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Sicko

I watched Sicko, Michael Moore's new documentary about the health system in America, last night, and I have to say, if I were American, I'd be pissed the fuck off.

I'd also be looking to move to France.

Fuck, I'm tempted to move to France for the benefits.

At any rate, the horror of the American health system is well documented amongst my friends from the States and I was curious how the film was going to treat the subject. Instead of focusing on people without health insurance, Sicko chooses to focus on those in the States who do, and in doing so, opens a whole new dimension of tragedy up. It shows an elderly couple who, after three heart attacks and cancer in each, are left bankrupt, and must move into their daughter's house because of the cost of their treatment, even with insurance. It talks to the man who cut off the tips of two of his fingers--the middle and the ring--and was told, in hospital, that the cost of reattaching his middle finger was $60,000 and the ring finger $12,000. He could only afford the lesser of the two. I can't remember if he had insurance or not, but that story fucking horrified me. It then goes through a list of men and women who have been screwed over by their health insurance, who have denied their treatment, and which often results in death. A husband. A little girl. One gets the feeling that Moore could very well have filled up two hours of these stories, but he doesn't, heartbreaking though they are.

Instead, Moore compares America to the UK, Canada, France, and to Cuba, and finds, in hospitals, in doctors and patients, people who are, in turn, horrified and amused, by the notion that you would have to pay for operations.

"We're not in America," they say, more often than not. "This isn't the States."

It is, really, a heartbreaking film.

Especially if you're American.

The question that Moore raises is the film is how can a country do this to its people, and continue to allow it to be done? In answering it, he returns to the answer he gave in Bowling for Columbine, wherein Moore argued that it was fear that ultimately motivated the country's love for firearms. However, here, Moore argues that it is fear that allows the country to continue to treat its citizens so poorly. Whereas in the earlier film, Moore can be seen to arguing that fear is a cause of gun related deaths, and that it is fed by the media who sensationalise violence, Moore is instead arguing that fear of losing health care, of losing jobs, of losing something, is what American citizens need to get over to change their situation. It is almost as if he can be seen, in the edges of the film, whispering, "If we have a revolution, we can all get universal health care. Unbought politicians, too."

Perhaps the only complaint I have about the film is that his vision of free health care for everyone is, from my own experience in this country, a bit perfect. You will not, with free health care, suddenly be living in a fine and happy society in which everyone gets what they need--there will still be waits, health insurance companies, and the lovely 'elective surgery' option. Moore's view of free health care, then, is just a little rose tinted. However, even with this oversight, you cannot look at this film and leave it thinking that America has a good and fine health system that takes care of its people and that it has made the right choice in not having free health care. It's a film that, while for Americans is trying to motivate social change, is also a film for that serves as a warning for everyone else, of what can happen when profits are placed before people, and it's well worth watching on that level for anyone who wonders how it will relate to the Non-American.

Lastly, it should be said, I downloaded Sicko. It's not out in Australia yet and I was curious. I hear Moore is good with the notion of people downloading it and, with that knowledge, I suspect the film has been released by the studio for such use, since the download I got of it was DVD quality, with perfect sound and image. It's not a dodge bootleg, like sometimes happens with newly released films (and which is why, for the most part, I can't be fucked wasting the bandwidth--there are better, older films to download). So, if you want to watch it now, go find the torrent.

Comments

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deborahlive
Jul. 3rd, 2007 03:38 am (UTC)
Yeah. I'm glad Moore decided to take the approach he did. My family is a real good example of what he's talking about. My husband works for a company that regularly wins awards for their great Family Focus and benefits and all. And yet...our part of the monthly haelth premium is $300. When my husband had surgery last year, our part ended up being about $3000. And our co-pay on his meds run about $200/month. And he doesn't even have cancer or anything. He "only" has chronic back pain.

After the second surgery he developed an infection. Needed antibiotic infusions (which took two hours) every 12 hours and that went on for about three weeks. But they didn't admit him to the hospital when it first happened because the insurance company said no. They figured he could ride in a car with an infected surgical wound for an hour each way twice a day. Sure. Why not?

The co-pays have been steadily going up over the years. He has a precription which he has to get a new pre-approval for every month. If the doctor's office forgets, and we try to fill the prescription, it costs $300. But we don't have to buy the whole script, of course. We can buy individual pills for $10 each until the preapproval comes through again.

There have been times when the insurance company has refused to approve a treatment or medication his doc recommended. But it's okay, cause those are real nurses doing the second-guessing. Just cause they haven't examined or treated him for the past few years, well, hey, whatever.

Nice, huh?

I don't usually talk about this because I don't like to whine, but just in case anyone wonders if Moore had to search hard to find these cases. He didn't.

Anyway. I don't feel like I need to see the movie, but I hope it opens the eyes of people who don't realize how badly the US treats its sick people.

benpeek
Jul. 3rd, 2007 03:51 am (UTC)
it's awful. just awful. i have no idea how such a system could exist anywhere.
tigersmeleth_86
Jul. 3rd, 2007 04:41 am (UTC)
Simple, the US has very, very bad systems. I'm going into education, and my father is a doctor who I happen to work for. I've found lately that my dad is a very, very rare doctor in the United States. Not only does he shoo people out after 10 minutes (he can spend up to 5+ hours on one sick patient, and 1+ on a healthy one), but if people cannot afford healthcare from him, he gives it to them for free. Granted, we are owed 40,000+USD as a result, but it's much better than letting people go sick without treatment.

I was in the ER once and had to be taken there by ambulance in February, the bill was frightening. The ambulance alone was 900USD, and I didn't have oxygen or meds put in me. *shakes head*
benpeek
Jul. 3rd, 2007 05:04 am (UTC)
at least there are some doctors who help people out. i was wondering if there was, during the film. i kept thinking: surely doctors can help folk out anyway?
ironed_orchid
Jul. 3rd, 2007 07:55 am (UTC)
You're the second non-american I've seen comment on this film.

I haven't seen it yet, but it sounds like it should be compulsory viewing for all those Australians who think that privatizing health care is the way to go.
benpeek
Jul. 3rd, 2007 11:31 pm (UTC)
yeah, very much. i live in fear of howard doing that, though he appears to have dropped the idea these days.
(Anonymous)
Jul. 3rd, 2007 03:32 pm (UTC)
It's a generalization but there are good and bad doctors.

And there aren't just a few bad doctors or doctors that make decisions that turn out to be mistakes.

I know folk who've had good, bad, and mixed experiences.

---factory farmer
deborahlive
Jul. 3rd, 2007 04:00 pm (UTC)
Yes, that's quite true. I think what is objectionable about the US system is the extent to which care decisions have been removed from the hands of the doctors. The insurance companies are driving important decisions about diagnosis and treatment. Insurance companies are also heavily invested in pharmaceutical companies and in medical management companies. Most large medical offices are run by accountants at medical management companies. The policies about how many patients are seen and for how long are not made by the doctors.


(Anonymous)
Jul. 3rd, 2007 09:08 pm (UTC)
The last thing I want to do is defend wrong doing. But the insurance companies don't always get it wrong. They also don't always get it right either.

I agree that their is corruption in the system. There are corrupt folk and we'll never be able to fully wring them all out.

In a "free" system somebody is still going to be making a decision regarding what procedure you can or cannot have. You go from insurance companies to some other group. Some will say that this other "group" will do a better job than the insurance companies. I'd predict that it's going to be just as mixed as it is with insurance. Some folk will be happy and some will not. And some will have mixed experiences.

When I think of free health care I think of lots and lots of folk suddenly getting health care that didn't before. And that's going to cost money. I don't want to pay even more money for health care.

In both the "free" and insurance systems there's a lot of talk about keeping prices down and whatnot but let's face it if the person had to pay for the 100k operation out of pocket then the number of 100k operations would drop. The prices would fall as very few would be willing to undergo 100k operations. In both the "free" and insurance type systems they will pay for those operations (and deny some too).

---factory farmer
benpeek
Jul. 3rd, 2007 11:30 pm (UTC)
When I think of free health care I think of lots and lots of folk suddenly getting health care that didn't before. And that's going to cost money. I don't want to pay even more money for health care.

In both the "free" and insurance systems there's a lot of talk about keeping prices down and whatnot but let's face it if the person had to pay for the 100k operation out of pocket then the number of 100k operations would drop. The prices would fall as very few would be willing to undergo 100k operations. In both the "free" and insurance type systems they will pay for those operations (and deny some too).


usually, i try not to get into this stuff, but i do live in a free health care system, so i have to tell you, man, seriously, you're just wrong.

in australia, health care runs at a lot of different prices, depending on your needs--if you need dental coverage, optical, massages, and that kind of stuff. my friends pay an average of about thirty bucks a month for it. me, i don't have health care. i'm thinking it will change for me this year, because health insurance companies will charge me more when i turn 31, cause i'm more likely to die, apparently. i dunno where they get that stat--i'm outta the suicide age ;)

but: i have never ever heard of a person being turned down for an operation based on money. never. the worse stories here are of people on waiting lists. if you have the money and the health insurance, you can jump waiting lists at times and go into private hospitals.

in my personal life, i have never once paid for anything relating to a doctor. a couple of years ago i had x-rays on my foot. didn't pay a thing. a couple of months ago my sister in the US fell down some stairs. her x-rays cost her thirteen hundred dollars. i have a psychiatrist--i've had one for over six years now. i've never paid him a cent. a year or so ago, my grandfather, who is in his late eighties, went to hospital with a bit of bowl cancer--he doesn't have one bit of health insurance, and is in fact, british born. he had a need, it got seen too, he got excellent treatment, and returns regularly for check ups.

it's our taxes that pay for this, and that's the way it should be. we pay for police. we pay for the fire department. we pay for roads. and we thus pay for hospitals and health care.

it's not a perfect system, man, i know this. medicine can get expensive. elective operations provide a divide between rich and poor. free dental clinics take forever to get into. but, the stuff you're arguing there? it's not even a consideration here. it's seriously not.
(Anonymous)
Jul. 4th, 2007 03:20 am (UTC)
It's the mindset though that someone else should pay for one's medical care. And also that you should be paying for someone else's medical care.

I don't know what happens in Australia but there's the phenomenon of overbilling here in America. Because someone else (the insurance company, etc.) is going to ultimately foot the bill then as many charges will be put down as possible. As much money as possibly can be charged will be charged.

We end up paying more than if we just had to pay upfront.

Don't know about your sister's situation but there isn't a lot of emphasis put here on convincing folk to get health insurance.

---factory farmer
benpeek
Jul. 4th, 2007 03:56 am (UTC)
It's the mindset though that someone else should pay for one's medical care. And also that you should be paying for someone else's medical care.

if people can't afford medical care, i'm more than happy to pay for it. one world, one people, one colour of blood, y'know?

i've never heard of anything about overbilling in aus, but it could happen. mostly our complaints are that the government just doesn't put enough funding into hospitals and such here.
(Anonymous)
Jul. 4th, 2007 04:04 am (UTC)
My point should not be interpreted along the lines of those without health care should not get health care.

It's the observation that the insurance and universal health care systems obfuscate the costs and allow for corruption. The individual doesn't have to care about the cost of the bill when someone else is paying it.

I don't think that it would ever happen but it's a theoretical position which is that if there were no insurance or universal coverage systems health care costs would drop.

---factory farmer
benpeek
Jul. 4th, 2007 04:09 am (UTC)
i don't think it would drop, myself.

anyhow: people do abuse health care systems. if you watch SICKO, you can see people pretending to be canadian to get treatment. it happens here, too. but the point is, if people need medical treatment, then hey, they should get it--and does it matter where they're from or how they go about it?

anyhow, i guess we've got a difference of opinion on it, which is fine.
(Anonymous)
Jul. 4th, 2007 04:14 am (UTC)
Here in America they charge you less if you're uninsured.

We don't have a culture here of wanting to treat illegal aliens. We spend a lot of time and effort trying to get rid of them :)

---factory farmer
(Anonymous)
Jul. 4th, 2007 04:49 am (UTC)
And one more point while I'm pointing.

Australia doesn't have the budget issues that the US has. The US pretty much runs huge deficits except when unintentional things happen. And when there's a surplus then it's how quick can the surplus be spent. Forgetting completely about the national debt which is in the trillions.

We have a Social Security system here where both political parties haven't hesitated to spend its surplus each year for years and years.

So the appeal of universal health care to the US government is yet another way to create a revenue stream. But it doesn't matter how much money our government gets it just continues to get deeper in debt.

---factory farmer

mariness
Jul. 5th, 2007 02:16 am (UTC)
"Here in America they charge you less if you're uninsured."

:: blinks ::

Um, what on earth are you talking about?

I'm American. Several years ago I was without health insurance because I was working two part time jobs, neither of which provided it. I figured I was in my 20s and healthy, so fine.

And then, after a fun little gynaecological exam, I found I needed surgery.

And since I didn't have insurance, I was charged the full amount for everything, including medication. Nine years later I am still trying to pay off these bills.

When I chatted with another patient who happened to be with Blue Cross and was also fighting with the hospital about charges on her bill and copayments and so on, we found that she was charged overall LESS for the same surgery because Blue Cross had negotiated a lower rate for their clients.


mariness
Jul. 5th, 2007 02:20 am (UTC)
I do agree with your point about overbilling, no question.

But one thing that hospitals that run ERs have to do, to stay financially stable, is charge more BECAUSE they are not getting repaid by people without health insurance, only some of whom are illegal aliens. (Actually, here in South Florida some of the people without health insurance are extremely wealthy South Americans paying directly for their care but that's a separate issue.) If the hospitals knew that they would receive payment from everyone, this would be less of an issue -- but since not everyone is insured, they don't know that.

I'd also, given the number of illegal aliens in this area, suggest that what we put our time and effort into is talking about getting rid of illegal aliens, not actually doing much about it, but that's a pretty cynical local view and I'll admit possibly wrong.
wendy_waring
Jul. 4th, 2007 10:09 am (UTC)
I gotta disagree with what you said here, Ben:
Perhaps the only complaint I have about the film is that his vision of free health care for everyone is, from my own experience in this country, a bit perfect. You will not, with free health care, suddenly be living in a fine and happy society in which everyone gets what they need--there will still be waits, health insurance companies, and the lovely 'elective surgery' option.

When we moved from Canada to Oz in 1990, we were shocked (and appalled, yes) at the idea of 'elective surgery' and the waiting lists. The private hospital, jump the queue thing, reminded us of the States. Both of my parents were quite sick when I was a kid, and the care they got was extremely good. My sister works now in the hospital system, and when I tell her about some of the waiting lists/delay of care/problems my partner has (he has rheumatoid arthritis) she's (wait for it) shocked and appalled.

With a period of conservative government in Canada, some of the healthcare system has been eroded, but it's still pretty robust. Hospitals and educational institutions are almost entirely public in Canada. Private schools and hospitals are for the seriously wealthy, not the middle class. So it can be done.

And just an anecdote -- when I was a kid, my family went camping in the Catskill mountains. After dinner, my dad started having chest pains. We packed up the tent, and drove six hours north like fiends in order to avoid being caught in the States...

benpeek
Jul. 4th, 2007 10:14 am (UTC)
i'm not quite sure what you're disagreeing with wendy?

in the film, moore simply doesn't examine free health care at all. it's presented simply as a perfect solution. it's a good solution, don't get me wrong, but there is no real even handed examination of it in the film. just as moore doesn't show any benefits to the american one (though maybe there aren't any). my comment is simply about the black and white nature of his portryal. to me, nothing in this world is perfect, and nothing is purely villianous.
wendy_waring
Jul. 4th, 2007 10:33 am (UTC)
I was quibbling with: 'there will still be waits, health insurance companies, "elective surgery"'. I only experienced these when I moved to Australia, at the age of 30. Up until then, living under the Canadian health system, health insurance was for someone who wanted a private room with TV, elective surgery was for getting bigger boobs. But of course, yes, you're right, black/white, perfect/evil is boring.
benpeek
Jul. 4th, 2007 10:46 am (UTC)
oh, yeah, okay, fair enough. i was mainly talking about australia, so i was just coming from that point of view.
davidcook
Jul. 4th, 2007 11:58 am (UTC)
bradhicks also writes about Sicko and health care here, here, and follows up with some statistics here,
sparking a fair bit of comment ...
benpeek
Jul. 5th, 2007 01:56 am (UTC)
thanks for that.
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