Sicko

[Chickpea]

A bunch of us went to see it last night at the Carmike in Panama City. Would love to chat with those of you who have seen it.....

Nothwithstanding the fact that he paints his picture with broad strokes and is definitely biased, the movie actually revealed nothing new to me but I enjoyed it (if one can use a word like that to describe the despair one feels at the end!). It is sobering and a sad reality to see the mess of the health care industry here.

Let's try not be purely anecdotal and let's talk about why so many other nations can operate and run a functioning national and socialized health care system but we cannot do that here. Those of you in the medical field - please explain why it is so tough. Is it sheer number of people who need care here? Why can other poorer nations afford it?

For those of you who have seen the movie, I can vouch for the picture he has painted of the UK and France's care systems (in fact, as rosy as his picture was there are a number of unique features he did not even speak about which could have also bolstered his case even more).

Thoughts?

 

[6thGen]

Chickpea,
Even though I know that reading things that don't confirm your naive worldview isn't really your thing, I've addressed the problem many times on the universal healthcare thread. Even though I know you won't read it, I'll paraphrase Carville and say it's the tax code, stupid. Hope this helps.

 

[Mango]

Chickpea,
Even though I know that reading things that don't confirm your naive worldview isn't really your thing, I've addressed the problem many times on the universal healthcare thread. Even though I know you won't read it, I'll paraphrase Carville and say it's the tax code, stupid. Hope this helps.

Do you really believe that just tax code reform will still help yet the many people who can not even afford to buy health care?

I think Moore's movie is just going to ignite furor from those that don't or won't research the half truths he portrays. After all he is a filmmaker and reaping the huge rewards from pulling the heartstrings of the public.
He makes social health care look in other countries look like a virtual utopia with rivers of flowing chocolate, cough medicine, and a lollipop rainbow, when the truth is those countries have major flaws in their healthcare systems as well. I am not a regular reader of the New York Post, because its the FOX news of journalism, but Kyle Smith gives a review of Sicko that expresses my opinion as well of this film.

Everyone knows that we need obvious reformation and examination of our current situation here in the U.S.

It's a sad day when someone like myself has to add an employee to my payroll to keep my current insurance plan because a sole proprieter plan is much more expensive and doesn't offer anywhere near the same benefit.

I agree wholeheartedly with FFF ( who is in the medical profession) post in the lounge under another sicko thread that we are being ripped off in many respects.

But I do not think socialized medicine is the answer. Matter of fact, France is revisiting their plan altogether from what I read.

Social healthcare is NOT free in other countries. People pay much larger amounts into the systems in taxes.

There are no real easy answers. Do we need to look at malpractice reform? target drug companies and lobbyists in contributions to candidates? all of the above plus lots more?

I've already seen enough of the movie on-line and read Moore-on's plea on his web site to go see the movie, but I am not buying.
I rather donate my $9 bucks to R&D or wait for a documentarist to release a film that shows all sides of the fence to stimulate debate.

 

[goofer]

6th Gen

I think the tone of your comment is rude.

 

[Chickpea]

Do you really believe that just tax code reform will still help yet the many people who can not even afford to buy health care?

I think Moore's movie is just going to ignite furor from those that don't or won't research the half truths he portrays. After all he is a filmmaker and reaping the huge rewards from pulling the heartstrings of the public.
He makes social health care look in other countries look like a virtual utopia with rivers of flowing chocolate, cough medicine, and a lollipop rainbow, when the truth is those countries have major flaws in their healthcare systems as well. I am not a regular reader of the New York Post, because its the FOX news of journalism, but Kyle Smith gives a review of Sicko that I could have written.

Everyone knows that we need obvious reformation and examination of our current situation here in the U.S.

It's a sad day when someone like myself has to add an employee to my payroll to keep my current insurance plan because a sole proprieter plan is much more expensive and doesn't offer anywhere near the same benefit.

I agree wholeheartedly with FFF ( who is in the medical profession) post in the lounge under another sicko thread that we are being ripped off in many respects.

But I do not think socialized medicine is the answer. Matter of fact, France is revisiting their plan altogether from what I read.

Social healthcare is NOT free in other countries. People pay much larger amounts into the systems in taxes.

There are no real easy answers. Do we need to look at malpractice reform? target drug companies and lobbyists in contributions to candidates? all of the above plus lots more?

I've already seen enough of the movie on-line and read Moore-on's plea on his web site to go see the movie, but I am not buying.
I rather donate my $9 bucks to R&D or wait for a documentarist to release a film that shows all sides of the fence to stimulate debate.

Mango,

I do not know enough about the half truths that Moore portrays-in fact there is VERY much I do not know about the medical profession and health insurance BUT I can tell you that what was shown in the movie about health care in France and England is overall correct - having said that this does not mean that you will not find horrible stories if you go looking for them. To me the overarching point is that everyone, regardless of race, class and income is entitled to health care (which IMHO should be a right and not a privilege). You may think and believe that it is portrayed as utopia – well compared to this country it REALLY really is. Full stop. Period and no debate. As to being taxed – I am taxed here at 37% or so – in France I was taxed at 43% (believe me, I would GLADLY pay the 6% difference here and have access to the social services offered – I pay much much more than 6% now for health care, school, transportation, etc…)

One can purchase additional insurance in both the UK and France should one chose to (for care by specialists and doctors of your choice or for some fields that may not be necessarily covered in full, like homeopathy). And yes, the system is currently going bankrupt because of the sad state of the French economy and because more money is going out than actual contributions – however, the system has worked, generally well for many years/decades. Whether they overhaul the system OR re-structure it or whatever – who cares – at the end of the day if one has medical needs they are tended to.

Like you, I have been self employed and was appalled at the cost of self-insurance – in fact I got into a screaming match with the professional organization I belonged to because they offered group insurance as a means of saving money (through a very well known insurance company) BUT they would not offer, even as a separate rider, insurance to cover pregnancies (in fact it was clearly excluded). It outraged me because as a woman practitioner in my field, it was grotesque that the organization that supposedly represented us did not care about this and did not realize that it was a disincentive for people to try start up their own offices (whether it was a man, trying to make sure his wife could be covered, or a woman like me) – Parenthetically, I just remember thinking NO WAY women lawyers would put up with this crap if they were subjected to this.

Why is there not more outrage in this country? Why is this issue so present every 4 years in all the mouth of all politicians yet NOTHING ever gets accomplished? Like I said, there is nothing I learned in this movie but it was a stark reminder that we could do so so so much better. But I am so weary of hearing the same excuses year after year as to why it is not feasible.

And BTW: this is not a thread to persuade anyone to give money to Moore, etc...nor to even persuade people to see the movie - I literally couldn't care less. But I am interested in hearing from those of you who have seen it (like you!)

Thank you.

 

[6thGen]

Mango,
I find little in your post to disagree with. Yes, I do believe that changing the tax code will drastically help the situation because it is one step closer to the patient paying the doctor rather than the patient's employer paying the insurance company who pays the doctor. That's the short of it. Friedman wrote a lot about it before he died and the WSJ editorial page has picked up the ball now that Bush is doing something about it. Whether you agree with it or not, you'd enjoy reading up on it and it is far more rooted in fact than anything that comes out of Moore's production studio. Most of the stuff is premium, so I don't want to cut and paste it, but I think you said you get or read the NYT rival, so you've probably seen some of it.

Edit - one more thing - our life expectancy has increased by 30 years in the past half century. That's off the top of my head so the 50 years might not be exact, but the 30 is. I'd say our healthcare system is doing something right.

 

[6thGen]

Here's a blip.

Effect of Third-Party Payment on Medical Costs

The tax exemption of employer-provided medical care has two different effects, both of which raise health costs. First, it leads employees to rely on their employer, rather than themselves, to make arrangements for medical care. Yet employees are likely to do a better job of monitoring medical care providers?because it is in their own interest?than is the employer or the insurance company or companies designated by the employer. Second, it leads employees to take a larger fraction of their total remuneration in the form of medical care than they would if spending on medical care had the same tax status as other expenditures.

If the tax exemption were removed, employees could bargain with their employers for higher take-home pay in lieu of medical care and provide for their own medical care either by dealing directly with medical care providers or by purchasing medical insurance. Removal of the tax exemption would enable governments to reduce the tax rate on income while raising the same total revenue. This hidden subsidy for medical care, currently more than $100 billion a year, is not included in reported figures on government health spending.

Extending the tax exemption to all medical care?as in the current limited provision for medical savings accounts and the proposals to make such accounts more widely available?would reduce reliance on third-party payment. But, by extending the hidden subsidy to all medical care expenditures, it would increase the tendency of employees to take a larger portion of their remuneration in the form of medical care. (I discuss medical savings accounts more fully in the conclusion.)

Expressed as a fraction of national income, Americans spent a mind-boggling 17 percent of the national income on medical care in 1997. No other country in the world approaches that level of spending as a fraction of national income, no matter how its medical care is organized.


Enactment of Medicare and Medicaid provided a direct subsidy for medical care. The cost grew much more rapidly than originally estimated?as the cost of any handout invariably does. Legislation cannot repeal the nonlegislated law of demand and supply: the lower the price, the greater the quantity demanded; at a zero price, the quantity demanded becomes infinite. Some method of rationing must be substituted for price, which invariably means administrative rationing.

A look at the data is instructive. The effect of tax exemption and the enactment of Medicare and Medicaid on rising medical costs from 1946 to now is clear. According to my estimates, the two together accounted for nearly 60 percent of the total increase in cost. Tax exemption alone accounted for one-third of the increase in cost; Medicare and Medicaid, one-quarter.

Now consider a different breakdown of the cost of medical care: between the part paid directly by the government and the part paid privately. Government?s share went from an eighth of the total in 1919 to a quarter in 1965 to nearly half in 1997. The rise in the government?s share has been accompanied by centralization of spending?away from state and local governments to the federal government. We are headed toward completely socialized medicine and are already halfway there, if, in addition to direct costs, we include indirect tax subsidies.

Expressed as a fraction of national income, spending on medical care went from 3 percent of the national income in 1919 to 4.5 percent in 1946 to 7 percent in 1965 to a mind-boggling 17 percent in 1997. No other country in the world approaches that level of spending as a fraction of national income no matter how its medical care is organized. The changing role of medical care in the U.S. economy is truly breathtaking. To illustrate, in 1946, seven times as much was spent on food, beverages, and tobacco as on medical care; in 1996, 50 years later, more was spent on medical care than on food, beverages, and tobacco.

http://www.hoover.org/publications/digest/3459466.html

Read the whole thing.

 

[6thGen]

6th Gen

I think the tone of your comment is rude.

She doesn't read it so it doesn't matter. You haven't seen our discussions in the past. She's said a whole lot worse, and nothing I said in the above post was untrue.

 

[Mango]

Chickpea
Good "speaking" with you as always. Look forward to seeing you in sowal.

Although you may have had good experiences in England, I am not sure we never discussed your use of the system there, so I am assuming you have used it but it is my understanding there is a two tier system there where additional insurance can be purchased.
However, only 10% of the population has the financial ability to purchase it.
Also, there are limits that higher income folks are charged for the same health care that lower income folks pay, so 40 something % of a much higher income with a cap is significant.

Here is a good article from about how the NHS
(National Healthcare System) in England works. It's a bit long, but easy to peruse and scan quickly for pertinent data. It discusses rationing, long wait times to see specialists and GP's. The GP's feelings about the plan etc.


and 6thgen:
I read your article, and Friedman may have been a brilliant Nobel prize winner in the 70's, but brilliance does not always accompany common sense. What Friedman's idea completely forgets is 1) Human nature
2) the working class poor 3) devastating illness

Human nature in that in the amount younger people and those with less income how much they will deposit into medical savings if any at all.
Also, even if lets say a 25 year old starts a plan, how much could have possibly accumulated that would pay for any devastating illness or accident by say 30, especially with the phenomenal and rising costs of health care.

He's offering a theory, but does not substantiate it with any real data or hypothesis calculations which could easily be obtained from insurance companies as they obviously know these things.

BTW, if you ever call any of us stupid again, I will hunt you down and tag you as junk on the beach.

 

[6thGen]

and 6thgen:
I read your article, and Friedman may have been a brilliant Nobel prize winner in the 70's, but brilliance does not always accompany common sense. What Friedman's idea completely forgets is 1) Human nature
2) the working class poor 3) devastating illness

Human nature in that in the amount younger people and those with less income how much they will deposit into medical savings if any at all.
Also, even if lets say a 25 year old starts a plan, how much could have possibly accumulated that would pay for any devastating illness or accident by say 30, especially with the phenomenal and rising costs of health care.

He's offering a theory, but does not substantiate it with any real data or hypothesis calculations which could easily be obtained from insurance companies as they obviously know these things.

BTW, if you ever call any of us stupid again, I will hunt you down and tag you as junk on the beach.

“In the 70s”? Some of his best work was in his latter years. Regardless, he knew that many of his ideas aren’t politically feasible in the near term, so it was more of a long term idea to be achieved in increments. The lasting and most significant legacy of Dr. Friedman is that Capitalism and Freedom and Free to Choose are now considered mainstream economic understanding. When he published the book, the context was radically different than what was being taught and what was understood as fact. He also put the nail in the Keynes coffin that Hayek built.

As a rule, younger people (with less income) have fewer medical expenses. I and my employer pay roughly $3,500 per year on medical insurance. Even with prices inflated by what they would be under his plan I don’t touch that. “Especially with the phenomenal and rising cost of health care” ignores his premise. As for the working class poor and devastating illness argument, he’s argued in this and other cases that the private charity sector is far better and treating them than the government. And just because Friedman doesn’t publish hypotheses calculations doesn’t mean he hasn’t run them, and doesn’t mean they are accessible. It’s just that it’s not necessary to publish them when you’ve established yourself as the world’s most brilliant economist of the century.

At least you believe I am sometimes on the beach, rather than a double secret professional internet persuasion room in Cheney’s bunker.