I saw Michael Moore's latest film, Sicko last week. I have been thinking about ever since. Like many of Moore's movies, this one glosses over several realities to make a larger point. The larger point in this film is that American's have a vaules problem. We have a highly individualistic society and as such, we fail to place enough importance on communal values.
I don't disagree with that point. European democracy is social democracy. And that, in my opinion, is closer to the enlightenment ideals than our capitalistic democracy. Just the words I used to describe the difference tell the story. So Moore's larger point is well taken. Medicine is a social good and should be treated as such.
But then there are the details. He visits a NHS doctor in the UK. The doctor who is part of "socialized medicine" drives an Audi and claims to make $150K a year. You get to see the inside of his comfortable and fashionable apartment. He explains to Moore that if he gets patients to say stop smoking, he gets paid more. So doctors get results based pay. So my question is, how typical is this doctor in the UK? If doctors are so well paid, why the shortage? And this has a whole new relevance considering this week's terrorist plots in the UK. That, and Moore fails to mention that Brits have been demanding reforms of the NHS since Blair was first elected.
Then he goes to France where he tries to counter the claim that Europeans are over-taxed for their services. He introduces us to a two-income family that claims to make $8000 a month. It is unclear if this is net or gross. But if it is net, then it ain't your typical French family. The typical French family makes about what the average American family makes annually. A more effective argument for Moore would be that if Americans counted the cost of their medical care as part of their taxes, they would find that we actually pay a greater percentage of our gross income if not the same for less. Nor does he discuss that France has double-digit unemployment because companies don't want to hire full time workers because they have to pay out extra taxes. Sounds sort of familiar, no? Nor does he discuss France's debt problem or the fact that European countries are struggling with shrinking birth rates, which then leave them with fewer people to pay for the growth in the aging population.
That said, the French get great benefits for all their taxes. My host dad was very sick and had to have very expensive treatments that would have put the average American into bankruptcy. He had 3 years worth of interferon treatments and is now in remission. He didn't pay a dime. And, yes, doctors do come to your house when you are sick. And yes, you are well cared for. I love that part of the system and would love to see it implemented here.
The French also control their government a bit more than we do. Moore also points out that we Americans are somewhat afraid of our government while European government "fear" their people. Europeans (i.e. the French in this case) hit the streets and protest and the government gives in, not to mention in that in parlimentary systems, governments can be dissolved and elections called very easily. So politicians are a bit more concerened with social unrest.
American's have always distrusted government, but I think the fear set in around the Nixon years and has only increased in the Bush/Cheney years. Further more, we hold elections at set times, we can't just see our government dissolve over night. We are stuck with it for 4 years. On this fourth of July, I say that if our Revolution had started with the violent storming of a nortorious prision followed by the beheading of the nobility, then perhaps our government would be more "afraid" of us as well.
Then he goes to Cuba. Now that is a tear-jerking moment. It is truly touching and again, Moore's larger point is well taken. But, Cuba has a special health program for foreigners. So while he asked the Cubans to treat his band of Americans they way they would the average Cuban, I question if that really took place.
Finally, Moore is focusing on those people who have insurance, but whose insurance companies have denied them care. And he is trying to get those of us with "good" insurance to think again. Will it cover us if we need it? Chances are no. He also exposes the insurance company hit men who will dig back five years into your medical history to find out that you had a yeast infection in 2002 that you failed to mention on your application form. And they will declare that this is a pre-existing condition that you should have mentioned. Since you didn't, they are revoking your coverage. Again, I am not sure how typical this situation is.
Overall, I agree with Moore that our medical system is very messed up. I agree that our individualistic, capitalistic values system contributed to the attitude that everything is for profit. Doctors should practice for the purpose of helping patients, rather than their pocketbooks. And I think there are those that do, and those that don't. I think we have a shortage of doctors in this country as well. We should be building medical schools rather than prisons and limiting the role of insurance companies. I don't think they should be traded on the stock market. This is about our health and well-being and how we care for each other. So for all the loose facts, I still think Moore is on track.
Wednesday, July 04, 2007
Sicko
Posted by USWest at 9:41 AM
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11 comments:
Here is a link to a World Health Organization list of major health indicators for a large number of countries:
http://www.who.int/whosis/database/core/core_select_process.cfm
Perhaps a subject for another thread but I'll take issue with the idea that communal concepts of democracy associated with the ideologies of social democrats (not the majority view in Europe by the way) are closer to the ideas of the Enlightenment.
Any reading of thinkers like Locke, Jefferson, Madison etc will show that the rights of the individual are everywhere the foundation of all political legitimacy.
Social Democracy as espoused by European parties of the center left is a product of a later time - the late 19th and early 20th centuries.
The United States Constitution is absolutely the best example of how the ideas of the Enlightenment can be put into institutional form.
Whether you think that's a good thing or a thing worth modifying is a different question but I have no doubt that the founding fathers would have overwhelmingly opposed socialized medicine. But then they were a bunch of rich, white, rural elites living 230 years ago.
RBR is a bit more versed in the Enlightenment and European Democracy than me. And I 'd like to see a post on this. Correct me if I am wrong, but didn't Locke say something to the effect that private property was key to democracy. But that in taking private property, one should take only enough to sustain one's family and perhaps a bit more, but to leave enough for others? I recall having read that somewhere. This may be case for going back to the Federalist Papers, which we all need to do from time to time.
I would argue that in all of the talk about individual rights and such, there was still a notion of the role of government to protect its citizens and ensure domestic tranquility. Perhaps it is the feminist in me, but protecting domestic tranquility and protecting me also means making sure we have education and health. I think all of the enlightenmet philosophers understood the need for a healthy and educated public. The context in which they lived was very different from ours today.
They lived in colonies who still had deep communal ties, where people still brought food to the neighbors and help rebuild houses after they had burned. We still to that to a certain extent. But we lack, I think, a sense of collective fate. We have this attitude that "I send my kid to private school, so why should I pay taxes for public school?" We don't stop to think that we benfit from have everyone educated. These are social goods. And the cost benefit analysis should justify certian community programs like health and education. Moore points out that we have already "socialized" the police and fire department. And there are movement afoot to contract that out to private companies, the way we have with ambulance services and utilities. All of that is well and good, but that we lack adequate regulation to make sure these companies are delivering as promised.
I don't think this was a problem in days of the Constitutional Convention. Protecting individual rights does not mean forgeting community needs. We still live collectively after all.
I think this is Moore's best movie by a mile. Scenes still haunt me.
I look forward to seeing the movie if it ever comes to my little town on the prairie.
As for the founding fathers...it is interesting to speculate about what they would have supported if medical science had the capabilities it has today. Back then, they were barely beyond leaches and bleeding sessions. Staying healthy was largely a matter of avoiding the doctors in the first place.
On the one hand, Sicko fails to adequately address the cost/tax issue (as USWest points out). But it still succeeds admirably in its key point: to show that America's health care system is broken and we can do much better as a society if we think of it as OUR problem rather than each individual person's. By refraining from making any recommendations, Moore makes his movie more powerful.
Ha , Ha RBR! I still think we should stay away from doctors! I'm not convinced that they have my best interests in mind all the time. My great grandmother lived to be 98. She stayed as far away from doctors as she could for as long as she could. She once went the doctor for something and he gave her pills. She cam straight home and threw them in the toilet.
She broke her left hip, and while on the gurney in th hospital, got so angry with the nurse, that she kicked the nurse in the face with her right leg. It was, in the end, the hospital that killed her when they punctured her lung with the feeding tube.
Just a quick FYI that I forgot to mention, but Sarkozy's new government is talking about introducing a "small" fee for medical services as part of its reform package. This is in large part due to the high debt burden that the French government is facing.
In addition, it wants to put a 50% cap on the percentage of taxes that can be taken from any one family. That tells you something!
On the off chance anyone reads this (I'm about a week late, I know)
On the weekend previous to this post, I was in Colonial Williamsburg, and had an interesting conversation about colonial health care with the woman hosting the apothecary there.
According to her,
(a) while you got _treatment_ from a doctor, it was understood that it was up to the individual to actually do the "getting better". Perhaps unsurprisingly, they knew that the leeches, etc., that a doctor might offer were no cure-alls.
(b) physicians took the Hippocratic Oath seriously (it's an Oath, after all; people held them to it). If someone needed a doctor, the doctor had to treat them, whether they could pay for it or no. (If, as was usually the case, an ill person couldn't inform the doctor of his or her predicament, the physician was understandably not responsible for not treating them.)
Kinda includes both the notions of individual rights & responsibilities and communal obligations.
Ah, all too true , Bob. My friend has smoked for years and years, through 2 pregnancies and the nursing that followed, in fact she is just finishing up the second one. The whole time, she defended her right to smoke, refusing to admit it was an addiction, or if she did, rationalizing it.
Now, she isn’t feeling good any more, and is convinced it the cigarettes. She has heard of the latest “stop smoking” drug, and she wants it, NOW. She is angry that her OBGYN told her to go see a GP for such things. She is angry. I am glad she is finally taking responsibility, but I don’t understand she expects everyone to hop to and deliver her some miracle drug. Guess they all better hurry before she changes her mind!
Changing the subject: The Economist recently pointed out that medical care in the US is so regulated that we already have a hybrid system. The argument they put forth, not surprisingly, is that the health market is so regulated, that they system is overburdened with the extra costs. It claims that things should be left more to market forces, that the regulation costs get passed to patients, and that the FDA either sits on helpful drugs too long or not long enough.
The economist points our that employer provided health care is tax free since it is paid for with pre-tax wages. This, the Economist says, is a type of government assistance.
The argument is interesting, but the Economist failed to discuss market failure, or the morality of leaving certain things, like say health, to the markets.
The Economist is written by politicians in many instances, so take what they say with a grain of salt. You can tell the article you site was written by one because he / she says we are over-regulated....sorry, but bullshit. (In our current facist global order, they want to de-regulate everything). If regulations were so heavy, then we wouldn't have all of the pharmaceuticals that get cleared and advertised, we take 'em and they pretty much kill us. the disclaimers on those drugs are huge and who would put that shit in their system. And what is with the nanny state about smoking? The way to help prevent the illness smoking causes is to stop the cigarette companies from putting in 576 additives that are addicitive!!!....then it's just nicotine and tar...I don't think that's any worse than alchol. I'll make a deal with all of the people that think smoking is the all evil health care cost: I'll pay (the public), as some have suggested, for all illness related to smoking if all non smokers will pay for all of the comma's and heart attacks caused by the new drugs and for all of the artery cloggin food they eat at McDonalds and everywhere else....let's see who has to pay more. this country has completely lost it's mind.
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