Editore"s Note
Tilting at Windmills

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June 22, 2007
By: Kevin Drum

MORE SICKO....Jonathan Cohn saw Michael Moore's Sicko last night and confirms that there are places in the film where Moore plays a little fast and loose. Still, he says, "Sicko got a lot of the little things wrong. But it got most of the big things right."

And that's a helluva lot better than getting both the little things and the big things wrong, as Moore's critics so often do. Michael Tanner, for example, the Cato Institute's one-man hurricane of healthcare obfuscation, wrote a "pre-buttal" of Sicko that criticized Moore for touting France's great healthcare system but failing to mention their "shortages of modern health-care technology." Shortages? Cohn called Tanner to ask what he was talking about, and long story short, he was basically just making stuff up. Which prompts this summing up from Cohn:

Tanner's op-ed was a good reminder of the proper context for considering Sicko — the fact that opponents of universal health care have been spewing half-truths and outright falsehoods for decades. If anything, the proponents of universal health care have probably been too honest, getting so caught up in nuance and policy accuracy that they undermine the very real moral power of their own argument. As another great health care debate begins, it's worth remembering that the fundamental challenge isn't technical. We have plenty of good ideas for achieving universal coverage. The challenge is political. Our side needs some passion and, yes, perhaps a little simplicity, too. That's what Moore has supplied. No wonder the health care industry is spooked.

I wish they were more than spooked. But I guess that will do for a start.

Kevin Drum 2:07 AM Permalink | Trackbacks | Comments (86)

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Comments

What bothers me is praise for Canada's health care system. When a former prime minister of that country needed cancer treatment... he went to Massachusetts.

If an 80 year old woman needs hip replacement surgery... she goes on a waiting list for 5-8 months.

Of course, you can get surgical procedures for your pet dog in no time at all.

www.fedlocally.com

Posted by: Hamilton on June 22, 2007 at 2:27 AM | PERMALINK

I can guarantee that any error or mistake of fact, no matter how slight, will be elevated to "riddled with lies" within a week. It will be compared with Moore's "error-filled" F-9/11. Pundits will recall that that film probably cost John Kerry the election. Moore's weight and manner of dress will be mentioned frequently.

Unless and until large employers embrace the notion of universal health care, that is when a significant portion of the American ruling class decides to adopt it, there will be no universal health care.

Posted by: James E. Powell on June 22, 2007 at 2:39 AM | PERMALINK

You can take you anecdotal evidence, Hamilton, shove it up your arse without a painkiller, and still have that removed before the weekend at any decent Canadian clinic at little or no charge for the visit.

You're welcome!

Posted by: Kenji on June 22, 2007 at 2:40 AM | PERMALINK

"your anecdotal evidence", that should read

Posted by: Kenji on June 22, 2007 at 2:43 AM | PERMALINK

kenji:

A great deal of the push for nationalized health care in the U.S. seems to rely on case-by-case anecdotal evidence, including almost all of Moore's film. I wouldn't sneer at it too hard if I were you.

Posted by: harry on June 22, 2007 at 2:57 AM | PERMALINK

The drug industry will be rolling out their big guns and start shelling our side soon enough.

They are waiting to see the whites of our eyes.

They are busyin buying up adverbs and puplicists that are experts at confronting these kinds of challenges.

They'll buy some politicians and stuff even more money in their pockets.

They'll buy the best talk show hacks and stuff their money in their pockets.

They are testing focus groups with responses and sound bites, even while we gloat.

Once their shelling begins, they'll look to see which approaches work.

Then they'll pore even more money down that conduit, like water down a fire house.

They'll put out the fire Moore starts, and will be even more in control afterwords as a result.

Right now, I see no good out come coming out of all this.... ever.

Our country sucks because big money can buy politicians.

We are a banana republic. And it pisses me off no end.

Posted by: Bubbles on June 22, 2007 at 3:06 AM | PERMALINK

Of course, you can get surgical procedures for your pet dog in no time at all.

But that's because there isn't a lot of demand for health procedures for dogs- most poor people say "the hell with it" if it's expensive and let the dog die.

Conservatives oppose universal health care because high medical bills keep blacks and immigrants down. People who work at places like Pathmark, three jobs, often don't have unions in this country so they don't have medical plan too, and if they don't know better they never get any kind of health insurance, or they don't get it because it's just too hard to make ends meet.

Our side needs some passion and, yes, perhaps a little simplicity, too. That's what Moore has supplied.

The left turned on Michael Moore afte Fahrenheit 9/11. That was totally uncalled for, and an absolute betrayal. I'm not surprised if he sees us all a lot differently now. A lot of upper-class lefties may sneer at Moore, waiting for him to say something that makes no sense, because he looks like the dumpy people their mothers and father taught them to fear. He's actually a very intelligent guy and would be solid gold for our side if we would've just embraced him and given him what he needed.

As far as passion, our side definitely needs social movements, and it needs young people on our side, and it needs more recruiting and indoctrinating people with the basics of what we believe in, just talking about the common-sense stuff, but too many of our people seem too interested in just being "holier-than-thou" all the time and criticizing everyone around them.

Posted by: Swan on June 22, 2007 at 3:14 AM | PERMALINK

As an American who has lived in Canada for more than 25 year, I'll sneer mightily, Harry, and with more than anecdotal knowledge.

Posted by: Kenji on June 22, 2007 at 3:16 AM | PERMALINK

Why is it that the criticism of national health care comes solely from those who have never experienced it and have no idea how or why it works?????

Goofs!

It works! And cheaper than here! It's proven.

Put up some facts, ass holes.

Other than that, KD still sucks for avoiding certain topics because it hurts him.

Posted by: notthere on June 22, 2007 at 3:32 AM | PERMALINK

The left turned on Michael Moore afte Fahrenheit 9/11.

?

Posted by: Disputo on June 22, 2007 at 3:38 AM | PERMALINK

"When a former prime minister of that country needed cancer treatment... he went to Massachusetts."

Question:

If you get cancer, do you think your health insurance will be sending you to Massachusetts for the best cancer treatment and care that money can buy ?

I own my own business and pay close to $700 a month for health insurance for my family, and I can guarantee you that I'm going to the local doctor if I get cancer.

The common theme between us being:

WE'RE NOT RICH AND FAMOUS

Therefore, you've managed to waste everyone's time with anecdotal bullshit that doesn't apply to 99.9% of the people in this country.

This is the favorite boogeyman of the right-wingers. They manage to convince people that they're going to get the caviar care when they need it, and it's a lie. They're not going to get the caviar care, despite paying caviar rates, just like there's a very good chance that they'll never be wealthy like the Horatio Alger fairy-tale that is constantly fed to them.

Posted by: OhNoNotAgain on June 22, 2007 at 3:58 AM | PERMALINK

It's amazing how quickly the (paid?) whores for the Health industry get here anytime the topic of universal insurance comes up. And they're not the usual trolls...

Anyway, you'd need something like morals to not want to keep a gravy train like this going! But I don't think their scare tactics are gonna work so well this time round. Best thing for the industry would be to get elected a Democrat who favors a system which allows them to keep their sticky fingers in the pot and have the cause of real change put off for years. Better the candidate who wants to wield a chainsaw.

Posted by: snicker-snack on June 22, 2007 at 4:17 AM | PERMALINK

If the GOP argued the facts, they'd lose the argument. Instead, the have to rely on scare tactics (buzzwords like "SOCIALIZED medicine" and "rationing") and extreme, non-representative anecdotes ("my brother's best friend's sister's boyfriend heard about some guy who read that French doctors use leeches").

It's time we repaid them in kind.

Pure and simple: Republicans are profiting from ethnic cleansing.

Infant mortality in the US is 300% higher than in Japan, 250% higher than Finland, Iceland, or Norway. We're 30th in the world (pretty close to last for all industrialized nations), far behind other industrialized nations such as Sweden, France, and Germany, and even worse off than Cuba. Yes, Cuba. But hey, we're just above Botswana! U-S-A! U-S-A! U-S-A!

The infant mortality rate for African-Americans is double the rate of the general population. And an American woman is 10 times more likely to die in child birth than a woman in Sweden.

Let's add that up - our system is between 50%-100% more expensive than our peers, covers less than half the population, and has African-American babies dying at a rate 500-600% higher than our peers, and women dying in child birth at a rate 1000% higher than Sweden. Republicans oppose fixing the system, but happily accept large campaign contributions from the health industry to prevent change.

Certainly seems like it adds up to Republicans profiting from ethnic cleansing.

Health care-wise, we are to the rest of the industrialized nations what Mississippi is to the rest of the United States - a pathetic, backwards laughingstock where the poor and minorities suffer the most, while the rest of our populace is so ignorant of their standing in the rest of the world and so blindly patriotic that we're proud of what we have, rather than ashamed.

Posted by: Augustus on June 22, 2007 at 4:50 AM | PERMALINK

A better review of Moore’s movie, by David Corn of The Nation (and it is not behind a pay wall) is here.

A few excerpts (sorry if I am running afoul of copyright law here):

“Moore opens the movie by looking at two cases involving Americans who don't have health insurance. One fellow who sliced off the tips of two fingers is told at the hospital that he can attach the ring finger for $12,000 and the middle finger for $60,000. He can't afford both. Ever the romantic, Moore reports, this man opts to save his ring finger.”

“Moore began this project by advertising on the Web for tales of health care woe. Within a week, he had received 25,000 emails. A woman is denied payment for a major procedure because she neglected to mention on her insurance application that she once had a yeast infection (which was, of course, unrelated to the procedure she needed). A mother loses her 18-month-old daughter because a hospital won't treat her without authorization from her insurance company and her insurer insists she takes the child (during an emergency situation) to an in-network hospital. A woman who was in a car crash is denied payment for an ambulance trip because she did not receive pre-approval for that cost. A man is denied a bone-marrow transplant that could save his life and dies.”

“He (Moore) visits Canada, England, and France and compares their health care delivery systems to America's. He plays this for loads of yucks. In a British hospital, he goes looking for the place where a patient has to pay his or her bill. He cannot find such a check-out counter. Then--a-ha!--he finds a cashier. But--here comes the punch line--this is where the hospital hands out cash to patients who need a few pounds to cover the cost of their transportation home. Yes, in a British hospital you can leave with more money than you came in with.”

If America can afford to piss $2 billion per week down on our collective leg in Iraq and accomplish absolutely nothing, it can afford universal health care coverage.

Please see this important film and then write your Congressman and Senators and demand universal health care coverage for all!

Posted by: The Conservative Deflator on June 22, 2007 at 6:05 AM | PERMALINK

There's really only one quasi-political question we have to ask ourselves as a nation: do we want to ensure that everyone has access to a basic, minimum level of health insurance coverage? Yes or no.

If no, fine, keep the system we've got.

If yes, the rest of the issues are technical.

And, technically speaking, the most efficient and cost-effective way to ensure that everyone is covered is to toss everyone into one big risk pool.

Posted by: JM on June 22, 2007 at 6:16 AM | PERMALINK

"Please see this important film and then write your Congressman and Senators and demand universal health care coverage for all!

Posted by: The Conservative Deflator"

If only this would do some good. Better to buy our own elections and congress critters. But if I can't afford health care, how can I afford a congress critter?

Posted by: slanted tom on June 22, 2007 at 6:21 AM | PERMALINK

Sorry you are so cynical, slanted tom. It's easy to understand, living in Bushworld for over six years. But we all can make this a better world, if we stick together. The conservatives have proven that they can make it a worse world by sticking together...

Posted by: The Conservative Deflator on June 22, 2007 at 6:36 AM | PERMALINK

Everybody knows Canadian health care is worse than ours. Why are liberals still peddling their lies?

Posted by: Al on June 22, 2007 at 6:50 AM | PERMALINK

I hope I'm not too late in simplifying the discussion...

To preempt the usual suspects, and save everybody time and effort, here are the standard conservative responses to any discussion of health care reform. Note that this this is a continuously refined list that I try to post every time Kevin mentions "health" and "care" in the same sentence; you should feel free to add more responses so that we can have a more comprehensive list for next time.

1. Single payer plans are socialistic and therefore ipso facto evil.

2. I know someone who knows someone who's related to someone from Canada who had to wait for tennis elbow surgery for months and months and came to the US and he had the surgery immediately and it saved his life.

3. Look what's happening in France right now; their health care is socialized and there are riots in the streets.

4. We have the best health care in the world and anyone who says otherwise is part of the blame-America-first liberal socialistic treasonous left.

5. Anybody who wants insurance coverage can get it, and the only reason some people don't it's because they don't want to.

6. People who get sick got sick because they weren't paying attention to their diets, etc. and they are therefore to blame for their problems; why should the taxpayer pay for lazy people who sit around eating hamburgers and watching TV and so get fat and sick?

7. Those who can't afford health care cannot do so because they are lazy and do not work hard enough to afford to pay for what they need in life and so they want me to pay for their expenses.

8. Those with children who cannot afford health care for their children shouldn't have had any children and to have done so was irresponsible; if we reward them with free health care they'll never become responsible.

9. Italians are disappearing because they don't reproduce enough, and they have socialized medicine, which obviously has not helped them to continue surviving as an ethnic group.

10. What we need is to promote preventive medicine so that nobody gets sick again.

11. All we need to do is make sure insurance companies do not have to pay any taxes whatsoever, which will undoubtedly lead to more competition, better care and lower prices.

12. Cuba has socialized medicine; you want to live in Cuba?

13. All statistics quoted by supporters of socialistic remedies to health care are false or faked, a priori; all anecdotes offered by opponents of health care are true and accurate, a priori.

14. With socialized medicine, research into new drugs and therapies will stop immediately, because it is the current healthy competition among our insurance companies that directly drives medical research.

15. Our problem is too much health care, and people tend to abuse the system by going to the doctor too often. With socialized care, we'll get even more abuse, while the market forces of free capitalism will discourage the slightly sick from tying up the system with complaints about sniffles.

16. The problem with health care is Medicaid and Medicare, which encourage the poor and the old to get sick more often.

17. I don't want my tax dollars paying for someone else's sex change operation, abortion, [insert your own "morally" objectionable procedure].

18. Liberals are for it? Then I'm against it.

19. Health care resources are limited. There needs to be some way to ration them. If we nationalize the healthcare system how is it decided who gets what?

20. Americans don't walk and eat too much junk and that's why they are sicker than the citizens of other nations whose health care systems are therefore cheaper and more efficient.

21. America's racial pool is mixed and not all of us are therefore equally endowed with perfect Anglo genes and that's why some Europeans who are more Anglo than us are healthier and that's why their health care systems are cheaper and more efficient. If we didn't have brown immigrants, the eastern European immigrants, the southern European immigrants, and those others...

22. La, la, la, la, I can't hear anything, la, la, la, you liberals are idiots and you suck, la, la, la...

___________________________

Posted by: Aris on June 22, 2007 at 7:04 AM | PERMALINK

> the most efficient and cost-effective way to ensure that everyone is covered
> is to toss everyone into one big risk pool

Yes. And when we have done that, there is no role in health care for insurance companies. At all.
Insurance companies remove value from the health care system; they do not add value. All their operating expenses and profits come out of the insured's pockets on top of the base cost of the care delivered.

Posted by: joel hanes on June 22, 2007 at 7:43 AM | PERMALINK

"What bothers me is praise for Canada's health care system. When a former prime minister of that country needed cancer treatment... he went to Massachusetts."

The super wealthy who can afford any car they want disproportionately choose to own Ferraris and Lamborghinis. Conclusion: the Italians have a better transportation system than the US.

Posted by: cactus on June 22, 2007 at 7:51 AM | PERMALINK


The super wealthy who can afford any car they want disproportionately choose to own Ferraris and Lamborghinis. Conclusion: the Italians have a better transportation system than the US.

Posted by: cactus


Where does one learn to spin like that? Or is it more some talent that a person is born with? In any case it's a great gift.

Posted by: slanted tom on June 22, 2007 at 8:17 AM | PERMALINK

...When a former prime minister of that country needed cancer treatment... he went to Massachusetts."

So Pierre Trudeau, dying of cancer takes a flyer on an expensive treatment that, by the way, fails. Steve McQueen tried Mexico, and it didn't work for him either.

If you can't spot the market failure involved here, you're not really trying.

Posted by: bobbyp on June 22, 2007 at 8:27 AM | PERMALINK

Sorry you are so cynical, slanted tom. It's easy to understand, living in Bushworld for over six years. But we all can make this a better world, if we stick together. The conservatives have proven that they can make it a worse world by sticking together...

Posted by: The Conservative Deflator

I'm so cynical because...
but you're right, although the system (health, energy, economic, political and moral) is broken it's the only one we have, and the only one we're likely to have because the system is self-reinforcing. So change proceeds at a glacier pace, if at all. Meanwhile, these systems are have created the real danger of the total ecological breakdown of our home planet. The real glaciers are melting, along with ice caps, while our political system remains frozen in place.

Fossil fuel and political type like Rove and Cheney have to go. The solution of ANY problem that includes fossil fuel, types like Rove or Cheney and his supporters need to be rethought.

I hope that explains, to some extent, why I appear cynical.

Posted by: slanted tom on June 22, 2007 at 8:33 AM | PERMALINK

Great list, Aris. I laughed! I cried!

Posted by: shortstop on June 22, 2007 at 8:53 AM | PERMALINK

Some jerk: What bothers me is praise for Canada's health care system.

Some other jerk: Everybody knows Canadian health care is worse than ours.

Canadian health care works fine. The me-first attitude of US rightwingers is never more apparent than when they are criticizing the Canadian health system. They should look into their selfish souls: If you are so selfish that you don't care about the health of your fellow citizens, you are a scumbag indeed.

Posted by: Bob M on June 22, 2007 at 9:12 AM | PERMALINK

Yes, some of the richest people in the world come to America for health care. Because the richest people in the world can afford the best health care America can provide. That doesn't mean the system is working for the rest of us.

On the other hand, while there might be a wait for some health care in Canada, for many in the USA, the wait is permanent.

My favorite argument by the scare mongers is that universal healthcare will add massive bureaucracies. Yes, it will, but it will also remove massive bureaucracies - namely, the insurance companies. Each insurance company is a huge apparatus for processing paper, taking in money, and disbursing it.

Posted by: Misplaced Patriot on June 22, 2007 at 9:22 AM | PERMALINK

But can we still pay the radiologists $500k a year if we change health care? Why shouldn't the specialists live like kings while teachers can't afford decent health care? This is America, damn it!

Posted by: razorboy on June 22, 2007 at 9:37 AM | PERMALINK

The selfishness of liberals boggles the heart and soul of every person of faith.

Charity begins in Baghdad. First let those unfortunate souls in Middle East who have been oppressed and enslaved for centuries have their freedom and liberties.

Only then can you think of spending the hundreds of billions of dollars (that we are using for the Iraq war) for our own health care.

Poor President Bush cannot get through to Americans that we have to sacrifice for the Iraqis or we fail as a nation and more importantly as human beings.

Posted by: gregor on June 22, 2007 at 9:51 AM | PERMALINK

Americans can't WAIT for anything ...yes, I realize that's a generalization...I mean, mostly, the trolls on this and other blogs and callers in to conservative radio blowhards! Not being able to have your itch scratched immediately would drive the likes of George Will nuts...but, of course, they'd have all the $$ they need to speed up the process here so they'd never notice...

Posted by: Dancer on June 22, 2007 at 9:57 AM | PERMALINK

My income comes from the healthcare confab.
The thing is neither fish nor foul. Is it a basic need like water or a profitable business like
ipods?

Try this model. You develope the ipod and it is very popular. Everyone needs one in their lifetime. You calculate your costs including a profit and put it on the market. In the Apple store the customer gives you an ipod coverage card from BlueipodBlueItune. You submit the bill to BIBI and they send you a check for $45. The customer pays $100 month for BIBI coverage.

So its the evil insurance providers? No. The evil
doctors? No. The evil hospital (insert my job here)? No. Its the enterprise, M&M Enterprises.
Everybody has a share. How to fix it? Well lets face it, there is no problem so big that it can't be ignored. Ask Czar Alexander.

It will not be fixed by those who derive income from it. It will be fixed by those it abuses.
Sick people of the nation, rise up. At least sit up. O.K. just lie there, but nod your head.

Can Congress=HealthConFab lobby fix it? No, the US
democracy is based on goodfellow compromise. At best it can fix %20 of any problem. A bad appendix? Congress will pay to take %20 of it out.

So this problem will be ignored.

The lessons of history say that huge problems are solved by revolution, totalitarianism, or catastrophe followed by slow recovery. Or any combination.

I predict catastrophe. No pundit whiny out , "Its hard to say how this will turn out, we'll keep watching".

Catastrophe. There is no way to fix it with the feable tools we have.


Posted by: utahguy on June 22, 2007 at 10:06 AM | PERMALINK

It'll be socialism, I tell you! Socialized medicine!

Oh wait, that's what they said about Medicare back in the sixties.

Posted by: nemo on June 22, 2007 at 10:09 AM | PERMALINK

Ten issues that go away with a national health insurance system--and two that don't:

1. The approximately 47,000,000 uninsured: All will have access to coverage with incentives for provider efficiency and the most cost efficient interventions.

2. The profit squeeze on employers who provide health insurance to employees: It�s estimated that U.S. car makers have expenses of over $1500/car related to health care coverage for employees. A national system, delinked from employer based insurance, allows our employers to compete on the same basis as those in other industrialized countries.

3. Our disgraceful system of health care for GI�s and their families: Incorporating the VA and military health care systems is into a National Health Insurance program provides more and better options for care. These will be community based and thus provide more convenient access.

4. The administrative duplication and fraudulent behavior of multiple insurance providers, each with their own administrative overhead and fiduciary responsibility to generate profits: It�s estimated that we spend 30% of our expenditures for health on administration ($1059/capita in U.S. vs $307/capita in Canada). That could easily be halved or more with a national health program.

5. The conflict of interest between insurers, providers and patients.

6. The crisis in emergency rooms: With insurance people will have a place, other than ER�s, to go with non-emergent medical issues

7. The dance of the veils billing system: There is no set price for services. Those with leverage, i.e. large insurers, are given large discounts while the individual pays the full amount. If everyone has insurance there will be one negotiated price.

8. Big PHARMA�s free ride: We pay more for medications than any other industrialized country. PHARMA�s mantra that they need profits to encourage creativity is bogus when one considers they spend more on promotion and advertising than research. In a national insurance scheme drug price negotiation will be the rule�as it is in the rest of the industrialized world. (see more below)

9. Bankruptcy due to enormous medical bills

10. Our mediocre health care outcomes: We spend more per capita than anyone, yet our outcomes are in the middle of the pack. With universal access we can expect this to change.


None of this will be automatic and actually having an efficient functioning system of care will require much due diligence and negotiation.

What won�t change is physician unhappiness with reimbursements and the continuing issues with intellectual property rights. No where in the world are physicians as well paid as here. We�ve made the profession entrepreneurial and money driven and in the current non-system reward procedures rather than primary care. It can be anticipated that a national health insurance scheme will want to flatten the disparities and redistribute, somewhat, the fees. One would hope this would guarantee all physicians reasonable reimbursement for their time and expenses. However, meeting the expectations of the profession will be almost impossible�as it is now.

We do need some type of protection for innovators in our system. We should not however delude ourselves that this is a �free market�. Patent protection creates monopoly and in health care that has resulted in a life threatening market distortion that we can no longer afford. We need to somehow require patent holders to price their products responsibly and to be efficient in their product development and marketing. Once again meeting the expectations of the industry and their stockholders will be almost impossible�as it is now.

But in both cases the status quo is not working.

Posted by: www.medicynic.com on June 22, 2007 at 10:09 AM | PERMALINK

The kicker -- the wretched, grim, hair-pulling, rictus-inducing, embalming-fluid-toasting kicker -- is that if we adopted the any of the terribly expensive socialized medicine approaches of our industrialized peers, we'd live longer and spend less doing it.

Listening to our trolls, reminds me of the scene from "In the Name of the Father" where Jerry Conlon tells his attorney that he sometimes just wants to stick a fist into his mouth or to have his mouth sewn shut so that he'd never have to speak another word of English. Opponents of single-payer, medical-care-for-all remind me that it's easy to do wicked things without even trying.

Posted by: Jeffrey Davis on June 22, 2007 at 10:15 AM | PERMALINK

What bothers me is praise for Canada's health care system. When a former prime minister of that country needed cancer treatment... he went to Massachusetts.

Yeah, and he died of cancer in the end. Conclusion: the US medical system is a killer!

Posted by: Stefan on June 22, 2007 at 10:20 AM | PERMALINK

Lovely, more "fake but accurate" defenses to the latest left-wing propaganda.

Just so we're clear then, "opponents of universal health care ... spewing half-truths and outright falsehoods" is bad but proponents of universal health care spewing half-truths and outright falsehoods is perfectly OK because they "got most of the big things right."

Gimme a break. Count me among those, by the way, who are concerned about the massive problem of our current health care system and one who has not written off some form of government insurance as a possible solution. But I won't join those who excuse Moore's lies and distortions even if his basic point ("our system is broken") may be entirely correct. Yes passion and simplicity are important, but honesty and transparency are even more important - something Cohn seems to have forgotten.

Posted by: Hacksaw on June 22, 2007 at 10:21 AM | PERMALINK

If an 80 year old woman [in Canada] needs hip replacement surgery... she goes on a waiting list for 5-8 months.

How often does someone in the US without insurance have to wait for hip replacement surgery? Forever. They'll never ever get it.

Posted by: Stefan on June 22, 2007 at 10:25 AM | PERMALINK

But I won't join those who excuse Moore's lies and distortions even if his basic point ("our system is broken") may be entirely correct.

Please list with specificity two or three of Moore's "lies" in the movie.

Posted by: Stefan on June 22, 2007 at 10:28 AM | PERMALINK

I have a suggestion.

Conservatives love to use the idea of vouchers to get the government to pay for private schools.

I propose using health care vouchers to allow anyone to obtain coverage from any insurance provider. Not only would everyone have coverage, but it would reduce expenses since insurers could eliminate their entire sales force. How can conservatives oppose this?

Posted by: FS on June 22, 2007 at 10:40 AM | PERMALINK

Stefan,

Personally, I find Moore's "Cuba's health care system is great" propaganda the most offensive of his lies.

Curiously (OK not really), Cohn chose to use Tanner's pre-buttal to characterize the criticism of Moore's film, but Kyle Smith's discussion of the film's problems was both more detailed and, I think, more reasonable.

http://blogs.nypost.com/movies/archives/2007/06/kyle_smith_on_m.html#more

Posted by: Hacksaw on June 22, 2007 at 10:45 AM | PERMALINK

If anything, the proponents of universal health care have probably been too honest, getting so caught up in nuance and policy accuracy that they undermine the very real moral power of their own argument.

I'm going to start using this in real life. "I'm only losing this argument because I'm being too honest; also, the fact that you're winning the argument is part of the problem we're arguing about."

Posted by: Grumpy on June 22, 2007 at 10:45 AM | PERMALINK

"there are places in the film where Moore plays a little fast and loose" VS. "he says, 'Sicko got a lot of the little things wrong'"

Well, which is it? Or do we just write this stuff cuz it sounds "fair" and may hold up?

Posted by: Flamethrower on June 22, 2007 at 10:49 AM | PERMALINK

Personally, I find Moore's "Cuba's health care system is great" propaganda the most offensive of his lies.

No, again, please list with specificity two or three of Moore's "lies." This shouldn't be hard for you. Define what the lie is, and then explain (using statistics and cites) why it is a lie.

Posted by: Stefan on June 22, 2007 at 10:58 AM | PERMALINK

Irony alert: Republican tribalist Hack praising honesty and transparency.

Didn't the keyboard burn you as you typed that?

Posted by: Gregory on June 22, 2007 at 11:12 AM | PERMALINK

I remember Gingrich speaking in the House in the early '90s, when he was dutifully working to weaken the Clinton health care initiative, stating that, in Canada, you can't choose your own doctor. Absolutely, screamingly, false. But he was perfectly happy to say it. And I saw no coverage the next day pointing out his lie.

We're in for more of the same, and we'd better be prepared to call them on their lies. Otherwise it will be a complete waste of time and energy.

Posted by: DNS on June 22, 2007 at 11:14 AM | PERMALINK

Personally, I find Moore's "Cuba's health care system is great" propaganda the most offensive of his lies.

For example, you can detail for us where exactly in the movie Moore says "Cuba's health system is great." Does he actually say it's "great," or does he actually show that in some respects it provides more coverage for more people at a lower cost and with some better results (i.e. infant mortality) than the US system?

And if you believe this is an inaccurate claim, please explain why, using easily available comparative statistics on the health care systems of both countries. This should be easy, because of course you wouldn't simply spew half-truths and outright falsehoods....

Posted by: Stefan on June 22, 2007 at 11:16 AM | PERMALINK

I'm going to keep posting this on every health care thread because: a.) I can; 2.) it's true; iii.) I think it's important:


The problem with health care in this country is that we see it as a privilege, not a right.

If the left can frame the issue in that manner I think it'd be cakewalk.

Sure, there are other ways to frame it -- it's the morally correct thing to do ... the Christian thing to do ... the affordable for business thing to do ... the good for national security thing to do -- but I think completely changing the way we look at it is a good way to start.

Once that's done, we can apply the same frame to education and other issues.

Posted by: Mark D on June 22, 2007 at 11:26 AM | PERMALINK

Posted by: Hacksaw on June 22, 2007 at 10:45 AM
Stefan,

Personally, I find Moore's "Cuba's health care system is great" propaganda the most offensive of his lies.

Curiously (OK not really), Cohn chose to use Tanner's pre-buttal to characterize the criticism of Moore's film, but Kyle Smith's discussion of the film's problems was both more detailed and, I think, more reasonable.

http://blogs.nypost.com/movies/archives/2007/06/kyle_smith_on_m.html#more

The first paragraph in the body of the linked article reads:

"Michael Moore’s latest documentary “Sicko” is an urgent bipartisan plea. Democrats and Republicans, liberals and conservatives, Yankees and Red Sox can surely all agree, says Moore, that our health care system ought to be run by Fidel Castro. "

And no, Kyle Smith doesn't get any more insightful or specific in the rest of the aricle.

If that is what Hacksaw considers detailed and reasonable, then the first half of his chosen moniker is accurate at least.

Posted by: tanstaafl on June 22, 2007 at 11:31 AM | PERMALINK

"We have plenty of good ideas for achieving universal coverage. The challenge is political. Our side needs some passion and, yes, perhaps a little simplicity, too."

Especially spot-on about the need for simplicity, Kevin. We don't need the confusion of the medicare drug benefit, i.e. What worries me is, we will cobble together something far worse in complexity than the Rx benefit-something akin to the EU constitution-and it will take two years to get going, and then fail.... by one vote. The thing that ruined the Rx benefit IMO was excessive choices that were mistakenly thought to "improve" it. Keep it Simple

Posted by: Doc at the Radar Station on June 22, 2007 at 11:35 AM | PERMALINK

Many countries that have universal care are much smaller than the U.S. Do you want the power of controlling healthcare for 300 million people in the hands of the few elected officials of the federal government? Are we give them that power, and trust that it will always be altruistic, intelligent leaders holding it? And, as both Parties have served the special interests for the past two decades, why should we not expect them to serve the same special interests when they are in control of the nation's healthcare?

If universal healthcare is done, it must be done by the States. This way, power remains decentralized; the system would be more stable and more likely to serve those it was intended to serve.

Posted by: brian on June 22, 2007 at 11:35 AM | PERMALINK

brian, everyone's favorite faux-reasonable concern troll, writes: Are we give them that power, and trust that it will always be altruistic, intelligent leaders holding it?

Which is rich, for someone who supports Bush, who has hardly been altruistic or intelligent with the power he has claimed, and which no one has given him.

Meanwhile, brian, since no one's talking about health care itself being run by the government -- merely paid for -- and since existing Federal health insurance programs are more efficient than private health insurance, a massive special interest (on whose behalf brian, intentionally or otherwise, argues) that only subtracts value from health care, not adding any, the ansdwer to the question "Do you want the power of controlling healthcare for 300 million people in the hands of the few elected officials of the federal government?" is an unequivocal yes.

Smarter trolls, please.

Posted by: Gregory on June 22, 2007 at 11:40 AM | PERMALINK

Usually it helps to read the rest of the article fellas.

Stefan, Moore's claim in the movie is that the ground zero workers in Cuba were able to get lung cancer treatments they were not able to get in the US (I suspect this is true) and that in getting the treatments in Cuba these workers were treated no differently than the average Cuban (this is the lie). As this article notes:

http://www.latinbusinesschronicle.com/app/article.aspx?id=1356

In reality, Cuba has three types of health systems, argues Jaime Suchlicki, the director of the Institute for Cuban and Cuban-American Studies at the University of Miami and a leading expert on Cuba. One for the Cuban military, members of the Communist Party and leaders of the government. A second one is for foreigners who pay in dollars or foreign currency and a third one for the general Cuban population. The first two are excellent, with modern equipment and availability of medications," he says. "The third, which is for the majority of the Cubans, is a veritable disaster with poor equipment and few medications and in many instances without the availability of Cuban specialists."

This of course makes perfect sense given what we know about communist governments, their effectiveness, and their "fairness." But if you want to buy into Moore's fantasy that if only we used Cuba's system all would be well, there's little more I can do for you.

Posted by: Hacksaw on June 22, 2007 at 11:45 AM | PERMALINK

I don't think we have to take it as far as what Augustus says at 4:50 AM to make the point. If we argue that this is ethnic cleansing like he does, we open ourselves to counterarguments that blacks suffer increased infant mortality from increased drug use among pregnant mothers, or other social problems, etc. This is a quagmire obviously-- Republicans will argue it to an ignorant audience even if they know the facts don't represent it-- but all I'm arguing is, to go out on a limb amd make an argument like that, we have to deal with all the other possible causes of increased infant mortality that may not be related to not providing free health care. Upshot is, it's going to be too easy for the conservatives to make us look like we lose the argument, make us look like wackos, make borderline-racists think the blacks bring it all on themselves, etc.

Instead, I think we can say it as simply as I did in my original comment:

Conservatives oppose universal health care because high medical bills keep blacks and immigrants down. People who work at places like Pathmark, three jobs, often don't have unions in this country so they don't have medical plan too, and if they don't know better they never get any kind of health insurance, or they don't get it because it's just too hard to make ends meet.

Add labor in there- they oppose universal healthcare to keep labor down, and put them in an insecure bargaining position, afraid to anger the bosses and lose what little they still have.

Posted by: Swan on June 22, 2007 at 11:47 AM | PERMALINK

Do you want the power of controlling healthcare for 300 million people in the hands of the few elected officials of the federal government

or in the hands of the few unelected executives looking to make a killing, as it were? tough choice.

Posted by: benjoya on June 22, 2007 at 11:58 AM | PERMALINK

In reality, Cuba has....

Uh, huh. US righwingers tell all sorts of lies about the Canadian health system, let alone the Cuban one. Facts are too reality-based for them, the scum.

Here's what happened when I had to go to the hospital for a gall bladder operation. I went to the hospital, showed my card, had the operation, recuperated overnight, went home. That's it.

Who would not want such an easy system? Plus you save money.

Posted by: Bob M on June 22, 2007 at 12:00 PM | PERMALINK

Right wingers please remember that:

Talk Radio is just talk.

You wouldn't take me at my word, so why would you take Rush, or Neil or Sean at their words?

On the other hand their sponsors make money when you believe what they say and and status quo is maintained. They are paid to say the things they do.

Posted by: slanted tom on June 22, 2007 at 12:00 PM | PERMALINK

Gregory don't knock Brian so fast. In Canada the health system is run by the states (ie Provinces)
This works great for the large and or rich ones and not so well for the small impoverished ones.
Maybe the best combo for the US is federal funding and drug price negotiation to get the lowest possible costs, the states would control the delivery of care policy in their own jurisdictions as they see fit from cash for service only, to insured managed care to government hospitals - their choice. The French have this worked out the best. I think an important political advantage to having the states take control of the actual delivery is that it avoids the unanimity problem, where you have a complaining Alabama or Wyoming that wants to stay completely private insurance holding up a national system. Cut em lose. Let the signing up for the fedreal program be optional and voluntary, state by state. There will be enough intitial states to give economies of scale, once the system is up and the apocalypse doesn't happen the voters in the hold out states will do the right thing.

Posted by: Northern Observer on June 22, 2007 at 12:02 PM | PERMALINK

Those of you who wish to focus on Moore's errors are doing the work of the insurance companies. The message of the film, that our system is broken and way too expensive, is 100% and we ought to focus on fixing that. Why is it when someone tries to bring an issue to our attention, Gore with Global Climate change and Moore with healthcare, we get into endless debates on the accuracy of every little item, while doing precious little about the problem itself?

As to the Cuban system, I would assume they do what they can with the money they have available to an embargoed country.

As to Canada, I have heard, but cant confirm that an additional 5-10% in the money into that system would eliminate waiting times and still cost less than our system by far.

I wish someone with actual knowledge of the various systems around the world could write a detailed comparison. I will look for one. We get all sorts of comments from people whom I have no confidence in being truly aware of the facts. I am sure we can design a system that works for us but fixes our mess. We dont have to copy anyone but one thing is for sure in my mind: limit the insurance companies involvement in health care. Our health care cannot be subject to profit margins, which brings a rationing of care in its own right. If people want to buy supplemental coverage, great.

Posted by: jammer on June 22, 2007 at 12:09 PM | PERMALINK

If an 80 year old [Canadian] woman needs hip replacement surgery... she goes on a waiting list for 5-8 months

If an 80 year old American woman without decent health insurance needs hip replacement surgery, she will not be placed on a waiting list.

American healthcare is so much better than other nations because we do not let our un- and under- insured wait for healthcare. No, they are told up front there is nothing that can be done for them, so they can stop waiting and pick themselves up by their bootstraps.

Posted by: Brojo on June 22, 2007 at 12:12 PM | PERMALINK

jammer:

To me, the reason people focus on Moore's errors is because we agree that the U.S. health care system needs to be fixed but have concerns that some of the proposed solutions have significant drawbacks to them as well. When "documentarians" like Moore and Gore play fast and loose with their acts in order to advance their agendas, it is only natural that the focus will be on their errors.

Put another way, just because I think Moore is full of crap doesn't mean I think all is well with our health care system. I certainly doesn't mean, as Swan and Augustus preposterously claim, that I love our current health care system because by golly it sure helps keep black and immigrants down. But Moore is presenting potential alternatives to our system, he is not merely drawing attention to the problems of our system. And when he distorts and misleads about those potential alternatives, he is misinforming the fairly large crowd of people that tend to take him at his word. That is the danger of leaving his propaganda films unchecked and unanswered.

Posted by: Hacksaw on June 22, 2007 at 12:20 PM | PERMALINK

from the CIA Factbook:

Life expectancy at birth:
total population: 77.23 years
male: 74.94 years
female: 79.65 years (2005 est.)

Guess which country?
Give up?
Cuba.

They must have a terrible health care system for the average guy.

For comparison purposes only:

Life expectancy at birth:
total population: 77.71 years
male: 74.89 years
female: 80.67 years (2005 est.)

Posted by: Jeffrey Davis on June 22, 2007 at 12:25 PM | PERMALINK

Al: "Everybody knows Canadian health care is worse than ours."

If by everybody, you mean people as stupid as you, of course you are right. Now, go choke on a pretzel. arselicker.

Posted by: Kenji on June 22, 2007 at 12:26 PM | PERMALINK

jammer,

Here's a potentially useful document:

http://www.euro.who.int/document/E84968.pdf

Posted by: JM on June 22, 2007 at 12:29 PM | PERMALINK

Hamilton: "Of course, you can get surgical procedures for your pet dog in no time at all.


Veterinary clinics are all privately run in Canada. There's no health coverage for pets, you idiot.

Posted by: Kenji on June 22, 2007 at 12:35 PM | PERMALINK

...we agree that the U.S. health care system needs to be fixed but have concerns that some of the proposed solutions have significant drawbacks to them as well.

There is no perfect universal coverage system. All of the western European systems have undergone/are undergoing reforms, revisions, tweakings. That sort of thing is inevitable as all countries are constantly encountering epidemiological and demographic changes.

The point is that even with the "drawbacks," the populations of universal coverage countries want to maintain universal coverage. You don't see any universal coverage country packing it in and opting for our sort of "system."

Posted by: JM on June 22, 2007 at 12:38 PM | PERMALINK
…. Moore's claim in the movie is that the ground zero workers in Cuba were able to get lung cancer treatments they were not able to get in the US ….Hack at 11:45 AM
Moore takes some Trade Center work site people suffering work related illness to Gitmo where, as he points out, if Bush is to be believed, the guys who plotted to blow up the towers now have full medial while the guys who cleaned up, don't. Distortions are the stock-in-trade on the right.
….….If universal healthcare is done, it must be done by the States…. brian at 11:35 AM
That was Hillary care: State managed. Talk to Harry and Louise. Of course, the size of the country is irrelevant and the usual cant is that economies of scale would apply. Also, the standards of care should be nationwide. Mississippi and Alabama would not want to spend on their po'folk as you well know.

Of course, we have noticed the danger to government programs that occurs when highly ideological rightist regimes come into power in the US. Bush has managed to pervert and destroy practically every government agency and program. When the sabotage is deliberate and ideological, it's hard to overcome, especially when the same party in congress declines its oversight role. Government haters don't belong in government.

….That is the danger of leaving his propaganda films unchecked and unanswered. Hack at 12:20 PM

Actually the danger is the corporate funded lies, disinformation and propaganda that you represent. Thanks to the paid propaganda of Harry and Louise, 47 million are worse off. Moore has a point of view, so what? Is he accurate when he says that people receive treatment at lower cost elsewhere? Yup.

Posted by: Mike on June 22, 2007 at 12:43 PM | PERMALINK

Mike,

Is Moore accurate when he says people receive treatment at lower cost elsewhere?

The answer is it depends. In the ground zero workers case, for example, it is accurate that those individuals may have received lung cancer treatment that their insurers in the US would not provide. So far so good as far as Moore is concerned (assuming these individuals actually were cared for once the cameras stopped rolling). But Moore uses this example to show how anyone can get this treatment in Cuba, for free no less. This is simply not accurate.

The only thing I would add to your comments, JM, is that in many countries with universal health coverage, we see that either a formal or informal multi-tier system emerges, with wealthier citizens continuing to have private insurance that offers better health care than the state-provided system. So no, these countries are not opting out of universal health care, but they are also not operating under a true one-payer system either. Seems to me the US will evolve to a similar solution, with some basic level of universal health care and then additional options for those willing to pay for them.

Posted by: Hacksaw on June 22, 2007 at 1:02 PM | PERMALINK

What bothers me is praise for Canada's health care system. When a former prime minister of that country needed cancer treatment... he went to Massachusetts.

Gawd, yet another strawman dance. Listen, Hamilton you twit. If I had the means, I would be headed to Sweden to get treatment for my Rhuematoid Arthritis.

If I picked up the phone right now to get an appt with my Rheumatologist I would be waiting 6 to 8 weeks to get in. When I tried to find a new Rheumatologist, the earliest anybody local could see me is in 3 months. And I have BCBS insurance...its decent (and I know how lucky I am to have it).

Take your strawman anecdotes and shove it. They are irrelevant to the real issues.

This is the second time we've heard Kevin mention Moore's allegedly mistakes and falsehoods... yet not a single example to back it up. Yes, you were saying, this time, that someone else said it, but still if you are putting it in your post. Back it up.

Posted by: Simp on June 22, 2007 at 1:02 PM | PERMALINK

...we see that either a formal or informal multi-tier system emerges, with wealthier citizens continuing to have private insurance that offers better health care than the state-provided system.

Take the NHS as an example. Private health insurance exists. But it is not accurate to say that the care covered by private insurance is "better" than the care provided through the NHS. Typically, such plans provide for things like a private hospital room or elective surgery "on demand."

...but they are also not operating under a true one-payer system either.

This is quibbling a bit, but again with the NHS example, no one is allowed to opt out of the NHS premium payment mechanism (taxation), so private plans are purchased over and above the amounts paid by an individual to the government. So it's a "true one-payer system" in that if you've got an NHS number, you can access care in the system. But you can choose private care if you want.

Here's the point: every system rations care in some way. "Waiting lines" for particular forms of surgery is one example: resource limitations require that choices have to be made in terms of clinical priorities. In the US, we ration care by price and ability to pay.

Posted by: JM on June 22, 2007 at 1:34 PM | PERMALINK

JM,

Fair points and I think you have done a great job characterizing the reality (i.e. the ups and downs) of the NHS. The important thing, and you have done it in your comments, is to be honest about what alternative solutions can and cannot do. Some people seem to forget or ignore the basic truth you cited: every system rations care in some way. And while our current system, which does ration by price, has led to unacceptable coverage gaps, we need to bear in mind that, contra Moore, the solutions in other nations have drawbacks of their own. Only then can we make informed decisions about fixing our system.

Posted by: Hacksaw on June 22, 2007 at 1:46 PM | PERMALINK

Our side needs some passion and, yes, perhaps a little simplicity, too.

No problem. You have plenty of passion and simplicity.

Posted by: MatthewRmarler on June 22, 2007 at 2:05 PM | PERMALINK

Marler, there's a sale on shame at Wal*Mart today. Go get some.

Posted by: shortstop on June 22, 2007 at 2:17 PM | PERMALINK

I pay assloads of money in insurance premiums - and I tell you what, for service? I get crap.

Watching this movie made me mad as hell.

Opponents of national healthcare are going to attack Moore. Because he's fat. And they're going to accuse him of lying. They're going to attack the messenger. Not the message. Because they can't win, attacking the message.

Posted by: osama_been_forgotten on June 22, 2007 at 2:27 PM | PERMALINK

You have plenty of passion and simplicity.

This from a guy who still claims that Saddam Hussein was a threat to our national security. You don't get much simpler than that.

Posted by: heavy on June 22, 2007 at 2:44 PM | PERMALINK

Yes passion and simplicity are important, but honesty and transparency are even more important - something Cohn seems to have forgotten.
Posted by: Hacksaw on June 22, 2007 at 10:21 AM | PERMALINK

Oh - so when a CORPORATION uses lies and packaging and simplicity to sell a product, it's okay - but when Michael Moore does it, it's wrong?

Look - where Michael Moore is fast-and-loose with the facts, it's because he has to package the information in his film for an audience that's not sophisticated enough or interested enough in hard statistics and science. He writes his message in crayon, using short sentences, and small words.

He's never claimed to be the end-all of this debate. His aim is not to settle the argument. His aim is to open people's minds to the debate. Some people will be convinced that we need National Healthcare, just by watching SiCKO - those people will be jumping to a conclusion that they hadn't ought to jump to. But others in the SiCKO audience are going to open their minds to the debate, and that's going to be the venue of the sunday morning talkshows, the blogs, and the upcoming political campaigns and debates.

There's a time and a place for hard facts, statistics, and detailed analysis. That's not what Moore was trying to do in SiCKO. Criticising him for simplifying his message for mass-consumption is a dishonest attempt at attacking the messenger.

The facts in the healthcare debate are there, they're widely available, for anyone who wants to go there. He hasn't hidden anything, and he surely hasn't misrepresented or lied about anything. The only thing he's done wrong is argued with anaecdote. Most of us know that that's not valid argument, but we appreciate that it makes the argument more accessible to a broader audience.

Posted by: osama_been_forgotten on June 22, 2007 at 3:04 PM | PERMALINK

Only then can we make informed decisions about fixing our system." Posted by: Hacksaw on June 22, 2007 at 1:46 PM

But there are informed decisions being made on the NHS. The decisions are being made by those who have a decided advance of influence and power to maintain the status quo for their personal benefit. These decision makers have the power to choose between filling their wallets or giving social privilages to strangers, and baser instinct is prevailing.

Since profit is a fact of modern life, what really needs to be addressed is either how to disconnect the NHS from profitability, or else patch it once again to the satisfaction of those in power over it.

Perhaps we are looking at curing a symptom called the NHS, rather than attempting to ease (note I did not say irradicate) the underlying disease among decision-makers where philanthropy has been replaced by something less palatable. What this run-away free market society is doing is recalibrating our social programs for the advantage of the few, not the many.

We cannot fix one without addressing the other.

Posted by: Zit on June 22, 2007 at 3:14 PM | PERMALINK

"All of the western European systems have undergone/are undergoing reforms, revisions, tweakings. That sort of thing is inevitable as all countries are constantly encountering epidemiological and demographic changes."

What happens when they have ideological changes? I'll bet those are the most challenging...

Posted by: just saying on June 22, 2007 at 3:49 PM | PERMALINK
But Moore uses this example to show how anyone can get this treatment in Cuba, for free no less. … Hack at 1:02 PM

I understand you fondness for using Cuba as a comparison. It is, after all, a third world nation. [Health and Education, comparing Cuba to the US ] However, according to standards in developed nations, the US pays more and receives less than any.
…Indeed, a May 15 study from the Commonwealth Fund study comparing the quality of the US system with five other countries found that despite spending twice as much per capita, the US ranks last or near last on basic performance measures of quality, access, efficiency, equity, and healthy lives. "The US stands out as the only nation in these studies that does not ensure access to health care through universal coverage," says Commonwealth Fund President Karen Davis….
in some respects, France comes pretty close to the ideal. Not only are its 62 million citizens healthier than the US population, but per capita spending on health care is also roughly half as much.

…make informed decisions about fixing our system. Hack at 1:46 PM

Those 'decisions' are always influenced by enormous expenditures of funds on TV ads by corporations who benefit the most from the status quo.

Posted by: Mike on June 22, 2007 at 4:05 PM | PERMALINK

You do realize that if we do impliment a universal healthcare that our government will do it as inefficiently and as expensively as possible with lots of money going to their friends in low places. To the comments about high infant mortality rate in the U.S., I have read that the discrepency is caused by the fact that we have different methods of counting preterm babies that we attempt to save.

Posted by: rickr on June 22, 2007 at 5:53 PM | PERMALINK

What happens when they have ideological changes? I'll bet those are the most challenging...

Indeed. Just to carry on with the example of Britain's National Health Service (NHS) that I was discussing above: for many years, the NHS has experimented with "internal market mechanisms" that were/are designed to inject more competition into the service. It's been years since I followed that stuff closely, and memory has faded, but suffice it to say that some of the experiments had some positive impact, others were hopeless failures.

But the larger point, which I tried to imply in an earlier comment on this thread, is that the majority of people in in Britain want universal coverage. They accept that they've got to pay for it, and they accept that there will be cross-subsidies (the healthy/relatively wealthy inevitably subsidize the coverage of the sick/relatively poor).

In other words, they've answered "yes" to the question of whether or not they want to ensure a basic, minimum level of insurance coverage for the whole population. The rest of it involves technical issues (what works, what doesn't, what is the most appropriate means of financing, what is the benefit package, etc.) And as long as we rely so heavily on for-profit, private health insurance, we will not achieve universal coverage.

Posted by: JM on June 22, 2007 at 6:05 PM | PERMALINK

One good point to ask anti-universalists: how could every single industrialized nation be wrong, and have lousy health care. Why would their populations all let them do that?

Posted by: Neil B. on June 22, 2007 at 7:57 PM | PERMALINK

I am a retired nurse who put a husband thru medical school in the 60s. So I know the doctor, the nurse, and the administrations's perceptive.

I am only going to address one issue: The 80 year old lady with hip replacement on a waiting list.

Not every 80 yr old is a subject for surgery
Waiting and preparation may be necessary

To do bypasses and hip replacement as a matter of record is not a good thing.

We did them when medicare first came out because it gave us a chance for mass learning of new technology. Rich people want highly experienced doctors. These operations were expensive but worth what medicare would pay as training.

Masses of old people got and died from the first cabbages because they were dangerous but necessary for learning.

Many old people with cataracts got surgery under medicare so they could learn how to use the new lazers. Now if you have not maintained the same insurance all your life; it is a prexisting condition.

The explosion of health care after medicare was essentially using old people to perform more procedures than ever before. Things that were never classified as surgery suddenly became so like removing ingrown toenails.

Universal health care needs caps on the doctors as much as the patients. You have one group of doctors saying to another what you want is not needed but being done to line your pockets. Both are wrong.

So from the beginning we will say after 70 no public transplants if you want one you will have to have supplemental insurance to pay for it. That is the only place insurers belong competing for the wealthy and rich. If you are Jane Fonda you can have anything you want whenever you want it but if you are little old lady on the block you choices will be limited. That has some element of common sense.

Posted by: 'yoduuuh on June 23, 2007 at 2:48 AM | PERMALINK

JM pointed out that private care is also available as an alternative to the NHS. I'll add that this is true throughout all of Europe. Here in Spain, a great many people have private insurance and use the insurers' own hospitals, but if money gets tight, they always have the Social Security national health system to keep them and all their family fully protected; and S.S. hospitals are the best in the country.

Another thing: if U.S. promoters n.h.s need to keep their message simple, why don't they call for "Medicare for everyone - and 100%", (I seem to recall that Ted Kennedy was speaking along these lines.) Medicare was a great blessing to my late, widowed mother when she was living in Maine, even though it was a squeeze for to meet that uncovered 20%.

Posted by: LeRoy on June 23, 2007 at 2:58 AM | PERMALINK

In response to a call before for some facts rather than anecdotes, here are some:

Survival rates of common cancers in different countries or regions, based on the numbers of diagnosed patients and their 5 year mortality rates (Sources: Commonwealth Fund, Health Affairs, Datamonitor)

stage I colorectal cancer
UK: 70%
Germany: 80%
US: 90%

stage I breast cancer
UK: 78%
US: 97%

Leukemia
EU: 35%
US: 50%

Esophageal carcinoma
EU: 6%
US: 12%

Mortality rates for breast and prostate cancer

Total breast cancer 5 year mortality rate:
New Zealand: 45%
UK: 45%
France: 35%
Germany: 33%
Canada: 28%
Australia: 28%
US: 25%

Prostate cancer 5 year mortality rate:
New Zealand: 55%
UK: 50%
France: 45%
Germany: 35%
Canada: 30%
Australia: 25%
US: 20%

Take those last two data sets into consideration. If you are a woman with breast cancer in Britain, there is nearly a 1 in 2 chance that you'll be dead in five years. In France and Germany, at least a 1 in 3 chance. In the US, a 1 in 4 chance, but a 3 in 4 chance that you will live.

For prostate cancer, your chances of surviving five years are literally 1 in 2 in Britain. Flip a coin, heads you live, tails you die. In France, its' not much better. Germany and Canada, you have a 1 in 3 chance of dying. The US, 1 in 5. There is an 80% chance that you'll survive.

Added to this is the fact that the US is funding 75% of the world's medical and biotech R&D. Europe is essentially dropping out of the biotech race because they can't afford it. Major European pharmaceutical firms, like Bayer and Novartis, are doing most of their research and getting most of their profits from the US these days. This is an issue that Moore won't touch, because it doesn't support him. Politically-controlled socialized medicine kills innovation.

BTW, there's a reason that Michael Moore and other political health care proponents always cite life expectancy and infant mortality, rather than say cancer mortality, as their big statistics. They're easy to game. It's as regular as clockwork: infant mortality and life expectancy. The only problem is that both of these statistics are affected by a large number of factors, and health care is not a significant one. Habits (diet, smoking, exercise) affect life expectancy. Maternal work, diet and family life affect infant mortality. Case in point: Mexican-Americans have a lower infant mortality than African-Americans despite the fact that they're half as likely to give birth in a hospital. Oh, and it's a bad idea to quote statistics from Castro's Cuba as gospel in general (on infant mortality, for example, like China, Cuba aborts high-risk infants). Even in Europe, they won't list infants who are premature or underweight in their infant mortality statistics.
Keep in mind something about government health care. Politicians respond to voters. Dead people don't vote. Ergo: the politicians won't care whether you live or not.

Posted by: Tom on June 23, 2007 at 7:47 AM | PERMALINK

Tom,

It appears that you and some others are conflating how medical research is managed with how medical insurance is. As I understand it, these are two different issues. Has Medicare made our medical technology less efficient? I haven't seen any evidence that it has, so why would an expansion of that program or something similar hurt our ability to treat cancer? Please explain, preferably with evidence rather than paranoid theories about the evils of socialism.

Posted by: Jess on June 24, 2007 at 12:51 AM | PERMALINK

Also liked the list, Aris. It is a mighty cloud of bullshit indeed that erupts from the right whenever the subject of health care reform is brought up. Glad to see at least one hardy soul is trying to taxonomize this stuff so the rest of us may wade through it more quickly.

Posted by: sweaty guy on June 25, 2007 at 12:33 AM | PERMALINK




 

 

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