Wednesday, September 1, 2010

"Sicko" (2007): An Indictment of the U.S. Healthcare System

Contrary to popular (American) belief, we do not have the world's premier healthcare service.  While many specialties and procedures are renowned for in the U.S., the vast majority of Americans receive sub-par medical care.  In fact, 100,000 patients die from medical malpractice every year in America and the U.S. is ranked 37th by the W.H.O. for healthcare, right above Slovenia.

While, I normally skirt around polemics like Michael Moore, the looming, controversial issue of healthcare reform in the states, my grandmother's ailing health, and my recent interest in health care issues (I'm currently reading Nutrition and Physical Degeneration by Weston Price, MS., D.D.S., F.A.G.D. and and Surviving Your Doctors: Why the Medical System Is Dangerous to Your Health and How to Get through It Alive by Richard S. Klein, M.D.) made it impossible for me to ignore this seminal documentary.  So many of my peers had seen it and discussed it that I felt I had to give it a viewing before judging it or its creator.

A lot of the documentary was old pat for me as I've known of the ills of private HMOs, but the darker aspects of it — like its inception by Kaiser and Nixon was new for me.  It was news to me that Hillary Rodham Clinton had attempted to implement universal health care in the states during the Clinton regime but failed due to the financial and political clout of HMOs (and is now the 2nd highest recipient of HMO contributions).  Also, it was shocking to find out how people in other socialized countries like Cuba, Canada, England, and France have much lower infant mortality rates and much longer life spans than Americans.  In fact, the poorest English person still has on average a higher life span than the wealthiest American.  "A baby born in El Salvador has a better chance of surviving than a baby born in Detroit." These facts are disturbing to say the least.  (For those inherently skeptical of statistics coming from a Michael Moore film, here's a website just for you.)

I liked the amusing albeit sobering anecdotes in the beginning from normal Americans.  One man had accidentally sawed off the tips of his middle and ring fingers in a construction accident.  He wasn't insured so they gave him a choice:  $60,000 to reattach the middle finger or $12,000 to reattach the ring finger.  He was a romantic, so he chose the ring finger and now leaves his stubby middle finger for use in lame magic tricks for kids.

It was quite sad to be reminded of how we as a nation are treating the 9/11 volunteer aid workers.  As we all know now in hindsight, inadequate protection from the toxic airborne fumes at ground zero has led to debilitating upper respiratory problems for these unfortunate American heroes.  However, they are not getting the medical care they deserve because they were volunteers and not officially working for the state.  In the documentary, in a rather bombastic fashion, they got the medical care they needed instead in communist Cuba, free of charge — after a failed attempt to get medical care from U.S. doctors at Guantanamo Bay.

I'm shocked that this movie was made in 2007, but it is so relevant even to this very day and people like me who have only heard about it in the past year.  In England, they had National Health Services, since 1948, after the war, when the country was in shambles.  So what excuse does the United States, have now not to have universal healthcare in the 21st century under the tutelage of Barack Obama?

I would suggest every American on the fence about healthcare reform to watch this film.  For me, learning about other nations' systems was the most enlightening portion of the documentary.  Some of my favorite scenes concerning this aspect, are not even included in the documentary, they're in the DVD's Special Features section (I particularly enjoyed watching these videos).:

"What if you worked for GE in France?"

(I couldn't find the full video posted on YouTube, so just rent the DVD because it's quite amusing and all the footage that is in the special features makes it well worth the rent!  In case you were wondering, the laundry bit was an inside joke because in France the government provides a free nanny that cooks and does laundry for new mothers).

"This Country Beats France."

(I'm particularly impressed by harnessing sewage for renewable energy and by the government hiring a philosopher to gauge the most ethical usage of funds for the long-term.)

There's also a very good video called "Uniquely American" in the special features.  Where a lady, who had already recovered from cancer, wasn't insured but needed a biopsy.  In proactive, American fashion, she collects the money from the community through fundraising to pay for the test but finds that in the quagmire of US healthcare, things aren't so simple.

There's also an amazing (extended) interview with Che Guevera's daughter (Aleida Guevara) about the Cuban health care system.  (This can be found in the "Interview Gallery" section.)

If you like topics concerning philosophy, I also highly recommend listening to the interview with Tony Benn (also found in the "Interview Gallery" section).

22 comments:

  1. I don't know why Blogger isn't letting me embed the two videos:

    Here are the respective links:

    Norway (http://www.youtube.com/watch?v=k4L6-0WRfSA)

    GE in France (http://www.youtube.com/watch?v=F9g3e3oCoUQ)

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  2. Interview with Che Guevara's daughter Pt. 1: http://www.youtube.com/watch?v=ia7jMgTWh14

    Pt. 2: http://www.youtube.com/watch?v=LRPkpiGiuOM

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  3. Lol@ skeptical of Michael Moore, I clicked the link. I don't like Michael Moore's simplification of things, on the surface, I would say I don't believe about the French nannies (or that it's as simple as it sounds), and did you forget about the tax (purportedly to rise from 17.5% to 19%) in the UK at the minute as a result of the previously lowered rate (15%) during the recession to encourage purchasing. Anyway, I guess no one can argue with the point of the documentary even if I dislike his spin. Anyway will check out the documentary and make some actually informed commentary soon.

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  4. Looking forward to your "informed commentary" after you watch the film. (Those links are to videos that were not apart of the documentary.)

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  5. There are several things I disliked about this documentary, the first was the patronizing tone. Why exactly is Michael Moore sarcastically pretending to be conservative throughout the whole movie? Is it a failed attempt to give a "fair" account of the system, or just another way to patronize the viewer, particularly the American viewer with the same kind of "Everyman" logic that Glenn Beck uses. The similarity in narrative strategy between Glenn Beck and Michael Moore is a telling indication of the selective discourse behind the documentary. Every American knows Michael Moore is a liberal, so this kind of parodying of a typical American voice irritated me throughout the entire movie.

    The self-victimization of the family at the start was a little too much. I almost laughed out loud, when the poor middle class couple had to leave their roomy middle class family size home in their not one but two cars, and move into a room in their daughter's house. Eh... it's shit that they had problems with their health and all, but I'm not particularly moved to start crying because a middle class family has to resort to living together, isn't that kind of what millions of people do without complaining anyway. It's hardly the end of days.

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  6. The Guantanamo stunt also annoyed me for several reasons. The brazen faced publicity stunt was a deliberate attempt to manipulate the viewers's emotions using the infallible 9/11 rescue workers. A well-reasoned out case with clear logic would have been more interesting than the sentimentalism of this part of the film. The second was the apparent anger he felt that "the evildoers" had access to health care while "the good guys" did not. Are we ignoring the fact that a lot of Guantanamo's prisoners were being held without charges or trials, that many were tortured or worse, wasn't this in any of your other documentaries, Michael? The idea of positing "the best people" in the nation as an example seemed contrary to the aim of the documentary, as if the viewer was being asked to prioritize the health of these heroes over the lives of others, this doesn't seem to fit with the concept of universal health care.

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  7. Yet another thing that annoyed me was the overly rosy picture painted of other countries in Europe and America, particularly the UK, France and Canada. In another attempt to patronize the viewer, Moore apparently thinks that we can't confuse Americans by giving them a serious consideration of the pros and cons of NHS style systems. Sure, I agree with the point he is making in the documentary, but the systems of European countries are not flawless, and portraying them in this way is detrimental to the point he is trying to make. Interviewing a middle class, wealthy, working class family about how higher taxes don't affect them is hardly representative of the whole nations, particularly the poorer or more marginal groups in French society. The rampant racism in the UK and France, and growing support for the British National Party is also skirted over. Yeah, so the NHS is essentially an OK system, particularly in contrast to the US system, but insinuating that the UK or France is some sort of Utopia, and that higher taxes doesn't cause problems is deliberate simplification of the issue. Healthcare needs to be put in context of the wider parameters of public funding in general.

    The point of the documentary, as it happens is one that I agree with, in the sense that I support the idea of universal healthcare. I know people in the UK who are against the NHS though, and who feel that privatization is an inevitability, this angle was totally ignored by the film however.

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  8. The overly boisterous and over-weaning sentimentality of the documentary is a tired format for Michael Moore. Watching this film was almost identical to watching Bowling for Columbine, the topic had just changed. I respect that there needs to be a voice airing these issues acting in dialogue as such with Glenn Beck's show, but the bluster of the film was unnecessary and a more balanced and well-thought out, less driven narrative could have been more persuasive.

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  10. Well I'm not going to attempt to address all of those comments, but I can try to address some of your points. First off, maybe this film makes more sense from an American perspective?

    It doesn't seem to be "boisterous and over-weaning[ly] sentiment[al]" for an American audience member because you need to remember the context. The American public is bombarded DAILY by pundits that berate and smear any mention of universal healthcare. I don't watch TV but whenever I step into the gym, on most of the TV screens, I see some talking head describing how Obama is driving the nation on a course to communism and ruin with his universal healthcare proposal. There is little to no opposition to this view in the US, even on CNN or MSNBC. Moore's film is the first instance where this general acceptance that universal healthcare in the U.S. is not feasible nor practical is genuinely challenged using facts. The fact that it is presented with the medium of interviews and moving anecdotes doesn't mean the facts are incorrect.

    Anyone skeptical of all the quotes and statistics in the movie can just check them online. I posted a link in the blog entry but here it is again: http://sickothemovie.com/checkup/

    I think that his manner of presenting information is uniquely American. Very few Americans are willing to sit through a conventional "documentary." I made the mistake of telling one of my college friends that I enjoy watching documentaries and was immediately derided as a "nerd." This is point of view is common in the states, even in highly educated circles. The fact that Moore makes a "documentary" engaging means that more average Americans may be willing to spend money and watch it. Unlike Canada or the UK, the US has an inadequate budget for public channels (actually make that a singular channel, e.g., PBS); so PBS is not the equivalent to BBC or CBC (Canadian). There is not a culture of watching documentary shows on TV in the US. If a movie is to make any sort of impact in American society it has to be interesting and also get people talking at the water coolers. I think Moore did a good job of understanding the dynamics of American society and how to be most effective in getting this message out there, while still presenting the facts in an innovative format.

    Again perhaps universal healthcare being possibly a good idea might not be a remarkable idea to a European but it certainly is for the average American, so in order to not "scare off" the average viewer. Moore prudently tried to present "Sicko" from the perspective of the average target viewer.

    Moore will always have his detractors and I admit I prejudged him because of "Fahrenheit 9/11" but I think he did a commendable job with "Sicko."

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  11. Also for me at least, I nearly found the extras more engaging than the documentary footage because I find the characters he interviewed: Tony Benn (Labour Party MP), Aleida Guevara (Che's daughter), various other lawyers and professors to have remarkable insight on this immediate and related topics.

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  12. "...as if the viewer was being asked to prioritize the health of these heroes over the lives of others, this doesn't seem to fit with the concept of universal health care."

    The notion was that our gov't doesn't even take care of our heroes, much less the general public.

    Also, frankly, they ARE entitled to healthcare more than the general populace. After all, they risked their health and livelihood out of a sense of compassion and perhaps patriotism to help save lives at ground zero, even though they were not being paid by the state to do so. I, for one, did not go to NYC and risk my health and suspend my employment in order to save lives so I and others like me are not in the same position as them. At the time, people were not aware of the toxic fumes at ground zero. Their respiratory ailments are now well-known to be directly caused by the volunteer relief work at ground zero but now that it's over with the US gov't wants to wipe its hands clean of the ethical imbroglio?

    The aim is obviously to provide coverage for all citizens but the point was that even those who service this nation without expecting compensation are cast aside and left to suffer due to politics.

    America is the only advanced, developed nation (OECD) in the world that doesn't provide healthcare for its citizens. As America is the world's richest country, I find it quite shameful. It's not even a matter of finances. It's purely a matter of will and selfishness. If we only directed smaller percentage towards warfare and the military-industrial complex, it would not be a great feat to provide adequate coverage for all. (I mean even the tiny island of Taiwan can manage!)

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  13. Also, this might be another cultural thing, but your scoffing at the fact that they were supposedly well-off because they owned 2 cars? That's just about the average for an American household or less (most families have 2 or 3 cars). We used to have 3 cars but when I moved to Taiwan my dad sold my car so now we only have 2 and we are a middle class family. Also, most if not all of these vehicles are bought with loans and not paid off in full at the dealership.

    Not scientific but just to corroborate this well-known fact: http://wiki.answers.com/Q/How_many_cars_does_the_average_American_family_own

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  14. I think maybe I resent the implication that all Americans are stupid, or that there is such a thing as an "average american viewer". This is what Glenn Beck and Fox News do, maybe if the American audience wasn't constantly pandered to with shock and awe media tactics, then they wouldn't be so willing to be misinformed. I get your point about 9/11 rescue workers, and I never said that they didn't deserve healthcare benefits, but for universal healthcare to work, Americans have to be willing to provide for the scum of America, as well as the heroes and the average Joe.

    I would challenge the fact that a couple (two people) need more than 2 cars to be middle class. I don't really understand what your point is? Should we expect every decent hard working american family to have a house bigger than they need, and more cars than they can possibly drive?

    As you said, I'm not an American, but that doesn't take away the right of a non-american to criticize the dramatics and sentimentality (http://en.wikipedia.org/wiki/Sentimentality) of the documentary.

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  15. And as I said, I agree with the point the documentary was making, just not the way it made that point.

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  16. "The self-victimization of the family at the start was a little too much. I almost laughed out loud, when the poor middle class couple had to leave their roomy middle class family size home in their not one but two cars, and move into a room in their daughter's house. Eh... it's shit that they had problems with their health and all, but I'm not particularly moved to start crying because a middle class family has to resort to living together, isn't that kind of what millions of people do without complaining anyway."

    So, you asked what is my point?
    I hate to keep playing the different culture card, but perhaps that's where the point of contention ultimately lies?

    I can't see how you cannot fathom how degrading it would be for parents to move into a cramped room at the house of one of their child's houses. This is not a movie about how millions of other people live. This is a movie about America for Americans. You're comparing apples and oranges.

    Having to sell your house and cars and move back in and inconvenience your children would be horrifying for any parent in America. You could clearly see how annoyed the the kids were that the parents were imposing on their life and space. One of them even started to berate the mom about how they can't just move in their house when they can't afford rent, but the mother was on the verge of tears when she explained she did not want to do this any more than they wanted them out of their house, but they were out of options.

    Cancer is projected to afflict nearly 1 in 4 Americans, so their plight is dramatic but probably isn't as rare as one would hope.

    Also, thanks for the condescension but I have a vague notion of what sentimentality means. I already said that I think it was a calculated move by Moore to make the film appealing to the target audience (educated liberal Americans don't need to be convinced) and who says a documentary has to be devoid of human emotion to be credible?

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  17. It wasn't condescension, you corrected my English, so I pointed out that the word I used existed.

    I can't fathom why if your mum or dad had suffered from a bunch of different illnesses and were broke, you would give them a lecture like that and why wouldn't they be happy enough to help them out for a few months. It doesn't really reflect well on American family values.

    The emotional part of the documentary brings it into moral ground, when logic would have sufficed. My point is that healthcare makes sense logically and doesn't need to become a moral issue.

    I don't understand what the cancer statistic is meant to address?

    Putting it down to cultural differences is fair enough.

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  18. No, I did not correct your English. I modified it to fit grammatically within my sentence, where I used them as adjectives and you had used them as nouns.

    Humans are not perfect. It's perfectly understandable for people to lash out selfishly and inconsiderately.

    The cancer statistic is meant to address the fact that this is a rather common occurrence in America. That many Americans can be put into serious debt due to a debilitating illness like Cancer, even if they do have private insurance, like the couple you keep referring to in the documentary.

    Fair enough.

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  19. I watched the movie just now so I go joint this mud-slinging fest. I think there are a lot of cultural issues in this movie and the debate going on here. I agree with Conor that Michael Moore's tone was pretty patronizing; why does he have to act like he is a republican or anti-health care? We all know what his stance is. Also, he does give a pretty rosy view of Europe and Canada. They still have a lot of problems. I have many Canadian relatives and a few of them have had to take a trip down to the US and pay out the cash because they would have to wait to long in Canada for some serious issues. Also, there are a lot of issues right now with the sustainability of these health care systems, I think Spain and France. Of course, I do prefer a universal system, but he never really talks about how these countries manage these systems.

    The thing with the cars is, unless you live in New York or Chicago, your main form of transportation is a car. Without a car you are stuck, and unless something is near by, you miss out on economic opportunities. It's a crappy system, but that's the way it is. Also there are a lot of shitty cars out there so you can probably find something for cheap. Having a car does not mean you have a lot of money. I know plenty of people that have purchased used cars for about a $1000 USD, they're not great cars but they move.

    I actually think the biggest hurdle in the US is the political system. A lot of money is flowing from corporations to politicians, but other countries try to limit this, unlike the US. Also, pork barrel politics is also a huge problem (awarding money to a particular state district which is often used to further a politicians campaign and image). This is also related to bloated legislation in the US, each politician agrees to vote for a law if they can tack on their own local project which is usually awarding money to their district.

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  20. I don't think anyone can assert that a current system is perfect but it's all relative and I do believe there are numerous superior systems to the American one.

    I've never been to Canada, so I can't comment, but I have lived in Taiwan and I know from first-hand experience that socialized medicine can be fast, efficient, and very effective. On average, I wait 1/100th of the time I would wait in the U.S. for the same health care. (Often in the US, I would even be denied service due to my HMO company or they weren't receiving any new clients and when I did get an appointment it would be several weeks or even months till I would be seen.) Then again, I had a general Blue Cross Blue Shield coverage. In the US, if you have the cream of the crop in private HMO coverage perhaps it might be better than the socialized healthcare in Canada...in my case and for most middle-class Americans, it's not applicable. (Now that I'm adult, I don't even receive coverage anymore and am part of that 40 million figure, who don't have any healthcare coverage at all.)

    Most places in the U.S., lack public transportation. Again this is due tot he political atmosphere that doesn't believe in providing public goods unlike in Taiwan, Europe, etc., which all have excellent metro, rail, and bus systems.

    I also want to point out that it's much easier to tear something down than it is to build it up.

    There's a fine line between constructive criticism and negative critiques made just to incur doubt and anxiety and to block any progressive social change (Republican politicians and Fox News anchors take note.)

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  21. Yeah, that's all true. The system seems to be pretty good in Taiwan, and most highly developed nations seem to have a better. Japan has a mixed system where students and the self-employed tend to be on government health care and everyone else is on employee health care. I couldn't find anything about health care in South Korea. Here is a nice comparison of different systems.
    http://en.wikipedia.org/wiki/Health_care_system

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  22. That's a good link. I've seen it before. I think it shows that there isn't a one-fits-all healthcare system.

    Each country based on its needs, finances, cultural affinities, etc. should tailor it for themselves. However, in spite of this, the commonality is that the better healthcare systems adhere to the belief that all citizens should be able to have proper access to it despite race, creed, or social status. For instance, in Taiwan, it is not completely free like it is in the UK or Canada, but it's still well within the means of nearly all its citizens (free for certain people like the elderly). There is a monthly fee for NHI and there is a co-pay fee whenever you go. This seems to work well for Taiwan since it reduces the burden on the state and those that use the services more pay more with their co-pay amounts. It also allows for many private clinics and hospitals to crop up throughout the country, servicing people who would rather avoid the gov't hospitals like National Taiwan University's.

    It all boils down to whether or not a country as a whole believes that citizens have a right to adequate healthcare or if it should only be available to those who can afford it.

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