My Sicko Turn
I saw Sicko mostly because of this article:
… the theater was in chaos. The entire Sicko audience had somehow formed an impromptu town hall meeting in front of the ladies room. I’ve never seen anything like it. This is Texas goddammit, not France or some liberal college campus. But here these people were, complete strangers from every walk of life talking excitedly about the movie.
And the movie delivered as promised. I need to see it again. I was frightened, saddened, amused, and angered. I was also touched, especially by the scene in which the 9/11 firefighters from NYC were honored by the Cuban firefighters.
Everyone should see this film. A couple of questions that it raised for me:
- Why would we ever want to privatize education, when we can see what a miserable mess managed health care is in the hands of private insurance companies?
- In countries where there is government health care, are people generally happy with it, as the movie leads us to think? And if so, do those people also feel the same about their schools?
I’m curious whether cultural values for a government role in providing social services are specific to only some things, or whether they extend to most facets of life - if people feel taken care of. It seems to me that once a society embraces something as a fundamental right, then fairness dictates that everyone should have equal access to it. We’ve established that value for education. Public safety is also a shared value. I believe we’re arriving at the same point for health care. And the problem isn’t that we can’t agree on whether people should have those things, but how to equitably and adequately distribute the benefits. The fact that 50 million people in this country don’t have any insurance is shocking to me, and it makes me wonder how anyone can mouth slogans about “leaving no child behind,” or “right to life,” or “freedom to choose,” when the basic needs of nearly a third of our population aren’t being met.
The NYT said the film documents systemic failures and foul-ups. Actually, the film made the system appear more malevolent than that. There were several tragic examples that featured people who’d been denied coverage, and they were not accidental. Moore interviewed people whose job it is/was to review claims. One (I have to see the film again to get his name) said, “People don’t fall through the cracks. We open the cracks, and sweep people towards them.”
Moore showed that people are afraid to change jobs for fear of losing coverage, or that they might lose their homes because they can’t afford the co-pay charges. People deny themselves groceries so that they can afford medication, and hospital patents are dumped on skid row because they can’t afford to pay their bills. These are some of the more egregious shortcomings that were documented, and they are all familiar. It’s not news, and yet I was viscerally moved to see it all happening at once. My heart was in my throat throughout the movie, and maybe that’s because health care is a family issue for me, and will be forever. George Bush’s advice to take good care of ourselves is an insult to the sensibilities of anyone who knows what it means to have your back against a wall.
I liked Moore’s movie most of all because it wasn’t fair and balanced. He didn’t explore the downside of any of the alternatives that he suggests. There was no need. Things are messed up bad enough that they speak for themselves. He used juxatposition, the soundtrack, and historic footage that has high symbolic value to create powerful emotional reactions in the audience. Moore posted a quote from a memo by an insurance company rep that he somehow got hold of, in which the guy said, “You’d have to be dead to be unaffected by Moore’s movie.” We’ll see.
(I’m leaving town for a few days, so if I don’t respond to any comments on the site, I’m not ignoring anyone - I’m gone.) See the movie.
Bonus: Sicko links
Paul Martin wrote,
Just discovered your blog and liked your posting about Sicko. As a Canadian who moved to Vermont four years ago, I’m always conscious of being in a borderland, both literally and figuratively. The healthcare system here in the US is one thing that constantly reminds me of the difference between the two countries. One of the frequent reactions in Canada to all of Moore’s films is that he oversimplifies things and that things there aren’t quite as rosy as he sometimes suggests they are. I think for the most part, though, that Moore’s dead on. Some in Canada will tell you about longer wait times there for elective procedures and that can be very true, but as Moore pointed out last night on CNN and as I tell my students in the US who frequently seem convinced that the system here is vastly superior to anything elsewhere in the world, wait times will of course be shorter if you cut 50 million people out of the line to begin with. I’ve had fantastic care here in the US, though it’s all been routine medical visits to the doctor for my family. Nevertheless, I find it hard to feel good about the system here when so many people have no access and when my employer pays about ten times the premiums that my employers back in Canada paid to the government. THe Canadian system has its problems and needs some work, but no one there ever loses sleep over whether or not they will be able to afford to go see the doctor. People here also talk about how we pay for healthcare in Canada out of taxes and we do, but the government there pays about half of what the US government is paying now per capita and that doesn’t even include all the premiums paid by US employers and employees to privately run insurance companies. I can’t even begin to imagine how much money would be saved here in the US by a single payer system, but it would be an enormous amount. And I think it would also make America much more competitive economically than it currently is. Most importantly, it would cover everyone.
I’ve yet to see Sicko (hoping to get there this week) but have blogged about it a fair bit over the last few weeks at my own blog (http://pwmartin.blog.uvm.edu).
Back to my own borderland…
Link | July 11th, 2007 at 6:17 pm
Doug Noon wrote,
Paul, this was helpful. My family and I have enjoyed several long vacations in the Yukon. We prefer family camping in Canada to Alaska, as a matter of fact, because there is more infrastructure - free firewood, clean outhouses, boat ramps, roads to lakes, etc. than we have in Alaska, which is pretty raw. Not that wild places don’t have their charm and beauty, but without a big boat or an airplane Alaska is a hard place to travel. Not only that, but we’ve found the people there to be quite civil. Hard to explain that part, but it’s just the feeling we get while we’re there.
We visited with some people who worked in a lumber town in BC a few years ago who told us about the wait times, and they made it sound like a problem. So I’m glad to get another point of view. There’s bound to be trade-offs in any system.
I checked your site, but I didn’t log in to comment on your post (sorry, but I’m in a rush to leave town at the moment). Your comment about the guy who dissed your country in front of a bunch of Canadians was right on. Some people do need to get out more.
Thanks for your comment. Hope to catch up with you again at some point.
Link | July 11th, 2007 at 8:34 pm
clay burell wrote,
In Korea, I’m a legal resident and I get Korean national health care.
In one year, I’ve already used it several times for a recurrent spastic back (morphine shots, codeine, x-rays, examination, consultation: my cost? Maybe 10 bucks USD) and for bronchitis (so kill me, I smoke. Wait, you don’t have to. I’m killing myself.) - again, xrays and meds cost a pittance.
There are more uninsured Americans than there are Koreans in Korea.
I read somewhere that only two developed nations don’t offer national health insurance: the USA and South Africa. Interesting connections to other social justice issues shared by the two.
As for Canadians? I work with a LOT of Canadian teachers here in Korea. Did in Shanghai too. I’ve often mentioned that they seem generally better educated and somehow both more civil and more relaxed than my compatriots. Not a statistical thing, but still. And granted, things are a lot more crowded in America, generally, which may have something to do with it. That, and our military budget surpasses that of the rest of the world combined (China included).
Have a good trip, Doug.
Link | July 11th, 2007 at 11:20 pm
Doug Noon wrote,
Good comment, Clay. The global perspective is very helpful. Thanks.
Link | July 12th, 2007 at 12:00 am
Stephen Downes wrote,
> In countries where there is government health care, are people generally happy with it, as the movie leads us to think?
In a word: YES
We would NEVER want a U.S.-style system.
We get more freedom, more choice, and better health. And everybody is insured, no matter how much or how little they earn.
The stories you hear about waiting lists are often by rich people upset because they can’t jump ahead, pushing the poor people out of the way.
I guess we feel pretty much the same about education, except that it has never occurred to anyone to privatize the system.
Link | July 12th, 2007 at 3:55 pm
Harold Jarche wrote,
When universal health care was first introduced in a Canadian province, the doctors went on strike. Today, they would all go on strike if it was taken away. Change is a tough thing, especially with vested corporate interests on one side.
Bonne chance.
Link | July 12th, 2007 at 5:48 pm
Teemu wrote,
> In countries where there is government health care, are people generally happy with it, as the
> movie leads us to think?
From Finland. Many people see a lot of challenges in the current public health care system in Finland. Still most people do not consider privatization of it as a solution. They see that the right solution is to develop the governmental health care system, not to replace it with something that will obviously be more unfair and unequal. People consider health a human right and see that protecting human rights is a government’s job.
> And if so, do those people also feel the same about their schools?
Still from Finland. Yes. People highly appreciate the public school system guided by the state but implemented by the municipalities. According to several studies also the learning outcomes in Finland are OECD top and differences in outcomes between schools are smaller than in other countries. (http://www.minedu.fi/OPM/Tiedotteet/2006/9/OECDx_Suomalaisen_koulutuksen_tehokkuus_maailman_kxrkex.html?lang=en). Also education is seen as a human right and again we may ask: whoes job is to protect human rights?
Link | July 13th, 2007 at 2:54 am
Chris L wrote,
I haven’t seen _Sicko_ yet, but it is a terrifying sign of the times that the latest political solution seems to be not helping people gain access to health care but mandating the purchase of private insurance as a matter of law (see “Stupid Implmentations of Possibly Good Ideas, Massachusetts”). I find it hard to believe (I probably shouldn’t).
If I thought there was some hope of rehabilitating the private system then some of the ideas behind mandatory insurance would make sense. I don’t think that’s the case… nor do I think these kinds of half-measures, so open to being twisted by the same forces that have brought us to this impasse in the first place, can be implemented fairly…
Link | July 13th, 2007 at 3:15 pm
Mr. B-G wrote,
The private healthcare lobby is powerful and influential. What steps does Moore recommend we take to make his vision a reality? I haven’t seen the movie, but I plan to.
Link | July 13th, 2007 at 8:28 pm
Artichoke wrote,
Sicko has yet to be officially released in New Zealand Doug, but after your blog analysis I will ensure I make time to view it.
In response to your question
In countries where there is government health care, are people generally happy with it, as the movie leads us to think? And if so, do those people also feel the same about their schools?
I think the situation in New Zealand is much like that recorded in Teemu’s response from Finland. Health care and educational provision are seen as human rights and are provided for by the government. Which doesn’t mean the system is without critics or paid for alternatives.
In terms of education we do have alternatives to state schools - and surprisingly some of these (the integrated schools) are government funded. As has happened between us on other moments shared Doug - I find that I have been reflecting upon a related issue at Artichoke.
Link | July 14th, 2007 at 12:55 am
M Barber wrote,
Gidday from down under. In Oz despite constant the ‘push’ of media rumblings about the ’state of the health care system’ most people are pretty content with it. Is it perfect? Not at all.
But we know have a government that it trying to privatise it it. They began supporting the private firms by placing a levee on tax earnings of ‘high income people’ who, according to the government mantra, ’should do the right thing and take out private health insurance so as to ease the burden on the public system.’
Not a bad idea in itself except what we now have it two streams of tax funding - the government taxes us to give money to the public system; and the government taxes us to give money to the private system. And there are cues in both systems so giving cash to the private system hasn’t fixed the issues, just split it in two at twice the cost.
My good lady wife has worked in both streams and is currently in the private system. Her general view works something like this - if you have an emergency then get yourself to a public system because the best doctors for emergencies are usually in the public system - they’re in it to keep you alive and face serious and a variety of issues every single day of the week. If you have something you want fixed but can delay the need, then private is great because you can pick your own highly competent and specialist doctor and usually get a nice room with a slightly larger TV.
In Australia we are under significant pressure from the US owned pharmacolgy purveyors to release the low cost pharmacy ties that we currently hold onto. In other words, the BIG Pharmacy firms want to be able to prevent genericsfro keeping costs down and for every drig ever invented by the drug companies to be funcded by the taxpayer no matter what the charge.
And we may soon discover it is a debate we’ve already lost. Both private and public streams can be helpful - niether will ever be perfect but history has proven in other industries, when the private industry dominates, the profits don’t go back to the public, and that usually means more pain for those lacking resources.
Link | July 15th, 2007 at 3:42 pm
Doug Noon wrote,
Back from my little journey….enjoyed reading through the comments. No horror stories from the “socialized medicine” countries.
As to what Moore proposes as an alternative, I think that he doesn’t directly propose any one thing. A health care “expert” on the radio commented that maybe the US should look at Germany, which has a “hybrid” system. Not sure what that means, since I didn’t look yet.
The movie was, indeed, propaganda. I think it was meant to provoke discussion more than to recommend answers. I’m glad for the international response here. US citizens (like Chris and me) who see the limitations need to begin advocating for at least some discussion about this.
Stephen’s comment about it never occurring to Canadians to privatize their education system is testimony to their good sense.
Link | July 15th, 2007 at 8:01 pm
Catherine Davis wrote,
I did see ‘Sicko’ and as with all Moore’s films I do know there is another side although it was highly entertaining - we laughed and cried throughout and in the end everyoone in the theater applauded.
I do work in the Canadian Health care system in Calgary and while there are lots of criticisms it is one that works. Because we all pay into our health care system we feel ownership of it and can make suggestions on how to improve it. Overall our healthcare workers are committed to providing the best care possible and treating everyone with dignity, because in illness and death we are all equal. In every election, healthcare is one of the defining issues that politicians must address. We are proud of a system that values every life and enables access to care to anyone regardless of social class or ability to pay.
So why is it that each US citizen who have the right to vote, don’t make this a priority election issue? Why did terrorism or fear of it take over election platforms? We do have the ability to make decisions as individuals. In a few of the cases profiled in the movie there were opportunities for doctors and nurses to step forward and act based on personal values. The case that still haunts me is of the toddler who was running a high fever and her mother took her to a hospital that wasn’t covered under her insurance. Instead of acting immediately to help a seriously ill child those that were in charge of care waited too long, then transferred her to a hospital that was covered although by that time it was too late. As health care professionals we are expected to follow an oath to provide the best care possible and ‘Do no harm’.
So to me the message is Human rights are not just the responsibilty of federal governments they are the responsibility of individuals, families, communities and states.
Link | August 16th, 2007 at 10:05 am
Doug Noon wrote,
Catherine, when I mention the Canadian system to people, they immediately say something about long waiting times and few options. I suggest they see the film. The idea that Canada’s system doesn’t work because it limits choices and offers second class care has been effectively sold in the US, so it’s good to hear from people with personal experience. We need something different here, something that works for everyone and not just those with money who can afford the premiums and co-pays.
You’re correct to observe that human rights are a shared responsibility of both individuals, government, and societal institutions. Thanks for your contribution here.
Link | August 16th, 2007 at 10:44 am