Sicko: concerns about US medicine

How does it feel to get brainwashed?

MahSpoon said:

How does it feel to get brainwashed?

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ohhh so true...you fell for it

MahSpoon said:

How does it feel to get brainwashed?

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is this the 2nd or 3rd sicko thread?

Dude, that movie is ridiculously biased.

at least the third time this has been posted.

And I'm genuinely curious why this was an "amazing" movie. I watched it yesterday and I have to honestly say it was extremely disjointed. In the first half of the movie he basically makes some very strange, half-assed attempts to show how terrible insurance is, though of course that was 5 cases out of the how many hundreds of millions of americans we have? seriously, those cases represent the norm in america? the rest of the film gives socialism a handjob without ever actually mentioning the true nature of socialism. it's just "free, free, free," never "so how does it ACTUALLY get paid?"

then he goes to Canada and shows us some American ABUSING the system.. lying to get free healthcare. seriously, that's convincing? some guy gets his $24,000 surgery "for free"... at what point does Moore discuss how much everyone pays in taxes for this "free" healthcare? I seem to have forgotten that part.

how about England, where his interviewee doctor "zomg lives in a million dollar home!!!?!!?!?!" and makes.. umm.. $150,000/year? seriously, you're going to brag on how much that guy makes and where he lives? if someone made $150,000 in the US and lived in a million dollar home he'd be fighting bankrupty every step of the way. oh yeah, and the doctor "gets a bonus for making people health!!!" let me ask you, what effect does having healthier patients have on healthcare spending? they spend less on healthcare if they're not at the hospital, right? is that..umm.. the same thing that Moore was bashing the US insurance reps for doing, saving money by getting people not to go to the hospital?

then there's France, where the guy "who had never worked a day in France" goes back home from the US to get absolutely free healthcare. and after his chemo, his doctor writes him a note that gives him 3 months paid leave from work. yes, the man who "never worked a day in France" gets 3 months paid leave from work. how is he getting paid leave from work if he has never worked in France? 2+2 is not 4 in this situation.. if you fell for it, you're an idiot. then he goes on and on about some nanny who washes your clothes and watches your kids.. seriously? what's that have to do with anything?

and "smart, sexy" Hillary Clinton, well that's a pure work of genius. all he does is say "dem evil republicans is doin it to us!!1" and talking about how great the democrats are. except he never once actually makes a point that couldn't be said about democrats. it also never comes to any kind of logical conclusion, just throws out a bunch of stupid clips about "I love my mama."

if you really think it was convincing, go back and watch it without the blinders on your eyes. see how much information is left out on a case by case basis. ask if everything truly was "free" (think about their taxes). ask yourself if the sob stories he threw in there are actually 100% true (a baby gets turned away from the ER with a fever of 104? EMTALA might have a problem with that). the ONLY thing it showed about US medicine that's "bad" is that some people have some really terrible insurance and horrible stories about their crappy insurance. that's not everyone, but I guess if you're only going to show a few stories then you can make them look however you want. notice how he said he got 25000 emails from people with sob stories about their healthcare. how many do you think he'd get if he asked for good healthcare stories? 25,000 is .0001% of the population, is that a fair representation of all americans?

that's all I've got off the top of my head.

armybound said:

at least the third time this has been posted.

And I'm genuinely curious why this was an "amazing" movie. I watched it yesterday and I have to honestly say it was extremely disjointed. In the first half of the movie he basically makes some very strange, half-assed attempts to show how terrible insurance is, though of course that was 5 cases out of the how many hundreds of millions of americans we have? seriously, those cases represent the norm in america? the rest of the film gives socialism a handjob without ever actually mentioning the true nature of socialism. it's just "free, free, free," never "so how does it ACTUALLY get paid?"

then he goes to Canada and shows us some American ABUSING the system.. lying to get free healthcare. seriously, that's convincing? some guy gets his $24,000 surgery "for free"... at what point does Moore discuss how much everyone pays in taxes for this "free" healthcare? I seem to have forgotten that part.

how about England, where his interviewee doctor "zomg lives in a million dollar home!!!?!!?!?!" and makes.. umm.. $150,000/year? seriously, you're going to brag on how much that guy makes and where he lives? if someone made $150,000 in the US and lived in a million dollar home he'd be fighting bankrupty every step of the way. oh yeah, and the doctor "gets a bonus for making people health!!!" let me ask you, what effect does having healthier patients have on healthcare spending? they spend less on healthcare if they're not at the hospital, right? is that..umm.. the same thing that Moore was bashing the US insurance reps for doing, saving money by getting people not to go to the hospital?

then there's France, where the guy "who had never worked a day in France" goes back home from the US to get absolutely free healthcare. and after his chemo, his doctor writes him a note that gives him 3 months paid leave from work. yes, the man who "never worked a day in France" gets 3 months paid leave from work. how is he getting paid leave from work if he has never worked in France? 2+2 is not 4 in this situation.. if you fell for it, you're an idiot. then he goes on and on about some nanny who washes your clothes and watches your kids.. seriously? what's that have to do with anything?

and "smart, sexy" Hillary Clinton, well that's a pure work of genius. all he does is say "dem evil republicans is doin it to us!!1" and talking about how great the democrats are. except he never once actually makes a point that couldn't be said about democrats. it also never comes to any kind of logical conclusion, just throws out a bunch of stupid clips about "I love my mama."

if you really think it was convincing, go back and watch it without the blinders on your eyes. see how much information is left out on a case by case basis. ask if everything truly was "free" (think about their taxes). ask yourself if the sob stories he threw in there are actually 100% true (a baby gets turned away from the ER with a fever of 104? EMTALA might have a problem with that).

that's all I've got off the top of my head.

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You're right. Nothing's free. Moore surely made a huge mistake on the film. But don't you think it's a better system because less money goes to healthcare as there's no insurance companies' profit out of patients' money?

LicensedPremed said:

You're right. Nothing's free. Moore surely made a huge mistake on the film. But don't you think it's a better system because less money goes to healthcare as there's no insurance companies' profit out of patients' money?

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I think it's a less wasteful system where less money is tied up in paperwork and overhead, yes. would I call it a "better" healthcare system just because of that? no.

I think you're a little laxadaisical about Moores "huge mistake," since that was the ENTIRE point of the movie. if the fundamental basis of the movie is a "huge mistake," how could anyone take it as a good story?

Moore also failed to mention that the US has about as many uninsured as the entire population of these socialized countries. how do you know this system will work when our population is so much larger than theirs?

armybound said:

I think it's a less wasteful system where less money is tied up in paperwork and overhead, yes. would I call it a "better" healthcare system just because of that? no.

I think you're a little laxadaisical about Moores "huge mistake," since that was the ENTIRE point of the movie. if the fundamental basis of the movie is a "huge mistake," how could anyone take it as a good story?

Moore also failed to mention that the US has about as many uninsured as the entire population of these socialized countries. how do you know this system will work when our population is so much larger than theirs?

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I do not know and nobody knows the answer at this point. But I have a humble opinion that it would be way better than what we have now. I am not saying that we should follow other countries' examples (they have their own culture and their healthsystem is based on their culture) In my opinion, I think we should keep what we have now except insurance companies. If government kicks in the business where insurance companies now reside, healthcare cost will drop (because government does not make profit), more people can go to see doctors (people have to pay healthcare taxes but it surely is less than insurance fee) without hurting our healthcare quality(because same amount of money is still paid) unless government seeks fiscal policy from it(they obviously cannot do this). Isn't it certainly a better system?

LicensedPremed said:

I do not know and nobody knows the answer at this point. But I have a humble opinion that it would be way better than what we have now. I am not saying that we should follow other countries' examples (they have their own culture and their healthsystem is based on their culture) In my opinion, I think we should keep what we have now except insurance companies. If government kicks in the business where insurance companies now reside, healthcare cost will drop (because government does not make profit), more people can go to see doctors (people have to pay healthcare taxes but it surely is less than insurance fee) without hurting our healthcare quality(because same amount of money is still paid) unless government seeks fiscal policy from it(they obviously cannot do this). Isn't it certainly a better system?

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You're assuming that insurance overhead is the sole reason for high healthcare costs and peoples' inaccessibility to healthcare, which simply isn't true. Theoretically is it a better system, yes. In practice, will it be? I don't think so.

I also don't see the point in "fixing the problem" of a small portion of the population, but forcing the entirety of the nation to participate in it. I think the US could find ways to fund healthcare subsidization for the poor or underinsured without forcing everyone to change their healthcare plan. Even in these cases where people are in socialized medicine, it's not uncommon for people to also take out private insurance so they can be seen by specialists of their choice in a reasonable time at a more private facility. Now that person has to pay twice to get the same thing they were getting before. That's fair..?

Government-run insurance right now is also one of the worst reimbursers, according to what I've heard. It may "reduce healthcare spending," but that means hospitals will be making less. I'm not sure if that's good for the future of our healthcare system, especially as the baby boomers hit retirement and their kids age. We're already on the cusp of a healthcare crisis due to too few doctors and nurses, paying them worse while keeping medical school prices high surely isn't going to fix that problem.

I also want to mention Moore's disgust with "pre-existing conditions." You know, if you were to be able to get insurance at any time, why would people keep insurance? You'd just buy it when you're sick and get rid of it when you're healthy. If my dad needed a $100,000 bypass, I'd just buy him insurance right before the surgery and get rid of it afterwards. We'd only be out like $500 in fees and premiums, no big deal. I wouldn't buy car insurance until I wrecked..

But what's that do to the insurance company? That puts them at a HUGE loss that needs to be made up elsewhere. Socialized systems don't care because you pay for life, there is no adding/dropping. You don't get to choose your insurer or your level of coverage.

And the woman who didn't get "pre-approved" for the ambulance ride is interesting.. maybe ambulance rides were not a part of the policy that she signed up for. They never mention that, do they? You have to think about these things a little more critically.

You're assuming that insurance overhead is the sole reason for high healthcare costs and peoples' inaccessibility to healthcare, which simply isn't true. Theoretically is it a better system, yes. In practice, will it be? I don't think so.

I do not think so too. I believe that high healthcare cost is due to lack of preventative medicine. Before people get sick, they can surely prevent it with less or no money. What I was saying does not intend to solve our health problem entirely. what I meant is BETTER not SOLUTION.

I also don't see the point in "fixing the problem" of a small portion of the population, but forcing the entirety of the nation to participate in it. I think the US could find ways to fund healthcare subsidization for the poor or underinsured without forcing everyone to change their healthcare plan. Even in these cases where people are in socialized medicine, it's not uncommon for people to also take out private insurance so they can be seen by specialists of their choice in a reasonable time at a more private facility.

I did not make a point in "fixing the problem" in the first place. As I was saying, I meant BETTER not SOLUTION.

Now that person has to pay twice to get the same thing they were getting before. That's fair..?

I am sorry. I do not understand this part. Maybe it's due to my lack of comprenesion level.

Government-run insurance right now is also one of the worst reimbursers, according to what I've heard.

What is it that you heard? Can you specify this?

It may "reduce healthcare spending," but that means hospitals will be making less.

I did not say pay less to hospitals and doctors as it can lead less healthcare quality. My point was getting ONLY insurance companies' profit out of healthcare industry. In my theory, still same amount of money is paid to doctors and hospitals.

I'm not sure if that's good for the future of our healthcare system, especially as the baby boomers hit retirement and their kids age. We're already on the cusp of a healthcare crisis due to too few doctors and nurses, paying them worse while keeping medical school prices high surely isn't going to fix that problem.

Of course we have serious problems. But we cannot seek a nuclear bomb or WMD to blow every problem away.

LicensedPremed said:

I do not think so too. I believe that high healthcare cost is due to lack of preventative medicine. Before people get sick, they can surely prevent it with less or no money. What I was saying does not intend to solve our health problem entirely. what I meant is BETTER not SOLUTION.

I did not make a point in "fixing the problem" in the first place. As I was saying, I meant BETTER not SOLUTION.

I am sorry. I do not understand this part. Maybe it's due to my lack of comprenesion level.

What is it that you heard? Can you specify this?

I did not say pay less to hospitals and doctors as it can lead less healthcare quality. My point was getting ONLY insurance companies' profit out of healthcare industry. In my theory, still same amount of money is paid to doctors and hospitals.

Of course we have serious problems. But we cannot seek a nuclear bomb or WMD to blow every problem away.

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I agree with preventive medicine. Moore went on a little spiel about how Europeans are so much healthier. I think he was trying to say that it's because their healthcare systems are so much better.. simply not the case. Americans are fat. Americans are lazy. This causes a lot more healthcare problems than we need. Proper diet & exercise are preventive medicine that would save a lot of lives. Look at Moore's list of top killers in the US.. diabetes, cardiovascular disease, stroke.. all can be somehow tied to poor diet and exercise if you think about it. Stroke and diabetes mellitus can be argued, but still, you have to realize that a good way to save a lot of healthcare dollars is for Americans to simply eat better and get off their butts. It's that simple.

I wasn't saying you particularly were saying it's the solution, I was referring to people who say socialized medicine is the cure.

The part I didn't make clear was about socialized medicine and how people have to pay for the government-given insurance (through taxes) and often have to take out private insurance as well. This means they have to buy 2 insurance plans to get the same payout (private insurance). I guess people think that private insurance completely goes away when there's a socialized system in place, but it's not true.

I have been told (by a friend who works in hospital reimbursement) that Medicare and Tricare pay really poorly. I can't back it up with any figures though, sorry.

Saying you'll simply take profit away from an industry is a bit of a slippery slope. Why don't we steal Big Oil's profit to subsidize gas prices? Well, the US has a capitalist economy, and people don't get punished for pulling a profit. Now if you want to expand the US government health insurance, I'd be all for it.. but it should be opt-in. People should be able to choose to have it instead of forcing everyone to pay some fixed amount of their salary for it, whether they want it or not. In my opinion, anyway.

stat3113 said:

So I just saw Sicko and it was amazing. I'm beginning to have serious concerns about the US medical system and whether I could be happy practicing here. I feel like I would want to spend massive amounts of time working in free clinics or volunteering abroad (Cuba seems nice.) That or working full-time in Europe. That French on-call doctor was really cool.

But I'm sure reality comes home for most idealists like this when they graduate with 300,000$ in debt and they realize they have become indentured servants. They find the most well-paying jobs (which are in many cases the jobs that involve the most moral slippage) hoping to get rid of that crazy debt and then be free to save the world. And before they know it, they are 70 years old and they have spent their whole life in the system, dreaming of the day they could get out.

We are strangled with debt, kept in chains, so that we make the least amount of trouble for the world order. There is no way an average doctor with tons of debt fresh out of medical school can even dream of working at a free clinic or moving to a 3rd world country. I'm just feeling pretty pessimistic about the role of medicine in modern society. Any thoughts?

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Quit feelin' sorry for yourself and make a difference. Support (monetarily or otherwise) the AMA and voice your opinion to congress.

Truth be told, a big change is in store for medicine. But if physicians break this code of silence we become accustomed to as we are continually raped by HMOs, medicare, insurance cos, and drug cos, we can make this change for the better.

Don't believe everything you hear. This movie probably has some valid points, but Michael Moore has been very error and spin prone in the past. He is a huge (hehe) liberal and will ALWAYS present a one-sided story that is mostly full of ****.

... and don't vote for Hillary.

armybound said:

I have been told (by a friend who works in hospital reimbursement) that Medicare and Tricare pay really poorly.

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Medicare is pretty middle-of-the-pack. Most other insurers peg their schedule to Medicare's in some way or another. The nice thing about Medicare is that if you file your claims electronically they actually get paid in a timely fashion without much fuss. Not so for many private insurers.

Medicaid reimburses very poorly.

Gut Shot said:

Medicare is pretty middle-of-the-pack. Most other insurers peg their schedule to Medicare's in some way or another. The nice thing about Medicare is that if you file your claims electronically they actually get paid in a timely fashion without much fuss. Not so for many private insurers.

Medicaid reimburses very poorly.

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Maybe I mixed up what he said between Medicare and Medicaid.

armybound said:

Maybe I mixed up what he said between Medicare and Medicaid.

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You wouldn't be the first.

There was a good article in the Wall Street Journal this past week about the utter failure of Medicaid in its mission to give poor people access to health care - the upshot of the article is that Medicaid is so poorly run and underfunded that doctors are abandoning the system, so Medicaid recipients cannot find doctors who will accept it as payment for services...article entitled "Note to Medicaid Patients: The Doctor Won't See You," ran on Thursday, July 19...

I'm sure that my view on this is going to be very ignorant and altruistic, but what more can you expect from a new pre-med?

From my point-of-view, I don't know that the socialization of American health care would affect *how* I would act on a day-to-day basis (in the workplace). It might mean that resources are stretched more thinly, and that I thus cannot help as many people, but you still just do your job. A person comes in, you diagnose, you treat to what extent you can. *shrugs*

Outside of that, I'm a capitalist, through and through. Off the clock, I would disparage socialized health care. Whenever you start drifting that way, a portion of the population (small or large, I cannot attest to) rides the system. My grandfather does it as much as he can. He would be an able-bodied 60-year-old if he would eat properly and get exercise, but instead he sits on his ass and drink diet coke and eats fast food, working up an array of health issues. And he just wants Uncle Sam to pay for all of it. Meanwhile, my grandmother works two jobs to pay for his lifestyle.

A bit poetic, when thinking about socialized health care, from my view. But, I'm no socio-economist, either. I know that I'm not considering all the factors, and only drawing from a narrow pool of experiences.

Hey, if you can't afford healthcare then why should you get care? Why should I pay for you and your family to achieve better health? Either pay up or get sick and die I say.

LifetimeDoc said:

Hey, if you can't afford healthcare then why should you get care? Why should I pay for you and your family to achieve better health? Either pay up or get sick and die I say.

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Playing the devil's advocate a bit, but honestly, why should you? Is medicine a charity?

Did I miss the part of the Constitution that says people are born with the right to free healthcare?

Didn't say anything about the constitution. It's just that in a society with so many riches, it's sick that we can't raise the level of health of our neighbors, at least from a humanitarian perspective. From a purely business perspective you can look at providing health-care as increasing worker productivity and output. Or from a purely selfish perspective, saving money by not paying for care at its most expensive when you truly are sick. I just find it sad that our system of health-care is so advanced, yet fails in many basic respects of preventing disease and early death when you look at it from a nation-wide perspective.

I don't know how accurately Moore represented the healthcare systems in other countries (Canada, France, England, Cuba), but the horror stories about people here who actually DO have insurance really hit home, and I think there's really no reason we [soon-to-be privileged, American physicians, etc] should be excusing it. It makes me think this is a reason to have more representation in the medical field by underprivileged students who will better understand (wrong word) and be drawn to these issues.

You can't prevent people from eating McDonalds 3 times a day. The best free healthcare in the world can't prevent our obesity problem due to poor diet and lack of exercise.

The breakdown here is at a very basic level.. personal responsibility for your own well-being.

Taxing the middle-class isn't going to solve the health crisis that people burden themself with.

armybound said:

Playing the devil's advocate a bit, but honestly, why should you? Is medicine a charity?

Did I miss the part of the Constitution that says people are born with the right to free healthcare?

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Except...why shouldn't it be? Maybe it's not a good example, but there's a compulsory public school system and we all have to pay taxes that contribute to it, even after we stop using it, or even if we home school or go to private schools. Granted, it has a lot of problems in poorer areas of the country that need to be fixed, but why is the idea of government-funded health care for all so different from other government-funded programs that we don't seem all that opposed to?

Lifetimedoc said:

Hey, if you can't afford healthcare then why should you get care? Why should I pay for you and your family to achieve better health? Either pay up or get sick and die I say.

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As I said, my view is drawn from a very narrow amount of experience. But, from what I've been through, I simply know that there are people who are capable of contributing, but don't. "From each according to his ability, to each according to his need." Communism, I know, but I think that the principal applies to socialism, too. And we get a bunch of people like my Grandfather, and where do you think it will take the system?

I live in Canada, and I think "Sicko" portrays a completely wrong version of Canadian healthcare. A day doesn't go by that the Canadian media complains about the lack of money and resources in our system. The wait times are not 45 minutes...try all night. If you are going to die, lose a limb, or eyesight, you will be seen immediately however (thank God). Most Canadians also have private health insurance (often included as job benefits) apart from the so-called "free" care that we receive as citizens. I use my health insurance to pay for prescriptions and things that are not covered by the social plan, which would be extremely expensive without it. Because of Canada's large size, it is tough to centralize care to a few main facilities in big cities as countries like France or Sweden can do. Driving 500 miles for specialty care is not unheard of. We have to pay to send doctors and nurses to the most remote regions of the country and then build hospitals or fly patients out for proper care. It is extremely inefficient considering the shortage of resources (our tax money). The grass isn't necessarily greener on the other side, and not a day goes by I don't hear about the impending collapse of socialized healthcare in Canada.

armybound said:

The breakdown here is at a very basic level.. personal responsibility for your own well-being.

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The structural problems within the healthcare system itself are far more damaging. The amount of money spent on healthcare in this country could provide top notch care for every man woman and child, and give every physician a fat paycheck. But it isn't. The sad reality is that we're paying for a high level of universal care but we aren't getting it.

In case anyone is interested, I compiled some links to online reading about healthcare problems and policy from a variety of different angles. Enjoy.

Gut Shot said:

If you want to become educated on the topic, the short answer is to read anything and everything you can find, no matter how viscerally you may disagree with something. Everyone has a perspective and a point to make. For starters, Dr. Thomas Bodenheimer wrote a four part series on various aspects of the health care system. If you read those you’ll know more than 99.8% of premeds (and about 80% of practicing physicians). The first three are here:

http://www.annals.org/cgi/content/full/142/10/847
http://www.annals.org/cgi/content/full/142/11/932
http://www.annals.org/cgi/content/full/142/12_Part_1/996

The birth of Medicare (many parts):
http://www.medicarerights.org/maincontenthistory.html

The system explained (many parts):
http://www.yourdoctorinthefamily.com/grandtheory/index.html

Slate has some interesting left-leaning pieces:
http://www.slate.com/id/2161736/
http://www.slate.com/id/2114554/
http://www.slate.com/id/2099036/

For the free marketeeers:
http://www.marketmed.org/fmm.asp?fmmfont=fontsml

You can search all manner of health policy topics in the scientific literature with PubMed:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
The journal Health Affairs has a lot of free content:
http://www.healthaffairs.org/

Amazon has numerous books on the topic, although they tend to be written by people with and agenda and/or an axe to grind. For starters:
Bleeding The Patient by Himmelstein and Woolhandler
As Sick As It Gets by Mueller
Health Care Meltdown by Lebow
Critical Condition by Barlett
Market-Driven Healthcare by Herzlinger

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LicensedPremed said:

I believe that high healthcare cost is due to lack of preventative medicine.

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That's one cause. Here's another:

While I wish everyone could have equal access to healthcare, Michael Moore is not my solution. His movies always seem to be hearsay vignettes without much hard hitting research.
If you want a provocative solution to American healthcare, read Brave New World of Health Care by Richard Lamm. He was the governor of Colorado and has a well researched proposal.

Gut Shot said:

That's one cause. Here's another:

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this is probably because how difficult it is to become a physician. The amount of new physicians per year is relatively fixed because of the limited amount of US medical school graduates per year. Administrators on the other hand come from all backgrounds.

Gut Shot said:

That's one cause. Here's another:

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Gut Shot said:

That's one cause. Here's another:

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that is scary.

armybound said:

that is scary.

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Gee, and people use that kind of graph to scare people about national health care when private health care is just as scary.

DocFunk said:

this is probably because how difficult it is to become a physician. The amount of new physicians per year is relatively fixed because of the limited amount of US medical school graduates per year. Administrators on the other hand come from all backgrounds.

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The growth of administrators tracks perfectly the rise of HMO's.

LifetimeDoc said:

Gee, and people use that kind of graph to scare people about national health care when private health care is just as scary.

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they both have their flaws. I think administrative overhead (as depicted by the picture) is a huge problem with private insurance. I think it can be dealt with through reform, though.

and the uninsured can be given access to preventive healthcare if we can find a way to raise money. the recently proposed tax on cigarettes would have been a great start. raising our federal gas tax just 2 cents would probably also make a great source of funding.

notice that we can keep out privatized healthcare system while subsidizing healthcare for the uninsured if we simply find ways to pay for it. an important message here is also preventive medicine, though. flooding the ER is not the solution to your problems.

Or simple subsizided check-ups once or twice a year would catch problems before they turn into disasters. Things like bad eating habits and such.

We just might need to give people a bit of shock therapy and say things like "Eating McDonalds 3 times a day will cut your life expectancy by half and decrease your quality of life at the same time." People who ignore such strong warnings will continue on with their lives, but I hope most change their ways.

Another one of my faves:

Gut Shot said:

Another one of my faves:

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percent of total healthcare spending?

TheRealMD said:

Or simple subsizided check-ups once or twice a year would catch problems before they turn into disasters. Things like bad eating habits and such.

We just might need to give people a bit of shock therapy and say things like "Eating McDonalds 3 times a day will cut your life expectancy by half and decrease your quality of life at the same time." People who ignore such strong warnings will continue on with their lives, but I hope most change their ways.

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there's a warning on the side of cigarettes which says it can give you cancer, yet people puff away. people really don't seem to care much about the future, just the right now. if a Big Mac tastes good right now, I'm going to eat one right now. I don't care if it might give me a heart attack 40 years down the road.

just an example. logic and responsibility is lost on the general public nowadays.

armybound said:

some guy gets his $24,000 surgery "for free"... at what point does Moore discuss how much everyone pays in taxes for this "free" healthcare? I seem to have forgotten that part.

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In all fairness, Moore did address this point, though "addressing it" entailed interviewing one supposedly middle-class French family about taxes and their income. Most of the flaws with Moore movies come from too much reliance on anecdotes, rather than hard numbers.

armybound said:

percent of total healthcare spending?

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You got it. I also think you might enjoy Malcolm Gladwell's article The Moral Hazard Myth. Personally, I think we can make private insurance work in this country, but he outlines nicely why the push towards actuarial insurance is a bad idea.

Gut Shot said:

You got it. I also think you might enjoy Malcolm Gladwell's article The Moral Hazard Myth. Personally, I think we can make private insurance work in this country, but he outlines nicely why the push towards actuarial insurance is a bad idea.

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thanks for the link, moral hazard is definitely my main reason for objecting to universal healthcare. while I don't fully agree with the author that moral hazard is completely false, it's enlightening to see the other side of the argument and how the uninsured often make poor decisions about their health based on their ability to pay.

of course, I don't think you can fully compare those who are 100% responsible for the cost of their healthcare and those who are 0% responsible. I don't think the solution, or the problem, is as black and white as presented here.

Whether you agree with Michael Moore or not, I think it's great that we're even having these discussions and educating ourselves about the system. It's OK that this might be the 3rd thread to discuss Sicko and US health policy. It's important! So, even if you think Moore is a total idiot, the least you can do is appreciate the fact that he's questioning the status quo and inspiring discussion and debate, no?

Thanks, Gut Shot, for sharing all those great links!

People complain about paying higher taxes for health care if universal health care would be mandated, but you are already paying taxes for health care in the form of insurance premiums! Did you know that 50% of all bankruptcies in the US are triggered by medical care costs? What is the point of having the best hospitals in the world, the best doctors in the world, the best prescription drugs, etc. in the US if no one can afford them?

I think administrative overhead (as depicted by the picture) is a huge problem with private insurance. I think it can be dealt with through reform, though.

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In 1999, health administration costs totaled at least $294.3 billion in the United States, or $1,059 per capita, as compared with $307 per capita in Canada. After exclusions, administration accounted for 31.0 percent of health care expenditures in the United States and 16.7 percent of health care expenditures in Canada. Canada's national health insurance program had overhead of 1.3 percent; the overhead among Canada's private insurers was higher than that in the United States (13.2 percent vs. 11.7 percent). Providers' administrative costs were far lower in Canada.

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http://content.nejm.org/cgi/content/abstract/349/8/768

RosaVerde said:

Whether you agree with Michael Moore or not, I think it's great that we're even having these discussions and educating ourselves about the system. It's OK that this might be the 3rd thread to discuss Sicko and US health policy. It's important! So, even if you think Moore is a total idiot, the least you can do is appreciate the fact that he's questioning the status quo and inspiring discussion and debate, no?

Thanks, Gut Shot, for sharing all those great links!

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Its true that it's a great thing that our heathcare systems problems have been discussed recently - but I really hate giving that credit to M^2....it just makes me feel all dirty and used.

Also regarding the $24,000 elective injury to the canadian citizen. I love how Moore actually thinks are system is flawed because if he got this ELECTIVE surgery done in the US where he is NOT a citizen and does NOT have insurance it wouldn't be free to him. It's free in his country because he pays taxes for it there! not here! I'd find it hard to believe that I could go to Canada right now as a non-citizen and get elective surgery done free.

novawildcat said:

People complain about paying higher taxes for health care if universal health care would be mandated, but you are already paying taxes for health care in the form of insurance premiums! Did you know that 50% of all bankruptcies in the US are triggered by medical care costs? What is the point of having the best hospitals in the world, the best doctors in the world, the best prescription drugs, etc. in the US if no one can afford them?
http://content.nejm.org/cgi/content/abstract/349/8/768

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your 50% figure is inaccurate.

or an inaccurate representation, anyway. you should look at the actual wording of that study.

pguin said:

I'd find it hard to believe that I could go to Canada right now as a non-citizen and get elective surgery done free.

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It wouldn't be so simple as to show up in Canada and get free care. You have to live there for a certain period of time before qualifying for their services without significant out-of-pocket costs. A pregnant woman in labor cannot, for instance, just cross the border and have a free delivery. Their policy is written to avoid such situations.

That said, I do know someone who emigrated to Canada because she was diagnosed with Pick's disease. For those unfamiliar, Pick's is a terminal form of brain atrophy similar to Alzheimer's, only more selective in it's region of brain destruction. Anyways, the dilemma came down to either A.) staying in the US and receiving nursing home care until her insurance maxed out, then waiting until her private estate was exhausted, then transferring to a state facility, or B.) emigrating north, paying for services out of pocket for about a year, and then qualifying for Canadian nursing home care (which was comparable in quality to the private US facility).

Canadian's complain about their system, and I'm sure they have legitimate gripes, but they'll never have to worry about going bankrupt from medical bills. That peace of mind has to be worth something.