By Antonio D. French
Filed Friday, June 29, 2007 at 12:39 PM
Michael Moore's latest documentary, Sicko, comes out today. A critical look at America's failure to provide for the health and welfare of its people, the film has received praise from both sides of the political aisle. Labels: Culture
Show times at the Chase Park Plaza are: (12:00), (1:15), (2:30), (4:00), (5:00), 6:30, 7:30, 9:00, 10:00
For your outdoor viewing pleasure, Martin Casas' Frontyard Features will being showing A Night at the Museam in Francis Park, 5399 Donovan Ave, next to the tennis courts tomorrow night.
Click here to listen to KWMU's story on Casas' mission to bring St. Louis' movie lovers outdoors this summer.
And for those of us who are patiently waiting for the 6:00 release of the iPhone, might we suggest this great program for converting those Netflix DVDs to iTunes viewable movies.
11 Comments:
Don't forget the weekly Friday night free movies at Gazebo Park in the Old Orchard area of Webster Groves, which follow a free live music concert. Tonight the Zydeco Crawdaddies are followed by "Goonies."
6/29/2007 1:14 PM
Unfortunately, Michael Moore doesn't garner an overwhelming credibility rating because he interjects his biases into just about everything he produces.
Beware of the propaganda. At the same time, think through the health and medical crisis in this country. Socialized medicine hasn't worked too well anywhere it has been practiced.
6/29/2007 3:24 PM
Unfortunately, Rupert Murdoch doesn't garner an overwhelming credibility rating because he interjects his biases into just about every NETWORK HE OWNS.
Beware of the propaganda. At the same time, think through the health and medical crisis in this country. Socialized medicine has worked in EVERY OTHER DEVELOPED NATION where it has been practiced.
Fairness Doctorin Fun
6/29/2007 4:21 PM
Socialized medicine has worked very well in Cuba, considering they rank only a few points below the United States, while their GNP is far lower than ours. Socialize medicine works if there is a political will and good management.
6/29/2007 4:43 PM
Healthcare is a favorite topic of mine. I fear it would take PubDef much too far afield to have a thorough discussion here.
The term Socialized Medicine doesn't really mean aything except that nobody goes bankrupt when they get sick and everybody gets what I'll call "basic" helathcare without having to beg for it. The UK/Canada model is only one, and its very different from France, which is very different from Germany and Holland.
The bugaboo here in the USA is that every other system rations care overtly. Here, we claim not to ration care at all, but do it covertly even when you have insurance. Most people are fooled by the claim.
I hang out a lot over at The Healthcare Blog. If you're interested, check it out.
I plan to see the film next week.
t
6/29/2007 7:20 PM
"Socialized medicine has worked in EVERY OTHER DEVELOPED NATION where it has been practiced." I have lived in two countries with socialized medicine. I personally like the idea, but it is bankrupting the countries. It is either inaccurate or false to say it has worked in every other developed nation where it has been practiced. That's why so many with the money come here for health care.
Notwithstanding, we do have to do something about our healthcare system--just not by telling ourselves lies.
In France, workers are so heavily taxed to provide socialized medicine that it is difficult to personally rise above the almost-poverty state. Socialized medicine is not free--it costs big time.
6/30/2007 2:41 PM
> it is difficult to personally
> rise above the almost-poverty
> state.
And that's different from here exactly how?
The whole business climate of Europe is very different from here. One problem they have is that their laws make it somewhere between very expensive and illegal to fire anybody. So businesses don't hire in the first place. Except they don't consider it particularly a problem — security is highly valued there. They can't understand how someone here can be fired for any reason or no reason at all, putting an entire family at risk. This is the trade-off they choose.
> Socialized medicine is not
> free--it costs big time.
Our un-socialized medicine costs much more than their socialized medicine, and by many measures produces worse outcomes even among the well-insured. Other industrialized countries spend 10% of their GDP on healthcare and take reasonable care of everyone. We spend 18% of our GDP and don't take reasonable care of everyone. We could start by being up-front about what we're doing.
Two hints if you get your health insurance through your employer:
1) You are not the customer of the health insurance company — your employer is. And your employer is not your mommy:
2) Your employer sees health insurance simply as a part of your salary that's necessary to keep you from jumping ship.
But maybe you don't jump ship, maybe you fall overboard. If you get too sick to work, you'll be offered an 18-month COBRA plan where you have the opportunity to personally pay your health insurance premium even though you have no income. Or maybe you're lucky and still have your wife's income, but her employer doesn't offer health insurance and your family was covered under your employer. Figure $700 — $1,200 per month for the premium. Don't pay the premium and take your chances. Pay it and lose your house. Take your pick. But let's say you manage to pay it.
At the end of the 18 months, you'll be kicked to the individual market. If you can get coverage at all, it won't cover the disease you've got, it'll cost at least half again as much as you have been paying, and your out-of-pocket expenses will be higher (i.e. it'll cover less). Miss a payment and you're out of luck. Not just you, your whole family.
When you're finally destitute, you can go on Medicaid and try to find a doc who will spend 20 minutes with you for the $50 the Great State of Missouri offers him. Maybe you'll be lucky and the doc you saw when you had reasonable insurance will keep on seeing you. But many don't participate in Medicaid at all. Its hard to blame them: a reasonably organized and run doctor's office needs around $200/hr coming in the door for 1,500 hours a year. Per physician.
If you manage to survive until your 65th birthday, life gets easier again because of Socialized Medicine — Medicare. But Medicare reimbursements are falling too. What will happen to the program under conditions of unrealistic expectations, covert rationing, misaligned incentives, and the millions of Baby Boomer retirees that will flood the system over the next 15 years? Some docs are already dropping out of the program.
Here's a book that's a pretty good introduction and not too wonky. Standard disclaimers apply.
I do not want a UK style system for all the reasons people fear and because it does not fit very well with our national character. We want to leave more space for personal initiative than others do. Fortunately there are other models.
I think this is all I should say here on PubDef. If you're interested in healthcare policy, there's The Healthcare Blog.
On second thought, maybe I'll post a review of Sicko and that'll be it.
t
6/30/2007 11:59 PM
ouch. you found a couple films in playing in st louis this weekend. of course, i had a bunch of other films you didn't care to share this friday film feature?
sincerely,
Film-Geek Fridays on hwy61 blog
7/02/2007 4:27 PM
I just saw SiCKO. When its not tragic, its really funny. Highly reccommended.
Nobody goes to a Michael Moore film expecting to see anything "Fair and Balanced", so its no good complaining that its anything but polemical propaganda. When having gone that's what you get, its also what you deserve to have gotten. If you want something Fair and Balanced...
... well, I don't know what to tell you. Good Luck.
The film is a series of vingettes interlaced with a series of classic Michael Moore stunts. It is difficult to say very much about it without spoiling the punch-lines for you, so I won't. Instead I will mention a few of its underlying premises, and finish up with just a touch of wonkitude.
Everybody makes presuppositions. The presupposition of Europe is Human Solidarity. The presupposition here in the USA is Radical Individual Liberty. It has given us very different systems. This is starkly presented: Moore asks people why they're willing to pay high taxes to support free healthcare for the other guy. The response is always the same: "Because he'd do it for me." Here we have the right to Life, Liberty, and the Pursuit of Happiness (not necessarily its attainment). The French have liberté, égalité, et fraternité, and how different the consequences!
In one place Moore apparently presupposes a "right to retire" when he finds an elderly man working in order to pay for his medicines. This apparently places no greater burden on him than anyone else working to earn a living, but Moore sees it as a bad thing. I am not positive I agree entirely.
Solidarity is a two-way street: as there is a right receive necessary help, so there is a duty to contribute. How shall these be balanced? When our canonical retirement age of 65 was set, the life expentancy of an American man was 64. To accomplish the same thing today, we'd have to make the retirement age 78 or so. And women live longer than men — now that they participate so fully in the workforce, shall we have different retirement ages for men and women so to keep things equal?
Is it right to presuppose a "retirement age" at all?
Moore acknowledges the problem of un-insurance: he does spend some time on the plight of the destitute, but the focus of the film is mostly on the insured, and on how the incentives are all fouled-up. A great deal of what you'll see are examples of what I have called covert rationing.
He demonstrates how the system is simply too complicated for most people to navigate when under the stress of an acute or emergent episode. For some people, it is too complex under the best circumstances. This is by design, and is one mechanism of covert rationing.
One thing I noticed: we have (as Moore points out) "socialized" emergency medicine. An ambulance WILL come get you, and an Emergency Department is required by law to stabilize you regardless of your ability to pay. But we have not "socialized" non-emergency medicine. So it is completely possible for a person to call and ambulance and be seen in an Emergency Department, for the ED docs to determine this isn't quite an emergecny, and for your insurance company to deny payment for the ambulance ride and the work that was done to figure out there was no emergency after all.
Or after you are stable, the hospital discharges people to... where?
This is all perfectly "legal" and maybe even "right" under the current rules. But Moore asks a very good question: Should we tolerate this? And where does "healthcare" end?
A couple of analytical wonky points:
Moore does a good job showing how care is rationed by ability to pay and by covert means in the USA, but does not acknowledge that care is indeed rationed in other countries. OK, he's not required to do so. He never said he was going to be Fair and Balanced. Fine. But this is the wonky section of my little slapdash essay.
Whether or not certain proposed treatments here are "experimental", if they were experimental they would not even have been proposed in Canada, England or France. But when HMOs here tried "not mentioning" things that just might've been of some benefit, everyone screamed bloody murder and not least doctors — they are paid for doing procedures whether they help or not.
Even if its not experimental, it might be rationed: in England, Moore himself would be ineligible for hip replacement surgery because he is too fat. Realities like this are not mentioned. There is literally no end of things that might possibly help just a little. At some point, someone has to say "no". In the socialized systems, this is said out loud and up-front.
While Primary Care docs in England are paid better than they are here, specialists are paid considerably less well. I am not saying this is such a bad thing. But in France, Primary Care docs are paid about 1/3 of what they make here. These circumstances partly explain how "costs" are so much less across the pond. But! They're experiencing the same pressures we are from the rate of growth in expenditures, and even for them it is unsustainable. What's more, their economies don't grow as fast. So what they'll do is ration more (i.e. no curative treatments for cancer in those over 70 years, for example). We will do the very same thing, but we're not up-front about it.
Anyway, enough of this. I hope PubDef-ers will go see the film. Maybe it can help motivate America towards the excercise of that greatness all her own which
"...lies not in being more enlightened than any other nation, but rather in her ability to repair her faults."
—Alexis de Tocqueville (French guy)
t
7/02/2007 8:11 PM
Tom---I wonder if you are as bitterly disappointed with proposals from Clinton, Obama and Edwards as I am.
They seem united in not wanting to piss off the insurance companies.
My state senator McKenna sponsored a resolution to endorse the Conyers single payer thing. I guess it is not all that courageous since it has no consequences.
It seems to me "single payer" are words which frighten presidential candidates more than they frighten the voters.
7/03/2007 1:27 AM
Single Payer are words that frighten politicians because they frighten voters. If they didn't frighten voters, politicians would be all for it, and that's the reason they frighten the voters. Neat, huh?
I cannot say I am bitterly disappointed because an incremental approach is the only approach that has a realistic chance to make the least improvement in an environment where there is no social consensus about distributive justice and the means to achieve it. I myself am more interested in solving the consensus problem. But this is very slow.
The downside of incrementalism is that it increases complexity. sigh.
t
7/03/2007 9:24 AM
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