It boggles my mind, that despite the fact that we KNOW that there are millions in this country without health insurance, and we KNOW that Michael Moore is attempting to do something about it, there are still those out there who so dislike him, that they are STILL in denial and continue to nit-pick each of his arguments.

Hi Peter,

...they are STILL in denial and continue to nit-pick each of his arguments.

nitpicking? Moore insults our intelligence with his very 'doctored' accounts of socialized medicine.

What do you think of the points raised in this article?

'Sicko': Heavily Doctored, By Kurt Loder http://www.mtv.com/movies/news/articles/1563758/story.jhtml

13,000 people in a cold grave don't care much that the problem is fixed now. The official Katrina death toll stands at 1,300, just 1/10th that figure. Anyone, they are both failures of government, but the health care system doesn't deserve the entire burden of the blame.

Anyone else think Moore dodges the heart of the question on cancer: why are we better at that?

Longevity has a lot more to do with diet and lifestyle than with getting to the doctor when your sick.

The World Health Organization now says the Japanese live the longest and have the most years of disease- free living, compared to any other human population.

I live here in Japan. Here is a nice article on our eating habits:

http://tinyurl.com/2m5vrj

The "abusing the system" argument is so silly. No one is going to fake an illness to get an operation they don't need. And the "problem" of a few hypocondriacs that may pay a few too many visits to the doctor, well that "problem" can probably be fixed by setting a small fixed fee (say, $20) for a visit to the doctor. Oh, and maybe that pimple isn't a pimple after all.

wabisabi Don't you get it the current system in this country doesn't work. Say what you might at least you get health care in those other countries, until that changes your arguments ring hollow.

Sorry to go off like that. But I don't have Health Insurance, and if something happens to me I AM FUCKED REALLY FUCKED! So when somebody like wbisabi tries to alibi the current system, it fucking makes me so fucking angry. The system is fucking broke and at least if I lived in one of those other countries I wouldn't be worry the way I do. So take you fucking capitalistic solves everything philosophy and go shove it up your ass!!!

Wabisabi, please tell me how our non-universal health care system would have handled the French situation better.

Moore's film is more of a propaganda piece. I wish it was an honest documentary but it is not. What Moore is advocating something very radical. If I have understood him correctly he is for universal health care plus that there is no competition from the private sector! Finally from Andrew Sullivan's blog (Added emphasis by my):

"CNN highlights some obvious information that somehow never made it into "Sicko":

Moore focuses on the private insurance companies and makes no mention of the U.S. government-funded health-care systems such as Medicare, Medicaid, the State Children's Health Insurance Program and the Veterans Affairs health-care systems. About 50 percent of all health-care dollars spent in the United States flows through these government systems.

"Sicko" also ignores a handful of good things about the American system. Believe it or not, the United States does rank highest in the patient satisfaction category. Americans do have shorter wait times than everyone but Germans when it comes to nonemergency elective surgery such as hip replacements, cataract removal or knee repair.

So half of US healthcare is already government-funded; and patient satisfaction with treatment is the highest in the world. Does that not count for something in the argument?"

You know, I'm sure that the people who can get health care are quite satisfied with the treatment they receive, and why shouldn't they be? But what about all those people who couldn't receive the treatment in the first place? They don't have the chance to be satisfied or dissatisfied with the treatment, do they?

Hesam What does any of that matter if you can't even get health insurance.

Michael may have missed an important point here. You have to die of something. When mortality due to infectious disease, heart disease etc. is reduced then the average life expectancy increases but the mortality due to cancer increases. The probability of developing cancer increases with age. All countries with longer life expectancies than the U.S. also have higher cancer morbidities. The U.S. does indeed lead the world in developing cancer treatments although, due to the high cost of new treatments, is not particulaly better at large scale exploitation of these innovations. We Canadians, and I am sure this applies to other jurisdictions, recognize that the U.S. has the best health care system for millionaires on the planet.

Now that I've seen the movie, and done some more reading, I feel ready to chime in again.

As best I can tell, Moore's argument is simple: profit motive has no place in a modern healthcare system.

The best arguments against Moore, at least, the best I can find suggest that medical advances are the result of profit motives, and this is why America leads the world, even though most people can't afford the amazing advances we have discovered.

Here is my problem: I cannot find any clear-headed debate on this issue. All my conservative hangouts refuse to accept that we have a problem here, and site like 1gm drown me in anti-capitalism rhetoric the moment I suggest certain activities are better off NOT left to the Federal Government.

Riddle me this:

1. How much will Kucinich's plan cost?

2. Who gonna pay? Are we going to borrow MORE money to pay for it?

3. What additional restrictions on my diet & lifestyle should I expect, once this system is implemented? For example: trans fats, cigarettes, high-fructose corn syrup, fries slathered with deep-fried cheese- each of these will result in expensive healthcare issues in the future. What will be our public response? What is the appropriate balance between personal freedom (i.e. the right to eat like a slob) v. the greater good of our social order (i.e. collective costs of lung disease, heart disease, diabetes, obesity, etc)?

Not trolling; I'm seeking some real, specific answers.

Michael may have missed an important point here. You have to die of something. When mortality due to infectious disease, heart disease etc. is reduced then the average life expectancy increases but the mortality due to cancer increases.

Excellent point!

You know I have been waiting for Sicko to come out not so much to see (looking forward to it) as for the massive debate it was sure to engender. The interesting questions are actually the ethical questions. How do you allocate a limited resoure when demand is sure to be unlimited? How do you prioritize something like lung transplants? Would that be in reverse order to the quantity of cigarettes smoked? If behaviour leads to disease who should bear the cost? If you're looking for an ethical place to start assume no child is responsible for their health problems and develop a single payer system for children. You could at least see some of the pros and cons of such a system and it would alleviate some of the worse consequences of your current system such as job lock. Rooting for you U.S.A..

How much will Kucinich's plan cost?

Who gonna pay? Are we going to borrow MORE money to pay for it?

What additional restrictions on my diet & lifestyle should I expect. . .

Based on models in France and Canada it should cost 40% less that the current system.

Increase taxes. The increase will be less that we spend privately. Medicaid adminstration costs at 1% insurance companies at 15-30.

What lifestyle changes. None that I'm aware of, that issue is separate from the idea of a single payer system. It's something the country would have to discuss and decide on.

I wonder how much it really would cost, in terms of taxes. For people who already have health insurance, they're substituting increased taxes for insurance premiums, except since the efficiency of public health insurance is so much higher than that of private insurance (see the statistic quoted in the linked article above the clip), they would have to pay less in taxes than they do now in premiums. Of course, the rich would be paying more than their share, and the poor less, so for those earning more you'd have to add back that cost. In the end, the balance between savings due to increased efficiency, and cost due to taking care of the poor would be a net loss to the rich and a net gain to the poor.

As far as I can tell, the only people that would lose out in moving toward universal healthcare are the private insurance companies themselves (mostly those at the top, since they're the ones making most of the profits, and many of those lower down could presumably do the same job but for a different employer), and the (other) very rich.

Unfortunately it's the insurance companies and the very rich who control both the public message and the legislative system. Somehow we'll need to get past that before we can fix things.

The idea of Univeral Health Care will die as soon as middle America realizes that it will include illegal immigrants as well as citizens.

Richard Lamm had it right - triage will be a necessary evil in a world of resource constraints.

Either that or we will be forced to dismantle our $625 billion war department.

Gentlemen, just sit back, relax, and wait for the real fun to begin: human-to-human bird flu (H5N1)! The mettles of our health care and insurance systems will then be thoroughly tested, especially since not one place is anywhere near prepared for it and there are no cures. I can hardly wait!

Norm:

1. We currently spend ~15% of GDP on healthcare. (GDP was $13.4 trillion in '06), ballpark number: $2 trillion spent on healthcare per annum.

2. At a 40% discount, costs drop to $1.2 trillion.

3. In '02 we spent ~$250 billion on medicare, another ~$295 billion on medicaid in '04. In other words, we already spend $545B per annum.

4. If I have stated these numbers correctly, we are looking at a $655B increase in federal spending, but net a savings of $800 billion when compared to current spending (fed, state and private).

5. Medicare requires a 2.9% payroll tax. Should we assume another +~6% payroll tax to cover the $655B shortfall? Is the economy (specifically: job creation) strong enough to handle that right now?

6. If we don't take from payroll taxes, where do we take from? Multiple sources is fine, but popular targets, i.e. capital gains tax, also affects the job creation issue.

7. Are jobs more important than human life? No. So let's skip the rhetoric. But without an economy to pay for this, none of us get healthcare, so it is a relevant issue.

I also see no reason why Americans couldn't also elect to purchase additional medical treatments, for example, high-tech cancer treatments, thus ensuring a profit margin remains for future R&D. I'm not interested in keeping billionaires healthy, I'm interested in continuing the march of scientific progress. No disrespect to Canadian or EU readers, but this is the one place where American healthcare excels.

Also, Peter G writes:

How do you prioritize something like lung transplants? Would that be in reverse order to the quantity of cigarettes smoked?

Don't blow this off Norm. I think this is a valid question, and one of the many unintended consequences of a collective healthcare solution, be it socialized or not.

The reality is: I make poor choices that result in costly health risks. Where does my personal freedom end, and the collective good begin? Does it make sense to allow cigarettes and corn syrup to remain legal, if those costs are now borne by every working American, even the super healthy vegans like Mr. Kucinich? That doesn't seem very fair to me. Then again, outlawing Mountain Dew doesn't appeal to me either.

Also: note that I call it "collective healthcare". I find that helps reduce knee-jerk anti-socialism sentiment. However, as I understand it, Kucinich's plan DOES entrust these funds to be managed via federal government. Do I have that right?

Please correct any errors above.

Wabisabi, please tell me how our non-universal health care system would have handled the French situation better.

Jez man, you did a good job of reading what I wrote. That they were "failures of GOVERNMENT" and that "the healthcare system doesn't deserve all the blame"

Why are you asking me to defend a position that I don't have?

wabisabi Don't you get it the current system in this country doesn't work. Say what you might at least you get health care in those other countries, until that changes your arguments ring hollow.

What arguements are you talking about?

On the lung transplant question, I don't see how that would change in a universal system relative to the system we have now. Organs are a limited resource as it is, and both their availability and the need for them are unaffected by how healthcare is paid for. The processes for deciding how to prioritize the lists are already extremely complicated, and indeed do take into account lifestyle issues such as smoking. Maybe I'm missing something, but can someone explain how organ transplant lists are affected by the source of funds for care?

I an afraid I laid a bit of a trap for Wabisabi. In a single payer system the lung would go to an obese lifelong smoker if he were the only possible recipient on a tissue match criteria. In a for profit system the recipient would be the organic waste receptacle unless someone offers to pay the bill for that smoker.

My bad. I addressed the wrong commentator. Sorry Wabisabi. It's Canada day so I'm stepping out with one last comment. It would be impossible to argue that the U.S. is the world leader in medical innovation however I must dispute the idea that this has any relation to a "for profit" health care system. If you look at who wins Nobel prizes or other awards for excellence or, indeed who patents new medical technologies I think you will find that a large number of them started their careers in other countries. The U.S. is a worldwide draw for scientific talent because of the generosity of private individuals, foundations and the incredible depth of endowments that make possible research that could take place nowhere else in such massive volume. The individuals responsible for these inventions are driven by other things then a simple profit motive and the U.S. is the most fertile ground for this type of endeavour. This is not to say that other countries have nothing to contribute but however much we lament the loss of our top researchers to American institutions ultimately we all benefit from their discoveries. I do not believe for a moment that having a single payer system in the U.S. would put the slightest brake on the rate of innovation.I am not overly familiar with HMO's but how often do they call on their subscribers to announce what latest therapies they are adding to their coverage?
Happy 4th of July all!

In a single payer system the lung would go to an obese lifelong smoker if he were the only possible recipient on a tissue match criteria. In a for profit system the recipient would be the organic waste receptacle unless someone offers to pay the bill for that smoker.

Zaphod suggests that issues of how to prioritize organ transplant lists are a potential problem with universal healthcare. It's this argument that I fail to understand.

I think current standards for prioritizing are probably just fine. The only difference is that there will be more in the pool. Though there may very well be less overall demand since conditions will be discovered earlier when other treatments are still available. The argument about jobs reminds me of the Broken Window Fallacy Money not spent supporting insurance companies will be available for other products creating new jobs.

As for not wanting to pay for the smoker. I was impressed by the English system where they reward doctors when their patients follow their advice and become healthier they get bonuses. How about this your child plays with matches and your house catches fire. You call the fire department they put out the fire, but send you a huge bill because you obviously didn't teach your child not to play with matches. It comes down to our different views of what is reasonable when it comes to personal responsibility and the role it should play.

The argument is this wabisabi, I DON'T HAVE HEALTH CARE NOW? If I lived in one of those other countries I would. That IS THE ARGUMENT! Are you stupid or something? Millions of people in this country like me don't have health insurance. wabisabi your are naive and narrow minded. You live under the delusion that capitalism has a solution for everything. Capitalism doesn't solve every thing sorry sometimes it makes the problem worse, sorry! Your like a snake oil salesman that thinks you can solve everything with a magic pill. Grow a brain! What they have in other countries works better in that guess what? EVERYBODY gets health care, wow that was real hard to figure out! Oh and the fact their is a conflict of interest for a profit health in insurance. Here it is, why in the hell would a for profit company want to help me if it meant they would make less money? Oh duh it just dawned on me that is why I don't have health insurance, because DUH they can't make any money from me. God your clueless.

Referring to the Wingnut Manhatten Institute? Are you kidding me? The MI heartily qualifies for Bill Maher's rule, "you can't call yourself a think tank if all of your ideas are stupid".

But I see the Hilton groupie King finally got the man who correctly called him a "bastard" on.

It is interesting to see how all the wingnut shills come out to criticize foreign health care systems that they know nothing about. But ignorance never stopped a 101st Fighting Keyboarder.

Speaking of life-style choices, maybe we should ban the automobile. How much do 40,000 deaths and tens of thousands more injuries cost the economy?

But do you know what costs the most per individual case? Failed suicide attempts. Sometimes, like jumping out a window, they leave terrible injuries that cost a lot to treat.

So do the libertarians and other free-marketeers think that we should let the failed attempts succeed?

But don't private insurance companies exclude suicide for coverage? So the collectivity has to pay anyway.

zaphod,

regarding the balance of freedom to eat like a slob and the individual responsibility not to be a weight on society:

socialized medicine does not imply regulating or banning unhealthy foods. there are no such laws in france or the nordic countries, for example. it is a totally separate issue as far as i can see. whatever you think of legislated regulations on food has no bearing on whether you believe profit-making health insurances companies will be better than a universal governmental one.

as far as the diet of the average person in the u.s. is concerned, i think a big improvement can be made by simply offering healthier choices in more. i think people would go for them.

as for who will pay for any proposed socialized medicine scheme, michael moore seems to be suggesting two points:

a) -that being universal, the scheme can save significantly on overhead (down from 20% to 1%). this should free up funds that can go into healthcare itself.

b) people in the united states are already paying more for healthcar than people in other countries. with universal healthcare, taxpayers are picking up the tab.

whatever your political stance, there is ample reason to start looking into the issue of improving the quality of life of the average person in the world's richest country.

http://www.cnn.com/2006/HEALTH/parenting/05/08/mothers.index/index.html

http://upload.wikimedia.org/wikipedia/en/4/4a/Infant_mortality_vs.jpg

Listening to Michael Moore’s detractors regarding our need for national health care (Yes, socialized medicine!) is like listening to the few demented souls who still support the war—and they are probably the same people. Sorry people, just like with the war, you have been too wrong for too long and no one should listen to what you have to say.

Oskar:

Thank you for the information. It appears I am getting all worried about nothing, re: freedom (slob) v. society (cost).

My only real remaining concerns then:

1. How do we cover the ~$600B shortfall?

2. How do we keep congress from raiding these funds, a la social security?

3. Can we preserve excellent R&D? What sort of motivations will remain? Which new motivations are created?

4. How can we balance this expense so that costs grow proportionate to tax revenues funding it?

Why is the infant mortality rate increasing in Mississippi, for the first time (correct me if i'm wrong) in the past century.

Why isn't every single child, regardless of socio-economic status able to get health care?

Why are we ranked 37th for overall health care, according to the WHO?

Why is our infant mortality rate higher than most other industrialized nations?

Why can I get kicked off my insurance for becoming sick? Isn't this why I pay insurance?

How is it ethical that people get promotions for letting their customers die, after denying service? How can a company that supports such a practice be something I'm supporting?

Why is it ok to keep fire and police departments socialized (Oops, i swore), to keep profit out of saving lives, but it's perfectly acceptable to put a price on my lung, or my kidney?

Why is it one system or the other. Why not parts from both? Does it have to be either "commie-pinkos socilized 3 month waiting lists" or "i'll sell you your finger back for $60,000"?

Why is this conversation so muddled? Why do people defend the american system so much? Why defend socialized medicine so often?

These are all the questions I have, which never seem to be answered. Jingoism comes to mind when the american system comes up, and socialized medicine seems either demonized by the flag-waving americans, and too rosy a picture when talked about by the other side, those who have been screwed by the system (which is most of us).

I'm sorry, but what a person does should not relate to whether or not they get health care. Just because someone eats crappy food, I should let them die? Is it worth me keeping a little extra money to let other people die, just because of bad choices? Honestly, is this your arguement? How much does another human being mean to you? Would you trade your plasma tv for a child's teeth, because they only eat McDonalds and it's sugar riddled food?

I just want an honest answer on this.

I have been paying for a catastrophic health insurance policy for 20 years now. (self-employed). It has a $5,000. deductable, so it does nothing, really, but protect (I hope!) my house and assets from being confiscated if I get sick. This costs $2,400. a year.

I am a great insurance risk, over 50 never sick, healthy diet, exercise, etc. Just the kind of person the insurance company makes money on.

I just paid a hospital bill for a accidental broken bone in my hand. So feeling a bit ripped off to have this bill on top of my monthly bill for "health insurance".

Would my taxes go up $2,400 a year if we had single payer? The average family pays $11,000 for full coverage each year for health insurance. Sometimes we have to look at real costs.

And these costs are making the US less competitive in the business world. I know a few small business owners who cannot afford to expand because of health insurance costs. This is holding back our productivity in all areas-the major exception would be health insurance companies.

I see a vicious circle in America. The big food corporations lace our diet with corn syrup, sugars, artificial sweeteners, trans-fats, etc. Europeans will not buy our meat products because of hormone, antibiotic and steroid contamination.

Then big pharma has to try and develop drugs to try and 'cure' the terrible health consequenses of big agribusiness.

Willey,

Go out and educate yourself. The answer to all your questions are easily found. To you question "Why are we ranked 37th for overall health care, according to the WHO?" Here your answer The World Health Organization. EDUCATE YOUSELF! Oh as far as who is going to pay for it we already are, the US pays a larger percent of it GDP then any other country on health insurance. So what are you talking about? Most countries pay for it through taxes we pay for it out of are wallets and we pay more even if you include those taxes. The difference is that people that can't afford to pay for it get screwed and sometimes die as a result that they can't afford to cover their health expenses. My question to you, is if you so damm interested why don't you go out and do a little research? Have you heard of google?

Willy,

Oh to you other question "Why is our infant mortality rate higher than most other industrialized nations?"

Again LAZY ASS The World Health Organization! Have you heard of reading? GET OFF YOU ASS AND GOOGLE IT! I don't know why I bothering to take the time to answer your LAZY ASS questions!

My mistake the infant moratality rates come from National Center for Health Statistics, Centers for Disease Control and Prevention, I just GOOGLED that unlike some other people here!

Carl - I have read these studies. Maybe I was unclear. (Don't you think if i'm smart enough to ask these specific questions, I know the answer?) Aren't we the "greatest country in the world"? How can these things be acceptable to the citizens of the US? How can people stand by this and say that this is "the best health care" in the world? It's more of a psycological question. What is it about these things that isn't profoundly frightening to us? Are we so "lasse faire" about this country that it's not a problem we think we personally need to deal with?

I just keep seeing people everywhere saying that "socialized medicine isn't the answer", well, buddy, our system is worse off than theirs, by almost every measurement. Do people just not know these things, or do they just not care?

Hey Carl and Willey, You both have some great points. But Carl makes a statement that brought to mind the costs of this system in America.

I not only pay directly each month for 'health insurance', but some part of the taxes I pay each year goes into Medicaid/Medicare.

Right now, neither of these payments I make are giving me medical coverage!

How fair is that? If I dont go bankrupt from a huge unforseen medical crisis before I turn 65, then I will be elegible for medicare.

And even that is not going to provide good health coverage for me, after a lifetime of paying taxes and paying for private health insurance.

I have watched the movie and I can safely say that anyone who is attacking Moore has not watched the movie.

For starters he has a go at everyone. If anything he has sunk Hillary Clinton presidential election if democrat voters saw the video.

Secondly he doesn't at anytime in the movie say that other systems are perfect. What he does say is you should take the best parts and build a new health care system.

Watch the movie then comment. Then research what he has done. Don't take people deciding for you.

The US system is terrible. I mean when you can get drugs in Cuba for 5c where an Average American with Medical insurance is paying $120 a week for then your system is seriously broken. Or dumping sick people into homeless shelters when their medical insurance runs out.

You can continue to stick your head in the sand, or actually do something about it.

I thought Moore paying an anti-Moore website 12K for their medical insurance so the site could stay up was a nice touch.

http://www.msnbc.msn.com/id/19113385/site/newsweek/

I hope that the 70 percent of U.S. citizens who, like me, wouldn't mind paying higher taxes if it means health care coverage for all stay at home rather than going to see Sicko. The reason: 70 percent of U.S. citizens wouldn't mind paying more in taxes if it means health care for all.

One of Moore's working, apologists refrains is that the French, British, and Canadian systems are flawed but the solution is to take from those systems the things that work, using "American know-how." If Moore had made that the central theme, instead of preaching to the choir, he would have release a movie worth watching.