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Okay, so I finally saw the movie. I had to take my family with me as the only place showing the damn thing was 40 minutes away. My older boys (15 and 14) felt it was well done, but they were skeptical about some of the information. My 8 year old daughter was bored to tears. My wife enjoyed much of it but also doubted many of Mr. Moore’s accusations. She especially hated how he focused on the word FREE that people used when describing care in other countries. She is right. Nothing is free.
I let my thoughts percolate for a while. I rehashed some of the scenes in the movie (the term “documentary” really is questionable). I have also read the articles written about SiCKO as well as seen Michael Moore fight it out with both Wolf Blitzer and Sanjay Gupta.
Basically, SiCKO was a very good movie. It has opened the public’s eyes to many of the problems in our healthcare system. Personally, I agree with Moore that we need a change. I also agree with him that all Americans should have the opportunity to have healthcare. So our beginning point and end point is the same. What the real problems are and how to fix them is where we tend to split. I believe healthcare should be affordable and not free. I also believe in a 300 million payer system and not a single payer system.
I am grateful, however, that he didn’t hammer physicians in this piece. He could have. I envisioned him secretly filming a pharmaceutical sponsored dinner with a dozen doctors eating at a 5 star restaurant. The “expert” speaker could have been found to be a pharmaceutical whore. Moore then could have tracked the doctors’ prescribing habits over the next year and determined whether they were influenced by that dinner.
Moore could have also gone to a big ACP, AAFP or ACC medical conference and exposed how much big pharma was paying for their exposition hall. Moore easily could have tracked how drug reps are hired (looks?) and made that whole scene look silly. He didn’t.
Two omissions that were needed, however, were the trial lawyers/tort reform and patient responsibility.
You can see that my picture included in this piece is a parody I am putting in the next Placebo Journal. It is called LiTIGO and I pretend to go on a journey, like Moore, to discover how other countries handle the malpractice lottery. It turns out they have great answers for that as well. Without tort reform and malpractice insurance reform, doctors in this country will continue to order tests to cover their asses instead of being cautious but fiscally responsible. This issue is real and adds to the bankrupting of our healthcare system. A point Moore left out.
Lastly, the big issue of patient responsibility needs to be addressed as it is a huge piece to solving the puzzle. On many occasions, Moore points out how unhealthy we are and how we rank low compared to other countries. What he doesn’t say is that the diseases that we rank poorly in are all behaviorally determined. We are a fat, gluttonous and spoiled country that wants quick fixes but continues to ignore our own personal health. I often tell patients, “Ask not what your doctor can do for you. Ask what you can do for yourself.” No fix to our healthcare system will ever work when the people of that system smoke, eat poorly and rarely exercise. Add to this the mentality of “I want the best and I want it now or I will sue” and you have the perfect recipe for imperfection. Which is what we have now.
Finally, I have thought long and hard about this. I am not a huge fan of Michael Moore. I also have a lot of disagreements about this film. I do, however, respect the fact that he focused on a topic that our slimy politicians have been skirting around forever and brought it to our attention. He provoked the healthcare debate and hopefully we can all use this for good. He also made HMOs and managed care look disgusting, which they are. For that part alone, I am awarding Michael Moore the 2007 Placebo Journal Tenesmus Award.
I let my thoughts percolate for a while. I rehashed some of the scenes in the movie (the term “documentary” really is questionable). I have also read the articles written about SiCKO as well as seen Michael Moore fight it out with both Wolf Blitzer and Sanjay Gupta.
Basically, SiCKO was a very good movie. It has opened the public’s eyes to many of the problems in our healthcare system. Personally, I agree with Moore that we need a change. I also agree with him that all Americans should have the opportunity to have healthcare. So our beginning point and end point is the same. What the real problems are and how to fix them is where we tend to split. I believe healthcare should be affordable and not free. I also believe in a 300 million payer system and not a single payer system.
I am grateful, however, that he didn’t hammer physicians in this piece. He could have. I envisioned him secretly filming a pharmaceutical sponsored dinner with a dozen doctors eating at a 5 star restaurant. The “expert” speaker could have been found to be a pharmaceutical whore. Moore then could have tracked the doctors’ prescribing habits over the next year and determined whether they were influenced by that dinner.
Moore could have also gone to a big ACP, AAFP or ACC medical conference and exposed how much big pharma was paying for their exposition hall. Moore easily could have tracked how drug reps are hired (looks?) and made that whole scene look silly. He didn’t.
Two omissions that were needed, however, were the trial lawyers/tort reform and patient responsibility.
You can see that my picture included in this piece is a parody I am putting in the next Placebo Journal. It is called LiTIGO and I pretend to go on a journey, like Moore, to discover how other countries handle the malpractice lottery. It turns out they have great answers for that as well. Without tort reform and malpractice insurance reform, doctors in this country will continue to order tests to cover their asses instead of being cautious but fiscally responsible. This issue is real and adds to the bankrupting of our healthcare system. A point Moore left out.
Lastly, the big issue of patient responsibility needs to be addressed as it is a huge piece to solving the puzzle. On many occasions, Moore points out how unhealthy we are and how we rank low compared to other countries. What he doesn’t say is that the diseases that we rank poorly in are all behaviorally determined. We are a fat, gluttonous and spoiled country that wants quick fixes but continues to ignore our own personal health. I often tell patients, “Ask not what your doctor can do for you. Ask what you can do for yourself.” No fix to our healthcare system will ever work when the people of that system smoke, eat poorly and rarely exercise. Add to this the mentality of “I want the best and I want it now or I will sue” and you have the perfect recipe for imperfection. Which is what we have now.
Finally, I have thought long and hard about this. I am not a huge fan of Michael Moore. I also have a lot of disagreements about this film. I do, however, respect the fact that he focused on a topic that our slimy politicians have been skirting around forever and brought it to our attention. He provoked the healthcare debate and hopefully we can all use this for good. He also made HMOs and managed care look disgusting, which they are. For that part alone, I am awarding Michael Moore the 2007 Placebo Journal Tenesmus Award.
12 comments:
Full disclosure, I have not yet found "Sicko" in a local theater and will watch it at first opportunity.
That said, I too have read and watched Moore on his latest rant praise government health care at every possibility. I have heard neither Moore nor any of his interviewers note that it was government involvement in health care that created so many of our current problems. The basic economics of government provision of services are shortages and price inflation. Were the (very real) malpractice issue to disappear, health care would still be in a crisis precisely due to the government involvement allowed by those who think medicine is a right. Moore deals with this burning house by crying that we have not yet thrown enough gas on it to extinguish the blaze.
The problem with Michael Moore movies is that unless one is knowledgeable about the subject matter of the film BEFORE you go in, you have no idea what is true, what is exaggerated, what is omitted, and what is a bold-faced lie.
Moore's "Fahrenhite 911" established him as a left-wing activist who's sole purpose was to derail the 2004 presidential election in favor of the democrats. Fortunately, many of America's voters were saavy to Mr. Moore's political connections, and thanks to talk radio and others, were also informed of the truth to counter his lies and exaggerations.
The problem with this film is that there has not been as big a response to his lies/exaggerations/omissions/etc., and so the unsuspecting/uninformed public who goes to see this film will think that the Canadian/UK systems are so far superior to our own, that we need to elect Hillary Clinton to get this type of system established in the U.S. and save ourselves from certain doom.
I say "Sicko" may have some unintended positive outcomes as you mentioned. However Moore's left-wing agenda overshadows any good that could come out of this film and places serious doubt on any validity that may or may not be present in the film.
I haven't seen Sicko, yet, but also plan too.
I work in medicine as a sleep technician. As one of the millions of Americans without health insurance, I admit to being of 2 minds on this problem. On one hand, with children with asthma on daily meds, I would love help with the costs of the meds and also be able to take my kids to a doctor when they're sick, not wait until we're sure it's serious before we spend the $185 at the doctor. On the other hand, I know we'd pay, and pay big, for "free" health care.
I agree it's patient responsibility and a CYA mentality in doctors. In discussing the CYA mentality, though, you can't underestimate the power of insurance again. If the doc doesn't order tests and is found guilty of malpractice, malpractice insurance won't pay. At the least, the doc's premiums go up. At worst, the doc's bankrupt and can't get employed. Pick your poison.
To me, a big part comes back to insurance. Patient's ignore their health cause "insurance'll pick up the tab". Doc's order to CYA so they can stay in business. And insurance controls it by dictating "appropriate tests" and reimbursements, and yet being necessary because a major illness will bankrupt a family.
As long as the health plan companies in the US are allowed to pay absurd salaries to their executives, waste money and have no significant accountability we won't see any improvements. Most americans are too scared to speak up or do anything because they don't think they have a choice. I think we either need major increased regulation of this industry (which is packing away profits like the oil companies off the public) or a single payment system. I also don't think the influx of canadian specialty physicians looking to make money off the american system that pays specialists huge fees and underpays primary care is an indication of a problem in Canada... they have plenty of primary care physicians and we don't. I practice near the Canadian border in a rural area of upstate NY and see both sides... we definitely are the losers!!
I saw Sicko here in LA at a screening put on by the Screen Actors Guild, so the audience contained of a LOT of uninsured actors. They LOVED it and cheered repeatedly during the film, giving it a standing ovation.
Personally, we will not fix the health care system unless we get more primary care doctors, which will not happen until PCPs get paid more and medical students don't have so much debt.
I also agree that personal responsibility is key. MY documentary is going to be called, "Fatso."
Once you've been to those other countries, and you see they have lower malpractice costs, you might realize that it's because the people there don't need to recover for the cost of their past and future medical bills, nor as much of their lost wages, because of universal healthcare and a deeper social safety net. If you want to make that tradeoff for reduced risk of your insurer paying a judgment, by all means do so.
I agree with this editorial:
'Sicko' tells only part of health story
(Original Publication: July 8, 2007, by Phil Reisman of The Journal News)
If you believe the horrific statistics, 69 million American adults are obese, or severely obese.
Among them are 3.8 million who weigh more than 300 pounds and 400,000 who weigh more than 400 pounds. Forty-five years ago the number of people considered to be dangerously overweight amounted to 13 percent of the population. As of the year 2000, it stood at 31 percent.
I could go on and on with this.
But you already know the score: Obesity is a national crisis that correlates with the rise of diabetes, heart disease and other ailments. The strain this puts on the cost of health care is nearly incalculable.
I'll bet Michael Moore would be considered obese - though I have no idea what his body mass is. But he's unquestionably fat, and certainly does not look healthy by any objective standard.
Moore's corpulence stopped me short every time he appeared on camera in "Sicko," his seriocomic indictment of the American health-care system. As a satirist, Moore never lets the facts get in the way of his message. But in the case of "Sicko," the fact of his obviously large belly couldn't be ignored, at least not by me.
It was the one joke in the film that was unintentional. For nowhere in "Sicko" does Moore even make the slightest reference to preventive measures like diet and regular exercise as an important piece of the overall health-care puzzle. Nor for that matter does he mention cigarette smoking, drug abuse and alcohol.
Now, I should say here that I enjoyed "Sicko." As I said on my blog, Moore provides a service in his opinion-documentary - let's call it an opinumentary - by exposing the corporate greed of the health insurance industry, whose bottom-line raison d'etre is to come up with new and ever-corrupt ways to deny sick people adequate care. He takes a well-aimed shot at the forked-tongue politicians like former Louisiana Rep. Billy Tauzin, the sleazeball architect of the Medicare prescription drug bill whose reward was to get a $2 million-a-year lobbyist job with the pharmaceutical companies. Though it clearly grieves him to do it, Moore even singles out his heroine, Sen. Hillary Rodham Clinton, for ridicule, revealing that she's second only to Rick Santorum in accepting campaign donations from health-care special interests.
The passing slap at Hillary is Moore's idea of "balance," and is probably one of the reasons why "Sicko" hasn't sustained as many apoplectic attacks from the right as "Bowling for Columbine" and "Fahrenheit 911" did.
For instance, when I saw "Fahrenheit 911" at the Bronxville movie theater, the police were summoned because somebody was staging some kind of minor protest either against or for Moore's statement. I couldn't be sure. In any case, I saw "Sicko" at the same theater and there was no excitement afterward, unless your definition of "exciting" is a guy on the street handing out fliers for moveon.org.
Former New York City Mayor Ed Koch, an online film reviewer, who gives out plus and minus ratings, told me on my WVOX radio program last week that he would probably see "Sicko" because "he did something he normally doesn't do - he stated facts." At the same time, Koch pretty much summed up the feelings of many Moore-bashers when he said, "I don't like him. He is the pits, in my judgment. I believe he is so filled with hate of America, I don't want to contribute to his fortune." (That shouldn't be a problem since Koch gets to review movies without having to pay for his tickets.)
Moore is preaching to a larger choir this time. After all, just about everybody has a complaint about the health-care system, even the lucky ones among us who have insurance.
But even with "Sicko," Moore is more punch line than "Frontline." He relies on his usual bag of tricks - the wacky, Looney Tunes-type graphics, entertaining outakes from President Bush's vast trove of bloopers and blunders, and, of course, pathos provided by truly heartbreaking stories from bereaved victims of a cold, heartless world. Is there a Michael Moore movie that hasn't had a tearful, "Queen For a Day" moment?
In his moralizing, Moore oversimplifies a complicated issue. His essential message is that Western European countries and Canada have socialized medicine and so should we, though he conveniently leaves out all the bad parts. When I watched "Sicko," with all its appealing propaganda about free prescription drugs, doctor house calls and the like, I thought perhaps the answer to our health-care problems is to simply let the 40 million uninsured Americans illegally immigrate to, say, France. Lafayette, we are here!
Not that France doesn't already have an immigration problem, but you won't know that by watching "Sicko."
Finally, Moore travels to Cuba with some ailing 9/11 rescue workers who are in desperate need of medical treatment. Lo and behold, they get first-rate care in the land of Castro, of all places!
What Moore neglects to report is that the average Cuban has to beg for medicine while top government officials, military personnel and tourists like Moore and his entourage receive top-drawer care. Indeed, Cuba actually boasts "health tourism." In one account I've read, Cuba especially attracts foreigners seeking cosmetic surgery like liposuction and tummy tucks.
This leads me back to Moore and his weight problem. As it turns out, reports have it that Moore actually took this problem in hand and got highly specialized treatment. He lost 50 pounds.
No, he didn't waddle up to Canada. He didn't sashay to France. Or swim to Cuba.
He enrolled at the Pritikin Longevity Center & Spa in Aventura, Fla., where rates start at $3,500 a week (double occupancy) to lose weight.
See, this is a great country.
Reach Phil Reisman at preisman@lohud.com or 914-694-5008. Read his blog, Extra, at http://reisman.lohudblogs.com/
I haven't seen the movie Sicko, because I can't sit still in a movie theatre. It just is a waste of precious time to me to sit in the dark, listen to people around me talk and make out while eating milk duds and popcorn and smelling stale popcorn on the floor from the last showing. However, From what I have HEARD about the movie, It does not go far enough to describe the ridiculous paperwork, the lack of contact of Doctors with patients, and the fact that the doctor who delivered me, never had the luxuary of a Sonogram, a c-section planning period, or a night off from delivering babies when they were wanting to be born. He also never prescribed pain medications to a monther before or during birth . However, he was generous with pain killer after the birth procedure, if the mother was not breast feeding and asked for it. Some how this wonderful doctor brought 100's of my generation into the world 56 years ago. I do not have any birth defects except to have lived past the good old days. Medicine has become gutless and by doing so has lost some of the best opportunities in the world to practice medicine. He was a wonderful diagnostician as a GP. I now have a GP who draws blood one time every six months, and runs a basic metabolic panel. I have a gastro for stomach aches, a pulmonologist for a chest cold, and a hematologist for iron deficiency anemia, I have a cardiac Specialist to listen to my heart and a Psychiatrist to listen to my soul. My GP who was my doctor from birth until he passed away, knew how to do all of this without more than an occasional Xray. The nurse stuck my finger to count my blood cells. And, this wise man who seemed old to me, listened to my heart literally and figuratively. God bless the GP and may God return him or her to their rightful place of honor.
Boon doc:
re: "they have plenty of primary care physicians and we don't. I practice near the Canadian border in a rural area of upstate NY and see both sides"
Part of the problem at least with New York state is that it treats northern new yorkers like crap. There isn't a single top notch center/trauma center in the whole area. New York ignores the whole area. If it were not for U of Vermont taking care of ill Northern New Yorkers there would be no place near to send them. On top of that new york medicaid pays like $hit. I suspect when the poor state of Vermont finally realizes how the rich state of New York is screwing them too thee will be hell to pay.
I think we should have P4P for insurance companies/executives... WE rate THEM and it will affect their abilities to compete in the marketplace.
MCR said...
The problem with Michael Moore movies is that unless one is knowledgeable about the subject matter of the film BEFORE you go in, you have no idea what is true, what is exaggerated, what is omitted, and what is a bold-faced lie.
**
MCR hits the nail on the head. Michael Moore is one more dangerous snake oil salesmen of the new century. By snagging people in with a few legit stories and complaints, he drags the more naive toward his goal of a socialist utopia.
Moore's ideal is to penalize the "rich" (i.e. everyone not on the government dole or payroll) to pay for his idealized system, which would of course continue to support trial lawyers just in case the doc screws up (or even if he doesn't).
If you like how "well" Medicaid and Medicare pay docs, you'll "love" Michael Moore's health care.
All this stuff about Obesity is a red herring. The stuff about Michael Moore is a red herring and an ad hominem attack. Just because Michael Moore or someone else it does not logically follow they should be denied a right to decent health care. And this is why:
The vast majority of claims made about obesity are highly unsafe, and have been critiqued by many. Much musings on obesity are not based on sound science but on ideology, it appears.
If that is factored into the issue- it means not giving care to people because of their weight is like not giving care to people because of their colour.
This is without even considering whether sportsman should be denied treatment because their lifestyles are 'risky', which is the logical next step to saying fat people do not deserve health care, which is the implication of some of the comments here (to paraphrase: "stop moaning about our health system when you're so fat, Michael and related fat people".)
Don't believe me- seek the information for yourself. Michael Gard and Jan Wright's "The Obesity Epidemic" is an excellent read in this respect. It actually reviews the claims made about 'obesity' and how they are not supported by the scientific research.
Runswithscissors
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