Who are we? What have we become?
In Michael Moore's SiCKO, he asks those two questions of Americans.
I thought about this a long time. Most Americans aren't bad people. Granted, the crowd I hang with is an educated, intellectually curious group of artists (hell, I work in theater and for NPR) and obviously don't represent the mainstream American, but my father is an independent real estate broker in the heart of central Kansas, my mother works with him, my sister is a teacher in Kansas, and my in-laws are both a real estate broker and retired teacher in North Carolina. I know people on all sides of the political ideological divides, church goers and atheists, blue collar workers and professors, and I can state pretty assuredly that I don't know any bad Americans.
On the other hand, according to recent polls, a full 40% of Americans still believe that Iraq was in league with al Queda in the 9/11 attacks, a myth that has been disproven over and over (even though Bill Kristol and Ann Coulter continue to openly lie about it when both know better). Americans complacently watch as our government stomps around on the sovereign rights of other countries, slowly leaking our corporatized lifestyle into the mix and all the while allowing millions of their fellow countrymen and women to starve, freeze, and waste away in the streets.
Our feigned ignorance is mystifying. The New Yorker reported in 2005 that the death rate in any given year for someone without health insurance is 25 percent higher than for someone with insurance. When you factor in the denied claims and unscrupulous practices exposed in SiCKO it's amazing that our politicians seem to do nothing but gut funding to health care programs for the poor and the elderly on a fairly regular basis while likewise cutting taxes for the super wealthy and that we, the people most adversely affected by these policy changes, don't start beheading the rat bastards selling us out.
A huge part of the problem we face is that our news organizations have become less and less upfront about telling us how things are and more and more about parroting the corporate line. The media selectively ignores the slow bleeding of our existing health care programs and spins the lies of the HMOs and insurance magnates and we (at least a solid percentage of us) believe the bullshit. As an example, we saw nearly 24-hour coverage of self-righteous assholes claiming to try and save the (non)life of Florida vegetable Terry Schiavo but heard virtually nothing about these same politicians attempting to shred funding to Medicare at the same time.
Article comments
— go to most recent comments1 - Dave Nalle
profit is evil! destoy all doctors! destroy all insurance companies!
seriously. for there to be an absolute 'right' to healthcare you're suggesting we have the right to force other people to pay for it and to force doctors and hospitals to operate at a loss and provide free services. what's to stop them from exercising their right to be in a different business?
wait, i know. we can select 12% of all college students who do well on their math SAT and then threaten to arrest them and kill their families if they don't go to medschool and work for free for the new government health clinics.
ever checked the data on how well socialized medicine is working in england?
but seriously, i can't wait until part 2. knowing people who choose not to have health insurance i'm eager to give them your explanation of why they don't exist.
btw, what's wrong with just applying reasonable regulation to the healthcare industry?
dave
2 - Les Slater
I am fortunate, I have BlueCross / BlueShield Network Blue. I still have to fight like hell sometimes, but it is still much better than many other (most?) private insurers.
One company employed a Benifit Administrator type of outfit. Their main purpose was to discourage any payments for services rendered. They always had fax machines that conveniently and repeatedly, lost faxes. 'Well never got it; could you send it again?'
These shady, and should be criminal, practices are common. I would have no qualms, whatsoever, in destroying these fuck'n leaches of companies.
Free comprehensive health care for all. And yes, if there were medical university programs that were free to qualified applicants, you would not need a gun to get them to enroll.
Les
3 - bliffle
Strawman, Dave:
"#1 â€" July 11, 2007 @ 11:39AM â€" Dave Nalle [URL]
profit is evil! destoy all doctors! destroy all insurance companies! "
Some bad spelling, too.
Stop the insanity!
4 - bliffle
I'll argue that free universal healthcare in the USA would reduce total healthcare costs. How? Consider this: gross operating margins of for-profit health insurance cos. is about 40%. For gov medicare it's about 3%. Therefore, there is a 37% premium margin to private ins. cos. About 40 million US citizens are uninsured, about 15% of the population. therefore the 37% of unnecessary premium can easily cover 15% more people, all things being equal, and still leave , say, 22%, which would result in a net reduction in healthcare costs to the US public.
Therefore one can maintain that UHC would reduce net burden on US society. No healthcare rationing necessary.
And this is borne out by reference to foreign UHC systems which always operate at lower cost while providing universal care.
5 - Dr Dreadful
ever checked the data on how well socialized medicine is working in england?
At least it's there, Dave. As one who's experienced both systems (if you can call the American setup a system), let me tell you how nice it is to walk into and out of a doctor's office without having to pay; without having to worry how desperately a major surgery or a lengthy hospitalization is going to financially cripple you.
It's not perfect by any means: many hospitals and other medical facilities are old and inadequate; a significant number of doctors and other healthcare professionals are incompetent; you do have to pay copays, at an ever-rising rate, for prescriptions; and waiting times for many major surgical procedures can be years. But it's there.
Those who can afford it do have the option of buying supplemental private health insurance. Many people do so, continuing to use their state health service for most medical needs - turning to their private care only when the NHS can't cut the mustard.
Furthermore, from what I've seen - especially with HMOs - the standard of care in America isn't that much better.
6 - Les Slater
The Cuban healthcare system has a lot of shortcomings and the country is third world country that cannot afford a huge outlay in medical equipment and supplies. However their health statistics are very good, comparable to the wealthiest of countries.
Their system trains all their medical professionals for no cost to them as students. In fact they are paid. They do not end up with ridiculous loans to justify exorbitant fees. There are no parasitic insurance companies. They also have a significant pharmaceutical industry that provides much of the medication and a significant hard currency income.
Many people ask why a country like the U.S. can't emulate such a system. The answer is that the U.S. medical system is not designed to serve people. It is designed, and needs, to make a profit.
You can imagine the taxes people have to pay. Right? There are no payroll taxes in Cuba. Housing, although inadequate, is very inexpensive. Food lacks sufficient availability of variety but the caloric intake is quite adequate and the population is very healthy. There is no malnutrition.
7 - Lumpy
I'm looking forward to the 500 percent increase in prostate cancer deaths. We've got too damned many old men who like to drive really slowly on the highway anyway.
8 - REMF
Clavos;
Please read #7 and then tell me you still feel sorry for Lumpy because of his (alledged) handicap.
9 - Clavos
Hell, I agree with him, and I've GOT prostate cancer!!
10 - Ruvy in Jerusalem
Having lived in America with a BS/BC plan similar to that of Les Slater, and having lived in Israel with its universal health care, I honestly have to say that I prefer the system I live under now, in spite of many faults that it has.
To be blunt, Americans are fools to get all bunched in the shorts about universal health care. Some systems are better than others, and there are always ways that hospitals can save on what are really peripheral expenses (like throw away everything instead of sterilization and having a good laundry system) and concentrate on patient care and research.
Given that Michael Moore is a Jew-hating son of a bitch who is nothing more than a filthy fat slob who needs a serious operation to get his stomach smaller, I should condemn his movie. But if it takes a skunk to warn you that the dam upstream broke, it is best to ignore his stink and pay attention to his message
11 - Don Hall
"Michael Moore is a Jew-hating son of a bitch"
Whah?!? While not having anything to do with the discussion of healthcare, I'd love for you to elaborate on where you get this...
12 - sr
Hey Don, Ruvy forgot to mention that Michael Moore also eats shit and smells like it.
13 - Ruvy in Jerusalem
Don,
I'll answer you off-line... The subject is not at all germane to health care.
14 - Baronius
This article fails to explain why health care should be considered a right. Rights are pretty serious things. Is health care a human right or a civil right? What level of health care do we have a right to? By what means to we recognize that right? No set of statistics or complaints about Ann Coulter automatically confers a right.
15 - Alec
Don - An interesting and provocative post that lays out some of the issues, well, but I must take issue with you on a few things.
RE: FACT: Approximately 85 million Americans were forced to go without any health care coverage sometime between 2003 and 2004.
FACT: Health Insurance Companies are making unbelievable amounts of dough. In 2004 alone the Big Four HMO's reported $100 Billion in revenues. That's $273 million a day, every day. According to the Fortune 500 listings, these companies increased their profits 33% in 2005 and an additional 46% by 2006.
These facts may be true, but are not necessarily all that important. The bottom line is that many Americans go without health insurance because they don't need it. They don't have any significant health problems during the year or none that they cannot pay for out of pocket. Some people, especially those who are lucky enough to be young and healthy, choose to do other things with their money (and I realize that you will argue in an upcoming post that no one chooses to go without health coverage).
Secondly, I recognize that there are some who think that profits, especially related to health care are bad. Strangely, many of these people would also not set aside any money for research and development or innovation. In their ideal health care system, all money is always allocated to current care. This, briefly, is nuts. Setting up a national health care system because you want to deny profits to investors and shareholders will not guarantee better health care outcomes. Revenues that would otherwise go to "evil" profits will just end up going to equally evil waste, corruption and mismanagement.
There just is no such thing as free and universal health care. Somebody has to pay, and shortages inevitably occur when people can demand more services than they are actually paying for. Misallocations will occur when bureaucrats or activists make medical decisions, just as they do when insurance companies can overrule doctors. It's just a choice of incompetents.
Moore's "Sicko" is so obviously a one-sided polemic that it is pointless to use it as a guide to anything. It is, in fact, a great example of the worst aspect of self-described progressives, namely an appeal to a kind of infantile solcialism, where every political decision is made on the basis of feelings and compassion, not effective public policy or economics (not even Eurpopean socialism along the Scandinavian model, for example).
He doesn't really add anything useful to the debate about health care, and his depictions of the French, Canadian and UK systems are patently phony. Just google, for example, "canadian health care supreme court," and you get stories from June 9, 2005, when the Canadian Supreme Court struck down a Quebec private health care ban which forced all citizens into the state system, precisely because patients could not get timely access to health care and some died as a result. See, for example
There is also something disgusting about Moore's approval of the Cuban health care system, which depends on restricting the ability of doctors to leave the country or to make independent decisions about their own lives or medical practices (under the dubious rationale that since the revolution provided for their education they are obligated to "serve the people"). For political and economic reasons, Cuba has had to send large numbers of doctors to Venezuela (healthcare for oil), which reduces the number of doctors available to the Cuban people, and the use of "alternative" and herbal medicines in the Cuban health care system is little more than junk science.
There are also problems with the UK and French systems. But the bottom line is that even if you think that health care is, or should be a right, the hard question becomes, "how much are you willing to spend for it, and what you will do when inevitable shortages and hard decisions come up.
16 - Lumpy
The reason why we don't have universal healthcare now and may never is simple. Bad though the current system is, based on past experience we have zero faith in our government's ability to better and know that with them involved thw cost will be outrageous.
Right now we're tilting on the brink of giving up. We're overtaxed and overregulated right to the limits of what we'll put up with. Another massive bureaucracy and the asociated cost will be the straw that breaks the camel's back.
The only way I can see people putting up with socialized medicine would be if a whole bunch of other gocernment excess was done away with. At a minimum we'd need a more equitable tax system and privatized social security.
Otherwise I see revolution coming.
17 - Triniman
What's wrong with profit? Should all elementary and high school teachers be able to make a profit? If they are denied it, the fear is that the best of them will leave for greener pastures. Is that happening?
What about for-profit police and judges? If we don't have a for profit police system, the best of them will quit and go elsewhere where they can really make a handsome income.
If the US decided to implement universal health care, it probably could not do so. There would be many frivolous lawsuits. The insurance industry lobbyists would crank up the heat and spread fear. Examples of the shortcomings of the systems in the UK, Canada, etc., will be trotted out, much like a Michael Moore film in reverse.
Nope, there's no way that the US could possibly ever hope to implement universal healthcare. And despite the imperfections, those who have universal healthcare in other countries won't want to give it up.
What we need are films that answer Michael Moore, to show that things are best left the way they are in the US. There's a huge profit to be made for such filmmakers.
18 - Les Slater
Triniman,
I liked your last paragraph best.
Les
19 - Doug Hunter
"The richest country in the world is ranked 37th out of 191 countries in terms of the quality of its healthcare system."
That's a totally bogus number put out by some leftist UN bureacrats. They've got plenty of mileage out of this propaganda though, the sheeple have been parroting this like mad.
Why is it propaganda? It blends actual healthcare metrics with socialized medicine criteria (government run systems get major bonus points just for being socialized regardless of actual health outcome) The US low score doesn't show we have poor healthcare it shows we don't have socialized medicine.
20 - Lumpy
If you look at the relative death rates for the most common causes of nonviolent death the US looks a hell of a lot better than countries like germany where fast acting diseases kill you during the 6 months you wait for treatment.
21 - bliffle
Plenty of arm-waving and threats from the anti-UHC crowd, but nothing factual, nothing reasoned, nothing mathematical.
What say you anti-UHC enthusiasts to my argument in #4?
22 - Les Slater
Alec,
"I recognize that there are some who think that profits, especially related to health care are bad. Strangely, many of these people would also not set aside any money for research and development or innovation. In their ideal health care system, all money is always allocated to current care."
'Many' of that 'some' is less than the original 'some'. Who, what, are we talking about?
The term 'profit' here is also mystified. At least when I talk about 'profit' I am referring to private 'profit'. A medical system does not have to make any 'profit' in any sense, except if you consider the health and well being of a population profitable. This profitability, the well being of the population, considered in a social sense, is a necessity, especially to the working class.
The cost of research, and the maintaining of the system itself, would come out of surplusses in other areas.
Les
23 - Clavos
bliffle,
After two years direct experience with Medicare, I find your figures regarding the savings inherent in government provided health care to be misleading, at best.
Because of Medicare policies, my wife keeps getting booted out of hospitals before, even to my layman's eyes, she is ready to go home. As a result, she's home for a few weeks (a couple of times a few days) and then it's back to the hospital, usually involving an even longer stay.
Consequently, over the past 22 months, she's been in the hospital for 11 months, 2 weeks - more than half of the time. The cost to the taxpayers is approaching $500K, with no end in sight. The cost to her, in terms of lost quality of life, pain, etc., is immeasurable.
During that time, I've discovered such cost overruns as:
1. A wheelchair for which Medicare paid $4,500, and which I could have bought directly from the same mfr's website for $2,100.
2. A handicapped toilet seat which, because of Medicare policy, is rented, not purchased, from the provider, at $25/month. So far, the taxpayers have paid $550 for an item that retails at $150, and the clock is still ticking.
3. A hospital bed which is also rented. I haven't crunched the numbers on it yet.
4. A walker (retail $75) literally forced on her because "Medicare requires you to have it" for a woman who is paraplegic and can't walk.
The list goes on, but you get the idea.
bliffle, nothing the government does is less expensive than the private sector; have you forgotten the famous $600 hammers?
24 - Christopher Rose
Clavos, the treatment your wife has received is undoubtedly shoddy but I don't think that necessarily means state run medical programs are bad. The examples you cite are of a badly run and inefficient program but surely that only means it's badly run, not that it has to be...
25 - Les Slater
Alec,
"There is also something disgusting about Moore's approval of the Cuban health care system, which depends on restricting the ability of doctors to leave the country..."
And then "send[s]large numbers of doctors to Venezuela (healthc are for oil)..." and many other countries too, most without substantial, or any, payment. Cuba also trains people from other countries, including the U.S., to be doctors, for free. They also set up medical teaching facilities in other countries.
"...which reduces the number of doctors available to the Cuban people...". And there are still more doctors per capita than the U.S.
"...the Cuban health care system, which depends on restricting the ability of doctors to leave the country..."
First, the U.S. government restricts your right to travel freely. You can go anywhere you want as long as they say it's ok. You are not allowed to go to Cuba for instance.
"... or to make independent decisions about their own lives or medical practices"
What do you mean? The right to set up medical practices? Usually when I have gotten a job in the U.S., I have had to sign documents saying I would not go to work for a competitor, and those bastards didn't pay for my education either.
Les