Sicko the movie

Last night I watched Sicko, Michael Moore’s film about the U.S. healthcare system. I’ll give you some time . . .OK, now that you’ve recovered from the mention of the hated film-maker, can we move on? It was a movie that was disturbing, revealing, compelling, funny, infuriating, pandering, provocative, silly, and meaningful all at once.

The movie starts by telling some stories about people without insurance, one of which had to choose whether to reattach his middle finger for $60,000 or his ring finger for $12,000, or neither. It moved on to HMOs, the rigidity of that system, and the results (including a frightening recording of Nixon ). It also tells how a child died because the hospital she was taken to didn’t accept her insurance.

Then it goes to countries with “socialized” medicine, Canada, the UK, and France, in order to dispel the image Americans have about wait times, obsolete equipment, substandard doctors, etc. He talks to Americans who live in the UK and France who love the health systems there.

He takes some 9/11 rescue workers who now suffer respiratory and PTSD problems (who can’t get medical help from the government or their HMOs) to Gitmo, having heard from the federal government that the detainees there have great health care. Needless to say, he doesn’t get them in, but they are admitted and treated in a Cuban hospital by good staff with up-to-date equipment.

Finally he asks some very hard-to-answer questions, like: What kind of society dumps people who can’t pay their hospital bills on Skid Row or at shelters? Why do we accept universal schooling and publicly-funded libraries, but not healthcare? Where are our priorities and why do we feel that some deserve help while others don’t?

It was a very thought-provoking movie. On the whole it was very worth the watch.

8 Comments

Mike W. says:

Initially this movie was supposed to be about the pharmaceutical industry, which I think needs a Michael Moore-type harpoon. Having not seen the movie and only heard about it, here are my two sense from someone in the medical profession.

1. Healthcare costs are obscenely high in the U.S. The main reason is that people want their care now!!! They are unwilling to wait a week for the non-emergent MRI that will do nothing except give a back surgeon a reason to perform an unnecessary surgery that will not fix their back pain.

2. Sometime I think that I make more money than I should (I know I make more than I need, but that’s another story) and that equalizing the pay of physicians would help slow some of the rising costs. If those who practice preventative care were paid as much as those who practice therapeutic care, the incidence of disease would likely drop as more people would enter the severely undermanned primary and preventative care portion of the U.S. healthcare system.

3. The U.S. medical structure is set up to help you after you get sick, not help you to keep from getting sick.

4. HMOs aren’t as tyrannical as they used to be. Society has created a significant enough legal back lash against the stories that Michael Moore seems to be telling that they are rare occurrences. Additionally I think that you could find stories where the wait to get into the system in countries like Australia, Canada, etc. have led to unnecessary deaths.

5. Smart governmental funding of healthcare is not a bad idea. The problem is the ‘smart”. Often we think that bigger is better and that a federal program must then be better than a state or local program. This is almost always not the case (given equal resources). I have no problems with some governmental-funded healthcare as long as it is administered locally.

6. Certain Medicaid laws are ridiculous and this creates the fear that future federally-administered health care would have similarly silly laws. For example, there is no co-pay for a medicaid visit to the ER but there is one for a visit to the pediatrician…where do you think those who have no cash will then go for their primary health care at a 4-fold increase in cost to the system?

7. There is a law that was implemented in the 1980’s when private hospital ERs were turning away non-pay patients from their doors. Often these patients were very sick and needed emergency care. This law, EMTALA (Emergency Medical Treatment And Labor Act), was enacted to prevent such inhumane abuses. However, it went to far to the point that every person who comes to an emergency department must been evaluated and treated for their condition. This includes abdominal pain that has been going on for 5 years, headaches for 3 years, wanting a pregnancy test, wanting a drug test for their child, anything. The cost to the system is huge.

All that said, there is a profound need for profound reform in the health care arena. Increasing regulation requires that physicians spend more time with paperwork than taking care of patients. I could go on and on. Fundamentally there needs to be a shift from treating the patients after they have fallen off the cliff to emphasizing the dangers of getting to close to the cliff and teaching people how to avoid those dangers.

Moore seems to have taken the worst possible cases and painted them as if they are very common. It would have been better to deal with the day-to-day, run-of-the-mill type problems that are bankrupting the system and preventing those who need care from getting it. Unfortunately his solution is to federalize the whole thing.

Centrist says:

Mike, I was interested to see what you as a doctor would say. I think it’s good to see things from an insider’s perspective. I agree that Moore was very selective in the stories he told and very careful in the stunts he pulled. However, that does not change the underlying problem that Americans can’t afford healthcare. I count myself fortunate that i have insurance, but if I needed a liver transplant or incurred hundreds of thousands of dollars in medical bills, my insurance will not keep me in my house and out of bankruptcy. We’re the wealthiest nation in the world, but that wealth doesn’t keep us from getting sick.

Another benefit to universal healthcare would be getting rid of Medicaid and Medicare with their arbitrary rules and complexities. A universal system would cover everyone for everything. People would be more willing to see their doctors for routine check-ups and less acute problems if they could get in free and that in turn would allow the problems to be caught at an earlier stage where they are less costly to treat.

So if we don’t federalize the system, what other alternative is there to make sure no patient left behind (did I leave out a word there)? Anything besides universal coverage for everything will continue to expose the least fortunate to the ravages of some incomplete system. Capitalism and ‘the free market’ aren’t going to become the city of Zion any time soon.

Centrist says:

A day or two after watching the movie, I watched the bonus material. There was a particular extended interview with a British MP named Tony Benn that was VERY interesting. His seemed to be the kind of mind a liberal education would produce, drawing parallels, contrasts, relationships, and conflicts among many disciplines. It may have been the best part of the show. If you don’t want to watch Moore, watch the interview with Tony Benn.

Mike W. says:

“Capitalism and ‘the free market’ aren’t going to become the city of Zion any time soon.”

LOL. Which reminds me, did you ever read Approaching Zion?

Regarding the universal payor: it’s theoretically a good idea, but there are a few problems that must be considered.

1. Our appetite for health care must change or a universal payor system will bankrupt the system. We must be willing to let our elderly die without 10 hospital admissions during the last year of their lives. I think that I mentioned in a comment on a prior post that in GB, no one over 70 is admitted to the ICU and no one over 85 is admitted to the hospital. I don’t think that Americans who want to do what they want to do and won’t let anyone tell them otherwise will be willing to accept that.

2. The government wage bureaucrat has no vested interest in doing his job well. Neither do government wage nurses. If you want to see frightening levels of nursing care, visit a VA Hospital. These nurses have more job security (being a government employee) that a tenure professor. They can provide dangerous care for years without being reprimanded.

I know that I am throwing up all kinds of questions. It’s just that I worry that if we rush headlong into “government as the solution” solutions there will be many unseen consequences, just as there are with believing that business is the solution to all the problems (see my comment on your most recent Bush rant).

I would be interested in the interview with Tony Benn. Is it on YouTube?

Mike W. says:

I want you to know that you are distracting me from preparing my lectures on Intro to Political Philosophy and Isaiah and Hebrew Justice and Equality.

The Tony Benn interview was great. I agree with almost everything he said–Except, I don’t see government as the solution to the problems. I see human beings and families and communities as the solutions. Benn is exactly right in that Jesus wasn’t the MP from Galilee North. His doctrines are for individuals and families to implement. He was not interested in governmental structures.

I think you would love Tolstoy’s stuff. Read Resurrection, read The Kingdom of God is Within You.

BTW I found another interesting website that you will like:

http://www.themormonworker.org/index.php

Centrist says:

I agree with what you say, but of the few who accept the fact, only half are willing to take the time; of those only a quarter have the resources to help; of those only know what to do. Soon the task itself is impossibly overwhelming for the handful left. I guess I’m not yet ready for GWC.

I just need to fall back on what I learned from the New Testament last year. The good guys lost temporally–but they were still happy IN THIS LIFE despite their horrible situations. If I’m a servant, I need to be subject to my master, “not only to the good and gentle, but also to the froward.”

Mike W. says:

Maybe, but I only have one Master, and it isn’t my government. It are my servant.

As for the task being overwhelming: yes, if we think we have to solve it now. If certain individuals begin to think right and then are able to develop the skills and abilities to promote correct principles and actions, change can occur very quickly. I’ll send you my latest.

Mike W. says:

Er,

“it” meaning government, IS my servant. (sorry about the grammatical atrocities).

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