Sicko Critico

So there’s been this movie running about that seems to have a number of people talking; and sometimes in quite surprising ways. So when the director, Michael Moore, came on to CNN, that show decided to run a short critique of the film first.

This was, of course, done without warning to the director.

Considering the same show hands copies of questions being asked to their political subjects well before any interviews, you’ve got to think that the move was at the least in bad taste; at the most a deliberate axe.

But the most surprising thing was the remarkable weakness of the criticism: I’ve started thinking that it was orchestrated by supporters of Mr. Moore. Here’s the transcript, with my own notes in between:

DR. SANJAY GUPTA, CNN SR. MEDICAL CORRESPONDENT (voice-over): "Sicko" throws hard punches at the United States healthcare system, and it seems just about everyone has something to say.

(SOUNDS)

UNIDENTIFIED MALE: Moore was spot on.

UNIDENTIFIED MALE: The facts, I think, support what I believe.

Um. Are these two actually contributing anything?

GUPTA: And Moore presents a lot of facts throughout the movie. But do they all check out? Keeping them honest, we did some digging and we started with the biggie. The United States slipped to number 37 in the world's healthcare systems.

It's true, 37 is the ranking, according to the World Health Organization's latest data on 191 countries. It's based on general health level, patient satisfaction, access and how it's paid for. France tops the list. Italy and Spain make it into the top 10. The United Kingdom is 18.

UNIDENTIFIED MALE: Hello!

Never mind.

GUPTA: Moore brings a group of patients, including 9/11 workers to Cuba, and marvels at their free treatment and quality of care. But hold on. That WHO list puts Cuba's healthcare system even lower than the United States, coming in at number 39.

Right. Just like what’s shown in the movie.

Moore asserts that the American healthcare system spends $7,000 per person on health, whereas Cuba spends $25 per person.

Not true, but not too far off.

Well, this claim certainly isn’t! The movie claimed $251 per capita spent in Cuba – but that number is from 2003.

The United States spends $6,096 a year per person versus $229 a year in Cuba.

Again, if we go by 2003 numbers, it’s $251 for Cuba, $5,711 for the U.S. Interestingly, businesses in the United States will pay $8,340 per employee in health care coverage in 2007, according to Industry Week magazine, and don’t think businesses won’t consider that when they decide where to build a factory…

And astronomically more money doesn't mean far better outcomes. In fact, Americans live just a little bit longer than Cubans on average. So Americans do pay more, but the United States also ranks highest in patient satisfaction.

Interesting point – if raised in a free-floating, unattached fashion. An interesting follow-up would be why the difference in satisfaction? Is there a lower expectation? Plus, if patient satisfaction is already included in the equation (remember: “general health level, patient satisfaction, access and how it's paid for”) then doesn’t that mean the other three would have to be below 37^th? At the very least, one of the four would have to be shockingly bad for the final result to be so low.

And Americans have shorter wait times than everyone but Germans when seeking non-emergency elective procedures like hip replacement, cataract surgery or knee repair. That's not something you'll see in "Sicko" as Americans tell their tales of lack of coverage and suffocating red tape.

Repeat your own words: non-emergency, elective procedures. You also forgot to mention tummy tucks, liposuction and face lifts – all also non-emergency, elective procedures, but they do make a lot of money, and often leave the person paying for them much happier.

The quality of research simply oozes from this report!

It's true that the United States is the only country in the Western world without free universal access to health care. But you won't find medical utopia elsewhere. The film is filled with content Canadians and Brits sitting in waiting rooms, confident care will come.

In Canada, you can be waiting for a long time. A survey of six industrialized nations found that only Canada was worse than the United States when it came to waiting for a doctor's appointment for a medical problem.

WE’RE NUMBER FIVE! WE’RE NUMBER FIVE! WOOOOOO!!!!

Wait, is that something to be proud of? Sheesh, it’s not like Canada is even remotely perfect!

PAUL KECKLEY, DELOITTE HEALTH CARE ANALYST: That's the reality of those systems.

…Says the representative of this company…

There are quotas.

Just like with HMOs.

There are planned wait times.

Just like with HMOs.

The concept that care is free in France and Canada and Cuba, and it's not. Those citizens pay for health services out of taxes. And as a proportion of their household income, it's a significant number.

File under “No shit” and move on. Here’s an interesting definition of “freedom” for you: having both of a married couple get breast cancer, get full treatment, and not have to file for bankruptcy, like two of my friends. Getting 37 doses of radiation at $1500 per shot for prostate cancer, and not needing to get a mortgage, like my dad. Fighting depression all your life, needing years of medication and therapy, but surviving it without being in perpetual debt, as a Significant Other is doing. Hurting your wrist, but not being sure about the damage, so getting it X-rayed just in case – and finding a broken scaphoid, so taking steps to prevent the possibility of being crippled for the rest of my life, like I’ve done.

Over half of the bankruptcies in the United States is because of medical reasons. In what possible way does this help a society, a nation, or individuals? To be free of that fear is an amazing freedom.

GUPTA: It's true that the French pay higher taxes and so does nearly every country ahead of the United States on that list.

As mentioned in the movie.

But even higher taxes don't give all the coverage everyone wants.

One more time (sing with me if you like!): non-emergency, elective procedures. Compare “what everyone wants” with “what keeps people alive” and get back to me when you can find the difference.

UNIDENTIFIED MALE: Fifteen-to-20 percent of the population will purchase services outside the system of care run by the government.

Yup – and those who can’t afford to do so will be covered anyways. C’est weird, eh? I guess those evil socialists are actually allowing some private insurers to operate. Wasn’t that supposed to be illegal or something?

It’s not like the private insurers can compete directly against the government anyways: apparently, they can’t afford to.

GUPTA: So, there's no perfect system anywhere.

Again, file under…

But no matter how much Moore fudged the facts

What?

-- and he did fudge some facts

Which ones? You haven’t mentioned any here.

-- there's one everyone agrees on. The system here should be far better. Dr. Sanjay Gupta, CNN, reporting.

Again, that was just weak. If this was a “report”, I’m freakin’ Marie of Romania.