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Michael Moore's "Sicko"

For perspective, here are some personal anecdotes about wait times in the Canadian system. Take them for what they are worth:

Wait times are a problem, but don't draw the wrong conclusions from the numbers. Wait lists are priority lists. If you are waiting for an MRI for the knee that you sprained in your beer league game last weekend, you may wait a while. (This very situation exists in a team I play on). But, If you are a cancer patient, you will be bumped up the queue ahead of the weekend warrior with the knee problem.

I lost my grandmother (mother's side) and mother to breast cancer. Both went through all the stages of treatment in the Canadian system - lumpectomy, radiation, chemo, masectomy, bone marrow transplant etc. Their lives were extended for years by the treatment they received. At no time where they forced to wait unreasonable amounts of time for service or to see a specialist.

I have a father-in-law who is a dialysis patient and is currently hospitalized with the latest in a series of serious health problems related to his illness. He has had to undergo several serious operations for which he did not have to wait.

In the Canadian system, anecdotally from my experience, if you need treatment you will get treatment. If you can wait, you probably will.

And no...you will not have to wait in the emergency room if you have a broken neck. Get real.

Wait times are real and can be very frustrating. Perhaps even people with serious conditions slip through the cracks now and again. Various governments have been promising to fix the situation for some time now with no results. A previous government created the problem in the first place by slashing health care transfer payments to the provinces. (Health care is managed provincially and funded jointly).

Here's an anecdote from the American system:

I spent a summer in Ketchikan Alaska many years ago. While I was there, a rockslide destroyed a local beauty salon crushing the owner's legs in the process. She was uninsured, so she was struck by fate (boulder) and bankruptcy at the same time. I was repeatedly called a communist by the locals for being appalled by the situation.

Anecdotes, anecdotes....but still...give me an imperfect public system over an unjust private system any day.
 
Comrade Ogilvy said:
Yeah...Canadian health care is the ticket...and you wonder why Canadians flock to the border to jump out of the line to get the most advance care in the world.


http://www.thestar.com/News/article/216280
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And if you read the article, it states that this was a huge scandal, unique to Ontario, and that steps are being taken to prevent a recurrence.

Then think about what this family had to pay for their hospital stay after this horrific car accident. Are they financially ruined?

Sometimes, all it takes is one bad fall for a working person with health insurance to be pushed into bankruptcy.
Hundreds of thousands of Americans file for personal bankruptcy each year because of medical bills - even though they have health insurance, according to a new study by Harvard University legal and medical researchers.
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In February, I had a really, really bad headache. Since UCLA Medical didn't find any bleeding, they determined it was likely migraines. I saw my General Care the next day. It took three weeks until I saw Neurology. In the meantime, I was in pain the entire time, sick, vomiting, barely keeping up on my work. Status migrainosis is why I got to be Subject to Academic Probation last quarter. (I'm off it now, reagardless of this last grade I'm still waiting on.)

I have a cyst in the middle of my brain. Right now, it's not doing anything, but it needs to get checked once a year. This requires an MRI. For comparision purposes, an MRI is just shy of being as expensive as a year's fees (aka tutition) at UCLA.

Because, "too many people used the service," it is too expensive for UCLA to continue buying insurance for their students through the current company. As of Fall 2007, another company will take over.

Will my migraines and my cyst be covered? Am I going to get hit with, "pre-existing condition?" What happens after I graduate? Do I hope I get lucky and Los Angeles Unified School District has the same insurance company as UCLA? Do I skip the MRIs and just hope that the cyst stays dormant and stable?

The changing of insurance companies is not my choice. I'm not jumping around looking for a deal and I can't afford to buy it on my own.
 
LostAngeles said:
In February, I had a really, really bad headache. Since UCLA Medical didn't find any bleeding, they determined it was likely migraines. I saw my General Care the next day. It took three weeks until I saw Neurology. In the meantime, I was in pain the entire time, sick, vomiting, barely keeping up on my work. Status migrainosis is why I got to be Subject to Academic Probation last quarter. (I'm off it now, reagardless of this last grade I'm still waiting on.)

I have a cyst in the middle of my brain. Right now, it's not doing anything, but it needs to get checked once a year. This requires an MRI. For comparision purposes, an MRI is just shy of being as expensive as a year's fees (aka tutition) at UCLA.

Because, "too many people used the service," it is too expensive for UCLA to continue buying insurance for their students through the current company. As of Fall 2007, another company will take over.

Will my migraines and my cyst be covered? Am I going to get hit with, "pre-existing condition?" What happens after I graduate? Do I hope I get lucky and Los Angeles Unified School District has the same insurance company as UCLA? Do I skip the MRIs and just hope that the cyst stays dormant and stable?

The changing of insurance companies is not my choice. I'm not jumping around looking for a deal and I can't afford to buy it on my own.
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Sorry to hear about your pain..take care hope you get better.
 
As usual, some people in such threads will turn them into national healthcare systems pissing contests.

But, what should really be done, is to look at the problems of one's country's system, see what's broken, and consider what has worked elsewhere and why such solutions have worked elsewhere, to see whether they might be adapted to work here. It's important to see the actual causes of other system's problems as well.
 
Comrade Ogilvy said:
Yeah...Canadian health care is the ticket...and you wonder why Canadians flock to the border to jump out of the line to get the most advance care in the world.
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Er, no. While the image of Canadians flocking to the US for medical care persists (in large part due to sheer repetition of the talking point), when you actually look at the numbers of Canadians coming to the US and reciveing medical care, there really are not many of them. And a lot of those people are Canadians who are visiting the US, then suddenly need emergency medical attention.

http://www.pnhp.org/news/2002/may/phantoms_in_the_snow.php

Next time someone gives you that talking point, ask them for specific numbers of how many Canadians are coming to the US for treatment. They either have no idea or will change the subject.
 
Random said:
He really just sidesteps the issue. He mentions wait times, then asks people in a Canadian hospital waiting room how long they have been waiting. Not really the point is it? Kinda torn on the whole wait time issue. It is a serious problem in Canada, but Americans in similar economic/medical situations might find they have no access to healthcare at all. Healthcare is free but you have to wait for it vs. healthcare anytime but you can't afford it. Which would you choose?
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Yes, most people would prefer a wait list to not being able to afford treatment at all. And yes, I do admit there are people who fall through the cracks in the American system. But lets face it, the majority of Americans DO have health insurance (either private, or medicare/medicade).

So, the choice is not "wait list vs. can't afford". The issue is "Have most people get fast access while a minority suffer vs. everyone suffers equally".

Not happy with the entire patent law system for medications. Would much prefer a government-run prize bill system and seperate drug research from manufacture.
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Do you really want the government, with all its incompetence, having any sort of say into what drugs they'll develop for you? Corporations may be greedy, but I trust that more than inefficient government beuracracies.

Plus, how woudl your government-run prize bill system work when you are dealing with multiple countries (each with their own method of handling medications).
 
Random said:
Er, no. While the image of Canadians flocking to the US for medical care persists (in large part due to sheer repetition of the talking point), when you actually look at the numbers of Canadians coming to the US and reciveing medical care, there really are not many of them. And a lot of those people are Canadians who are visiting the US, then suddenly need emergency medical attention.

http://www.pnhp.org/news/2002/may/phantoms_in_the_snow.php

Next time someone gives you that talking point, ask them for specific numbers of how many Canadians are coming to the US for treatment. They either have no idea or will change the subject.
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Gee...no bias here...

Haaaaaa...Haaaaaaa...


About PNHP


Physicians for a National Health Program is a single issue organization advocating a universal, comprehensive single-payer national health program. PNHP has more than 14,000 members and chapters across the United States.

Since 1987, we've advocated for reform in the U.S. health care system. A large part of our work involves educating health professionals about the benefits of a single-payer system--including fewer administrative costs and affording health insurance for the 46 million Americans who have none.

Our members and physician activists work toward a single-payer national health program in their communities. PNHP organizes rallies, town hall meetings, and debates; coordinates speakers and forum discussions; contributes Op-Eds and articles to the nation's top newspapers, medical journals and magazines;and appears regularly on national television and news programs advocating for a single-payer system.

PNHP is the only national physician organization in the United States dedicated exclusively to implementing a single-payer national health program.
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Do you really want the government, with all its incompetence,
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Nah...we already have free govt. health care (For some)...and it`s called the Veterans Administration...what a beauty of a system.
 
Segnosaur said:
Yes, most people would prefer a wait list to not being able to afford treatment at all. And yes, I do admit there are people who fall through the cracks in the American system. But lets face it, the majority of Americans DO have health insurance (either private, or medicare/medicade).

So, the choice is not "wait list vs. can't afford". The issue is "Have most people get fast access while a minority suffer vs. everyone suffers equally".
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While a majority of people have health insurance, the only way to really know if you are going to get anything back is to get sick. The insurance companies have every incentive to take your money, and no incentive to pay for your claims. There are a lot of people walking around right now who have no health insurance, but won't find that out until they try to submit a bill. Even if they do pay out, you still have to worry about deductables, premiums, etc. One of the biggest causes of bankruptcy in the US is unexpected medical expenses.

We have set up a system where instead of health care decisions beings handled by one large government bureaucracy accountable to the people, we have those decisions made by thousands of private bureaucracies accountable to no one.

Do you really want the government, with all its incompetence, having any sort of say into what drugs they'll develop for you? Corporations may be greedy, but I trust that more than inefficient government beuracracies.

Plus, how woudl your government-run prize bill system work when you are dealing with multiple countries (each with their own method of handling medications).
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Corporations are greedy, so they have no interest in spending money to research unprofitable diseases and conditions. If they don't think they can make money selling a new drug to you, they have no motive to develop it, even as you slowly sicken and die.

A prize bill system for drug development is fairly straghtforward. We chose a medical condition that we want a treatment for, say for the sake of argument, gout. We then write a bill that says somthing like:

The US government will pay $250 million dollars to the first company that develops a medication for the safe treatment of gout. Formula will be made available to the public sphere for production by all interested parties.

If no one develops a drug for treating gout, it doesn't cost taxpayers a dime. If someone does develop it, they get paid for their work, and any pharmacutical company can produce it and distribute it as they see fit.

This helps cut away the pharmacutical lobby argument for excessive prices based on how much it costs to develop drugs. The best part is that we don't have to change anything with the existing system at all, we can just keep cranking out prize bills for any medication we think we might need. The patent method is stupid.
 
Comrade Ogilvy said:
Gee...no bias here...

Haaaaaa...Haaaaaaa...
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If you are aware of another study on the number of Canadians coming into the US for health care, please inform me of it. Until then, since it seems to be the only study I could find, I will continue to use it.

I know where my numbers come from. How about you?
 
Random said:
While a majority of people have health insurance, the only way to really know if you are going to get anything back is to get sick. The insurance companies have every incentive to take your money, and no incentive to pay for your claims.
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Actually, there is incentive to pay your claims... its called a legal contract. If the health insurance says "you will pay X if someone gets disease Y", then legally the insurance company HAS to make the payment.

Although I do have to wonder... there may be many cases where insurance companies attempt to avoid claims, just how often do those cases actually occur? If the companies pay out 99% of all claims as expected then the remaining 1% who do run into insurance problems are in a minority.

We have set up a system where instead of health care decisions beings handled by one large government bureaucracy accountable to the people, we have those decisions made by thousands of private bureaucracies accountable to no one.
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Actually, the government health care system is often the one that's responsible to no one, since government bureaucracy's are often very difficult to change (since managers cannot necessarily get any incentive for improvements).

Corporations are greedy, so they have no interest in spending money to research unprofitable diseases and conditions. If they don't think they can make money selling a new drug to you, they have no motive to develop it, even as you slowly sicken and die.
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You're right, they will concentrate on the more 'popular' diseases. But isn't that (by definition) going to end up providing the greatest health benefit to society in general? Should a disease that affects 0.01% of the population get as much attention as a disease that affects 10% of the population?

A prize bill system for drug development is fairly straghtforward. We chose a medical condition that we want a treatment for, say for the sake of argument, gout. We then write a bill that says somthing like:

The US government will pay $250 million dollars to the first company that develops a medication for the safe treatment of gout. Formula will be made available to the public sphere for production by all interested parties.

If no one develops a drug for treating gout, it doesn't cost taxpayers a dime. If someone does develop it, they get paid for their work, and any pharmacutical company can produce it and distribute it as they see fit.
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Ok, problems with your 'system'...
- It depends on the government being able to identify diseases that are eligable for a prize. Simply put, I don't have that much faith in government. It seems like half the time they are catering to special interest groups, the other half of the time the bureaucracy has no incenitive to make the 'best' decision.
- Who decides that a medication is eligible for a prize? If it cures 90% of the people, is it worthy? What if it leads to a 90% improvement in all cases, but no complete cures? Trying to determine what's elidgable for the prize could be a nightmare
- Drug companies (when they develop and sell drugs) base their prices on the fact that they will be selling medication in other countries as well. Are you going to make the prize high enough to compensate companies for revenue they would have earned from foreign sources? If so, you're basically subsidizing foreign health care.
- What happens if a company develops a medication for which there is no prize available? Are you going to say 'no patent protection'? If so, what incentive to companies have to create lifesaving cures that aren't covered by a prize?
- Are you going to FORCE a company to accept a prize? What if you offer a prize of $X to develop some medication, but the company says "We can develop a medication, but it will cost more than that. But we will go ahead anyways, not claim the prize, but try to sell the drugs on the open market"?
- if the prize isn't high enough to be an incentive for companies to produce a drug, who takes the blame for the potential deaths due to a lack of the medication? Drugs can be expensive to produce, and trying to assign a dollar value to their development costs almost seems like fortune telling

And, of course, what happens if there is
This helps cut away the pharmacutical lobby argument for excessive prices based on how much it costs to develop drugs. The best part is that we don't have to change anything with the existing system at all, we can just keep cranking out prize bills for any medication we think we might need. The patent method is stupid.
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The 'patent method' has produced hundreds of cures for hundreds of diseases. Its not perfect, but for all its faults, the end result is a system that has improved the quality of life for millions of patients.
 
D'rok the Lacone said:
Here's an anecdote from the American system:

I spent a summer in Ketchikan Alaska many years ago. While I was there, a rockslide destroyed a local beauty salon crushing the owner's legs in the process. She was uninsured, so she was struck by fate (boulder) and bankruptcy at the same time. I was repeatedly called a communist by the locals for being appalled by the situation.
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I don't understand how caring for a friends health and being appalled at the lack of care is a 'communist' idea. I believe those people were using an Ad hominem - An ad hominem argument is any that attempts to counter anothers claims or conclusions by attacking the person, rather than addressing the argument itself.

D'rok the Lacone said:
Anecdotes, anecdotes....but still...give me an imperfect public system over an unjust private system any day.
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Imperfect public system > unjust imperfect private system
 
Comrade Ogilvy said:
If you think health care is expensive now, wait until you see what it costs when it's free.
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Sheesh, we should just make this into a sticky.

Total health expenditures per capita, U.S. and selected countries, 2003:

figure-1.gif


Total health expenditures as a share of GDP, U.S. and selected countries, 2003:

ex-4.gif


The World Health Organization's ranking of the world's health systems:

1 France
2 Italy
3 San Marino
4 Andorra
5 Malta
6 Singapore
7 Spain
8 Oman
9 Austria
10 Japan
11 Norway
12 Portugal
13 Monaco
14 Greece
15 Iceland
16 Luxembourg
17 Netherlands
18 United Kingdom
19 Ireland
20 Switzerland
21 Belgium
22 Colombia
23 Sweden
24 Cyprus
25 Germany
26 Saudi Arabia
27 United Arab Emirates
28 Israel
29 Morocco
30 Canada
31 Finland
32 Australia
33 Chile
34 Denmark
35 Dominica
36 Costa Rica
37 United States of America

Well done, you just beat out Slovenia for the coveted thirty-seventh place.

Remember when you guys put a man on the moon? Ah, great days.
 
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Comrade Ogilvy said:
Sorry to hear about your pain..take care hope you get better.
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Thank you, but my condition is relatively mild and I don't know if I'm can afford it. I'm just lucky I'm insured now, because before, I couldn't afford it in the slightest. I still have trouble affording my medical bills.

If I'm (apparently) screwed, imagine how it is when it's something more serious...

Our system is broken. We can probably all agree on that point. The only real question is how do we fix it.
 
D'rok the Lacone said:
I spent a summer in Ketchikan Alaska many years ago. While I was there, a rockslide destroyed a local beauty salon crushing the owner's legs in the process. She was uninsured, so she was struck by fate (boulder) and bankruptcy at the same time. I was repeatedly called a communist by the locals for being appalled by the situation.
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Just out of curiosity... is there a reason this persion did not have health insurance? After all, I'd suspect that someone who was a business owner wouldn't exactly be classified as a member of the "working poor". Was her business doing that poorly, or did she just decide to gamble, thinking "I'm healthy so I can spend the money on fun stuff"?
 
Dr Adequate said:
Sheesh, we should just make this into a sticky.

Total health expenditures per capita, U.S. and selected countries, 2003:
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Yes, the U.S. is a very expensive health care system. I do wonder however j things like the legal system affects the costs. I know that its easier to sue doctors for malpractice in the U.S. than it is in Canada, and that might lead to extra costs (although I don't think its necessarily explains ALL of the higher costs.)

The World Health Organization's ranking of the world's health systems:

1 France
...
37 United States of America
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Keep in mind that when they did the rankings, they considered both the quaility of the health care, AND the financing. Thus, the ranking isn't exactly a measure of how good each country's health care system is; its more a measure of how effectively the health care money is spent. In fact, if you go and read through the report, the U.S. actually ranks #1 in at least some of the health care quailty factors; they just end up spending a whole heap of cash in order to reach that status (which lowers their ranking overall.)

Edited to add: Just to bring things back to the original topic: Did Moore's film Sicko actually talk about rankings? If it did, did he mention that the U.S. was rated #1 in responsiveness, or did he just mention how its overall ranking was so low?
 
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