What if Michael Moore had not made "Sicko"?

[Policenaut]

I think it needs a total revamp to be honest because the system wasn't designed to cope with the number of people that are on it now and the cost of new medical procedures. If it was started 40 years ago as a universal system them maybe it would be similar to Canada or the UK but it wasn't. And now that we have lost a potential of 40 years of time to tinker with a universal system we are seemingly stuck with what we have now because a total revamp would cost who knows how many trillions. We did elect new people in the end I think "change" is going to be more like "almost qualifies as slightly different".

 

[Rolfe]

There seems to be an attitude among better-off Americans that "I'm all right, let's not change anything". If there is really an argument that nothing needs changed, I haven't heard it yet. This at least is something Sicko does - show the plight of the people who aren't so lucky, in a way calculated to make the lucky ones sit up and notice.

Nobody is suggesting the USA should copy the NHS. Nobody is suggesting that the NHS is perfect either. However, note that when it fails, the aggrieved complainers are complaining about not getting what they're entitled to. Even free nappies (diapers) in that link. How many US parents in that situation would be entitled to have the nappies supplied to them free of charge? I think it's a bit naive of the man to be asserting that if he'd been in the USA and had insurance, everything would have been fine. Having a severely-disabled child isn't the easiest situation from which to maintain good insurance cover for the family.

The problems people are reporting about the US system are much more fundamental - people stranded with no entitlement to care. In spite of having paid a lot of money to insurance companies. That is what Sicko is about, and if I were American, it would certainly worry me.

For all the nose-holding about Moore's presentational methods, he is highlighting a very real problem. And I have to say I've seen even more emotionally-charged and dramatised presentations from the other side of the debate, with added lies. I think it is possible to look at the examples in Sicko just as we looked at them in Stossel's piece, and others. And I see all the posturing about the presentational style as a ploy to avoid doing esxactly that.

Rolfe.

 

[GreNME]

I would tend to agree that a revamp would more realistically and effectively service more people with healthcare and for lower cost, but unfortunately none of the current bills address this, and I couldn't think of a single politician in office right now who would ever broach the subject like that.

 

[Rolfe]

I think it needs a total revamp to be honest because the system wasn't designed to cope with the number of people that are on it now and the cost of new medical procedures. If it was started 40 years ago as a universal system them maybe it would be similar to Canada or the UK but it wasn't. And now that we have lost a potential of 40 years of time to tinker with a universal system we are seemingly stuck with what we have now because a total revamp would cost who knows how many trillions. We did elect new people in the end I think "change" is going to be more like "almost qualifies as slightly different".

I don't agree at all. Although you have lost time, other countries have come to universal healthcare late, and are managing quite competently. Belgium and Australia come to mind. You also have the unparalleled advantage of being able to look at the wide variety of systems in operation and choose what works, rejecting what isn't working. If only you would actually look at these systems and see what they achieve, rather than simply trawling for problems so that you can shout, oh look, universal healthcare sucks.

You are also spending twice what other countries do, per skull of population, to cover only about 85% of the population rather than 100%, and even the 85% can't be confident it won't lose cover. How long can you go on affording this? It's about 8% of GDP down the toilet, because you aren't getting overall better health outcomes for your money.

Choosing the path to get somewhere sustainable, where all your population can access affordable healthcare and you're spending maybe 60% of what you are at the moment is a tough call, but it's far from impossible.

Doing nothing is a recipe for a very bad situation a decade or two down the track.

ETA: I think you would find this film very informative. Sick around the world.

Rolfe.

 

[WUBRINY63]

What if Michael Moore had not made "Sicko"?

Republicans wouldn't need to just pretend like he didn't.

 

[easycruise]

Half of all the bankruptcies in the Unite States are due to medical bills.

More like sixty percent, actually, a claim which can be backed by evidence.[/i]"

Actually, according to the study, it's only 29%, if you take the time to read it. ""Debtor said medical bills were reason for
bankruptcy" was only 29%. Table 2, page 3.

I don't put much stock in that study for numerous reasons. First, according to the study, (table 2, page 3) 40% of bankruptcies are from a loss of greater than or equal to 2 weeks of income from their job. I don't think that you can blame the lack of universal healthcare for someone quitting their job because they are too sick to work. Costs of their healthcare itself have nothing to do with it. Blame it on the failings of their own health.

Second, 35% of debtors who filed for bankruptcies said that medical bills were greater than $5000 OR greater than 10% of their annual income. That doesn't mean that it caused it. Besides, getting sick and then getting cured is just another pothole of life. If your house needs a new roof, (around $5,000?) do you expect the government to bail you out and give you a new roof? Should we have government sponsored roof repair insurance? Where does it end with the Nanny State?

Furthermore, 31% of filers said they had NO insurance at the time of filing, which could indicate some irresponsibility on their part. And a whopping 40% said that they had a lapse in insurance coverage during the prior two years. (Table 3). With COBRA coverage lasting 18 months (last I checked), there seems little reason not to have insurance uinless they willfully dropped it. For you non-American forum members, COBRA is a federal law where you can continue getting your former employers health insurance, but you have to pay the premiums yourself at your former employers cost basis.

There has to be an accounting of personal responsibility here and I see a lot of it lacking in these bankruptcy filers. I can only wonder how many rolled the dice and bought a new plasma TV instead of paying the insurance premiums.

 

[easycruise]

repeat

 

[easycruise]

I don't agree at all. Although you have lost time, other countries have come to universal healthcare late, and are managing quite competently. Belgium and Australia come to mind.

Ahem. For years, there have been numerous news reports coming out of Australia that indicate that the system has many severe problems. Here's just a sampling.

http://www.smh.com.au/news/National.../2004/11/22/1100972329979.html?oneclick=true#

http://www.smh.com.au/news/National...y/2005/06/29/1119724691524.html?oneclick=true

http://www.smh.com.au/news/National...g/2004/11/30/1101577489952.html?oneclick=true

How long can you go on affording this? It's about 8% of GDP down the toilet, because you aren't getting overall better health outcomes for your money.

Ive read studies where we ARE getting better outcomes for our money. One was mentioned previously in this thread.

 

[Kevin_Lowe]

Ahem. For years, there have been numerous news reports coming out of Australia that indicate that the system has many severe problems. Here's just a sampling.

http://www.smh.com.au/news/National.../2004/11/22/1100972329979.html?oneclick=true#

http://www.smh.com.au/news/National...y/2005/06/29/1119724691524.html?oneclick=true

http://www.smh.com.au/news/National...g/2004/11/30/1101577489952.html?oneclick=true



Ive read studies where we ARE getting better outcomes for our money. One was mentioned previously in this thread.

As an Australian myself, this looks to me like exactly the behaviour Rolfe was talking about earlier: trawling for isolated problems to hold up as proof that government health coverage doesn't work, while ignoring the fact that the system as a whole achieves better outcomes for less money than the US system.

The Australian system is far from utopian, but nobody ever said it was perfect. Just much better than the US system from both moral and practical perspectives.

 

[jimbob]

There are so many "isolated" disasters about the NHS that makes one seriously wonder if they really arn't that isolated. Yet another one just yesterday...

http://www.independent.co.uk/opinio...lieve-that-the-nhs-is-sacrosanct-1775088.html

Ahem. For years, there have been numerous news reports coming out of Australia that indicate that the system has many severe problems. Here's just a sampling.

http://www.smh.com.au/news/National.../2004/11/22/1100972329979.html?oneclick=true#

http://www.smh.com.au/news/National...y/2005/06/29/1119724691524.html?oneclick=true

http://www.smh.com.au/news/National...g/2004/11/30/1101577489952.html?oneclick=true



Ive read studies where we ARE getting better outcomes for our money. One was mentioned previously in this thread.

These are reasons for improving the implimentation ofthe Universal Healthcare, not for avoiding it.

What do you have to say about the far greater failures in US healthcare for the large number of Americans who have inadequate coverage?

I can provide examples if you want.

 

[jimbob]

Here's another reason we need some pretty drastic health insurance regulations.

This supplemental memo (pdf) summarizing the findings of the House committee's investigation of rescission reads about like a transcript of Sicko.

It's deplorable that people can dutifully pay their premiums for years, even decades, and then basically be cancelled when they get seriously (expensively) sick.

Some shocking instances covered in the executive summare of the PDF:

Insurance companies rescind coverage even when discrepancies are unintentional or caused by others. In one case reviewed by the Committee, a WellPoint subsidiary rescinded coverage for a patient in Virginia whose insurance agent entered his weight incorrectly on his application and failed to return it to him for review. The company's Associate General Counsel warned that the agent's actions were "not acceptable" and recommended against rescission, but she was overruled.
• Insurance companies rescind coverage for conditions that are unknown to policyholders. In 2004, Fortis Health, now known as Assurant, rescinded coverage for a policyholder with lymphoma, denying him chemotherapy and a life-saving stem cell transplant. The company located a CT scan taken five years earlier that identified silent gall stones and an asymptomatic abdominal aortic aneurysm, but the policyholder's doctor never informed him of these conditions. After direct intervention from the Illinois Attorney General's Office, the individual's policy was reinstated.

Hard to disagree with the summary:

EXECUTIVE SUMMARY
Last year, the House Committee on Oversight and Government Reform initiated an investigation into problems with the individual health insurance market. This year, the Energy and Commerce Committee, and its Subcommittee on Oversight and Investigations, continued that investigation. This memorandum presents the Committee's findings.

The Committee sent document requests to 50 state insurance commissioners and three health insurance companies that provide individual health insurance policies, Assurant Health, WellPoint, Inc., and UnitedHealth Group. The Committee obtained approximately 116,000 pages of documents and interviewed numerous policyholders who had their coverage terminated,
or "rescinded," after they became ill.

The Committee's investigation demonstrates that the market for individual health insurance in the United States is fundamentally flawed. - -

ETA: and a bit more:

Insurance companies have evaluated employee performance based on the amount of money their employees saved the company through rescissions. The Committee obtained an annual performance evaluation of the Director of Group Underwriting at WellPoint. Under "results achieved" for meeting financial "targets" and improving financial "stability," the review stated that this official obtained "Retro savings of $9,835,564" through rescissions. The official was awarded a perfect "5" for "exceptional
performance."

In written testimony for today's hearing, all three insurance companies stated that the passage of comprehensive health care reform legislation, including a system where coverage is available to everyone and all Americans are required to participate, would eliminate the controversial practices of denying coverage based on preexisting conditions and rescinding policyholders for omissions in their medical records.

 

[easycruise]

As an Australian myself, this looks to me like exactly the behaviour Rolfe was talking about earlier: trawling for isolated problems to hold up as proof that government health coverage doesn't work, while ignoring the fact that the system as a whole achieves better outcomes for less money than the US system.

The Australian system is far from utopian, but nobody ever said it was perfect. Just much better than the US system from both moral and practical perspectives.

Not true. You have blinders on. Not isolated at all. Here's another report...Just a few weeks ago.

http://www.theaustralian.news.com.au/story/0,25197,25843610-7583,00.html

from the article...

""IT'S a quarter of a century since Medicare was established, but no one is celebrating. No wonder, considering the critical condition of the public hospital system throughout Australia. Instead we have a 300-page reform blueprint from the National Health and Hospital Reform Commission. At least the report has identified the main problem. The reality is that Australia's dangerously overcrowded public hospitals don't have enough beds to provide a safe and timely standard of care even for emergency patients. Unfortunately, the commission has strongly supported a range of non-solutions. The primary care reforms it proposes will not help our dysfunctional state-run public hospitals cope with an inexorable rise in demand from an ageing population.""

Sounds like your healthcare system really sucks.

It's just much better than the US system from both moral and practical perspectives.

Yea right. Sure it is.

 

[jimbob]

Let's look at Japan and Germany. These were countries whose infrastructure and economies were thoroughly destroyed in WW2, along with tens of millions of dead. They didn't become the economic powerhouses they are today by emulating the type of system that Castro forced on Cuba. Or look at Israel. Here's a country that started out as nothing but desert shortly after WW2. And today it's per capita GDP is three times that of Cuba. Economic systems like Cuba's have consequences.

Japan and Germany both have well-established welfare states.

I can't find the quote, but I have read that the Japanese explicitly tried to base make their welfare state more comprehensive than the post-1945 UK model.

 

[Safe-Keeper]

Rolfe: http://www.pbs.org/wgbh/pages/frontline/view/

 

[easycruise]

More horrific news from Australia..

""He (Rudd) would have to ignore the reality reported daily in our newspapers.

In NSW, hospitals don't pay doctors, nurses pay from their own purses to keep vital equipment operating, and drug companies, food suppliers even security companies refuse services to hospitals because they don't get paid. Pregnant women miscarry in public hospital toilets because of overstretched staff and facilities.

In Queensland, years after the "Dr Death" scandal, hospitals operate with doubtful doctor credentialling practices. In South Australia, bungle after bungle is revealed in cancer treatment in hospitals. The case for reform in our public hospitals is compelling.

But Rudd and Labor's track record is not promising. Apart from fixing hospitals, Rudd promised 31 GP super clinics for the nation. So far one troubled facility has opened. ""

http://www.theaustralian.news.com.au/story/0,25197,25102169-7583,00.html

 

[easycruise]

NHS denies cancer drugs to people with kidney cancer and they die sooner. Drug rationing, dontcha know.

http://news.bbc.co.uk/2/hi/health/7579422.stm

""We have seen distraught patients remortgaging their houses, giving up pensions and selling cars to buy drugs that are freely available to those using health services in countries of comparable wealth." "

""Although none of the available treatments "cure" cancer that has spread from the initial tumour, they can help extend a patients' life by around five to six months.""

And isn't that the rub with socialized medicine? Denied and delayed care causes people to die sooner. In the U.S. we may have denied care on experimental procedures, but delayed care isn't really the situation. Take a look at MRI and CT scan waiting times.
In Canada and the NHS in England, you have to wait many weeks. In the US, a day or two.

http://www.privatehealth.co.uk/news/july-2006/mri-and-ct-scans/

http://www.winnipegsun.com/news/columnists/tom_brodbeck/2009/08/14/10458756-sun.html

http://ottawa.ctv.ca/servlet/an/local/CTVNews/20080226/OTT_MRI_Wait_080226?hub=OttawaHome

And isn't the MRI or CT scan the real first step in diagnosing a potential severe health problem? Some tumors grow fast, and time is of the essence.

 

[Rolfe]

Rolfe: http://www.pbs.org/wgbh/pages/frontline/view/

Thanks, I found it myself last night, and started to watch it.

I think this and its companion piece, taken together, are actually the complete answer to my thread title. Together, they're almost as long as Sicko, they cover pretty much exactly the same points (the problems with the US health insurance market, and the fact that countries with universal healthcare systems are not exactly hell-holes of poor care), and it's done in a fairly straight documentary style.

Personally, I didn't find Sicko's presentational strategy off-putting. Sometimes trying to evoke an emotional response to a situation is a proper way of playing it. And it's not as if the anti-universal-healthcare advocates don't do exactly the same.

What annoyed my about Sicko was the lack of detail about some of the cases, so that we didn't know precisely what the problem was in the system that had led to the person's situation, or sometimes even if they were representing the situation quite fairly. However, so far I've found nothing to suggest gross misrepresentation anything like the sort that was so obvious in the Stossel examples and others.

The most misleading one I've noted so far was the Tracy Pierce story. The situation described might just as easily have happened in a country with universal healthcare - a dying man was clutching at straws and applying for untested treatments of dubious efficacy. The real irony here was a bit too subtle for Moore. That when this happens in the NHS (for example) the US right wing starts howling about rationing, and denial of care, and putting a price on human life, and having a "bureaucrat" between you and your doctor (no, these decisions are made by senior consultants, not bureaucrats). But exactly the same thing happens in the USA, because it's inevitable when terminal illness encounters an expensive straw to clutch at, and this is the real message of the sad case of Tracy Pierce.

The Frontline examples are all more fully explained, and without the emotional overtones. They're just as shocking as Sicko. So, if this is what the Moore-bashers wanted, they got it. The material exists. It's well done, indeed.

So how come this has such a low profile?

Rolfe (going to watch the rest).

 

[ddt]

Let's look at Japan and Germany. These were countries whose infrastructure and economies were thoroughly destroyed in WW2, along with tens of millions of dead. They didn't become the economic powerhouses they are today by emulating the type of system that Castro forced on Cuba. Or look at Israel. Here's a country that started out as nothing but desert shortly after WW2. And today it's per capita GDP is three times that of Cuba. Economic systems like Cuba's have consequences.

Thanks jimbob, for highlighting this part of BAC's post. I didn't want to derail this thread but it seems quite unavoidable.

Germany's welfare state dates back to the 1880s. It was instituted by Bismarck, a rightwinger. He instituted a.o. old-age pensions and a health care system that is still virtually the same. It's not completely UHC, but it has mandatory health insurance for low- and middle-income people, administered by non-profit insurers, the "Krankenkassen", which also offer non-mandatory insurance to high-income people, competing with for-profit insurance companies. Oh, and the same Krankenkassen administer the sick-leave money, which is 70% or 80% of your income, so you don't get broke while being ill due to lack of income.

For Israel's healthcare system, see Oliver's thread on it. It's an UHC system.

It helps to know your facts before posting on it.

 

[Rolfe]

Easycruise, tu quoque isn't much use as an argument.

The Australian system is off topic to this thread. The NHS was certainly covered in Sicko, with footage showing the normal experience of ordinary British people using the system. This is relevant in that opponents of universal healthcare frequently paint the NHS as some sort of hellhole that nobody would want to use if they could help it. In reality, we have no evidence that the proportion of British people feeling let down by the system is any more than those abandoned by the American system.

I would just point out one thing. Private health insurance is available in Britain, and there are quite a few companies offering it. It's significantly cheaper than in the USA, because the insurers know that most ordinary GP visits and emergency treatment will be provided by the NHS anyway. It's not uncommon for employers to provide this for their senior staff, as an employment benefit, principally because it gives a better choice of when you have elective procedures done, which can be important for businesses.

Maybe you need to look up how many private individuals buy private health insurance for themselves. There will be some, of course, well-off people who don't want to rub shoulders with the Great Unwashed in an NHS hospital. However, I doubt if you'll find anybody who is going without luxuries to buy private insurance because they're concerned about the standard of care in the NHS. If your scary picture was anywhere close to common perception, BUPA would be doing a helluva business - which just isn't the case.

The instances you point up involve new, very expensive drugs that have not (or not yet) been approved for use in the NHS. This will always happen to some extent. It happens in the USA too - look at the Tracy Pierce story on Sicko. The situations you describe are drugs that are not considered cost effective. Sounds callous, but would you want your insurance fund to pay $100,000 for a treatment for someone that had only a 10% chance of extending their dying process by a week? No?

So where do you draw the line? Your post suggests you think the NHS draws the line too low. You may be right. However, nobody has suggested the USA should do exactly the same. Considering that you're currently spending twice as much as we do (per capita) on healthcare, you should be fairly comfortable that you can set that line a lot higher if you choose.

You seem to suggest that universal healthcare is a failure if it can be shown that it doesn't provide absolutely everything to absolutely everybody. How does drawing the line at very expensive drugs that only prolong dying for some weeks negate the enormous benefits of excluding nobody from the standard, routine healthcare we see unfortunate Americans being denied every time we look at the issue - whether it's Sicko, or Sick Around America, or the findings of the House Committe that investigated recission last June?

How do you justify the exclusion of so many American people from the sort of ordinary, basic care anyone in Britain is guaranteed?

Rolfe.

 

[Kevin_Lowe]

More horrific news from Australia..

My apologies to Rolfe for derailing the thread. Easycruise, if you'd like to discuss the pros and cons of the Australian system as opposed to the US system please start a new thread and we'll discuss it there.

As Rolfe said, the specifics of the Australian system aren't germane to a discussion of the points made in Sicko.