.aspx

According to WHO, "The U. S. health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance, the report finds. The United Kingdom, which spends just six percent of gross domestic product (GDP) on health services, ranks 18th.

http://www.who.int/inf-pr-2000/en/pr2000-44.html

So, why is this happening? We still are spending an extraordinary amount on health care and yet not really getting a return on our investement.

Mark Ward said...

PL, Moore asks the question in the film "What kind of country have we become when we don't care for our own people?" He, and I, define care as receiving basic services as well as life saving or life assiting services. Getting a boob job is out, obviously. Getting both of your fingers replaced that you just sawed off accidently is a basic service. The guy in the film was told that his ring finger would cost 12Gs and the other would cost 60Gs so the insurance would only pay for the first one.

I am going to be putting up a post about this at some point during the week but the thing that struck me about the film was how much pity other countries like Canada, France, and England have for us when it comes to health care.

Anonymous said...

Already the term "basic services" is a pretty slippery slope. I don't see how getting fingers replaced would be a basic service. Particularly considering: a) a person can survive without the fingers and b) the amount of time/training it takes for doctors to reach a level where they can replace the fingers. I know that's just one example among many you could have given, but it does illustrate exactly my opposition.

I would argue that there even should be a limit to life-assisting services. Your previous example of a person with cancer - fine. Should be covered. Somebody who ODs, has attempted suicide, or otherwise is blatantly the cause of their own illness/injury, I would argue should pay oop.

Admittedly, that itself is a slippery slope. For example, what about the morbidly obese person who continually receives treatment for a multitude of associated ailments? I could argue either way, but in the end, I'll be damned if I'm going to pay for that. (Among the many other ways I will be damned...)

Anonymous said...

Hey, welcome back Crabmaster Scratch!

Mark Ward said...

PL brings up an interesting point that echoes something Crab said in his post. Our country is filled with people that are fucking fat. And getting fatter (stay tuned for a future column about this...)There is no way to sugar coat it. More and more Americans have only themselves to blame when they develop health problems.

Thus, any universal policy should have many preventative axioms in it. I don't think this is going to happen, however, as I believe our leaders want us fat and stupid.

Anonymous said...

We ought to be ashamed of ourselves, really. We are supposed to be this caring and loving country--highly moral--and look how we treat our sick people. Screw you, it's not my problem, it's your own fault. What a nation of selfish grubbers we have become.

France and Canada should pity us. We deserve it.

Anonymous said...

I make no claim of being caring, loving, or moral. But y'all probably guessed that about me anyway. If the impetus behind reforming health care is to make us more loving and moral, I'm even more adamantly opposed to it.

Anonymous said...

I hope that was a joke.

Anonymous said...

Which part? The part about me not being caring, loving, or moral? Nope, not a joke. The part about me being against reforming health care in order to make us more loving and moral? Nope, also not a joke.

I'm aware of no mandate that dictates that I must help pay for somebody to get medical care if they can't afford to pay for it themselves with cash, insurance, chickens, sexual favors, or whatever. Will I choose to help? Most likely. But I won't support writing a blank check. I reserve the right to say "No, I'm not going to help." After all, there's a reason why animals leave their sick and wounded behind. Only hubris makes our society think we're "better" than that.

Mark Ward said...

PL, thanks for summing up why, in the film, other countries pity us when it comes to our health care system.

And also illustrating what is horribly wrong with our country, wonderfully summed up in a recent post on his own blog by crabmaster. Check it out

http://blog.myspace.com/index.cfm?fuseaction=blog.view&friendID=79554559&blogID=296053826

Anonymous said...

On a parallel track, great article in the Chicago Trib, 8/5, on outsourcing mom and pop to India because our eldercare/healthcare sucks.

Everything is provided, healthcare, meds, food, nursing care using Social Security and saving enough to have family visit...maybe just our little way to give back to the rest of the world all that we have taken...dad's even off his cholesterol meds because he is now a vegetarian...course you have to speak French....so it goes.

Anonymous said...

I'm happy to be the sober Yin to your raging Yang. The fact that people in Canada, France, or wherever else perceive such a viewpoint as pitiful fails to move me. I can't condone political or societal policies based on a perception of the human condition that is grounded in entitlement. If that makes me wrong, I'm happy to be wrong.

Mark Ward said...

And yet, entitlement is fine for companies like Bechtel and Haliburton, right?

Anonymous said...

Explain...

Mark Ward said...

You seem to have a problem with our tax dollars going to lazy poor people who don't want to work. Ok, fine. So do I. But I also have a problem with my tax dollars going to lazy rich people who over charge the Defense Department on their no bid contract.

And they are wasting more of your tax dollars then Joe Schmo who wants some government aid to cure his cancer.

Anonymous said...

Lazy poor people who don't want to work are a big part of who I wouldn't want to pay for. Specifically with respect to uhc, there would be other "groups". The legitimacy of no-bid contracts notwithstanding, I also have an issue with lazy rich people.

Are we wasting more tax dollars on companies like Haliburton than we are (or perhaps, more relevantly, would be) on people I deem unworthy of medical coverage? I'm not convinced that's true. Using 2004 figures, the uncompensated care for uninsured individuals was $41B, a number that rivals any Halliburton contracts. And that's just the uncompensated portion. That's certainly not to suggest all of today's uninsured individuals I would deem to be unworthy of coverage....the point is simply that there is a significant pricetag associated with caring for people. (duh) I won't support any policy of blanket coverage, particularly if the only true selling point is that it makes vheights and truth girl feel better about themselves.

You bemoan money that is pissed away to Halliburton. I bemoan money that is pissed away on handouts to people unworthy of receiving them. Are we to feel better about ourselves in the latter scenario simply because some portion of the money isn't going into some fat-cat's pockets?

Anonymous said...

Just read HMHC's posting on the other blog. Touching, but as a whole I didn't get the point.

Anonymous said...

You didn't get the point? Y'all hatin!!

I was talking about social life in this country. I don't like the fact that it seems like the only acceptable way to meet people anymore is through some group, a mutual friend, or work. I think that because things are that way you have a lot of lonely people in this country who then dope themselves up on medication (among other reasons). I know I tend to drift off into other areas too, ah well.

As long as you were touched by it PL, that's the main point. ha

Be sure to listen to the music player on my profile. I recommend the song 12 Hundred, Mexican Radio, and Me and Mrs Jones. Maybe a little In The Navy too.

Anonymous said...

I was touched even more by that special hug my wife delivered from you to me. So I'm not at all hatin. I have no doubt that your assessment of social interaction, or lack thereof, is correct. I just didn't understand why it might be hyped as "what is wrong with our country." My anthropological skills are decidedly lacking, but if nothing else your conclusions seem to be based on generalizations formed from observations of suburban life.

Anonymous said...

I generalize all the time, we all do IMO. I think generalizations exist because they are generally true (some anyway).

I was in uptown all night last night, same stuff.

It very well could be "one of the things" that is wrong with the country...something that contributes to lonliness in many people. Then again, it's up to each individual to get out there and make a life for themselves (since Responsibility is my middle name).

Mark Ward said...

PL, wanted to make another point about health care. Remember the film Sicko is not about the "lazy" folks who are uninsured because they are unemployed. It is about people who work, dutifully pay their premiums, and are being bilked by the health care racket. The guy who lost his fingers worked hard everyday and paid for his insurance company to tell him what? One of his fingers is elective?

Stop thinking of the bad guys as people living off the government teat. Heck, with all welfare reform of the 90s, how many are actually out there? Moore wants the system changed so that people who work are covered no matter what. So do I. The bad guys are HMOs and the insurance industry.

Anonymous said...

Well, I'm in something of an unfortunate spot to try to proclaim HMOs and the insurance industry as the bad guys. Undoubtedly there are issues...I've never denied that. However, it is worthy of note that 80%+ of insured Americans are happy or very happy with the quality of their care (NY Times, ABC News). So, while HMOs and insurance plans have issues and are flawed, they often function quite well, if you are to believe those who benefit most directly.

It's no mystery that Sicko is about the working class people who get screwed by the system. Again, carefully constructed to be so.

That does nothing to diminish what I believe is patently obvious - that any replacement of the current system, while probably helping the carefully selected segment of society currently getting screwed, is unacceptably flawed if it does not attempt to eliminate money being wasted in a fashion different than it is today. I don't share the perception that money pissed away on those who don't deserve it is more acceptable than money pissed away on HMOs and insurance. Finger guy getting his fingers back may be a salve on your conscience...I guess I demand a little more from the outcome.

Mark Ward said...

At this point the only thing I demand is that our nation, which spends an extraordinary amount of money on health care, do better than 37th in the world. That is a complete and utter embarassment. Talk about wasteful spending. Clearly, the fact that it is public or private makes no difference. We are not getting a return on our investement.