Sicko is Healthy

Sicko is Healthy July 2, 2007

There is a lot of knee-jerk reaction against Michael Moore’s latest indictment of the US health care system, Sicko. But, overall, the experts pretty much agree that he gets the big picture right. Here’s the New Republic’s Jonathan Cohn, who writes extensively on health care:

“As Sicko rolled, it did little to allay my fears. I spotted plenty of intellectual dishonesties and arguments without context–enough, surely, to keep right-wing truth squads (and some left-wing ones) busy for weeks… Still, by the time the final credits ran, it was hard to get too worked up about all of that. Because, beyond all the grandstanding and political theater, the movie actually made a compelling, argument about what’s wrong with U.S. health care and how to fix it. Sicko got a lot of the little things wrong. But it got most of the big things right.”

CNN (taking a short break from incessant Paris Hilton coverage, so it seems) also got their fact checkers on the job, no doubt expecting a bonanza of error-laden propaganda. But it was not to be:

“Moore covers a lot of ground. Our team investigated some of the claims put forth in his film. We found that his numbers were mostly right, but his arguments could use a little more context. As we dug deep to uncover the numbers, we found surprisingly few inaccuracies in the film. In fact, most pundits or health-care experts we spoke to spent more time on errors of omission rather than disputing the actual claims in the film”

I’ve already laid out many of the problems with the US health care system in my argument in favor of a single payer system last week. The analysis backs up what I was saying, including the fact that the US spends far more for health care than the rest of advanced world, and attains far less in return. Perhaps the most pertinent statistic is the one from the World Health Organization, showing that the US is ranked only 37 in the world in terms of health care outcomes (while both France and Canada make the top ten). They also show the relative inefficiency of private insurance: while Medicare eats up about 1 percent on overhead, private insurance companies waste between 10 and 30 percent (as I noted in my post last week, this is because so much effort is put into screening people). In criticizing Moore, Andrew Sullivan puts forward the most bizarre argument I’ve seen yet: the anti-US health care position ignores the fact that much of it is under the auspices of the government anyway. Since this is the most efficient part, the obvious conclusion from Sullivan’s thought process is “Medicare for all”!

Opponents of single payer systems usually retort to two tactics: they play up waiting lists, and they argue by anecdote. And yes, in some universal health care systems, there are waiting lists for non-emergency elective surgery such as hip replacements. But that is not true everywhere. France has no waiting lists, allows free choice of doctors, and offers access to highly advanced medical care to those in need. And, in fact, the absence of waiting lists for elective surgery in the US has a dark side, as it reflects an over-supply of specialists relative to primary care physicians. This is not too surprising, given that specialists earn a whopping 300 percent more that primary care physicians here, as opposed to a norm of 30 percent elsewhere. Clearly, something is amiss.

So bear that in mind next time some smug free-marketer talks about waiting lists for hip replacements in Canada, or how Canadian doctors are trying to enter the American market. And keep some of these figures in mind too:

Health Spending per capita: US– $4,497; Canada– $2,483

Healthy life expectancy: US– 68.1; Canada– 70.5

Standardized death rate (per 100,000): US– 670; Canada– 561

Infant mortality rate (per 1,000): US– 6.9; Canada– 5.3

Child mortality rate (per 1,000): US– 7.6; Canada– 5.7

Maternal mortality rate (per 100,000): US– 10.5; Canada– 5.8

Number of uninsured:US– 45 million; Canada– 0

The question is, though, will people be able to see the big picture, and the basic truth in this movie, or will be they blinded by the minor inaccuracies, the stupid visit to Cuba, and the personality of Michael Moore himself?


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