02.12.08
Just a Few Comments on Michael Moore’s “Sicko”
The other night I watched Michael Moore’s movie “Sicko.” While I have never been much in favor of socialized medicine, and I knew that Moore’s film was pro socialized medicine, I still wanted to watch it because I was interested to know what arguments he raised. I found that he featured many of the common arguments, and while I don’t feel confident that he portrayed each side equally and completely, I do feel he did a good job presenting his points. I found his movie thought-provoking, and exposed a good case against the common fears of the anti-socialized medicine camp. That is, the concern that with socialized medicine quality medical care will decline and taxes will increase. Moore exposes the fact that our current, so-called, non-socialized medical system already compromises quality medical treatment, and it is already very costly, at times usurping the life-savings of those finally able to retire.
One point that Moore made, and seems to be used as one of the more common arguments for socialized medicine is that access to medical care increases health and longevity. I think that is a flawed argument. People develop diseases such as cancer and other life-threatening illnesses apart from how many doctors and hospitals are available to us. The lack of doctors isn’t the cause of disease no more than unlimited money can cure asbestoses and the many other diseases with no known cures. The frailty that comes with aging is not halted by the best doctors or medical facilities man has to offer. Improved sanitation may have made a significant improvement, but that is a separate matter from medical resources. So when Moore and others equate socialized medicine with improved health and longer life, I think it is misleading and misses the mark. People have good health when they take care of it and they can live in a healthful environment free of (or at least with a minimal amount of) toxins.
Included in Moore’s film is a small section on how much a general physician earns in the UK. My feeling is that Moore includes this segment to show that even in a socialized setting, doctors can make a very good living. And it is true from what he presents. However, what he didn’t present is what does a doctor in a non-socialized environment earn? Is it many times more? My guess is yes, but that is not revealed in his movie. So that brings me to another aspect to consider–greed. Are the fees paid to doctors here in the U.S. for their services really worth those exorbitant amounts? Why do bone marrow transplants run up bills large enough to pay for houses? Why do many drugs cost thousands of dollars here in the U.S. while in countries with socialized medicine cost only 6 Euros no matter the number of pills? Do the pharmaceutical companies get paid more from non-socialized medical systems or does the government pay the equivalent amounts to pharmaceutical companies that non-socialized people pay? For the most part, my feeling was the greed of big pharma has place a strangle-hold on non-socialized medicine. I generally felt that medical doctors were merely pawns of the pharmaceutical companies because the pharma companies are generally the ones who fund and support medical schools and medical research, including training up coming doctors and practicing doctors how to use their pharmaceuticals. But now I think that there is a greed aspect involved with doctors as well. I wonder, and I think that it may be likely, that doctors don’t go to school to just earn a comfortable living. I think many go to earn a lavish living. While I don’t think there is anything wrong with lavish living, I do think it is wrong to do it at the expense of desperately ill people to the point of relieving them of their life-savings.
Another problem with non-socialized medicine is the involvement of the medical insurance companies. Fortunately, I have not had much aggravation with medical insurance largely because I try not to use medical services much, if at all even when I was transfusion dependent. However, from those I know who use medical services, Moore’s assessment does have some truth to it. Basically, even if you are fortunate enough to be able to afford good medical insurance, if you are hit with a terminal illness, medical insurance will likely not save you from the poorhouse. Or a large portion of your savings will be drained, and many elderly have to continue working just to keep up with their medical bills. In that case, why bother with medical insurance?
In cases of basic medical assistance such as a broken leg or lacerated appendages, it seems that socialized services can be reasonable solutions. It is disease care that becomes a totally different ball game, and the differences between those types of care is not addressed or emphasized in Moore’s movie.
Finally, what I have not heard addressed from either the non-socialized medical group and the socialized medical group camp is that of “general hospitals” already in operation here in the U.S. Isn’t that a form of socialized medicine? Aren’t those free and available to anyone in need? Moore made another good point that here in the U.S. we already have other socialized services that seem to work rather well. Namely, the fire department, libraries, the police force, etc. Is socialized medicine really that evil? My feeling is that both socialized and non-socialized medicine has their problems and good points. But my feeling is that in order to bring about any meaningful reform, we need to understand health and well-being better. People need to learn to become less dependent upon drugs and doctors regarding their health. Companies who pollute our environment and our foods need to be reformed. People in general need to learn to take more responsibility for themselves, than expect the government to protect them. But there will always be greed and those lobbying for ways to make more money. There will always be the disrespect for the poor and destitute by some. For the time being, those who want better health will have to work for it themselves. I think that’s the way it always has been, and should be.
I know there are other angles to examine regarding the topic, but those are just my initial 2 cents. I’m glad I watched Michael Moore’s Sicko movie, and I do think it has caused me to re-examine my beliefs on socialized medicine. While it’s not a perfect system, it does appear to have some value.
Marlakins
Andrea said,
February 13, 2008 at 6:14 pm
Hi Marla–I saw Sicko awhile ago, and I enjoyed it, though Michael Moore doesn’t really look into things very deeply, and that bothers me–although if he did, it would probably be a more boring movie.
We DO actually have a form of socialized medicine now, in the form of Medicaid, Medicare, and also the fact that hospitals basically have to “eat” the costs of the care of whoever comes to their door if they can’t get it reimbursed. This creates a lot of stress for hospitals.
Another problem is that the current system promotes competition between hospitals. That means, for example, that every hospital in a given area has to have a CT scanner, so they can compete. In Canada, one CT scanner for a certain population is deemed to be OK. IN our area, hospitals advertise–come to OUR emergency room! This doesn’t seem appropriate to me.
It looks to me like socialized medicine isn’t perfect, but is better than what we’ve got. We won’t get it–our system is too entrenched–but I still think it’s a good idea.
Andrea
Administrator said,
February 15, 2008 at 10:40 am
Hi Andrea:
You know the “competition” thing can be a good thing and a bad thing. A bad thing for the reasons you mentioned, but a good thing in that it can motivate doctors to strive for excellence, not just sufficient. I guess that’s along the line of capitalistic ideology. On the other hand, it can go too far, too, where advancement comes before the patient’s best interest. So it my mind, the competition aspect can be a double-edged sword. But you are right, it doesn’t sound right to be “advertising” to come to our ER! Ha! Yikes!
Yeah the Medicare and the Medicaid thing is a form of socialized medicine, but it’s still not the same as the system in the UK or Canada, I “think.” The reason is that you have to be below a certain income status to qualify for those services here in the U.S. (At least that has been my understanding?) While in the UK and Canada, I think medical services are free for everyone no matter what their income. I know that my parents have pretty good medical coverage, but because of their income bracket, they still have to pay more than another person on a lower income bracket. At least that’s who it was explained to me when they were discussing how the cost of their drugs keeps going up each year.
Now “general hospitals” I think are free to anyone here. Course I’ve heard horror stories about those places! And I believe there are also government clinics here that are free, and again, horror stories there, too. Not the peaceful efficient service that Moore portrays in his movie Sicko. I discussed this with Brian and he reminded me that years ago when Aaron was a toddler he took Aaron to a government clinic for a TB test and had to wait 2 hours. Luckily, during his 2 hour wait he realized that getting a TB test was like getting a vaccine because you get innoculated with the bacteria. So he left and never had it done. My oldest sister is a nurse and in the earlier days of her nursing she was sent to a government hospital. There was one patient who was intubated and unconscious. She noticed something moving around in his mouth and found that his mouth was full of maggot! ACCCCCKKKKK! Yes, a fly must have gotten into his room and since he was unconscious and unable to shoo the fly away, laid maggots right in his mouth!!! They had to get another worker there to clean out his mouth, all the while the guy cleaning out his mouth swearing. . . You see these are the kinds of “socialized” medicine stories I’ve heard which Moore didn’t discuss on his video. But does that happen in non-socialized hospitals? I don’t know! Although I’ve never heard about that happening in a non-socialized hospital, I can definitely say that I’ve heard quite a few stories of misdiagnoses and improper drug administration to the point that patients have died. I had a friend who’s brother went in for a so-called routine stomach surgery from which he died on the operating table. My sister knew of a patient who had a shoulder injury from playing tennis who got the wrong meds and died. The list goes on, so how much better is socialized medicine to non-socialized medicine?
To have socialized medicine or non-socialized medicine is a hard call when you lump everything in one bunch. That is, I can see the benefit of socialized medicine for trauma injuries (car accidents, table saw accidents, skiing accidents, etc), but I’m not so sure it works so well for diseases because of all the money made with the drugs, the equipment, experimentations, etc. I am also curious to know what is done with the homeless in the UK and Canada and how they manage their health care. Moore showed a short clip of how we just dump them off on the street near the Union Rescue Mission. How is it handled in the socialized setting? I guess he leaves us to believe they are just taken in and cared for for however long it takes. I know when I was getting transfused, there was a patient there who they were telling me was hospitalized there already for a full year and was not getting better. They didn’t know what to do with her and she was not paying her medical bill. They couldn’t just toss her out. How many patients can you take like that and still have room for others? And this isn’t even discussing how this affects employers of these sick patients. Anyway, lots to consider. And this isn’t even touching upon natural alternative care.
Thanks again for your comment, Andrea.
Marla
patti said,
February 16, 2008 at 10:51 pm
Hot topic. Medicare is definately socialized medicine and if you ask doctors what they think about it, they’ll give it to you readily. Medicare is given to anyone over the age of 65. Fees are not based on how much money they have. There are flat fees depending on different types of options within medicare. Mom had lots of money and paid the same amount my parents pay (and they have little money). So medicare really is socialized medicine. The problem is, doctors have to write off so much of an appt. that they lose money that way. And now-a-days, it’s hard to even find a doctor that will take medicare. Doctors are required by the federal government to take a certain number of medicare patients. After that, they can choose not to take anymore. Marie has medicare because she has social security disbility (which is another sham) and I had a hard time finding a doctor who would see her. We even offered to pay cash and were told it was illegal to do that if you have medicare.
I think the bottom line to the cost of healthcare is big pharma. If you go through all the routes, it all goes back to them. When my folks had fee for service insurance, things were never like they are now. We simply paid our deductible and the insurance company paid the difference. No doctor write offs, etc. In some ways I think that’s why doctors raise their prices. So when they “write off” what the insurance company requires they will still have a decent payment for the appt. By far, when fee for service went away, so did patient directed, doctor helping medical care. Today, it seems all about the money. When pharmaceutical companies are handing doctors drugs everyday to give to their patients, there is no incentive to see/learn what that patient is doing outside the office that might affect their health. Instead, it’s “Here, take this pill. It’ll fix the symptoms.” Pull out the drugs, and I think a lot of the money issues go away.
Oh, too much to be said on this issue but it’s getting late. Maybe I’ll get on my soap box again later. Good post, Marla. The problem with Moore is he doesn’t give the whole story which I think is disengenuous (sp?) because there are a lot of liberals who will take what he says without doing any thinking for themselves. The stories I’ve read on both the MDS and leukemia forums about Canadian and European healthcare are not good. Yeah, they don’t have to pay much for their drugs, treatment, IF they can get it. People have had to wait months to get into a specialist only to find out their cancers are already very advanced. Or there is only one drug available because they don’t have what the US has on their treatment protocol. For me, socialized medicine is not the answer. The answer is educating people to take care of themselves with what they eat, etc. so they don’t run to a doctor everytime their nose runs. Then health insurance companies are truly only paying for those that are “sick” with disease and not stuff that could be prevented. Short of that, good old fee for service works for me.
patti
Administrator said,
February 17, 2008 at 7:05 pm
Thanks for your thoughts and comments, Patti. I don’t know all the rules regarding Medicare, so didn’t know that anyone over 65 could have it. So for the elderly, I suppose it is socially covered, but not for the younger ones like in Canada and the UK. I don’t think it matters there how old you are to use any of their medical services and meds. Personally, I don’t have a problem with the government helping the elderly or even the homeless because they don’t always have family to help them. People do have “accidents” by which they need help. What I do have a problem with is the drug culture and the mistaken belief that more doctors and drugs is the answer to our ailments and thus the government should “oversee” which drugs and treatments are allowable.
While I also agree that Big Pharma is likely responsible for the outrageous prices for drugs and influence many choices that doctors make, I also think that Big Pharma greatly profits by “using” our non-socialized system. They “need” our non-socialized system to make the exorbitant profits that they do. And so they actually lobby to keep our system non-socialized so that they can continue to charge whatever they think the market will bear. They can’t charge just any fee in a socialized system and that is why so many other drugs are available “here” and not in Canada and the UK because they make profit here. I have read of clinical trials to “test” new drugs that were conducted in places like Canada, but once the drug is “approved,” it becomes available here in the U.S. first before Canada. Why? I bet it’s because of profits. And just because they are available here doesn’t make it good, just profitable.
Big Pharma has been known to “test” their drugs (like birth controls and vaccines, etc) and new gadgets (surgical procedures and implant devices) on third world country citizens, so that they can have products to sell us here in the U.S. The stories I’ve read is that many of those “test” subjects are not fully advised on the true nature of their participation and likely not compensated properly, either, especially when things go wrong from unforeseen side effects of the drug or procedure being tested. It’s been a while since I’ve read about those things, so would have to go back and search for links on that or references.
I guess what I’m trying to say is that when we have rampant greed that is common in human nature, fee for service can work against us. Big Pharma is an example of that and uses our non-socialized system to hike up their prices and make mega profits. While I understand that supply and demand also play a role here, the stakes are skewed when people are sick. People will pay and even refinance their homes and forfeit their life-savings if they are afraid to die or lose their loved ones. That’s not comparable to whether or not you want a flat screen TV. In those cases, if there is no intervention regarding the cap price for a drug and/or procedure, then only the wealthy will be able to afford it. There will always be poor people (who just can’t afford and have nothing to sell), and don’t we as fellow human beings have some sort of responsibility to help those less fortunate? I think that’s Biblical. I don’t think it’s evil for the government to a lot for “some” medical services for trauma cases. My qualm is not that our government offers free medical care, but rather the “type of care” that is given is limited and controlled, to the point of monopolizing and telling us “what constitutes medicine.” I think this is where socialized medicine can become dangerous especially when “psychology” starts to come into the picture. What is normal? How are you to treat your child if he becomes ill? Which drugs are okay to give? etc. etc. etc. These things I do not think the government should have the final say on. I don’t think government should be deciding what is the “right” treatments. The money part (raising taxes) is not my biggest concern, but rather the “control” over our decisions. I don’t want a social worker knocking on my door making sure my kids have the proper vaccines. You see what I mean? We are on that path already especially in cancer care when alternative medicines are looked down upon and even illegal. I think the money part is just another issue that detracts from the true danger of “fully” socialized medicine because as Moore points out, we already have socialized services that work rather well like our fire departments, libraries, etc. In the case of medicine since so much profit can be made, something that is supposed to give us more freedom (capitalism and choices) is used against us by allowing Big Pharma, and medical insurance companies, and doctors (I bet somehow those 3 work together, ha ha) to charge whatever they think the market will bear. It’s as if Big Pharma is screwing us from both ends–charging us up the whazoo AND “training or conditioning” us to look to them for all our health needs.
Anyway, just a few more of my cents tossed in the mix. . .
Marla