Yesterday I was being horribly oppressed by my lack of air conditioning and massive laziness that prevents me from shutting my windows and turning on the units on the third floor, so I went to the Charles to sit in their AC for a couple hours.
Let me start by saying, Michael Moore is a wanker and a blowhard, and likes nothing so much as the sound of his own voice. That said, American health care is well and truly fucked, and he managed to point out a number of things fairly effectively in his latest MEMEMEMEMEME-fest (Ebert notes that Moore is less omnipresent on-screen in this one, which I suppose is true, but he still does the entire narration, and still makes dumb jokes).
1. American health care is more or less wholly under the control of a number of evil medical management corporations, insurance companies, and the pharmaceutical industry. He doesn't really talk about Big Pharma, but the movie would've been 6 hours long if he had, so: fine.
2. Many countries that have very little in common with the US (either in population, GDP, national mythos, etc) have wildly better systems (specifically Canada, the UK, France, and Cuba).
3. While you may not know anyone who has, because you are a smug and rotten middle-class bastard with broadband internet and probably cable, people die because our health care system is so awful.
4. "Socialized" medicine is, on the face of it, no different than socialized Defense, postal service, interstate highways, public schooling, etc.
5. Saying something once is not nearly as irritating as saying it four thousand times.
That last is really what makes me reserve giant plaudits for the movie, because it prevents the movie from making its points without leaving a bad taste in your mouth. When he surveys a number of patients at Canadian hospitals, after having already established that health care in Canada is free*, does he really need to go to all the people he already talked to and ask them how much it cost? And, having done that, does he have to do the same fucking thing in the UK and in France? I submit no, he does not.
As for the others, his journalism is so bias-flavored that even when you agree with him, you find yourself picking nits; honestly, he can't find anyone that has anything negative to say about the public health care in Canada, the UK, or France? Because while I don't know anyone who has used the French system, I know an American transplant to Toronto who can't whine enough about the national health service, and the FEEF**, who is a practitioner in the NHS, points out that government micro-managing of the hospitals actually damages the system more than anything else. I want people to secretly order this movie from Netflix as if it were porn, and watch it, and realize that our system sucks. As it is, they'll do the first, but go away comfortably distracting themselves with ad hominem feelings about Moore (and possibly Hillary Clinton).
It would seem that comparing countries with decent health care to the US would be compelling, but it's not, because he presents such a thin segment of happy middle-class recipients/practitioners that even I start looking for exceptions; yes, great, the 30-something NHS doctor that has a ₤500K flat and an Audi is doing OK, but does he come from money? Has he kissed more ass than most? What does his wife do? But no, that's the only example. Then he interviews a bunch of American expatriates in France who all look like they stepped out of a wine commercial, and surprisingly, they all have nothing bad to say about French health care. I'd love to believe them, but how about interviewing some rich bastard who is annoyed he has to pay taxes to a system that he doesn't use? These people certainly exist in America, I find it very hard to believe that they don't exist in the UK or in France.
I wanted to see this movie at least partly because a couple of my coworkers watched 40 minutes of it and then walked out. I couldn't imagine there would be anything in the movie that would justify such a reaction, and after talking to one of them, I still don't really get it; the best I can surmise is that the sob stories made them uncomfortable and they were annoyed at what they took as preaching (although I can't think of another way to present case histories, I can think of less deliberately heart-string-tuggy ways to present them), and sort of communally decided that they couldn't take it any more. This principle of group-think is well documented as a way to enable people to shirk responsibility for a decision that they want to make but don't want to have to justify, and that's fine, but I was still curious if there was more to it. Yeah, there wasn't. Honestly, shortly after the point they left, I almost fell asleep because it was getting so tedious. Of course, I also fell asleep during An Inconvenient Truth, and I know that I would be vilified if I suggested that a 100-minute PowerPoint presentation by one of the most disappointing political candidates in recent history could be REMOTELY soporific, so clearly I just have narcolepsy. Moving on!
Moore spent approximately 3 seconds on the major objections that conservatives have to national health care or national health insurance, preferring to show brief clips of Republicans saying stupid things (most notably Bush talking about OB/GYNs "bringing their love" to women around the country), and that's a goddamned shame, because there are always people in any group who can have their minds changed, and these are exactly the people who he deliberately fails to reach. The main objections, as I understand them, are as follows:
1. nationalized health care will restrict patients' choice in health matters
2. doctors and nurses will get screwed under a national plan
3. national health care will be slow and bureaucratic
4. SOCIALISM! SOCIALISM! SOCIALISM!
5. it'd be really, really expensive
6. (secret objection) private health care makes us SHIT TONS of money
As for the first, fucking tell me that HMOs don't restrict patient choice. Most people are baffled by their health care plans and are terrified of ever having to use them, have no real choice in plans through work, so just pick the cheapest (or the next cheapest if they want to pretend they care about their family), and if they ever do use them, get ferried around from doctor to doctor until they find one they can use. My shrink*** doesn't take my insurance, but I had already gone to her several times before that was determined (free through a separate benefit), and I am lazier than I am cheap, so I have paid her a shitload of money that I don't have to.
As for the second, Britain seems to be making it work. Also, doctors don't make nearly as much here as you think they do, and nurses put up with so much bullshit that they could make 5x as much and still be getting screwed. This is at least partly because THEY are the ones who have to turn people away. How about this: when a plan is proposed, make sure there's enough funding to keep salaries where they are or better. Problem solved.
The third: possibly, but what is it now? Hospital patient records are a horrible fucking mess, poorly stored on obsolete technology in largely proprietary formats, billing is designed to send patients confusing invoices that they may've already paid, and provide no guidance for resolution, and since hospitals are run by for-profit bureaucracies already (yes, I know they're "not for profit" for tax purposes; I don't see any of the executives feeling the funding pinch), they can't get much worse. By contrast, US Veterans' hospitals have been streamlining their electronic patient records for the last 10 years (I know this because I helped with some of it), because of a Federal mandate to do so. Busted.
The fourth: Fuck off. The US military is now the largest socialist effort ever devised.
The fifth: More expensive than it is now? I hardly think so. I am too lazy to crunch the numbers right now, but think of this: a for-profit insurance company exists to collect money from as many as possible and pay out as little as possible. Risk is spread across however many tens of millions a single company can insure. If that risk was spread across 300 million people, the vast majority who were not in need of care at any given time could easily absorb the risk of those who were. And why does it matter if the cost comes out of your taxes or your paycheck? Both of them are already coming out of your check, it would just alter the line item.
Lastly: Ah, there it is. Fuck you! This is all you really care about, and fuck you for making poor people swallow the other bullshit reasons as you protect this one.
In short, read up on single-payer, which could more usefully be called "National Health Insurance" and defined as "You pay taxes. If you get sick, go to a doctor or ER and get treated. End of story." And the next time a conservative whines about socialized medicine, punch them in the face, then throw them in your trunk, drive on public highways using publicly subsidized gas to a Post Office, and mail them to a particularly forlorn public elementary school.
* it comes out of taxes, fine.
** Formerly Evil Ex-Fiancee
*** yes, I am still insane
