Owing to the wonders of P2P leakage, I, like many of you, saw Michael Moore’s Sicko. Like most popular political documentaries (and recent Moore documentaries in particular), it doesn’t contain a lot of new information for anyone already participating in the reality-based community. In my case (as is the case for almost all Canadians), it was preaching to the converted, but it’s still important to see.
We’re proud of our universal health care system up here, but that’s no reason to get complacent. Canadians who favour an American-style private health care system are in a definite minority, but they have a well-funded and loud propaganda machine. The Fraser Institute, for example, a far-right think tank that favours health care privatization, pulls in $6.9 million in revenue a year. Its board members have included David Asper, whose family owns CanWest, Canada’s largest media corporation, which frequently reports that our health care system is in crisis. Recently, Torontonians have seen billboards and bus ads springing up around the city clamouring for “heath care reform.” While a politician who proposed an outright switch to a for-profit system would be committing political suicide, we are always at risk for a death by a thousand cuts. Sicko is a reminder of why we need to fight tooth and nail, not only to keep what we already have, but to push harder for an even better, even more inclusive system (the French one is looking pretty good).
Right-wing critics will call Sicko biased, but there’s no moral argument that can be made for a for-profit health care system. The portrait Moore paints of the American system is staggeringly dystopic: a woman who watches her toddler die because her insurance company won’t cover treatment in a non-approved hospital, an uninsured man forced to choose which one of his fingers he can have reattached, a disoriented elderly woman who can’t pay her bills who is put in a cab, still wearing her hospital gown and slippers, and dumped in front of a homeless shelter. Up here, we know that the American system is bad, but it’s not until we see these real stories from real people that we can appreciate how truly bad it is.
Americans are currently bound to their employers or insurance companies, at the mercy of what amounts to a lottery: Will I get sick? If I do get sick, will my insurance company pay for it? A long and complicated illness can bankrupt you, whether you have coverage or not. If you’re too sick to work, you lose your coverage. And insurance companies are inherently nasty: You pay them a premium, and they profit when you don’t get your money back. Combine this with a profit motive for health care providers (prolonged treatment rakes in more money than a cure), and you have a giant clusterfuck where the economic incentives conflict with saving people’s lives.
There’s a utilitarian argument for a private system that Moore hints at, and it’s a chilling one: a cowed population is easier to control than a free population. But how do you get the majority of Americans to agree to that arrangement? Moore argues, as others have, that efforts to humanize health care in America have failed largely because of Americans’ fear of socialism. These fears are easy enough to debunk, usually in a few sentences.
Argument 1: It costs too much.
No it doesn’t. America already spends more than countries with universal health care programs. Preventative medicine saves money, for one thing, and how can you prevent illness when you can’t afford the fee for regular check-ups?
Argument 2: But we’ll be drowning in taxes!
We do pay more taxes than Americans. But very few Canadians, if any, end up in debt for the rest of their lives because they couldn’t pay their taxes. Compare to the number of Americans who end up in debt for the rest of their lives because they can’t pay their medical bills. Everyone pays a bit more in taxes so that no one pays a lot more for health care.
Argument 3: With universal health care, you don’t get the freedom to choose your own doctor.
I don’t know why people get so upset about this one. For one thing, it isn’t accurate: My doctor was annoyingly uptight about my lifestyle choices, and inconveniently located, so I got another doctor. This process took under an hour. But even if it were true, isn’t it better to see a doctor you didn’t choose than to not be able to see a doctor at all?
Argument 4: Wait times kill patients!
Wait times vary according to region, but in urban areas, they really aren’t that bad. And it’s still preferable to not being able to see a doctor at all.
Argument 5: But…but…that’s socialism!
Doesn’t it sound better than what you’ve got now?
When I was six, my dad contracted viral encephalitis while we were on vacation in California (at the time we lived in Colorado). So he’s in a coma for a few days, then wakes up and is incredibly delirious and confused, making up stories for why he’s there, paralyzed on his left side, etc. So the insurance company, going “oh crap, an indeterminate hospitalization in this out-of-network hospital will be expensive,” decides that sending him back to Colorado would be cheaper than keeping him hospitalized in California.
So they get him, the delusional in-and-out-of-consciousness guy with the inflamed brain, to sign his discharge papers and then try and put him on a leer jet back to Colorado at midnight. This was all without telling any of us – not my mom and not his parents. It took a lot of screaming before they graciously agreed to postpone the trip to 5:30 AM the next morning, giving us time to get on the first flight (and my grandmother the ability to ride with my father on the jet) and at least be there when he landed. God. He’s lucky he didn’t get dumped outside of a homeless shelter.
And thanks to that wonderful insurance company, my father also didn’t get any inpatient rehab. Bastards.
There was also the insane nurse who thought my father had HIV, and actually pricked herself with one of his needles in order to force my mom to consent to have him tested. I don’t know if you can blame that on the for-profit system necessarily, but it was definitely bizarre.
I’m one of the lucky few people I know with fairly decent health care coverage, my partner on the other hand, not so much. He was throwing up on a daily basis for about 2 months before I finally dragged him to the “low cost” clinic ($50 bucks before they will even let you sit down in the waiting room)they gave him some pills and he was okay for a month or two.
Of course it came back much worse but luckily his work insurance had JUST kicked in so off the emergency room we eventually went, he had to stay overnight because he was so dehydrated and have CT scan and an ultrasound. They still hadn’t figured out what was wrong, so he had to go to his ‘regular’ doctor to get a referral, then go back to the hospital and have an endoscopy. Turns out he has acid reflux. As well as owing the hospital somewhere in the range of 600 dollars. I guess he reached his spending limit, because now if he goes to a clinic for something that would have been covered completely before the hospital stay, we get the bill for the majority of the costs.
I grew up luckily: my mom’s a nurse, and my dad’s a federal agent, so we never had any major gaps in medical coverage. But even they can tell you some horror stories; I haven’t heard of a person who couldn’t.
What I don’t understand is that government employees get good health care: if it’s good enough for congresspeople, why not the rest of us lowly peons?
I’ve gone through bankruptcy once due to medical costs. I had “good” cancer — thyroid cancer that did not kill me, just wiped me out fincancially and put me $130,000.00 in debt by the end of nine years — well, that wasn’t all the cancer; some of it was having a kid six years after the cancer with useless medical insurance, but anyway.
I went through bankruptcy two years ago, and now I have medical insurance again, but good shit, it’s useless. It covers almost nothing (doesn’t cover dental or vision, for instance, or mr. delagar’s sleep apnea), it costs five hundred dollars a month (that’s to cover me, mr. delagar, and the kid), it has fifteen hundred dollar deductible every single year, there’s a $30.00 co-pay on all the drugs (and I’m on five different meds per month, see the whole cancer thing above), and every time I have to have some procedure done, even *if* the insurance covers it, they only cover € of it, so we have to pay the other 20% — which, since a huge hunk of my income is already being eaten up by medical expenses, where do they think I’m getting that from? Santa?
So what’s wrong with socialism, hell yeah. Bring it on.
“What I don’t understand is that government employees get good health care: if it’s good enough for congresspeople, why not the rest of us lowly peons?”
Because they need to have something to define their privilege. All these things set them apart and help create a subculture of higher status.
Little things like that are very important to many people (if unacknowledged)…
Heya,
fellow Canuck here.
“Argument 3: With universal health care, you don’t get the freedom to choose your own doctor.”
Yep, you’re right, this is not even an argument at all – consider that HMOs provide their clients with a list of doctors/hospitals they can go to see, and if they go to a doctor/hospital outside those choices, they aren’t covered for the care they receive.
“Argument 4: Wait times kill patients!”
Again I agree – nope, not really. Patients with critical health problems generally don’t wait for care for any significant length of time that would affect the outcome of their treatment or threaten their lives. Besides which, think about what it would actually mean to not have any wait times – you’d have to have so many doctors on hand to treat any possible condition that could present that it would be impossible to keep them all occupied or even pay their salaries.
I think argument #4 is actually “I have to be inconvienced by wait times, like THOSE people”.
Argument 4 is bogus, we all know. What kills people is not having access to regular medical care so that their illnesses go unchecked until said illnesses are acute. What kills people is not having accesss to preventive care and good health education. What kills people is being kicked out of healthcare facilities before their treatment is complete or their condition stable, because they can’t afford to pay.
Sure in Canada some people have to wait longer than would be ideal for medical care. Some people get misdiagnosed, because doctors are human and victims of their own ignorance and biases as much as any other group of people. Some people have to spend more time in pain than anyone wants while they wait for equipment for which there’s a high demand, such as MRIs, because critical and acute cases take priority over chronic or non-critical cases (i.e., someone’s brain tumour, which is acute and life-threatening take priority over my mom’s back pain, which is chronic and debilitating, but won’t kill her if she has to wait a few weeks for diagnosis.) But I don’t know of anyone in Canada who has felt unable to even see a doctor or nurse practitioner in order to find out what’s wrong, whereas my American ex-husband, his mother, and many of my American friends don’t do regular checkups and more or less need to have lost a limb in order to visit a medical professional, they’re that (justifiably) scared of the cost of doing so.
Argument #2 “Everyone pays a bit more in taxes so that no one pays a lot more for health care” is a huge problem for whiny rich assholes. I guess they’ve just worked so hard that they’ve earned the privilege of witholding basic necessities from others.
The electricity where I live is owned by the city (or state, maybe – not sure), which means it’s super cheap. We heat the apartment, cook, run 4 computers etc and it’s never over $150/month. We used to pay that much just for natural gas. More socialism, please.
Antigone — the government-wide medical insurance program is indeed wonderful, and it is not restricted to congress persons. The only limit to its wonderfulness is that having been set up many years ago, it regards dental work and vision correction as largely recreational in nature, and they aren’t covered.
Otherwise, it is wonderful, and some years ago, I spent some time doing the math and satisfied myself that it could be extended to the entire population without needing more additional money than is already spent by the federal and state governments on medical care for the poor. In fact, it would probably cost less. Then they could add in the vision and dental coverage.
It even answers the objection, which I have heard, that it would “put private companies out of business.”
This probably isn’t a good place to explain how it all works. In any case, I’m more interested in why almost no-one ever suggests it, and why people think it wouldn’t work. Every federal employee (and there are a lot of us) knows it does work.
Yeah, it would be nice if dental and vision were covered, but luckily for me my covered the gaps in it. And I still know that even with that (correctable) flaw, it is head and shoulders over private policies.
I work in the veteran affairs hospital. I suppose Moore escaped this one. The VA system is good example of socialize medicine in the USA. If a veteran get sick, he just have to get to the emergency room and no matter how costly the treatment for X diagnosis, he does not have to pay a dime. I have seen veterans with treatments estimate in $100,000 and he never pay anything. So, if Congress say that socialize medicine is bad, then they are contradicting themselves.
Sorry for my English.