Nurse Gives Rectal Exam to Sicko

[Gus Van Horn blog]

By Gus Van Horn from Gus Van Horn,cross-posted by MetaBlog

Over at RealClear Politics is what I hope proves to be merely the first volley of an all-out carpet bombing of Michael Moore's latest agitprop, Sicko, in which he ignores the abject failure of socialized medicine everywhere it has been tried as he attempts to convince his audience that it will somehow "work" if tried in America.

The article is by Helen Evans, director of Nurses for Reform, an organization of European nurses "dedicated to consumer-oriented reform of European health-care systems". Its title is, "What Michael Moore left on the cutting room floor", and its first three paragraphs should pique the interest of anyone who has even the remotest concern for his health:

Michael Moore's denunciation of America's health-care system is about to hit the silver screen. In the film's trailer, a desk attendant at a British hospital smiles while explaining that in Britain's National Health Service, "everything is free." But for free hospital care, Britons pay an awfully high price.

Just ask the nearly 1 million British patients on waiting lists for treatment. Or the 200,000 Britons currently waiting merely to get on NHS waiting lists. Mr. Moore must have missed those folks.

Curiously, though, many American policymakers seem to think that a government-managed, NHS-style system is the answer to all of America's health-care woes. Before heading down that road, however, America's leaders ought to actually investigate Britain's experience with state-sponsored medical care. [bold added]

Miss Evans knows that for nurses everywhere to have a better shot at saving lives, she must first perform a post mortem on the system Michael Moore would foist upon his countrymen. And so she does, describing, among other things, the high rate of infections acquired by patients as a result of checking into hospitals, the results of shortages within the system, and rationing -- the final, predictable result of any attempt to provide necessities by government decree.

Her picture is very bleak, although even she had to leave out a few details, such as the fact that smokers in Britain will be denied certain surgeries altogether or made to wait longer for treatment they "still likely" may get if they do not quit. In addition, some physicians there are already also denying treatment to drinkers and the obese. Perhaps she ran into space limitations -- or maybe she wondered whether the full truth, being stranger than even Moore's most outlandish fictions, might strain her readers' credulity.

And then she necessarily also had to leave out Cuba, which Moore famously visited during the making of this propaganda piece in defiance of American law. I needn't discuss the Cuban system in any detail either, since the following news excerpt from The Chicago Tribune (blogged here) just about makes doing so at all unnecessary.

Medical procedures for show may be new to audiences in the States, but they're old hat in Latin America:

Some Cubans express resentment at the resources being poured into Mision Milagro, complaining that foreigners get better medical treatment than they do. Other Cubans seethe as they watch foreign patients driven to and from hospitals in new Chinese luxury buses while they wait for hours for scarce public transportation. [bold added]

Mision Milagro, by the way, is a program financed by Hugo Chavez of Venezuela, which is being used to gain popularity for socialism by providing free eye operations to the poor throughout Latin America and the Caribbean. Needless to say, their friends and relatives will see their improved vision when they return, but will remain blind to what life is really like for those who already live under socialism -- unless, of course, they succeed in imposing it upon themselves, at which point it will be too late for most of them.

Government officials want two things: (1) to have life and death power over others and (2) to appear to be all-powerful to everyone else. Is it any wonder then, that they universally ignore those they can take for granted, while pulling out all the stops for those not yet under their power? Specifically, is it really any surprise that Cuba and Venezuela are collaborating to put on Mision Milagro? Or that they do it at the expense of decent care for Cubans and Venezuela's coffers? Why the hell would anyone in his right mind accept what a medical system, run by a politician who doesn't govern him, does at face value? And, for that matter, why would he want a government official in charge of his medical care?

For all their disdain of capitalism, Fidel Castro, Hugo Chavez, and Michael Moore don't just epitomize the very worst imaginable caricature of hucksterism any of them could possibly impute to capitalism: They remind us that snake oil salesmen, needing consenting victims, are harmless by comparison.

If Mision Milagro sounds like a bait-and-switch scheme, Sicko should sound like false advertising at best. Unfortunately, your health is at stake, and the funny thing about the government is that unlike in the case of a lousy business, you're not free to go elsewhere.

-- CAV

http://ObjectivismOnline.com/archives/002647.html

[Tenure]

Michael Moore's opinions about Nationalistion and Regulation of various parts of the economy and the social infrastructure often remind me of that letter by Trotsky to the United States, where he goes on about how, due to the fact that America is rich, Communism will magically work, whilst ignoring the fact that it was the opposite of Communism which made America big, strong and sustainable.

I actually never want to get ill or break a limb in my life, not so much the immediate factor of the malady, but in fear of the treatment (or lack thereof). The NHS is a failed scheme, and if anything, at least this film will get people talking about the NHS, so that they'll know the facts about it (if not from Michael Moore, then from looking into the subject themselves).

[DavidOdden]

I actually never want to get ill or break a limb in my life, not so much the immediate factor of the malady, but in fear of the treatment (or lack thereof).

I'm curious (and thank god I never had to experiment), is there any alternative? If you do break something, are there private doctors you can go to if you have cash? It's not clear to me to what extent it is legal to compete with state doctors in Norway except in areas that they consider 'luxury' medicine, though I think the strong state monopoly relaxed about 5 years ago.

[Moebius]

Moore identified the right immediate problems but with the wrong long term solutions.

But it is true that socializing medicine would immediately improve many people's quality of life, albeit paid for by the more able.

[Groovenstein]

But it is true that socializing medicine would immediately improve many people's quality of life, albeit paid for by the more able.

"More able". That's cute.

Do you know where you are? I don't mean your axes in the space-time continuum. I mean this forum. Do you know what we think about socialized medicine??

I'm giving you two options at this point: (1) take this statement of yours to the debate forum where it belongs, then start putting some effort into trying to defend it rather than throwing out cheap baiting one-liners; or (2) retract it completely.

[JASKN]

Moebius, you're "right" about your second statement, if you can manage to turn a blind eye to virtually everything else going on but the individual who is receiving some kind of health care when he was receiving none before, and if you do that for only the first visit or two before the doctor he is seeing starts experiencing a waning of morale.

I think the result would be more immediate than taxes (which is the same thing), because it's easier to observe exactly what is going on, and the observer is the doctor. The tax money is spread out over countless government "need" programs and is virtually impossible to exactly trace. The doctor, however, watches his waiting room actually fill up with "need," which coincidentally is also very rude, ignorant, ungrateful, and completely at odds with the doctor's own view of his life and work. Since he will not last very long under such conditions, how is socialized medicine in the interest of even those "needy"? They'll soon be back exactly where they started, but worse, because they'll now never be able to work up to a time when they can afford the doctor's service; he's gone.

[Moebius]

"More able". That's cute.

Do you know where you are? I don't mean your axes in the space-time continuum. I mean this forum. Do you know what we think about socialized medicine??

I'm giving you two options at this point: (1) take this statement of yours to the debate forum where it belongs, then start putting some effort into trying to defend it rather than throwing out cheap baiting one-liners; or (2) retract it completely.

Let me clarify. I am against socialized medicine because in the long run --perhaps a decade or more-- it would create more problems than it solves. You can see this from countries like Canada which has an over-burdened medical system, impossibly long waiting lists for people who need things like surgery, as well as an ever expanding, inefficient government budget. But in the short run, many people that are not getting their medicine would in fact benefit immediately -- hence the attraction.

So, no, I do not endorse socialized medicine in principle -- particularly not in the veins of, say, Canada or Northern Europe. But nevertheless Moore was correct in identifying the issues about people receiving sub-optimal or even negligent medical care, which is further enforced by large HMOs who in turn use their profits to lobby the government. Essentially the HMOs loot from their patients, then use that money to collaborate with law makers, who in turn back up these institutions with favorable bills (which essentially equates to force, through the government).

So by socializing medicine, you will be solving some of the problems of the existing system, but create other problems with the other. That was my point -- which I agree was not very clear from my previous post. The way I see it is, Moore presented two systems to the viewers. In socialized medicine, the government loots from its people. In our current system, the HMOs loot from the people and the government backs it up with force (or at least failed its duty to protect the people from predatory looting). Now, we know that a choice between two evils isn't really a choice. The only difference is, if we switched over to a socialized medical system, we would solve our immediate problems, while the negative effects probably won't be very apparently until several years down the road.

That's my position. And to be honest I don't know what a better system would be. I suppose one idea is to completely de-regulate the medical field, let the market forces determine what level of care a person can afford or are willing to pay for, while the government simply enforce the honesty of both parties' transactions. Now, I like that idea. But in practice it would probably mean many short term casualties. On top of that, it would be impossible for a system like that to work efficient without first overhauling our entire government and economic structure (which probably would never happen in the United States, at least in my life time). After all, you can't morally expect people to fend for themselves without first creating a system where they are able to do that without any restrictions what so ever.

So -- any better ideas?

[K-Mac]

For all the flaws in the health care system, in the US and abroad, I must say that my recent experience left me feeling quite good about my particular situation. I slipped on a friend's icy driveway back in mid-January and broke my leg in two places. (Spiral fracture of my tib/fib.) An ambulance picked me up, administered some pain meds (thank you, thank you, thank you) and dropped me off at the local, brand new hospital. Xrays were taken, (pain meds wearing off, ouch) I was doped up again, (thank you, thank you) then my leg was set and I was sent to a private room in the ER. The next morning, I had a 3 hour surgery to insert a titanium rod into my tibia (larger lower leg bone). I was discharged the following afternoon.

I pay half of my health insurance premiums and my employer pays the other half, for a total of $340/month. My total out-of-pocket expenses for the broken leg are $2000. So my insurance spent over $45,000 on me during the past 6-7 months for the $2380 in premiums my boss and I paid. Where's the problem? I got top-notch, world class care, good hospital food and everything, for the bargain basement price of $2380 (premiums paid during the time my leg was broke) plus $2000 (my out of pocket expenses for a $45,000 broken leg.)

I can only imagine how much this treatment would have cost, and how long I would have had to wait for it, had I been just about anywhere else in the world. (It may have been free to me at the time, but you know someone is paying for it...and probably paying way too much for sub-standard care.) They probably would have just set my leg in a cast and sent me home, which would have meant that my right leg would end up about 3 inches shorter than my left leg. Gee, thanks for the permanent disability.

Basically, I feel like I received much better care than what I actually paid for. This was my first time in a hospital and my first major injury or illness, so I really don't have anything to compare it to except for the horror stories other people may tell, but there's my two cents for whatever it's worth!

[Moebius]

I think the result would be more immediate than taxes (which is the same thing), because it's easier to observe exactly what is going on, and the observer is the doctor. The tax money is spread out over countless government "need" programs and is virtually impossible to exactly trace. The doctor, however, watches his waiting room actually fill up with "need," which coincidentally is also very rude, ignorant, ungrateful, and completely at odds with the doctor's own view of his life and work. Since he will not last very long under such conditions, how is socialized medicine in the interest of even those "needy"? They'll soon be back exactly where they started, but worse, because they'll now never be able to work up to a time when they can afford the doctor's service; he's gone.

I agree more or less with what you're saying. But then on the other hand you have a doctor who may be forced by the HMO that employs him to prescribe medications or treatments that are substandard or even wrong for the sake of cost control, lest he gets fired -- could very well also be against the doctor's own view of his life and work. And the HMO may get away with this by using their loot money to in turn bribe politicians. Either way your doctor and patients are screwed.

So, like I said before, I think Moore correctly identified the problems. And again, like I said, socialized medicine would provide a short term solution -- only to cause other problems (for instance the ones you described) in the long run.

ps - I suppose another possible solution would be to sever the link between the politicians and the HMOs. But that essentially amounts to enforcing the enforcers -- which puts you back at square one.

[JASKN]

That's my position. And to be honest I don't know what a better system would be. I suppose one idea is to completely de-regulate the medical field, let the market forces determine what level of care a person can afford or are willing to pay for, while the government simply enforce the honesty of both parties' transactions. Now, I like that idea. But in practice it would probably mean many short term casualties. On top of that, it would be impossible for a system like that to work efficient without first overhauling our entire government and economic structure (which probably would never happen in the United States, at least in my life time). After all, you can't morally expect people to fend for themselves without first creating a system where they are able to do that without any restrictions what so ever.

So -- any better ideas?

If by "short term casualties" you mean "people who wouldn't have been able to pay for their care still wouldn't be able to pay for it," then what's the problem?

If I really "like that idea," I am not then going to aim for a lesser idea. So if total government deregulation in medicine is the goal, why would I entertain something that gets there only half-way, regulation here but not there? It's confusing and counter-productive; just focus your energy on the other, better goal.

I don't have a lot of perspective to back it up, but it seems to me like deregulation and freedom tend to work themselves out very quickly when given the chance, and that a start-from-scratch approach isn't desirable unless you have nothing to work with. And America definitely has something to work with!

[DavidOdden]

But then on the other hand you have a doctor who may be forced by the HMO that employs him to prescribe medications or treatments that are substandard or even wrong for the sake of cost control, lest he gets fired -- could very well also be against the doctor's own view of his life and work.

That is not the initiation of force, so it is wrong to say that the HMO is using force. The doctor does not have a right to a paycheck, and if he is unwilling to follow company policy on treatment, he has the freedom to quit. At least in a system governed by the free market, like in the US. You may as well complain about the patient who is forced to take some medicine. Are you suggesting that the HMO should be forced to allow their employees free reign to prescribe whatever line of treatment suites their whim? That the HMO should be forced to cover the costs of any arbitrary treatment that the doctor or patient asks for?

And the HMO may get away with this by using their loot money to in turn bribe politicians. Either way your doctor and patients are screwed.

Charging a fee for medical coverage is not looting, period. You need to curb your socialist proclivities if you're gonna continue here.

And again, like I said, socialized medicine would provide a short term solution -- only to cause other problems (for instance the ones you described) in the long run.

Not even a solution in the short run. Using force would be not only a long term disaster, but also an instant disaster.

[Moebius]

If by "short term casualties" you mean "people who wouldn't have been able to pay for their care still wouldn't be able to pay for it," then what's the problem?

I mean that some people that could afford medical care right now will not be able to -- particularly for more expensive procedures or expensive, long term pills.

If I really "like that idea," I am not then going to aim for a lesser idea. So if total government deregulation in medicine is the goal, why would I entertain something that gets there only half-way, regulation here but not there? It's confusing and counter-productive; just focus your energy on the other, better goal.

A. You're right, if total government deregulatoin of medicine was my goal, then I would NOT entertain any lesser idea. However I don't personally entertain any goals regarding medicare one way or another because I make enough money to cover any medical care me and my family will conceivably need. Like I said, I simply like the idea. Either way it would not effect me.

B. I do not have the required expertise to assess the feasibility or actual implementation of said idea. Hence, I do not know if it would in fact solve the current problems. Although, best I can tell you is that it is utterly and massively improbable barring some sort of revolution in the United States.

I don't have a lot of perspective to back it up, but it seems to me like deregulation and freedom tend to work themselves out very quickly when given the chance, and that a start-from-scratch approach isn't desirable unless you have nothing to work with. And America definitely has something to work with!

Meaning what? That you agree with me that de-regulation would work?

And I don't mean that we should blow everything up and start from ground zero. I am saying that you can't have a mixed economy that heavily regulates everything else (hence theoretically limiting each individual's aggregate productivity), but out of the blues de-regulate this one thing and expect things to just "work itself out".

[JASKN]

I wasn't clear: deregulation is the only solution, not just a good one out of several, and it would work a lot faster than you are suggesting.

Also, medicine would work itself out without regulation, but it probably wouldn't stay deregulated for long without an appropriate supporting government.

Lastly, wouldn't it be nice if you didn't have to pay so much for your medical care, even though you can, and instead invest it in more preferable areas of your life?

Edited July 9, 2007 by JASKN

[Moebius]

That is not the initiation of force, so it is wrong to say that the HMO is using force. The doctor does not have a right to a paycheck, and if he is unwilling to follow company policy on treatment, he has the freedom to quit. At least in a system governed by the free market, like in the US. You may as well complain about the patient who is forced to take some medicine. Are you suggesting that the HMO should be forced to allow their employees free reign to prescribe whatever line of treatment suites their whim? That the HMO should be forced to cover the costs of any arbitrary treatment that the doctor or patient asks for?Charging a fee for medical coverage is not looting, period. You need to curb your socialist proclivities if you're gonna continue here.Not even a solution in the short run. Using force would be not only a long term disaster, but also an instant disaster.

Did I actually suggest any of those things? Or are you just making assumptions again?

I already said I do not believe in socialized medicine. I even said the best idea I can think of is to de-regulate health care. Re-read it again if you didn't catch it the first time. So which of my "socialist proclivities" are you referring to?

And, is our current system (under our "free economy") really all that different from socialized medicine? Medicare aside, HMOs are already heavily subsidized by the government and rationed by bureaucrats. Hell, HMOs' penetration into the market is basically subsidized into existence. And because of the high barriers of entry into the medical field (you simply cannot compete with subsidies on economic terms), doctors essentially are forced to work for HMOs and thus stripped of their professional autonomy.

What you seem to fail to understand is that the argument here is not about socialized medicine vs free-for-all medicine. Socialized medicine are run by government bureaucrats. Our current system (in our supposedly "free" economy) is run by corporate bureaucrats endorsed by the government, which amounts to the same thing. Except in later case we're getting a one-size-fit-all managed-care plan instead of a government one in the spirit of cost cutting, which oftentimes end up being regularly and frequently reported for irresponsible and often-times dangerous penny pinching that strips their patients of medical options (like, you know, important surgeries or medicine, emergency cares, necessary but expensive medical tests, access to specialists, choice of physicians, etc).

Now, you asked a couple of interesting questions. Should the HMO allow doctors to prescribe whatever they want, and whether the HMO should pay for any test the patients want. Now, it seems obvious that you entirely missed the point given these questions. Doctors should be allowed to prescribe whatever is MEDICALLY NECESSARY to treat the patients, and that includes expensive tests, if that is what is needed. And the HMO does not pay for it -- WE pay for it, when we sign up for our health plans.

So as to avoid any more misunderstanding, I state once again for the record: I DO NOT support socialized health care. I DO think de-regulating medicine is a good idea.

[Moebius]

I wasn't clear: deregulation is the only solution, not just a good one out of several, and it would work a lot faster than you are suggesting.

I lack the expertise to assess the accuracy of this statement.

Also, medicine would work itself out without regulation, but it probably wouldn't stay deregulated for long without an appropriate supporting government.

I believe in capitalism, so yes, I believe that medicine would work itself out eventually under a free economy. The operative words being: FREE ECONOMY.

Lastly, wouldn't it be nice if you didn't have to pay so much for your medical care, even though you can, and instead invest it in more preferable areas of your life?

Well I suppose the most ideal situation would be I can pay for my medical care and still invest as much as I want in whatever areas of my life. True financial freedom -- probably my most important goal in life currently.

[DavidOdden]

I already said I do not believe in socialized medicine. I even said the best idea I can think of is to de-regulate health care. Re-read it again if you didn't catch it the first time. So which of my "socialist proclivities" are you referring to?

The ones where you claim that the HMO forces doctors to do things, and most offensively, where HMOs are looters. This is serious stuff we're talking about. Stop talking the socialist, anti-busines, anti-corporate line, now. I won't repeat myself.

[JASKN]

It's pretty easy to judge that freedom lets things happen fast; there is evidence everywhere, on small and large scales, past and present.

I guess there are two things we are talking about: the process of deregulating and how fast things would get better after the fact. I'm only interested in the intermediate steps when they're working toward the goal of no regulation. Are you saying you're undecided about whether men would work hard for themselves in the absence of a government working against them? And to me men working hard for themselves means fast improvement in medicine!

Edited July 9, 2007 by JASKN

[Moebius]

The ones where you claim that the HMO forces doctors to do things, and most offensively, where HMOs are looters. This is serious stuff we're talking about. Stop talking the socialist, anti-busines, anti-corporate line, now. I won't repeat myself.

Let's follow this line of reasoning:

1. HMOs actively lobby the government for subsidies

2. Subsidies allow them to penetrate the market and drive out all competition, stripping consumers of choice

3. Government use force to collect taxes

Therefore I conclude that HMOs indirectly use force to achieve their profits - making them looters in my book. Furthermore, by that reasoning, it is the HMOs that are anti-business.

I am not sure which part of that is "anti-corporate". And I sure as hell don't see which part of that is socialist -- especially since I have already repeated about 5 times that I am against socialized medicine. Now, it seems to me that even if you do not agree with my reasoning, it STILL does not make what I said "socialistic".

Oh, and I forgot, the HMOs don't force doctors to do things. They only create, through anti-capitalistic measures, a market where they are the employer of the overwhelming majority of doctors. Then they tell you that if you do not do as you're told, even if it is against your patient's best interests or your own morals, we will fire you. But, even you do not consider that "forcing", which part of that qualify exactly as "socialistic"?

I concede that I was not clear at all on my first post on this thread. But it boggles my mind how you could continue consider ANY of my positions, right or wrong, socialistic, if you had even bothered to read what I actually wrote.

[Antonio]

I have not seen Sicko and do not plan to. But I've been told that what is sorely missing from Sicko is any correlation or causation between the problems that regulation and protectionism cause for the health insurance market. For instance, we in California can't buy a policy sold in, say, Arizona. Like with gasoline, insulating insurance into 50 separate markets leads to higher prices. And it certainly defeats the purpose of having a common market of 50 states within a single nation, doesn't it?

You are not going to read much about that in the mainstream media because it reaches a level of complexity beyond that of most journalists' levels of education, and because it requires deeper digging that is harder to find in these days of newsroom staff cutbacks. Those of you who know me know that I speak from experience as a newspaper editor who works for a large corporation.

I recall having a conversation with our health care reporter where I had brought up how the ills of health care were caused by the price controls post World War II, which led to "fringe benefits" that were an end run around wage caps and the evolution of the market to where it was expected a third party would pay for health care.

I explained to her how there are three decisions involved in the economics of purchasing: the payer, the decisionmaker and the recipient of the benefit. When one goes to buy soup at the grocer, and with most economic decisions, it's the same person. I decide whether I need the soup, I'll pay for it and I'll benefit from consuming it.

In health care, that triangle is ripped apart. The doctor decides if I need treatment (prescription), an insurance company accountable to neither of us pays, and I benefit as the patient. One could argue too that the doctor benefits by charging someone other than the beneficiary and that the insurance company can intervene as decisionmaker by refusing to pay. In all scenarios, it's bad economics.

My reporter showed an involuntary look of intrigue and interest in her face, triggered no doubt by her higher-than-average intelligence. But she quickly reverted to herself at her desk and did not take the conversation further because it runs so counter to her bias in favor of a single-payer government-run health care system. I stumped her.

You'll never see an advanced debate in a movie like Sicko that's produced by a publicity seeking millionaire muckracker. Unfortunately, the mainstream media and the public will eat up all that pablum.

[Joshua A Davis]

I saw Sicko last night.

Debates aside on the question of whether or not there are long lines, whether or not healthcare becomes base-line upon the nationalization of said health care, etc, there were a few omissions and almost outright lies that I spotted from the onset when Moore said them.

First thing that really got my blood moving in resentment was when, in the beginning, Moore stated that this movie is "about the 50 million Americans who don't have health insurance. The other 250 million of you? You're living the American dream."

Honestly, how dare he. Maybe I am preaching to the choir here, but arrogance like that, in the opening credits for that matter, makes me want to write a few letters to say the least.

1. Moving on, toward the beginning, Moore stated that through their shady techniques and underhanded contracts, the health insurance industry has made a killing in profits over the past few decades.

Now, as someone in the insurance/insurance consulting industry myself (I'm an actuary), I can honestly say that yes, that's true, but he's not stating his basis for comparison. Relative to other industries, the insurance industry has the second smallest growth rate of any other American industry, the lowest one being airlines. What he also fails to mention is that the mainstay of insurer profit over the past 20 years has not come as a result of denying people claims, but rather the result of more advanced and more predictive modeling methods employed by actuaries.

2. The next thing that Moore sort of left out was the salary of doctors. He interviewed a British doctor to ask about his salary and the doctor said that he's paid 85,000 pounds a year and after bonuses and incentives, about 110,000 pounds per year. Moore goes on to say things like, "Wow, that's 220,000 dollars. That's amazing! You really are paid the same as Americans."

It is honestly beyond me who would fall for this tripe. He completely fails to mention the fact that he's interviewing only one single doctor, and more importantly, failing to mention that the British pound is worth twice as much as the dollar, yes, but the purchasing power of a single pound in Great Britain is virtually the same.

So if you think of his 110,000 pound salary in terms of dollars, well, a quick search on Google revealed that a doctor in a family practice averages 150,000 dollars in the US in 2002. And that was 5 years ago! [Source]

Furthermore, I remember this past winter, I went to Brazil for a month and I met three British girls who were newly made doctors. (Imagine my surprise when they told me that they never had to do undergrad -- that they went straight from secondary school to medical school and were now doctors at age 22!) When I told them that I was an actuary, they actually told me that actuaries actually get paid more than they do, to start, in England, something that would never happen in the states.

3. Next, Moore attempts to refute the claim that Europeans must be drowning in taxes from all their socialized healthcare. So he interviews a French family that makes 8000 dollars a month, which equates to about 6100 Euros (assuming 1.3 conversion) and goes on to marvel at the size of their home, how nicely it's decorated, spends time awing at how their only expenses are their mortgage and groceries, but never once actually says how much of their income is taxed.

Honestly, does he think that every single one of his viewers are complete morons?

4. Finally, at one point he says that our healthcare system is ranked 37th in the world, just above Slovenia, but never actually says what his basis of comparison is. Are we ranked 37th in the time it takes to get treated? 37th in the amount of successes per surgery? There's no information.

This was just at a glance. I'm sure if I'd looked harder, I could've found more flaws, and that doesn't even cover the issue of whether or not there really are long lines (as he claims there aren't) and whether or not it's burdensome on the consumer (he claims it isn't) and whether or not the quality of the healthcare is decent (he says it's top notch).

At the end, he talks about how a man with the largest anti-Michael Moore website on the internet was in danger of shutting it down last year because his wife had contracted cancer and he was forced to choose between the website and paying for his wife's chemo. In the end, Moore sent the website owner an anonymous check of 12,000 dollars (that was how much the website owner needed to stay running) to help. At this point, I was reminded of Ellsworth Toohey's speech on how to control a man's mind from the Fountainhead.

In the end, I watched this on my computer from Google video. Whether this was posted by Moore himself or by a bootlegger, call me Ragnar Danneskjold, but I'm glad I didn't support this propaganda in the form of the 9.75 it would've cost me to walk in the theater.

[JMeganSnow]

Basically, I feel like I received much better care than what I actually paid for.

That's one of the benefits of insurance: it takes advantage of the time value of money to pay for expensive stuff.

Re: the rest of this discussion, I find the term "substandard care" to be hilarious. Sub-what standard? At present, my

standard

medical care consists of slapping a band-aid on it. It works pretty well and costs me about thirty cents. If I want anything better I

expect

to have to pay more for it.

[Moebius]

Re: the rest of this discussion, I find the term "substandard care" to be hilarious. Sub-what standard? At present, my standard medical care consists of slapping a band-aid on it. It works pretty well and costs me about thirty cents. If I want anything better I expect to have to pay more for it.

You're missing the point. No one is arguing that you shouldn't get what you pay for, nor is the question whether you are satisfied with your medical care. It's that we are not given the freedom to choose the kind of health package we want from a competitive, free market.

[K-Mac]

You're missing the point. No one is arguing that you shouldn't get what you pay for, nor is the question whether you are satisfied with your medical care. It's that we are not given the freedom to choose the kind of health package we want from a competitive, free market.

I guess I just don't feel that way. My employer offers one insurance company to choose from, but it's a PPO so I can choose what Dr's to see, etc. The ambulance even asked me what hospital I wanted to go to. (Being in excruciated pain, I chose the closest, but I was surprised to hear that I had options.)

If I don't want the insurance my employer offers, I am free to purchase whatever policy I choose, or I can choose to be uninsured. Now I agree that these insurance companies are probably over-regulated by the government and that causes problems that need not exist, and of course, health insurance is not perfect, I just fail to see how it's as horrible as everyone makes it out to be.

[DavidOdden]

It's that we are not given the freedom to choose the kind of health package we want from a competitive, free market.

Explain concretely what laws you're referring to that prevent me from picking whatever health package I want. I don't want to hear any crap about HMOs looting from customers or forcing doctors to whatever. If you're referring to the fact that the government collects taxes and uses some of that money to make Medicare and Medicaid payments, then just say that that is all that your argument comes down to. I want to see the evidence that the govenment restricts choice of health plans.

[Qwertz]

For those who are Medicare-eligible, US Gov't sets precise standards for supplemental insurance programs (termed "MediGap" insurance). Insurance companies may only sell "standardized" MediGap plans, which must have certain benefits. MediGap insurance can only cover what Medicare doesn't cover, even if Medicare denies a covered claim. MediGap plans are mostly used to pay coinsurance and deductible costs that Medicare A and B do not cover. MediGap insurers are required to issue insurance to all who meet the legal requirements. MediGap insurers may not charge you more because of your preexisting conditions, and MediGap insurers are required to cover those conditions. You cannot buy more than one MediGap policy.

Medicare C is the allegedly free-market alternative to A and B, because it is coverage provided by private insurers instead of the government. But its coverage is dictated by the government (it must cover everything A and B would cover), and if you choose a Medicare C plan, you cannot get a MediGap plan.

You can refuse Medicare coverage altogether, if you want. Money goes to toilet either way. If you are 65 or older, Federal law requires your employer to offer you health insurance at the same rates as younger employees. If you decline Medicare at 65, but later decide to enroll, there is a 10% penalty added to your premiums for each year you weren't enrolled after 65. If you want to try to get private insurance after age 65, you'd better have a lot of money - the over-65 insurance market is so vastly dominated by Medicare that premiums are astronomically cost-prohibitive for Medicare-eligible Americans over 65 who decline Medicare coverage. Far higher than the would be if Medicare wasn't involved.

For under-65s, the Fed. Gov't hasn't gotten too involved yet - insurers are regulated by the states. Generally, individuals are allowed to buy any insurance from any insurer they want slash can afford, but the state will limit what kind of insurance may be offered, who may sell insurance, and in most cases, requires employers to offer particular insurance to employees. (Fed may be involved in this, too, I'll have to check.) These don't necessarily force individuals into any particular action, but they are certainly coercive on insurers and employers.

So the Fed. Gov't doesn't (yet) force people to obtain health coverage, either through Medicare or a private insurer. But if you are enrolled in Medicare, your supplemental insurance options are severely curtailed, and not enrolling in Medicare carries an exaggerated cost. In a sense, saying that the gov't doesn't force people into Medicare is akin to saying that Massachusetts doesn't force people to obtain health coverage. Sure you can choose not to have health coverage, but the gov't has seen to it that you will pay dearly for the privilege.

-Q