A Review of Michael Moore’s Sicko

[youtube=http://www.youtube.com/watch?v=joaAfBr9tAE]

Last night I took Michael Moore up on his offer and watched Sicko prior to its official release, with the trailer appearing above. The documentary made many excellent points on health care, but after seeing its overall philosophy, I am surprised that it received favorable reviews from Fox News and The Wall Street Journal. Perhaps their reviewers also have had unpleasant experiences with the health insurance industry.

Moore briefly mentions the problems of the uninsured, but concentrates on the millions who do have health insurance yet still run into problems. He shows people having financial difficulties after paying their deductibles and co-pays, or paying the bill when an insurance company refuses to cover a necessary service. He shows how insurance companies cherry pick the healthiest applicants and deny those it expects to have to pay out on.

Moore might give a false impression that people with chronic diseases cannot obtain coverage at all. In many states they can receive coverage in theory–if they can afford the rates. The chances are better if covered by an employer as opposed to needing to obtain individual coverage, but a catastrophic case might also cause an employer to drop or reduce coverage. Michael Moore has a valid point that insurance companies are in the business to make money, and that often means finding ways to avoid paying claims as opposed to covering medical care for the sick. Similarly, viewers might get the impression that insurance companies find ways out of paying every claim. They actually do pay out on a sizable number, but that doesn’t help the many people, such as those shown in Sicko, who do not have their bills paid.

Moore shows not only victims of the health care system, but those who worked for insurance companies and are now confessing about the tactics used. This includes medical directors for insurance companies who were well paid for finding justifications to deny claims. The health insurance companies attempted to rationalize this to their medical directors by claiming they were working only to deny payment, not medical care.

The more controversial aspects of the movie are sure to involve the visits to Canada, Great Britain, France, and, most of all Cuba. I prefer to stick with aspects of the movie I’m personally familiar with, health care in the United States, as opposed to debating health care plans in foreign countries I have only read about. Moore also goes beyond health care to support considerable more government services than many who are pushing for health care reform in this country are advocating. I’m sure that Michael Moore does white wash many of the problems in other countries, but the fact remains that all these countries are able to provide health care for all its citizens. That does not mean that we should necessarily follow any of these particular models, but universal health care is something an affluent society such as ours should be able to find a way to provide.

Detractors of Michael Moore are bound to attack his more leftist economic positions and attempt to claim that the Democrats are as far left as him. As noted in a previous post, Michael Moore believes that none of the Democratic candidates, including Dennis Kucinich go far enough. Only Kucinich backs a single payer plan, with the rest of the Democratic candidates advocating plans which preserve private insurance plans as well as private medical practices. The plans advocated are actually very similar to those enacted by Republican governors in California and Massachusetts. I’ve seen claims that Sicko is virtually a Hillary Clinton campaign ad. It is true that the movie takes a highly favorable view of Hillary Care while ignoring the problems, but Moore ultimately attacks Clinton for selling out to the insurance companies.

There is no way that Michael Moore will receive anything but opposition from the insurance industry, but he does try to appeal to doctors. In both England and France he makes a point of showing that, despite “socialized medicine,” the doctors continue to have an excellent standard of living. On top of that, they don’t have all the paper work hassles we receive from the insurance companies, as well as denial of payment. Michael Moore is receiving support from groups of doctors and nurses who have joined together in Scrubs for Sicko to give information to movie goers.

Moore looks at previous health care legislation, including portions of the Nixon White House tapes showing Nixon’s true motives for pushing HMO’s as a means to deny care. He also shows how George Bush’s Medicare Part D plan was really a scheme to provide greater payments to the pharmaceutical and insurance industries, but he does leave out many of the details. Moore could have said more about how many patients who were eligible for both Medicaid and Medicare had their prescription coverage changed from plans which negotiated lower prices to new plans which paid the pharmaceutical companies significantly more. He also said nothing about the Medicare Advantage Plans included in the legislation. Under these plans, insurance companies are paid more than it costs to treat regular Medicare patients, even though they cherry pick the healthier patients and engage in dishonest sales techniques.

Moore makes a variation of an argument which I have often made to libertarian-leaning friends who question why I would support changes in health care, even if far less than those advocated by Moore. As Michael Moore points out, we already have “socialized” police, fire fighters, soldiers, and teachers. In the rest of the developed world universal health care is also seen as the norm, although Moore does brush over the fact that many countries do provide universal care through utilizing private insurance. In the case of health care, the insurance industry has simply failed, substituting a business model based upon avoiding payments as opposed to providing a service.

There’s bound to be denial from the right as to the accuracy of the movie. While it certainly doesn’t excuse the other problems in their system of government, I’ve previously provided information on the validity of Moore’s comments on health care in Cuba. The National Coalition on Heallth Care has reviewed health care costs, as well as the number of people, including those with insurance, who declare bankruptcy due to health care costs. The American Society of Registered Nurses has also reviewed Moore’s facts and found those on the US insurance system to be accurate. Among their findings:

When we surveyed select counties across the world for life expectancy, which was defined as the life expectancy at birth for both sexes, the U.S. fared very poorly.

The U.S. came in 17th, tied with Cyprus, with a life expectancy of 78.0. Here are the countries in the top 17: Japan (81.4); Switzerland (80.6); Sweden (80.6); Australia (80.6); Canada (80.3); Italy (79.9); France (79.9); Spain (79.8); Norway (79.7); Israel (79.6); Greece (79.4); Austria (79.2); New Zealand (79.0); Germany (79.0); U.K. (78.7); Finland (78.7); Cyprus (78.0); and the U.S. (78.0).

In our survey of select countries across the world for infant mortality, which was defined as the number of deaths per 1,000 live births, the U.S. again did poorly.

The U.S. came in 16th, below South Korea, with an infant mortality rate of 6.4. Here are the countries in the top 16: Sweden (2.8); Japan (3.2); Finland (3.5); Norway (3.6); Czech Republic (3.9); France (4.2); Spain (4.3); Denmark (4.5); Austria (4.5); Canada (4.6); Australia (4.6); Portugal (4.9); UK (5.0); New Zealand (5.7); South Korea (6.1); U.S. (6.4).

The next question is whether the U.S. truly spends more than any other country in the world on health care. This would indeed indicate a mismanagement of funds budgeted for the health care system…

Again, Moore’s facts checked out. The U.S. spends $5,711 per person. That’s a whopping 33% more than the next highest spending country, Norway. Norway spends only $3,809 per person.

Here are the top 27 highest per capita spending countries in the world: U.S. ($5,711); Norway ($3,809); Switzerland ($3,776); Luxembourg ($3,776); Iceland ($3,110); Germany ($3,001); Canada ($2,989); Netherlands ($2,987); France ($2,902); Australia ($2,874); Denmark ($2,762); Sweden ($2,704); Ireland ($2,496); U.K. ($2,389); Austria ($2,306); Italy ($2,266); Japan ($2,244); Finland ($2,108); Greece ($1,997); Israel ($1,911); New Zealand ($1,893); Spain ($1,853); Portugal ($1,791); Slovenia ($1,669); Malta ($1,436); Czech Republic ($1,302).

It is not necessary to agree with all of Michael Moore’s personal beliefs to see the movie and acknowledge that we do have a problem. Nor must we necesarily agree with Michael Moore’s solutions. The problem is only worsening as the number of uninsured , as well as under-insured, continues to grow.

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