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June 28, 2007

Sicko

Back in 2000, when I was a second-year med student, I heard that Michael Moore was making a movie about the health care industry. I tried to get a summer internship on the project, and they weren't completely uninterested, but they weren't willing to pay and I couldn't swing a few months in NYC on my own dime.

Maybe if they had hired me, it wouldn't have taken seven years for Sicko to make it to the big screen. (I guess Moore had bigger fish to fry since then, but I choose to believe it's because they needed me.)

All bitterness aside, the movie opens tomorrow (Friday), and you should go see it. For years we've been told that the American health care system is the best in the world and everyone else wishes they were us, and Sicko addresses that fiction head-on, starting with domestic horror stories and then moving to Canada, England, France, and Cuba to find people who couldn't be happier with their care. It is linear, clear, and coherent in a way that most of Moore's other movies have not been--not because they were lacking, but because they were more about finding a point than making one.

I could pick nits, and in fact I did when I wrote my original (unpublished) review. But that's only because I spend the majority of my waking hours thinking about and working in the health care business, and none of them take anything away from the movie. My only substantial criticism is that I don't think the trip to Cuba with the 9/11 rescue workers really worked very well. It may help dispel images people probably have about health care in Cuba, but it's hard to believe that patients brought in by a famous filmmaker are going to get the same treatment as Jose Blow off the street. It gives something for Moore's critics to roll their eyes at, dismissing the valid (and, frankly, undeniable) points made by the rest of the movie. Of course, those critics would just find something else to scoff at, but the Cuba trip just seemed like a gimmick in a movie that didn't need one.

I don't think we're going to have a choice about reorganizing our health care system in the next ten years or so. What we're doing is just not sustainable, and if we're lucky public pressure will force changes before the system collapses under its own weight. In the next year and change we'll be putting the people in office who will probably be guiding that reorganization, so we really need to start talking about it now. If Sicko helps jump-start the conversation, maybe the seven-year delay will turn out to be a good thing.

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As I have discussed here, the media and some Lefty front groups wish to create the impression that nurses in general share Michael Moores view of American health care. Not only does this misrepresent the position of most American nurses, it conf... [Read More]

Comments

Just curious, why did you not finish med school? Or did you?

I'm asking because I'll be heading there soon.

--it's hard to believe that patients brought in by a famous filmmaker are going to get the same treatment as Jose Blow off the street.--

You got that right. And for some reason I think dissidents or non-friends of the totalitarian state jump to the head of any lines either.

I very much want to go to Cuba, soon, but I'd be going with eyes wide open.

Oh, I finished med school. (Barely.) I had a few months off between second and third year, and I was looking for a summer gig. I didn't find one, so I mostly spent the break drinking beer--the better option, in retrospect.

Good luck to you. It's both easier and harder than everybody says.

Apologies if you've written about this before, but what makes you think the system will collapse under its own weight? How do you envision that happening?

The same liberals who demonize Castro and Cuba wear his comrade Che Guevera's picture proudly on their tees. If you're one of them I have a couple of questions - Is it because you think he looks real cool in that bandana? Or are you unaware that he was a Communist, and not the bass player for Santana?

Michael Moore doesn't pay his interns? That's not very progressive of him.

" it's hard to believe that patients brought in by a famous filmmaker are going to get the same treatment as Jose Blow off the street "

Why not? That's been my experience in the UK when I lived there a few years ago.

I collapsed twice about 6 weeks apart at work (unconcious), was attended by ambulance officers, taken to a local hospital for recovery (about 6-8 hours each time) and then sent home by taxi about 80 miles (!) -- all for free.

Despite being a foriegner, not once did anyone ask whether I had health coverage, nor did they ask for my National Insurance number (state run, single provider insurance); they simply didn't bother because it doesn't matter.

My aged mother - who visited on holidays - also had similar treatment when she fell ill. She was a tourist, but that didn't bother anyone and she was never asked to pay.

The fact is that where there is universal cover, there is universal treatment. Everyone gets treated no matter who they are.

>The same liberals who demonize Castro and Cuba wear his comrade Che Guevera's picture proudly on their tees. If you're one of them

I doubt such people actually exist except in reactionaries' fantasies. The only Che champions I've ever met or read were also big Castro's Cuba pumpers. And they were reasonably sane folks only about 35 or so years ago when information on Che's life and beliefs was very romanticized and sanitized. His ultimate failing is not that he was -- oh, the horror! the horror! -- a Communist, but that he became a rigid "revolutionary" who thought the only meaningful political reform came through armed rebellion. And who carried imperial attitudes into local struggles with an arrogance just like any other intervening foreigner. Not everybody the CIA bumps off is a worthy martyr.

Apologies if you've written about this before, but what makes you think the system will collapse under its own weight? How do you envision that happening?
I foresee a big bump in the number of uninsured, as people find they're paying more and more for their health plans and they're getting less and less. At some point, a healthy person has to figure it isn't worth it. When you pull the healthy people out of the insurance pool, it gets a whole lot more expensive for the people left in, so a lot of them may decide it's not worth it. And so on.

Also, the Boomers hit Medicare in the next few years. This will make Medicare much more expensive, and rather than raise taxes they'll most likely reduce benefits. This shifts a lot of pressure onto private Medicare supplement plans, and increases the out-of-pocket cost for a lot of people who probably won't be prepared for it.

There are plenty of other potential train wrecks. I just have an overwhelming sense in my dealings with health care as an industry that we can't keep this up forever.

Michael Moore doesn't pay his interns? That's not very progressive of him.
He didn't want to pay me to be his intern. Big difference. :)

I saw the movie this weekend and it was wonderfull. It really broke me up and several points in the movie, and I think it did a tremendous job at highlighting the problems not only with the system, but with our government's backdoor deals with the Insurance Industry, and the Drug Industry. People were cheering and talking alot about what was discussed, and was the only movie I've ever been to where that's happened (9/11 was equally as uproaring, though, not as discussible as this one).

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