Given that so many Americans consider themselves to be Christians, they don’t seem to exhibit much love for their fellow man when they have to put their hands into their wallet to pay for some healthcare. Those young people who won’t pay up now will get to old age one day, if they are lucky – provided they don’t get murdered along the way by some Sicko with an easily-accessed gun.

By the way, Moore’s ample abdominal girth is such that he would not look out of place walking down virtually any street in the Good Old U S of A. Stop insulting him and answer his arguments with logic, but please try not to be totally and utterly self-centred in the stance you take. It would not be worthy of the Land founded by the Pilgrim Fathers.

I always wanted health insurance to be like car insurance… take care of yourself, don’t eat shitty foods, and worked out you’d pay pennies compared to all the fat son of a bitches complaining about how much it costs to treat symptoms of sheer laziness.

Think about it – why the fuck should anyone pay more in taxes to treat people unable to function in a free society? Put the whopper down and take a walk fat ass.

We’re still waiting to hear why a universal public system will be better than medicare and the va, why these improvements can’t be implemented now, and why we can’t open the va and medicare to voluntary participation to demonstrate the superiority of govt health care.

Instead, all we get is “after the revolution, we’ll all sing in tune”.

Remember the numbers. The universal health care people are promising to cover at least twice as many people with less than 50% more money. (The US govt is already spending almost 8% of gdp on healthcare and covers less than half of the population. The universal health care people insist that they can cut costs from over 15% of gdp to around 10.) Something has to give, and there isn’t enough health care profit or million dollar salaries to make up the difference.

I guess I must have laid quite a hurting on you in my old Buzzmachine posting days – regardless, you are a gnat that fails to jog my memory.

While your posts show that sometimes there’s no difference between say, ‘awful’ and ‘offal’, I am quite sure that I can differentiate between ‘frivilous’ and ‘frivolous’.

He incoherently rails about the need for “CONSCIENCE” in our healthcare system then labels his dad’s conscience an “affliction”.

Schizophrenia drugs would be more expensive in the socialist utopia as well – if they were developed at all.

For penny:
At least Moore has the gumption to get up and SAY something about a broken system, however badly he manages it. I don’t see anyone else taking the steps he’s taken…least of all you. Joe wouldn’t have to pay such high prices for medicare copayment if CONSCIENCE exercised some degree of influence over GREED.

For PxLated:
You’re a moron. Sod off.

For Geiger:
Good point. Your opinion is just as worthless. Sod off.

For Andy Freeman:
Somehow, Police departments and Fire Departments appear to do just fine on the public payroll…though not so well here in the Pacific Northwest since the Fed axed our timber compensation payments. Overall, though, they do a creditable job. Medicine is admittedly more technical, but would likely benefit from the systemic regulation imposed on these other public services… regulation that would be, of necessity, imposed to regulate costs…as would pharmaceuticals. Deregulation of these industries is largely the cause of the current nightmare we’re in. I find your smokescreen of disinformation specious and largely irrelevant.

For Greum:
Capitalism doesn’t work either. Ref: ENRON. Socialism isn’t necessary to create an efficient government agency. CONSCIENCE IS.

For James Robertson:
The fire and police departments don’t close up shop at 5:00 pm. I submit to you that a publically-funded Medical establishment will not do this, either.

For Thomas:
There is nothing wrong with Michael Moore backing out of a debate with a criminal such as DeLay…a worm who deserves his fate.

Mr. Maurice Ramirez actually made the most valuable points here in the commentary – and a distillation of his comment comes down to conscience, respect and acting out of enlightened self-interest. Bravo, Dr. Ramirez.

My father was forced to wait 7 hours in an emergency room waiting area for medical attention, while suffering from a 104 degree fever caused by an infection from the new Staph superbug (which he had contracted at a Doctor’s office elsewhere.) As a result of that wait, the infection spread to his heart valves, caused his kidneys to go into failure, and nearly put him in a coma. He spent three weeks in intensive care, and was finally released to hospice care after his doctors gave him about two weeks to live. Nice.

THIS from the ‘greatest’ vaunted healthcare system in the world…the American healthcare system.

Don’t make me laugh.

He refused to sue the hospital. Unfortunately, he’s afflicted with a conscience. If I had MY way, I’d've had a battery of lawyers presenting the head of the hospital with several lawsuits. I didn’t pursue it when I learned of his wishes.

At least, as I’ve said, Moore has the guts to get up and SAY something about this pitiful mess. He may not have gotten it ALL right, but at least he’s forcing us to look at it.

Thanks for posting this, Jeff. Let’s hope some good comes of Moore’s movie.

I’m amused by the indignant Medicare recipient posting his anger at his co-pay obligation with such a sense of entitlement. Healthcare isn’t free. Your not paying, means I pay for you. Any cutting edge pharmaceuticals or life savng technology coming out of socialized systems? Nope.

There is a nursing shortage. It’s been an industry with stagnating wages. Unused beds have been consolidating hospitals in major cities.

By total coincidence and an ironic twist of fate, I served federal jury duty the day I saw the movie and took an oath to hear all evidence before me without prejudice or preconception. Having being released from jury service by noon, I girded myself in that oath and drove to the theater. Plopping down my $7.50 for the ticket and $10 for popcorn and a large water bottle, I strode in air conditioned comfort to theater 8. The theater itself was virtually abandoned, despite the fact that I had chosen to attend the movie at Walt Disney World’s Downtown Disney AMC Theatre at the height of tourist season. I had expected the theater to not only be full but to be filled with people who are ardent supporters of Mr. Moore and his films. I must admit I would not be among them. Quite to the contrary, I had not seen a Michael Moore film in a number of years. I do enjoy the occasional documentary and own a copy of Super-Size Me which I still recommend to patients, but Mr. Moore’s story telling style is, well let’s say it is not to my taste.

Within the first moments I found myself confronted with an uncomfortable fact, Mr. Moore’s movie was attacking the same Heavily Mangled-care Organizations (HMO’s) that were in large part the very reason that I had left private to practice. Everything that Mr. Moore said about such large organizations as Aetna, Cigna, Humana and Kaiser were true. Of course in invertible Michael Moore fashion he told only one side of the story, paying only passing homage to the fact that five-sixth of the US population do in fact have healthcare coverage and that out of 300 million people in the United States, most of whom have Internet access, he received fewer than 80,000 replies to his solicitation for healthcare horror stories. Still, Mr. Moore was actually making sense.

Unfortunately, also in an inevitable Michael Moore fashion, he quickly snatched defeat from the jaws of victory. The totally incomprehensible detour to a cold war era campaign by the American Medical Association to speak specifically against the evils of socialists and communists in medicine was juxtaposed against the Clinton era’s attempt at Universal Health Care. Mr. Moore seems to have missed the fact that now New York Senator Hillary Rodham Clinton stated emphatically throughout her term as chair of National Healthcare Committee that Universal Health Care was not a socialized healthcare system.

Mr. Moore also seems to have forgotten the historical context in which the American Medical Association launched its anti-socialist campaign in those early days of the cold war. Communist fears gripped the nation for over twenty years and every “respectable” professional or fraternal organization “did its part” to combat the so-called Red Menace. The American Medical Association’s campaign against socialist medicine was a political statement against socialism and communism not against Universal Health Care.

Although I am a physician I do have the unique perspective of not being a member of the American Medical Association. In fact, at the same time that the American Medical Association was actively attacking socialists and communists in healthcare; they were also attacking my profession of osteopathic medicine and therefore if anyone would support Mr. Moore’s attack on the American Medical Association it should be me, a member of the American Osteopathic Association. Just as I swore earlier in the day to objectively hear the case against the defendant in federal court I must now objectively evaluate the arguments made by Mr. Moore and in the case of the American Medical Association Mr. Moore’s arguments fall far short of any form of reality.

Returning to the main theme of the movie (corporate greed as the oppressor of the people) Mr. Moore next attacked the profits and policies of the pharmaceutical industry. The donations to prominent congressional members and others in government were enlightening and even entertaining in their presentation, but there was no new news here. The Food and Drug Administration and even Congress itself has decried these practices for years.

Mr. Moore then took a brief trip around the existing Socialized Medicine Programs in Canada, Great Britain and France. He went to great lengths to describe their advantages, speaking to Americans who thought that they benefited from a socialized medicine system in which they had no need for insurance and no need to pay copay’s. He also spoke with fully satisfied individuals living in Canada and Great Britain.

Mr. Moore’s interview with one British doctor was quite enlightening. On screen I met a physician whose entire education had been paid for by his government and his government was generous enough to pay him a salary equal as a family practitioner equal to what I make as an emergency department physician. Although, I am board certified in family practice as well as emergency medicine, I never made as much in US dollar equivalents as this young man makes now. This London doctor lives in a four-bedroom home worth twice as much as my home and drives a car worth four times as much as my car. He has these benefits not because a socialized medicine system works better or even pays better but because he was the beneficiary of socialized education through graduate school. I labor under student loan payments that almost equal my mortgage payment and will do so for a thirty-year period of time. If I had the benefits of free education, I too could live in a home worth over a million dollars, although I would still drive my Saturn because quite frankly I like it.

Mr. Moore’s tour then took an unusual direction clearly designed to draw publicity rather than make any specific point. Mr. Moore took several 9/11 survivors and delivered them to Cuba in order to receive treatment for 9/11 related injuries and illnesses. Mr. Moore claims he did this because he had found an American “socialized medicine” system at Guantanamo Bay, Cuba and just wanted 9/11 heroes to receive the same medical benefits as Al Qaeda. Why not take these heroes to a state prison in Florida? The almost every state correctional institution in the United States, inmates receive the same or better care than the detainees at Guantanamo Bay. Again Michael Moore missed the mark.

I find it curious that while in Canada, a country that is accustomed to American film makers and quite frankly Americans sneaking across the border to obtain free healthcare, Mr. Moore and his would be American patient for the Canadian system found it necessary to flee Canadian police at two separate clinics in order to avoid arrest, yet in Cuba, a country well known world-wide to embrace its tourists but to be highly suspicious of those with professional movie making equipment, Mr. Moore appeared to never encounter a police officer. In fact Mr. Moore was allowed to photograph throughout the state-run Havana Hospital, the very same hospital where Cuban leader Fidel Castro received his recent medical care. Further Mr. Moore was miraculously permitted to photograph in and around a Havana fire station, exchanging gifts and even souvenir badges with fire brigade members. I find it equally interesting that these badges were conveniently available.

Mr. Moore, who appears throughout the movie, to this point, to be very upfront with the challenges and special arrangements made in the production of his film seems to leave out the fact that he doubtless had special dispensation from the Cuban government allowing both for his film making and the care of Americans on Cuban soil.

Despite these glaring inconsistencies, I was thrilled when the Cuban doctors began to touch on the issue of the relationship between the system and the healthcare professional. I thought that Mr. Moore was finally going to disclose American Healthcare’s greatest shame, the total annihilation of the nurturing relationship between healthcare professionals and their corporate masters. But alas, Michael Moore again shied away from the issue… why?!

An interesting conversation took place recently between a 45 year nursing veteran and her family. The topic of the day was the nursing shortage and the veteran nurse surprised all by announcing, “There is no nursing shortage, there is a hospital nursing shortage.”

She went on to explain that in the home health and non-institutional nursing fields, there is an adequate supply of nurses willing to work for employers who respect and value their services. According to this nurse who had worked in hospitals for much of her career, the problem today is that hospitals and other institutions see nurses and other professionals as replaceable rather than precious.

“No nurse my age is going to work for some young supervisor who believes that you manage people by threatening them or their license. There are too many jobs out there to deal with that nonsense.”

This veteran nurse struck on the key factor in any employee shortage, the relationship between employer and employee.

Healthcare has become a split marketplace with institutional care (hospitals and nursing homes) separated from non-institutional care. Nurses are gravitating to non-institutional care despite lower pay because of the factors that Intuit and others have come to appreciate. Employees care more about the relationships than the money. Veteran nurses remember being respected and appreciated for long hours and selfless dedication. It was not expected or required, it was given freely and accepted graciously. Even in a “materialistic society” people want to be loved and cared for, respected and valued.

There is no nursing shortage, there is a relationship shortage. This is the true problem with corporate healthcare in America.

All and all I will say that Mr. Moore’s film was an honest review of the current state of the Heavily Mangled-care in the United States. Greedy insurance companies take from doctors in the form of Malpractice Coverage. They take some patients in the form of health coverage; they raise profits through denials of care, restrictive practices, penalties against physicians who place patient care and safety ahead of performance numbers and by seeking to exclude those who most need insurance.

Sadly, the majority of Mr. Moore’s movie missed the point. American healthcare will not be served by the conversion to a socialized medicine system. Quite to the contrary most of the equipments seen in background of Mr. Moore’s movie was invented, designed, manufactured, or funded by the America’s private healthcare industry. American healthcare would be best served by rebuilding relationships with the most valuable resource in healthcare, the healthcare provider. All those Mr. Moore interviewed told stories of having a favorable relationship with a system which they respected and which respected them. Regardless of whether you are a healthcare professional or a healthcare consumer, the basis of the process of healthcare is a relationship based on mutual respect, the system delivering that healthcare must live by that standard as well.

Socialized medical systems certainly have their advantages for citizens of countries willing to live with different freedoms and different lifestyles than we prefer in America. A better system is out there, we need only have the resolve to find it.

Mr. Moore also falls significantly short in failing to make note of the reasons that so many Americans require so much healthcare. Even a man with only a high school diploma such as Mr. Moore must ask himself if five-sixth of the United States population have health insurance, then why do individuals in other countries live longer than we do. Perhaps it is because we also have an excess of food, an excess of cars, an excess of conveniences. United States longevity for it’s citizens and disease rates among its most vulnerable are so high not only because people put off necessary healthcare for fear of incurring debt, but because they chose instead to indulge in fast foods which are too high in salt and fat, drive rather than walk or bicycle for short errands, play video games rather than exercise, and finally watch movies about what others do rather than going out and doing something themselves.

As I watched the corpulent Michael Moore striding down the streets of London and France being passed by much thinner Europeans, I could not help but be struck by the fact that it is not our healthcare system, but our societal values that are truly “Sicko.” It is time we all put down our popcorn, take our water bottles and go outside to exercise with our children.

You know next to nothing about healthcare and economics.

It would behoove you to stick to the net, tech gadgets, and the like.

Anyway, how have you been? Miss me?

1. MRSA the superbug and killer virus – A by-product of the UK’s national health service.
2. Taxpayers pay for the NHS in the UK – layabouts don’t pay anything, showing that it is an unfair system.
3. In the UK we pay ‘national insurance’ to pay for the NHS which is taken from your pay each month on a percentage basis. Some believe that this alone pays for the NHS but the truth is there is alot of money drawn from other taxes to pay for the floundering health service.
4. I pay more each month to ‘national insurance’ than my friends in the USA pay for their health insurances (and their on higher wages than me).
5. Socialism cannot possibly work. There is only so much wealth in the world. Once you’ve done spreading the wealth to everybody in the world and trying to stop everybody from dying, everybody becomes poor and unable to sustain their lives and everybody dies.

The US spends a bit over 15% of GDP on healthcare. About half of that spending (a little under 8%) is already govt spending. If you believe that the govt can do it all for around 10% of GDP, you get to explain how moving everyone in the private system to the govt system can be done for less than 3% of GDP. Most people are currently not on govt healthcare, so you’re promising to double the number of people covered with less than 50% more money.

What? You’re going to change the way govt healthcare works? Great, but what’s stopping you? Which of your “innovations” can’t be implemented right now in govt healthcare? (Yes, they can do preventative care.)

Yes, you can lower average costs by adding healthy 18 year-olds to the pool, but that doesn’t make grandma’s hip replacement any cheaper. At best, it “lets” the 18 year-olds help pay for it. I’m guessing that they won’t want to.

No, there’s not enough saving in drug costs.

Still, if you think that govt healthcare is a great solution, let’s open up medicare and the va to voluntary participation. The volunteers will pay what it costs medicare and the va to serve them. We’ll see how many individuals and companies switch from Kaiser, Blue Cross, etc. We’ll see how many folks who can’t afford the private alternatives can afford govt healthcare.

What? Medicare and the VA can’t compete on price? I thought that they were cheaper?

Fair enough… it’s a popular movie & a popular point of view.

Very doubtful that we’re going to analyze & solve the the U.S. health care system problems… in the comments section here.

The core issues for me is that
1. No one goes bankrupt because they are ill
2. Everyone is covered

Public Healthcare is not perfect or even ideal. But I think that these two points are key. Finally the US, the world’s largest economy, has a mediocre population health and a deathrate of a country in the lower leagues. It is inconceivable that America can tolerate this.

In the UK – you get a mixed system – if you have the money – you can pay and experience a hotel like experience. if you have none, the conditions may be tiresome but you will get looked after

Andy Freeman argues that the 2% figure can’t be right, but offers no evidence. He also ignored the part about the million dollar salaries of private health care executives. There is nothing unique about “Medicare” fraud – there is plenty of fraud in the for-profit sector as well. The 2% figure includes the “fraud”, it’s part of the cost of doing business. How big a percentage of the total expenditures do you really think it is anyway?

James Robertson brings up the old canard about the DMV and the post office. Show me a private firm that can hand deliver a letter to your personal mail box from anywhere in the country for $.41. That seems pretty efficient to me. I haven’t had to visit the DMV in over a decade – it’s all done by mail.

What these critics have in common is their unwillingness to look at the facts. The facts are that the US has a poorly designed health care system and that other places do it better. What’s so hard about admitting that?

As I said before unless you are a shill for the industry why would you continue to support an imperfect system, especially when there are plenty of models to learn from?

“Moore also made the point yesterday on Bill Moyer’s show that we know what is wrong with the health care systems in Canada, the UK and France. We don’t have to copy the wrong parts, just the good ones. There is such a thing as learning from someone else’s mistakes.”

Jeff, I presume that neither you, nor the commenter I quoted – nor Michael Moore, apparently, have ever visited the Post Office or the DMV. I’ve never walked into a Doctor’s office near closing hours and had them slam the door in my face – I’ve had the Post Office do that to me.

If you think insurance companies are big, faceless entities that don’t care about you, just how stupid do you have to be to think that the health care version of the Post Office is going to be better?

Unless you’re going to argue that private has inherent inefficiencies and extra administrative costs (and the above ignores the known medicare fraud, so the 2%, which is arguably incorrect, is a bad deal), there’s a huge profit to be made by doing private correctly.

It’s interesting that the critics are unwilling to do better. If they’re correct, they’d dramaticallyi improve people’s lives, drive the bad people into bankrupcy, and have an opportunity to make serious money. Yet, they sit on the side and carp.

Their actions speak too.

Medicare doesn’t pay the “going rate”. Medicare decides what it will pay whether the doctor likes it or not. As more and more people become eligible for Medicare the doctors will raise their rates for those not on Medicare in order to make up the difference.

In the future, if doctors can’t make a good living because they are under price controls, then we will see a fall off in the best and brightest going into the medical profession and we’ll be saddled with the mediocre.

At SXSW, I saw “Manufacturing Dissent,” and it completely changed my mind about Moore. I’m a progressive, liberal, leftist type of guy who used to consider Moore a hero. He is not. Primarily he is into himself and takes more than “liberties” with many of his films, to the point of undermining the causes he purports to believe in.

Please check out the movie, especially if you “believe in” MIchael Moore. “Sicko” accomplished many things, but I can no longer blindly trust anything Michael Moore produces. If anything, I’m suspicious that the omitted truths and outright fabrications contained in this latest movie could only hurt the good cause of universal healthcare.

http://www.manufacturingdissentmovie.com/

Medicare has an overhead of about 2%, private health care has an overhead of about 30% (that includes profit, administrative costs, and inefficiencies from overlapping systems). The head of one the the big health systems managed to get himself a pay package worth $1.1 billion. The head of Medicare is a civil servant. Krugman has written many times about the expenses imposed on the system by risk avoidance. There are entire firms whose job is to find reasons to avoid insuring people and/or paying them for claims. A government administered, universal program would put these people out of work.

Moore also made the point yesterday on Bill Moyer’s show that we know what is wrong with the health care systems in Canada, the UK and France. We don’t have to copy the wrong parts, just the good ones. There is such a thing as learning from someone else’s mistakes.

I can understand shills for the private insurance firms floating libertarian ideas, but why the average person would want to support the present inefficient system is beyond me.