Greetings from
The Publisher . . .
From SiCKO — Health Care & Health Treatment— to Mariel HemingwayAfter watching SiCKO, Michael Moore's film on health care systems, I have to agree. It's sick.
The film is eye opening. It gives a different perspective of health care, unless of course, you've experienced health care in the US, Canada, Cuba, Britain and France. Let's hope you haven't. Moore visits all of those countries, so from that standpoint, it broadens the perspective on other health care systems for most of us.
It's not only worth seeing—unless you know about all these other systems— it's difficult to have the kind of overview necessary to seriously consider if universal health care is realistic. Does it work? What are the different ways it can work? Affordable? How do doctors fare in those systems? Moore looks at that.
My one complaint about the film is that there were no dissenters to his view from those countries with universal care. Are they that good? Then again, the film was 2 hours. Why spend very much time on the inevitable objector when most of us know so little about how other systems work?
Those who did say it wouldn't work here were not from those systems—they were our politicians. They had many reasons why it didn't, wouldn't and couldn't work—and definitely shouldn't.
After seeing the movie, however, you have to wonder if they are better labeled as our elected representatives or simply insurance and drug company barkers. For those mentioned, the amounts of money they receive as political contributions from insurance and drug companies were much more than their salaries as representatives. It would be interesting to get all the figures. Perhaps we have a universal version of care after all.
Did you hear about the Representative who thought Americans should get to choose which type of health care system they wanted and included as an option the same health care that our Representatives get? It didn't go over too big. Not much support for that one.
I wonder why Congress isn't provided health care by the insurance companies who give them donations? After looking at health care costs it might be that it's cheaper to give them each $200,000. That's how much Fidelity Investments recommended (March 2006) that a retiring couple have in savings just to pay for basic medical coverage.
President George Bush and Sen. Hillary Clinton each received more than $800,000 in political contributions from the health care industry. It's mostly nonpartisan.
Moore points out that there are four health industry lobbyists for every Congressman. He invited 200 of these lobbyists to view SiCKO and 11 showed up. They must have bought their own copies already.
Overall I think you will find this either a sad or mad movie. You can be sad about what goes on or mad about it, or both, at times. I think it would be difficult to be indifferent. Who in the world is not emotionally or intellectually—or totally—involved with our health system at some point or several points in their life?
There are important things to consider as we look at universal health care—choices, for instance. It's important to question what Moore may have missed. At the same time, some reviews of the film are simply not close to what is portrayed in the film.
Daniel Weintraub, who normally covers California's political news for the' Sacramento Bee , wrote that he worried about “the ever-expanding government Moore advocates.” He took some of the comments, on laundry for instance, very seriously. I took them as Moore pointing out the irony of how little our system does compared to other systems that will do your laundry.
Weintraub is afraid that a government bureaucrat will be deciding if an operation will be approved or not. Not one country Moore visited took that decision out of the hands of the doctor who was treating the patient, however. Insurance companies do.
Weintraub also stated that not all care, nor every operation can be provided for by the government,”“especially experimental care.” Will there be a waiting list for operations we need? Good question.
The film contrasts these decision makers. Who would you rather have making the decision? The American M.D.'s who review claims and are paid a bonus if they deny coverage to more people that the rest of the reviewing physicians in their group? Or the British doctor who is paid a bonus if more of his patients quit smoking, or takes early prevention tests that can predict illness?
Weintraub doesn't identify who does pay for experimental care. Universities or institutions studying with grants, perhaps, but insurance companies certainly don't. If someone has the kind of money it takes to buy experimental care, they could probably be able to buy it somewhere in the world. But should that determine whether a health system works or not?
The tragedy is that the list of pre-existing conditions that can deny us insurance—and care— is encyclopedic. In comparison that list is non-existent for common medical practices in countries with universal health care. The doctor caring for the patient decides.
Moore adds his humor and sense of irony throughout SiCKO, of course, but the film doesn't leave you laughing. We're the worst industrialized country in the world when it comes to longevity and infant mortality.
This may change, however. Import and outsource much more than we are now and there may not be enough industry to consider us industrialized much longer.
We claim to be the richest nation in the world and can't afford universal health care—but Cuba can. Think the worst about them, if you will, but isn't some care better than no care? Are we really rated high enough—37 th —to worry about dropping down the list.
The most disturbing part of SiCKO is seeing the close connection between health care and money. Moore asks us if the way it is, is how we want to define how much we care.
After seeing SiCKO I'm more inclined to think of our system as Health Treatment. The caring can come from individual practitioners, but it's not really part of the whole system. Many involved simply don't care. Just wait until you see the origins of HMOs.
Several of the more humorous sections dealt with our fear of socialized medicine. Moore shows how we have socialized fire protection and socialized police protection—and even a socialized library system——and don't think twice about that.
What's missing from the debate is alternative medicine and some fear restrictions on those approaches. Given how restrictive insurance coverage is now for many treatments, it is hard to believe it could become more restrictive.
The key is keeping our ability to choose. Most of us would continue to buy our supplements and pay for alternative practitioners that insurance won't pay for now. Universal health care would be there for the worst-case scenarios and like now, some doctors will be more open to alternatives than others. Keeping doctor's and patient's options is a vital element to a working system. It's too early to know about that.
A recent study concluded that dietary supplements could cut health care costs by $24 billion. If such studies gain acceptance we could find ourselves being encouraged to take supplements by doctors. Who knows for sure?
In conclusion, I realize that here I am, deja vu all over again. I finished here last month, though I did come from a different direction.
But again, in the US, as is often the case, it's up to the us part of US to take care of ourselves as best we can. In a preventative sense, who could be better?
But while eating right and exercising are often said to be our role in staying healthy, there are still no guarantees—and there's much more to it. What we know is that stress is the number one cause of disease. That doesn't go away simply because we exercise and eat right.
Going full cycle, as Mariel Hemingway shows in her book Healthy Living from the Inside Out (our cover article), that's a start. It's perhaps half of it. And her system can reduce stress.
Health also includes our inner and outer environments—but that's enough. I'll let you explore that. I think she really addresses the missing elements in our health care system—and our health.
I'll leave it to you also to see how SiCKO—contrary to what many people say—is by far Moore's most political film. It's just nonpartisan political. As you watch, just think in terms of how our representative democracy is based on participation, and how our health treatment system influences that.
Have a great month,
Steve
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