Having just seen 'Sicko' with my dad, a man who is (unlike me) an expert in the field of health care. Essentially, this is what he told me:
The movie is right to say that other countries with national health insurance do a better job of taking care of their citizens' health. That's the most important thing.
Other countries with 'socialized' or semi-socialized medical systems even manage to spend less money on health care than we do. 16% of US GDP - about two trillion dollars - is spent on health care. Most European countries (and Canada) spend about 6-7% of their GDP on health care. Even socialist Scandanavian countries spend about 9%, and all those systems cover everybody, as opposed to the American system which leaves about a fifth of the population with no insurance at all. Oh, and do you have trouble imagining what two trillion dollars amounts to? Just picture two thousand billion-dollar bills.
So what does all this money buy us? One of my dad's favorite examples is that there are more MRI machines in the greater Washington DC area than in all of Canada. That sounds good for us, but the truth is, we don't have any use for all those freaking MRI machines, and it amounts to a loss for the system. The US medical system puts great value in the newest and flashiest technologies and procedures, many of which are unnecessary.
Plus, more than a fifth of the money goes to administrative costs - the inevitable result of having a myriad of companies providing care. About 20% of Kaiser's budget goes to administration. By comparison, Medicare spends 2% of its budget on the same thing.
What the movie doesn't really talk about is the differences in the health care systems. Basically, he presents Britain, Canada, France etc. as being identical to the US, just with higher taxes in lieu of health insurance costs. Actually, what many of those universal systems have is an emphasis on primary care, and thus less of an emphasis on specialists. So, those famous waiting lists have people on them for exotic or non-urgent procedures.
By far my favorite part of the movie is his interview with former Labour MP Tony Benn. It sums up in clear and unpretentious language, I think, the philosophy not just of universal health care but the whole idea of social democracy.
8 comments:
Hmmm...this was also a charming comment made by the same Mr. Benn:
"Israel is occupying land that does not belong to it, just as Saddam Hussein occupied Kuwait and was driven out. Israel has built huge cities for Israelis in Palestine, and will not let Palestinians go back to their homes in Israel. There can be no peace, no end to suicide bombings, and no end to Israeli air attacks, without a Palestinian state, and the withdrawal of all Israeli troops."
http://www.bbc.co.uk/bbcfour/features/tony-benn-chat.shtml
I'd say the common denominator b/w this quote and the clip you linked to is a convenient dislike of personal responsibility, whether it is for the Palestinians or for those with a low income in his own country. A clipped British accent does not a good leader make.
I also have that stupid Soviet wheat-harvesting song stuck in my head.
Although, I am curious: don't you think the responsibility of the lower-income to provide themselves health care and the responsibility of the Palestinians (or anyone else) not to commit terrorism is like comparing apples and oranges?
It's one thing not to put bombs in nightclubs: it's something completely different to be 'responsible' enough to be able to afford very expensive medical procedures for conditions you have little or no control over.
whoa...hold up there. No one's comparing the actions of the Palestinians vs. that of low income people. I was referring to the conditions both groups find themselves in.
The Palestinians are in their predicament due to the actions of their leaders, their "friends" in the Arab countries, and their own average citizens. So, they are *responsible* for the misery that many of them live in and their lack of a state. As the Israelis are not responsible for their situation, it is not fair to expect them to remove checkpoints and end air strikes, thereby endangering their own security.
Low income people are also responsible for their predicament, whether through a lack of education, family issues, problems with drugs and alcohol, or that happy little "culture of poverty". Thus, it is not fair to expect other citizens to pay more taxes in order to alleviate their situation.
But Mr. Benn seems to think the opposite: that the Israelis and society are beholden to the Palestinians and low-income folks, respectively. So, he does not hold either the Pals or the low-income folks responsible for their own situation and expects those who are better off to just "fix things".
And there was a vodka ad a few months back that had a catchy Soviet-style song, complete with socialist-realist animation. But it was to the tune of "Yid, du Partizaner"!
Well, let's leave aside terrorism and focus on the point of the movie.
Moore touches only briefly on people in the US who have no health insurance; almost all of it is about people who, whatever their income, did the responsible thing and got insurance, only to discover that it wouldn't pay for their treatment, or that their premiums were astronomical, or that their insurance was cut off due to an illusory or very minor pre-existing condition.
Consider: someone earns maybe $60,000 a year. Not a lot, but more than average. He finds out one day that he has cancer. Or a brain tumor. Or he got hit by a bus. It happens to the best of us. Maybe the insurance company will pay all his bills, or some of them, or none. Is he being 'irresponsible' by only being in the upper third of wage-earners? Should his life come to an end because of something like that?
Is it 'fair' that the British and the Canadians and the French and the Israelis have voted to provide universal health care in exchange for higher taxes? They seem to think so, and you'd be hard-pressed to find a major political party or movement in any of those countries to privatize care. After all, in the long term it seems to save them money.
Dear, I left aside terrorism from the beginning - that was never my point.
I haven't seen "Sicko", so I don't want to make any specific criticisms of it. I actually think the emphasis on the supposed pitfalls of the insurance industry is better than the "45 million w/o health insurance" argument, for precisely the reason you mentioned. Those negatively affected are doing the responsible thing, and still being let down. My question (not a rhetorical one) would be, how often do people who have insurance have to face the kinds of situations Moore depicts? Are they the exceptions or the norm?
As for liberal democracies with universal health care, since they voted freely for this, there isn't really a huge problem (unless, of course, these countries have some entrenched cultural and social ideas against privatization - and all of the countries you mentioned do to a certain extent). But usually, the higher taxes in exchange for benefits doesn't end with health care - the Canadians and Germans and Israelis wouldn't be paying 60% of their income in taxes otherwise. A lot of this goes to inefficient government programs which would work better privatized. So, it's not really "unfair" in that it's coerced, but more in the sense that it deprives the citizens of more efficient, cost-effective options. For example, have universal health care, but crack down on striking municipal workers (because no one in Paris or Tel Aviv should have to tolerate garbage on the streets just because the collectors are feeling whiny).
My original comment wasn't on "Sicko" or universal health care, but on Tony Benn's feeling that democracy entitles the poor (i.e. not just those who have insurance companies that occasionally screw them over)to benefits at the expense of the rest of society. That removes all personal responsibility from those who are poor (the responsibility to not be poor, not the responsibility to have health care while poor - if I haven't cleared that up already). Hence, my comparison to his despicable comments on Israel - he doesn't hold the Pals accountable for their own actions.
"My question (not a rhetorical one) would be, how often do people who have insurance have to face the kinds of situations Moore depicts? Are they the exceptions or the norm?"
statistics on that kind of thing are hard to come by: after all, it can be a fairly subjective issue whether or not a procedure is 'necessary', plus insurance fraud etc.
Two facts are in evidence, though: One, the insurance business, being a business, has all the incentives on providing less care. Two, the insurance companies are incredibly profitable.
Also, there's the issue of premiums. Obviously the more health risks a person has the harder it will be for them to get insurance in the first place, and the more expensive it will be. And if someone develops health problems their insurance rates go up, making it harder to maintain coverage. Soo... the more a person needs health insurance, the harder it is to get.
Oh, and while we're on the subject of efficiency... is 6-7% GDP for full coverage less efficient than 16% of GDP for partial coverage?
Post a Comment