I was a bit (pleasantly) surprised to see this article by Kurt Loder. Loder takes a critical look at Moore’s latest film, ‘Sicko’ and finds it lacking in terms of facts.
Michael Moore may see himself as working in the tradition of such crusading muckrakers of the last century as Lincoln Steffens, Ida Tarbell and Upton Sinclair — writers whose dedication to exposing corruption and social injustices played a part in sparking much-needed reforms. In his new movie, “Sicko,” Moore focuses on the U.S. health-care industry — a juicy target — and he casts a shocking light on some of the people it’s failed.
There’s a man who mangled two of his fingers with a power saw and learned that it would cost $12,000 to save one of them, but $60,000 to save the other. He had no health insurance and could only scrape together enough money to salvage the $12,000 finger.
There’s a woman whose husband was prescribed new drugs to combat his cancer, but couldn’t get their insurance company to pay for them because the drugs were experimental. Her husband died.
[…]
Moore does a real service in bringing these stories to light — some of them are horrifying, and then infuriating. One giant health-maintenance organization, Kaiser Permanente, is so persuasively lambasted in the movie that, on the basis of what we’re told, we want to burst into the company’s executive suites and make a mass citizen’s arrest. This is the sort of thing good muckrakers are supposed to do.
Unfortunately, Moore is also a con man of a very brazen sort, and never more so than in this film. His cherry-picked facts, manipulative interviews (with lingering close-ups of distraught people breaking down in tears) and blithe assertions (how does he know 18,000* people will die this year because they have no health insurance?) are so stacked that you can feel his whole argument sliding sideways as the picture unspools. The American health-care system is in urgent need of reform, no question. Some 47 million people are uninsured (although many are only temporarily so, being either in-between jobs or young enough not to feel a pressing need to buy health insurance). There are a number of proposals as to what might be done to correct this situation. Moore has no use for any of them, save one.
As a proud socialist, the director appears to feel that there are few problems in life that can’t be solved by government regulation (that would be the same government that’s already given us the U.S. Postal Service and the Department of Motor Vehicles).
And our current health care system/problems by and large. This may not be very popular, but the U.S. system is somewhat like the French system in that it is a hybrid of both private and public health care. For example, the tax exempt status of health care benefits is a direct result of government policy that increases demand and pushes up prices. The tens of billions of dollars in health care subsidies also increase demand by some of the highest consumers of health care. This also pushes up demand and increases prices. The reduced competition that allows doctors to command higher salaries can’t work unless it has the governments blessing.
The problem with American health care, Moore argues, is that people are charged money to avail themselves of it. In other countries, like Canada, France and Britain, health systems are far superior — and they’re free.
I don’t know if Moore claims these other health care systems are free, but if so that is indeed a blatant lie. Nothing is free. These health care systems are funded via taxes (or in the case of France, taxes and fees consumers pay). This disconnection between the service being utilized and the actual costs is not a good thing to most economists. It creates a whole host of incentive problems if not done well, and even still the bureaucratic costs might outstrip any benefit such a system might provide; for example by expanding covereage and getting away from having those without insurance treated in clinic vs. emergency rooms.
That last statement is even truer than you’d know from watching “Sicko.” In the case of Canada — which Moore, like many other political activists, holds up as a utopian ideal of benevolent health-care regulation — a very different picture is conveyed by a short 2005 documentary called “Dead Meat,” by Stuart Browning and Blaine Greenberg. These two filmmakers talked to a number of Canadians of a kind that Moore’s movie would have you believe don’t exist:
A 52-year-old woman in Calgary recalls being in severe need of joint-replacement surgery after the cartilage in her knee wore out. She was put on a wait list and wound up waiting 16 months for the surgery. Her pain was so excruciating, she says, that she was prescribed large doses of Oxycontin, and soon became addicted. After finally getting her operation, she was put on another wait list — this time for drug rehab.
Whoopsies. Not surprising at all. After all, the problem the woman above faced was probably deemed non-life threatening and off she goes to the back of the que. This highlights another lie often told by those favoring nationalizing health care like in Canada. The 16 months of pain and suffering and the drug addiction that the woman developed are costs…costs that generally aren’t measured in terms of health care expenditures. Was she able to work? Was her family adversely impacted?
And Dr. Brian Day, now the president of the Canadian Medical Association, muses about the bizarre distortions created by a law that prohibits Canadians from paying for even urgently-needed medical treatments, or from obtaining private health insurance. “It’s legal to buy health insurance for your pets,” Day says, “but illegal to buy health insurance for yourself.”
Welcome to the world of unintended consequences. The reason why you can’t let people buy private health insurance is that then the government would only be left with those who don’t meet the criteria for private health insurance. Further, most of the people who do would resent having their taxes so high and having to pay for other people’s health care. You might see a backlash sort of like we saw here in the U.S. for welfare.
What’s the problem with government health systems? Moore’s movie doesn’t ask that question, although it does unintentionally provide an answer. When governments attempt to regulate the balance between a limited supply of health care and an unlimited demand for it they’re inevitably forced to ration treatment.
As any economist would say, “No duh.” This is obvious, after all that is what prices do. Prices ration resources (goods and services). By having government run health care you’d no longer use prices to ration health care, but another mechanism…government mechanisms. Long lines, mandantory wait times, simply prohibiting certain aspects of procedures/treatment or even outright banning of the procedure/treatment itself (e.g. vertility treatments–in Canada the selling of eggs for fertility treatments is illegal). Either way the resource will be rationed. Either it will be rationed based on political agendas or via the market and prices. Not surprising that Moore wouldn’t touch on this point.
This is certainly the situation in Britain. Writing in the Chicago Tribune this week, Helen Evans, a 20-year veteran of the country’s National Health Service and now the director of a London-based group called Nurses for Reform, said that nearly 1 million Britons are currently on waiting lists for medical care — and another 200,000 are waiting to get on waiting lists. Evans also says the NHS cancels about 100,000 operations each year because of shortages of various sorts.
I’m from the government and I’m here to help.
And just to reiterate a point Loder (and I myself) made earlier: The U.S. health care system is a mess. It is on a growth path that is completely unsustainable. Still, this doesn’t mean that we should embrace the nationalized health care that we see in England and Canada. Those systems are financial black holes as well and face very serious problems. The French system while better is also facing long terms sustainability problems like the U.S. just with a longer horizon until disaster. To the extent that Moore points out the problems and ugly aspects of the U.S. system it is a good thing. That Moore hides or ignores the problems with the health care systems in other countries and extols only the good aspects of these health care systems transforms his movie from a documentary into propaganda.
