I was working at Blockbuster when Sicko came out and was subjected to the trailer for it every 25 minutes or so. It shows that scene where Moore attempts to get into Guantanamo Bay (I vote we let him in) and a few voice overs from chubby himself. My favorite is the quote that the US comes in at 37 in a WHO health care ranking (2000). Moore chimes in "right ahead of Slovenia."
I was interested in this ranking when I studied it in my law school Bio-ethics course and I looked into the methodology a bit. Turns out that most of the US's crummy ranking can be attributed to a shoddy performance in the rather subjective category of "fairness." The US was demoted in fairness for such actions as creating Health Savings accounts and having patients pay more out of pocket than other countries. Keep in mind that they're not saying it was too expensive; they just want less to be out of pocket (and more from taxes or prepaid insurance). Saying that people paid too much out of pocket implies that the WHO knows what the correct amount is to be paid out of pocket (vs. paid by insurance or government). This is obviously a political judgment.
In a couple of less subjective areas the US was considered a poor performer. Infant mortality is singled out by Moore, who points out that Cuba has a lower rate. But no-one in their right mind is rushing off to Cuba to have their babies delivered. Turns out that the reason the US doesn't do well in this category is because our extraordinary medical technology has made almost every infant savable. We attempt to save infants that we know will have severe health problems. Children die here who would have never made it to birth in much of the world. Low infant mortality rates in Cuba are accompanied by one of the world's highest abortion rates. This is probably not a coincidence.
It is worth pointing out that the WHO ranked the US #1 in "responsiveness to patients' needs in choice of provider, dignity, autonomy, timely care, and confidentiality."
When you look at particular diseases, it is clear who the winner is. The United States has the best survival rates for most diseases. For example, our survival rates top the charts when you look at cancer, pneumonia, heart disease, and AIDS.
Considering cancer in particular, the US has a 5-year survival rate of 62.9% for men and 66.3% for women. The UK, on the other hand, has 44.8% for men and 52.7% for women. (BTW, this data is from the British medical journal The Lancet)
The real danger of socialized or single-payer systems is the threat to innovation. Most of the world's new medicine comes from the United States because it is actually *worth it* to do the research here, given the astronomical costs of medical research and the high rate of failure. Of course, there are exceptional doctors all over the world, but innovation comes mostly from the United States. Half of all new medicines introduced in the last 20 years are from the United States. 18 of the last 25 Nobel Prize winners in medicine were either Americans or foreigners working in America.
The rest of the world benefits from the rewards of the research because, once the work is done, Merck might as well sell its new-fangled drugs world-wide. After all, the Americans will pay for the research with the high profit resulting from the hard-won patent. Who cares if they are barely profitable elsewhere? Manufacturing drugs is easy. Inventing them is hard.
You might be better off having a sprained (turned? rolled? i forget) ankle in France, but you're definitely more likely to survive a major illness here in the good old us of a.
Michael Moore says he doesn't like documentaries. Maybe that's why he doesn't make them.
Saturday, March 29, 2008
Sicko
I went on quite a rant about socialized medicine on a friend's blog and thought I would post it here and see what everybody thinks. Enjoy! ;-)
Subscribe to:
Post Comments (Atom)
2 comments:
Retort:
With an MD father and an RN mother, medicine has always been a dinner topic. One of the primary contributing factors in infant mortality in this country (if not the most significant factor) is lack of prenatal care because people can't afford it. Uninsured women show up to hospitals every day to give birth to babies having never seen a doctor because they couldn't afford insurance and couldn't afford the cost of care without it.
The section about the insurance company "assassins" is absolutely true. My mom worked for a major medical insurance company when I was in high school. She quit after one of the cases that went through her department. I will never forget her crying at the dinner table over it. A 16-year-old high school diver hit the platform in practice and broke his neck, paralyzing him from the neck down. The insurance company she worked for dispatched the investigators. Not only would the immediate cost of the injury be expensive for the company, but the ongoing cost of continuing care for a 16-year-old quadriplegic would dip into their profit margin. They uncovered a doctor's visit when he was 12 or 13 where he'd been seen for muscle pain in his upper back and neck. When his parents had enrolled him in the new policy they hadn't disclosed this under "medical conditions" (you know, where they list things like heart disease, cancer, diabetes, etc). Not only did the insurance company deny every claim associated with his injury because of a "potential pre-existing condition", they terminated his and his entire family's policy due to their "willful falsification of information on the application".
I've also had a claim refused because it wasn't "pre-certed". For some reason they paid the "50% after the $100 deductible" for the ER visit, but refused the bill specifically from the doc who intubated me in the ER when my throat was swelling shut. Apparently I was supposed to stop them, pull out my cell phone, call the number on the back of the card, and give Anthem a head's up before I had a plastic tube shoved down my throat.
I'm not saying that socialized medicine is the answer. Obviously there's not an easy answer, otherwise someone would have fixed things by now. But the system in place _clearly_ does not work.
Call a lawyer! We love stuff like this. Bad faith insurance denials are incredibly fruitful areas for litigation. In most cases treble damages and attorney's fees are available. Almost any attorney would offer to take a case like the one you mentioned on a contingency basis (no recovery, no fee). If I won a case like the paralyzed child you mentioned, I could retire the next day.
I've done legal work for insurance companies (no names here) and can tell you first hand that they do engage in some shady business practices. It's never been governmental oversight that has brought abuses to light, though. It has always been attorneys filing suits, investigative journalists doing their thing, or (most likely - because they have the most at stake) stockbrokers investigating the real value of a company.
In a world where the government runs the show, we would lose 2 of the 3 main watchdogs. Sovereign immunity cuts out the lawyers, and there is no stock value to assess, so we are down to journalists. I don't know if you share my disillusionment with the mainstream media, but my recent experience with CNN and such has been basically a stream of reports about 1) what the government says it's doing today, 2) how people are going to celebrate the next Christian holiday, and/or 3) who's cat got stuck in a tree. I know this is a tangent, but when was the last time you actually heard a major news story that had been uncovered by the NY Times?
There are many things we can learn from the European health care models. I am only concerned that we learn from both their successes and their failures.
Post a Comment