Michael Moore's "SiCKO"

[whatireallywant]

No human designed system will ever be perfect but some are definitely more perfect than others. The US has utterly failed in reaching any kind of parity in its health care.

One of my biggest gripes about health care is that a lot of money is spent on useless end of life attempts to prolong life that should no longer be prolonged.

My grandmother collapsed three years ago at a friend's funeral. She was taken to the local hospital and then when they realized how serious her condition was, they airlifted her to a larger hospital.

She told everyone who listened that when it came to her time she did NOT want any heroic actions taken. All that expense meant that she suffered for two more days with a great deal of pain. She was 87 years old.

More was spent on her those last two days than was spent on her health care in her ENTIRE life.

Her wishes were disregarded by the medical system, she was forced to suffer and tens of thousands of dollars were spent to keep her alive for TWO lousy days.

We need to have a serious discussion about end of life treatment.

Sounds like she needed to have a living will. When I was sick 4 years ago, the hospital staff came around to me and asked if I wanted to make out a living will. I was too out of it to think about doing that by that time. After I recovered, I said to one of my friends, "They don't ask that of all the patients, do they? I kind of thought they did when they were asking it, but afterwards, I realized that they don't - that they asked me because they honestly thought I was going to die. Anyway, the thing to do about end of life treatment I would say is to have a living will - get it in writing, rather than just telling people what actions you want the medical staff to take.

 

[B_All4show]

Yup. Capitalism is designed at its core to take from everyone and give to the rich. I suppose that's fine if you're into buying cars, but it's no good if you have to buy health care.

It really doesn't matter what we can do on the operating table if the people who need it the most can't even get on the table in the first place.

Also -- if people are going to dismiss his Cuban excursion as a dog & pony show, then why wouldn't the US do it to make themselves look better?

Yup, your knowledge of capitalism is astounding.

 

[B_All4show]

And once again, the master of polemics and populism, the godfather of misrepresented facts and walking car accident strikes it.

I love that analysis of him.

 

[ClaireTalon]

<.> While Moore is definitely guilty of polemicizing, he does actually present facts and references, it isn't total sensationalism. Sicko is much better than Bowling for Columbine or Fahrenheit 9/11 as a documentary (rather than just sensationalism) just because he does actually focus more on facts and case-study than sensationalist confrontational tactics.

He presents facts in a way that distorts reality by leaving out facts that run against his theses. Has he said what I've said in my first post on this thread, that the Cuban health system is close to complete collapse due to its ineconnomic nature, that the French system offers basic support for everyone, but not more than a very basic support if you're not insured? That the German system is struggling with reformations (since my new man is German, I have a little more insight on those issues now) that are aiming at making it more economic? Or let's make it short: The publicly-funded systems are either cutting costs whereever they can, or are being re-designed after economic guidelines, and heading for more private provision and insurance.

 

[lgej]

Medicare is clearly a socialized form of medicine. How do our elderly feel about the fact that they have coverage? As someone who spent 35+ years in the health insurance industry (many as an exec), I'm quite conflicted, but how in the hell can we justify 50 million Americans, most of them working, who are uninsured? I'm not smart enough to figure this all out, but I'm glad I'm no longer in the industry.

 

[dong20]

He presents facts in a way that distorts reality by leaving out facts that run against his theses. Has he said what I've said in my first post on this thread, that the Cuban health system is close to complete collapse due to its ineconnomic nature, that the French system offers basic support for everyone, but not more than a very basic support if you're not insured? That the German system is struggling with reformations (since my new man is German, I have a little more insight on those issues now) that are aiming at making it more economic? Or let's make it short: The publicly-funded systems are either cutting costs whereever they can, or are being re-designed after economic guidelines, and heading for more private provision and insurance.

Warning, oversimplification follows.:smile:

The question is why are some nations with socialised systems moving toward more econo-centric models? - Money, right. Funding through taxation in increasingly insufficient to support the existing systems. This means they cannot continue to deliver what's needed.

Why are costs rising? Presumably a combination of several factors; the increased cost of medicine, ever more complex systems and the basic providing professional care. Part of the increased costs are the pricing policies of major pharmceutical companies some is simply reflecting increased demand from both new treatments and aging populations.

If socialised medicine is to remain socialised then it needs to be funded properly. This means tax revenues must either increase, supplemented or the system replaced. The last option leads us straight into the maw of insurance based provision, which it seems clear only works for those who can afford it. That number is falling and more and more people no longer have proper access to medical care as they should, and depend more on the safety nets. This is the root cause of this thread.

Of course the argument could be made that those who can afford insurance should do so thus leaving more of the remaining tax sourced services availible to those who can't. That sounds great in theory, well not really but it instantly provides a multi-tier system. Before we know it we're back at square one, those that can afford it get it, those that can't don't, or don't get what they need. Again, the root cause of this thread.

So why are tax revenues not raised? Simple, policitical inertia and fear. People won't elect or re-elect political parties which would raise taxes to a level where they would support the level of service people demand. Politicians are spineless, thinking only of re-election. People demand first rate medical care but are evidently unwilling to contribute more tax to fund it. They don't want to pay inflated profit driven insurance premiums either. They want their cake and eat it.

I'm not an economics expert but it seems to me that it would almost certainly cost less to pay a little extra income tax than said profit driven insurance premiums. The problem seems to be, many are too shortsighted, too greedy or simply too stupid to realise it.

 

[B_big dirigible]

I remember my jaw dropping at that growing death toll. Many deaths were among the elderly but 15,000 deaths is quite incredible. It was hot, abnormally hot certainly. In London it was frequently over 45c on the tube but the failure of the French healthcare system to cope was lamentable.

The French themselves certainly seemed to think so.

the simple fact that is was abnormally hot was a factor. The lack of A/C facilties (much more taken for granted in the US from what I've seen) undoubtably made things much worse than it may otherwise have been, as did huge numbers of medical staff being on their traditional August break.

It's the response to abnormal situations which determine the quality of a health care system. It's not normal for me to have a heart attack, but when I do, I don't want to hear that the physicains and techs are all off on holiday.

before you wax too lyrical remember there's typically 1000 annual heatwave fatalities in the US v 23 in Australia (1966-1995). That's 1/3rd the US rate. Heatwaves were the top weather related killer in the US, I don't know if that's still true.

Irrelevant. Moore is comparing the US and France. He's not comparing the US and Australia. My point obviously was that the French system is grossly flawed, and clearly not the model towards which we should be striving.

In general terms it seems to me that focussing on France in 2003 to disprove Moore's point seems as simplistic as him trying to use that same system to prove his, when neither is clearly the case. There are major, major problems with the US healthcare system, but there are are in many nations of course.

I'm not evaluating the US health system, I'm evaluating Michael Moore and his contentions.

Moore is astonishingly, blatantly partial and will try and convince you black is indeed white. But despite this, anyone denying that far too many people, in the US don't have ready access to health care and that this is not extremely bad is surely little or no less blinkered.

The usual tactic is to blur the distinction between health care and health insurance. They are, obviously, not the same thing. Another tactic is to assume that since health care is expensive, only those who can afford expensive things have access to it. This is false. I personally have had enormous hospital bills which were officially, as well as practically, made to disappear, simply because I was indigent at the time. The weak and strong points of the US health care system are far too complex to argue in a couple of paragraphs here. Or in a propaganda film.

 

[B_big dirigible]

I suppose it's a fundemental ideological differerence in upbringing and environment but to me, medial care being driven by profit in a modern society seems wrong. I know that's an oversimplification but the underlying ethos is, in general financial.

There are only a few ways to run anything.

1. Interest. This is the realm of the hobbiest. Low budget, wide range of quality.
2. Profit. Normal business; supply and consumption of skilled services, etc. High budget, tendency to high quality.
3. Bureaucracy. The socialist dream. High budget, wide range of quality.

Take your pick.

 

[B_big dirigible]

While Moore is definitely guilty of polemicizing, he does actually present facts and references, it isn't total sensationalism. Sicko is much better than Bowling for Columbine or Fahrenheit 9/11 as a documentary (rather than just sensationalism)

Bowling wasn't sensationalism, it was lies. He filmed entirely fake scenes to "demonstrate" his claims.

 

[Big Dreamer]

Bowling wasn't sensationalism, it was lies. He filmed entirely fake scenes to "demonstrate" his claims.

Bowling was partially lies and there were entirely fake scenes, but the movie as a whole was not entirely fake.

I don't see a problem with using Michael Moore's movies as one more piece of half-true information that you can mix in with the rest of your half-true information from other sources and ultimately form an opinion.

 

[B_big dirigible]

Why are costs rising? Presumably a combination of several factors; the increased cost of medicine, ever more complex systems and the basic providing professional care. Part of the increased costs are the pricing policies of major pharmceutical companies some is simply reflecting increased demand from both new treatments and aging populations.

You can't use supply and demand to understand medical costs. Supply and demand would predict that as the number of doctors in any area increases, costs would decrease. But they don't. They increase. The main reason is that things which used to be entirely taken care of by the local "doc" are now done several times - by the first physician to attend to it, by the physician he refers the patient to, by the uber-specialist he refers the poor patient to after that, by another physician asked for a "second opinion", etc. All of which takes time and money, and is in fact somewhat less likely to result in a satisfactory solution than when it was done by the old country doctor. So why doesn't the country doctor do it? One, there aren't many left. Two, he's not allowed to do it. Depending on jurisdiction, it may be illegal for him to do the things he did twenty years ago. Routine blood tests, examination of x-rays, growing of cultures - all must be performed by specialists. This is a real problem, and not just a financial one - your doctor can't look at an x-ray to see if you have a broken bone; he has to wait until the radiologist comes in. They're not generally on call 24/7; that's one of the attractions of being a specialist. If you like money but don't much like people, radiology is a good field, as you don't have to actually interact with patients (I'm not making this up - I know of radiologists who say this). God help you if you get in a car crash on a Saturday night. The ER people will keep you alive until Monday, but they won't know what's actually wrong until the radiologist wanders in at 9 on Monday.

You won't learn this stuff from the news (or from Michael Moore), you have to talk to a doctor to hear about it. With the rise of professional blogs, I was hoping that some doctors would take advantage of the medium to educate the rest of us about the real hurdles they face. But it doesn't seem to have happened. Lawyers went into blogs in a big way, and a few engineers, and some military personnel, but the showing by doctors has been disappointing. So we're all just flailing around in the dark here.

But a major part of the basic problem seems clear enough - it's the government itself which makes so much of our health care redundant and needlessly expensive. The same government which Moore thinks will make health care more accessible. I'm skeptical.

 

[dong20]

It's the response to abnormal situations which determine the quality of a health care system. It's not normal for me to have a heart attack, but when I do, I don't want to hear that the physicains and techs are all off on holiday.

Of course but that doesn't obviate the factors that lead to the events.

Irrelevant. Moore is comparing the US and France. He's not comparing the US and Australia.

I disagree, I was making the point that preparedness for and familiarity of such condition (or lack therof in the French case) is entirely relevant.

I'm not evaluating the US health system, I'm evaluating Michael Moore and his contentions.

I'm not quite sure of that.

The usual tactic is to blur the distinction between health care and health insurance. They are, obviously, not the same thing. Another tactic is to assume that since health care is expensive, only those who can afford expensive things have access to it. This is false.

Not always, and not usually.

I personally have had enormous hospital bills which were officially, as well as practically, made to disappear, simply because I was indigent at the time. The weak and strong points of the US health care system are far too complex to argue in a couple of paragraphs here. Or in a propaganda film.

Good for you, but my point was (then and later) that having to be indigent to obtain medical care at reasonable cost is hardly a glowing endorsement of the system that provides it, is it.

 

[B_big dirigible]

Bowling was partially lies and there were entirely fake scenes, but the movie as a whole was not entirely fake.

How may lies do you require before you can recognize a man as a liar? I think one is good enough. By that index, Moore is a liar. Period.

I don't see a problem with using Michael Moore's movies as one more piece of half-true information that you can mix in with the rest of your half-true information from other sources and ultimately form an opinion.

Garbage in = garbage out. Only a magician can make gold from dross, and Moore is a propagandist, not a magician. Half-true is also half-false. Mix half-false and half-false, and you'll get all-false at least as often as you'll get all-true. Guys like Moore count on that.

 

[Big Dreamer]

How may lies do you require before you can recognize a man as a liar? I think one is good enough. By that index, Moore is a liar. Period.
Garbage in = garbage out. Only a magician can make gold from dross, and Moore is a propagandist, not a magician. Half-true is also half-false. Mix half-false and half-false, and you'll get all-false at least as often as you'll get all-true. Guys like Moore count on that.

Then toss the Associated Press on the pile, and turn off your television while you're at it. Any organization that makes profit from bringing you the news has an agenda that's tied to those that line their pockets. I'm not saying that Moore isn't self-serving, I'm saying that he's one more in a very large pile.

 

[B_big dirigible]

Good for you, but my point was (then and later) that having to be indigent to obtain medical care at reasonable cost is hardly a glowing endorsement of the system that provides it, is it.

I'm endorsing nothing. I haven't any intention of writing a general evaluation of the American health care system. I'm not qualified to do so. I'm pointing out some lies and mistakes in arguments posed by those who lecture us that American health care is baaaaad. I'm not saying whether it's bad or not; I'm pointing out that some of the major critiques are blatantly false. The claim that health care is inaccessible to the indigent is one of those falsehoods. From actual experience, I know this to be a fact; it's not something I "read somewhere".

 

[B_big dirigible]

Then toss the Associated Press on the pile, and turn off your television while you're at it.

You are definitely right about those two.

Good, sound information on any topic is very hard to obtain - far harder than most realize. It's much easier to be a "groupie", make up your mind first, then swallow anything which fits your prejudices. That seems to be how most of us arrive at our "facts". But popularity is no indicator of quality.

This simple problem is why the US has an Electoral College. A farmer or tradesman wasn't expected to have good, solid information on offshore geography, tariff rates, treaties with Indian tribes, or the thousands of other individual items which factor into sound judgements by governments. It would be unreasonable to expect that he could; mastering any one of them is a full-time job. So it was intended that he vote for a man he believed to be of sound judgement, and who he also believed to have more knowledge of at least some of these things than he himself had - that is, his elector. That elector would use the same process to elect the president. Of course the College hasn't worked that way in years, if it ever did.

But the problem is real. I know a woman who thinks that New Mexico is a foreign country (not her fault; the poor dear is a victim of the New Hampshire school system). She basically doesn't know spit about anything. But her vote counts for as much as yours or mine. This is not a good arrangement.

 

[dong20]

You can't use supply and demand to understand medical costs. Supply and demand would predict that as the number of doctors in any area increases, costs would decrease. But they don't. They increase.

Errm, I know. That's why I said, oversimplification follows. It helps to read before engaging keyboard.

The main reason is that things which used to be entirely taken care of by the local "doc" are now done several times - by the first physician to attend to it, by the physician he refers the patient to, by the uber-specialist he refers the poor patient to after that, by another physician asked for a "second opinion", etc. All of which takes time and money, and is in fact somewhat less likely to result in a satisfactory solution than when it was done by the old country doctor. So why doesn't the country doctor do it? One, there aren't many left. Two, he's not allowed to do it. Depending on jurisdiction, it may be illegal for him to do the things he did twenty years ago. Routine blood tests, examination of x-rays, growing of cultures - all must be performed by specialists. This is a real problem, and not just a financial one - your doctor can't look at an x-ray to see if you have a broken bone; he has to wait until the radiologist comes in. They're not generally on call 24/7; that's one of the attractions of being a specialist. If you like money but don't much like people, radiology is a good field, as you don't have to actually interact with patients (I'm not making this up - I know of radiologists who say this). God help you if you get in a car crash on a Saturday night. The ER people will keep you alive until Monday, but they won't know what's actually wrong until the radiologist wanders in at 9 on Monday.

You should go on Mastermind. Chosen specialist subject - the blatantly (yet oversimplified) obvious.:biggrin1:

Seriously, that may be the case, generally (or specifically) in the US healthcare system, I've never had cause to avail myself of it so I can't say. The situation in the UK is far from being so cut and dried, though, sadly it seems to be headed that way.

You won't learn this stuff from the news (or from Michael Moore), you have to talk to a doctor to hear about it. With the rise of professional blogs, I was hoping that some doctors would take advantage of the medium to educate the rest of us about the real hurdles they face. But it doesn't seem to have happened. Lawyers went into blogs in a big way, and a few engineers, and some military personnel, but the showing by doctors has been disappointing. So we're all just flailing around in the dark here.

Some of my friends work in medicine, some here in the UK others overseas, some are doctors, some not and conversations with them over the years is, in part, where I formed and reformed some of my views on this. One or two would agree with some or all of what you say, one or two would say it was almost entirely round objects and misses or ignores the root causes. Most would, I suspect, like myself think that the truth is a somewhere in between. The consequences of excessive specialisation is usually high on the list of pet hates when the topic comes up.

But a major part of the basic problem seems clear enough - it's the government itself which makes so much of our health care redundant and needlessly expensive. The same government which Moore thinks will make health care more accessible. I'm skeptical.

The thing is, I agree you, at least in part. I disagree that it need be so and none of this alters the basic premise of what's been said by me, or others; that decent healthcare in the US and elsewhere is becoming increasingly unaffordable and thus inaccessible. The reasons are simple - people are unwilling or unable to pay for it. It really is that simple.

The reasons why they can't or won't are of course many and various, but primarily fall into the categories of self interest and unreasonable expectation of all concerned.

Your cynical observations while typically erudite seem intended to largely sidestep that simple truth.

 

[dong20]

I'm endorsing nothing. I haven't any intention of writing a general evaluation of the American health care system. I'm not qualified to do so. I'm pointing out some lies and mistakes in arguments posed by those who lecture us that American health care is baaaaad. I'm not saying whether it's bad or not; I'm pointing out that some of the major critiques are blatantly false. The claim that health care is inaccessible to the indigent is one of those falsehoods. From actual experience, I know this to be a fact; it's not something I "read somewhere".

I agree, most anything said here is a simplification, at best. No, I wasn't saying you made it up, I'm aware of the 'law' in this regard. My point was that the only reason you got access to healthcare without being saddled with the huge bill afterwards was because you were indigent.

Had you not been, you may have soon become so (yes, I know exageration).

 

[madame_zora]

Being indigent is better now than working for 18 to 35k- those are the people who really take it up the ass from lack of healthcare.

Big Dirge, while I appreciate your disgust with Moore for telling half-truths, who do you suggest is NOT doing that? I agree with you that he is a proven liar and should be viewed with skepticism, but SO IS EVERYONE ELSE! Personally, I don't know a single human being who has never told a lie- myself included. If we can only get information from perfect human beings, we are going to live in an information vacuum.

I don't take anyone's word as "gospel", but I think his movie will initiate some conversations that are long overdue on healthcare reform, at least the optimistic part of me wants to believe that. I haven't seen it yet, so I'll have to reserve judgement until I do.

 

[umass1]

I may not agree with everything that Michael Moore says, but he does get people thinking. One thing that I know I don't like is waiting in the E.R. for more than 8 hours just to be seen by the one doctor working there...