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FRED
06-17-07, 09:52 PM
iTulip Quick Review: The medical-industrial complex (http://content.nejm.org/cgi/content/abstract/303/17/963) was heralded in 1980. Almost 30 years later, what did everyone expect? Still, the movie supplies plenty of classic Moore movie tortures, including heaps of polemic, corny set-ups, and tear-jerker scenes.

Yes, the insurance companies, like the banks, have far too much control of our lives, but socialism is not the answer. Our contacts in the biotech industry tell us they are not going to invent miraculous cures for disease for the public good. They are going to do it for money.

Just as "Control Room" (http://www.msnbc.msn.com/id/4971287/) is the movie "Fahrenheit 9/11" was meant to be, we'll have to wait for another movie that is the movie "Sicko" was meant to be.


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Jim Nickerson
06-18-07, 02:40 AM
Two hours!! and I am no particular fan of Michael Moore's, but I thought this was time very well spent to watch the video entirely.

I am an atheist, and without wishing to disparage anyone's beliefs, being that in the great American society we are all free to believe as we choose, I must share my favorite saying, "Anyone who isn't an atheist is an idiot." I don't know who originated that, but personally I like it.

With regard to the insights Moore put foward about the American health care system, I would say anyone who thinks our system is great, or even good, is an idiot. Of course, if one is a health care provider, it is great, if not truly fabulous.

Moore focuses on the insurance industry and political will as being the culprits to the what he puts forth as problems with the system. Importantly he leaves out the prime factor as I see it, and that is the doctors themselves, as it is they who basically dictate all utilization of the system. I am not singling out doctors, but to exclude them is too significant an omission. You could also throw in the legal environment too.

To crossover to the thread about "doomers," I have not lived my life as one, but I hold the opinion that we need something to happen in this country of such severity that it forces us to change the way we do things with regard to health care, politics, and values.

DemonD
06-18-07, 06:20 AM
Jim, I somewhat disagree with your assessment. Laws regarding health care have made the system more than the doctors. You could say that the docs made the laws... but are doctors really guaranteeing illegal immigrants free medical care?

It is illegal for a hospital to turn away a patient. But it is not illegal for a hospital to bill someone for any amount they choose, put liens on your house/life, etc. So if you are super poor, don't own anything, they can't "get blood from a stone" so no problem - show up at your local ER and get your care, meanwhile the states and taxpayers pay huuuuuge burdens on those that do pay. This drives up the overall costs, and then of course the lower levels of clients start dropping out because of expense.

My belief is that wage deflation in industries and illegal insourcing as well as legal outsourcing have put downward pressure on the middle and lower-middle classes. Also, many of the un and underinsured live in rural areas and of course rust belt type places, where the economy isn't so great.

Another set of laws comes into play too, and that is nursing ratios for hospitals. On a regular hospital floor in CA, the regulation is 1 nurse for max 5 patients. I'm betting at least half of all the hospitals in CA do not or cannot comply with this, and why? Because there is a huuuuuuge shortage of nursing. Now what happens when demand goes up, when supply is low? You guessed it - wage appreciation. Nurses can easily make as much as doctors nowadays, without the expense and time and energy of med school. As I understand it, doctor's salaries have not increased over the past 20 years hardly at all. Jim, you may be more privy to that, but that's what I'm seeing.

I think it's easy to blame the AMA/doctors. But really, it's the whole system, from med school that costs 100k/year at many schools, to requirements for 24 hour hospitals, to requiring hospitals to treat.

I had a whole class one semester about many of these issues. The best arguments I've seen is that a one-payor national health insurance system would be the most equitable. But how likely is it that that will happen with Aetna, United Health Care, Wellpoint etc. running the world? That first couple that had to sell their house because of their medical bill, crying about how this could happen in america - I say duh. Health insurance companies exist solely for shareholders and upper management to make money, and screw the little guys for as much as they can get. Medicare, for all it's problems and issues, is far far FAR more efficient than any private sector managed health companies. I know a girl who was getting bill collector calls: SEVEN MONTHS AFTER SHE DIED OF CERVICAL CANCER!!!

I am also betting that that couple either a. voted for bush, or b. would never vote for hillary clinton who tried her damndest to do something significant about this in the 1990's, but oh no she was married to the guy who did the girl in the blue dress so waaaaaaaaaaaaaaaaaaaah i have to sell my home.

There is nothing in this movie that is news to me. However, if someone out there learns something and changes their viewpoint, makes them a little less republicrony loving, then Moore will have done his job. I wouldn't call this a grown-up documentary though. It's bias shines through like a huge light (even if I agree with that bias).

One final thought: I was reading my little vanguard retirement newsletter today. Medicare, for all it's efficiencies, is facing a shortfall of 66 trillion dollars. For all the bears out there who were wondering when financial armageddon will hit, when the "external event" will cause the downfall of the USA hegemony as a superpower - well, there you have my prediction. Medicare will be much more fucked well before Social Security, and especially as boomers keep trying to get blood from their own stone, they will find that 50 years of being more like the grasshopper instead of the ant, it will unravel rather quickly.

I would even suggest itulip do an article on the macro ramifications of Medicare insolvency, but the time horizon is still a ways off. (Shortfall prediction is for the year 2020.) And I highly doubt all the hedgies, VC's, corporate raiders, bankers, really give a hoots about it, especially because it will be much more political than strictly business. IOW it's probably a bit early, but something to put on the list and keep in mind, especially i would say about 8 years from now.

Uncle Jack
06-18-07, 07:58 AM
I stopped watching right about the time he showed that 5'1", 178 lb girl who was turned down for insurance, "BMI too high", Moore said, "I always thought that health insurance companies were there to help us."

Wrong answer. Read the basics of what insurance is all about. There is a moral hazard involved; those who most likely need it will seek it. That person too heavy due to a lot of personal choices early on is paying the price now.

Grown up documentary? Come on. The four hour pysch-umentary about Freud and his influence on the twentieth century was four hours well spent compared to Moore's stuff, any of his stuff for that matter.

Jim Nickerson
06-18-07, 11:04 AM
I stopped watching right about the time he showed that 5'1", 178 lb girl who was turned down for insurance, "BMI too high", Moore said, "I always thought that health insurance companies were there to help us."

Wrong answer. Read the basics of what insurance is all about. There is a moral hazard involved; those who most likely need it will seek it. That person too heavy due to a lot of personal choices early on is paying the price now.

Grown up documentary? Come on. The four hour pysch-umentary about Freud and his influence on the twentieth century was four hours well spent compared to Moore's stuff, any of his stuff for that matter.

I think stopping on the fat girl's rejection kept you from gaining a larger perspective.

grapejelly
06-18-07, 11:32 AM
There is a health care system that is totally completely private and almost 100% free from government interference. It is 10% of the price of the parallel one and delivers excellent care.

It is known as veterinary medicine.

As an example: an expensive advanced cruciate ligament knee surgury for a dog costs $3000 vs. 10 X that amount for a human.

The human health care system is bad because of interference with the free market, e.g. government regulations, ligitiousness, tax-favored treatment of third party payers and employer financed healthcare, Medicare and Medicaid, etc.

Just look at what is done every day in veterinary medicine and you can see how far off we are with humans and with no good reason either. None.

synthesis66
06-18-07, 12:55 PM
I am a health care provider and there have been those of us out there for decades trying to tell people what was going on. It was always said that when medicine and business mixed, the result would be utter disaster, and it has been.

Health care is about people, not profit, and although one must be financially responsible in the administration of practice, once the profit motive kicks in, the 'care' stops. Greed eventually destroys everything.

Spartacus
06-23-07, 11:24 AM
This video is no longer available.
Michael Moore grows up and makes a real documentary about 45 million people with no health care in the richest country on earth.


When I lived in Houston I heard this a lot and never really questioned it. Later I read things like Juliet Schor's work and Roy Kaplan's and others and every time I read "richest country " I mentally add ....

whose riches are far, far higher than they were in the 1950s,
but whose riches now buy far, far less happiness than they did in the 1950s .

Jim Nickerson
06-23-07, 12:23 PM
When I lived in Houston I heard this a lot and never really questioned it. Later I read things like Juliet Schor's work and Roy Kaplan's and others and every time I read "richest country " I mentally add ....

whose riches are far, far higher than they were in the 1950s,
but whose riches now buy far, far less happiness than they did in the 1950s .

I didn't get whatever was your point here, Spartacus, but when it comes to the cost of healthcare in this country, it seems accepted that it will escalate unendingly in cost, and that the citizenry must accept that and come up with a way to fund it or either do without. I reject that tenet as Moore seems to do.

The cost of healthcare at some point in the US must be controlled--period.

jk
06-23-07, 03:05 PM
There is a health care system that is totally completely private and almost 100% free from government interference. It is 10% of the price of the parallel one and delivers excellent care.

It is known as veterinary medicine.

As an example: an expensive advanced cruciate ligament knee surgury for a dog costs $3000 vs. 10 X that amount for a human.

The human health care system is bad because of interference with the free market, e.g. government regulations, ligitiousness, tax-favored treatment of third party payers and employer financed healthcare, Medicare and Medicaid, etc.

Just look at what is done every day in veterinary medicine and you can see how far off we are with humans and with no good reason either. None.

when the care gets too expensive, we just put the pet down. ready for that in the human system?

FRED
07-01-07, 10:32 PM
Bump! It's baaaaaack!

Spartacus
07-22-07, 10:04 PM
I could have been clearer - it was off-topic, but I thought of it because in health caere, the line "the richest country can't ..." gets trotted out quite a bit.

I used to be really impressed with "the rich" ... . But that was long ago.

Since then I've read all the research (Daniel gilbert I guess is the current leader in popularizng it) that shows the rich are not much happier.

Money doesn't buy happiness. That was my point.

Juliet Shor studied workors and advertising, Roy Kaplan studied lottery winners, and there's been lots of other research - money doesn't buy happiness.

(still am on many levels - it will take me becoming rich, and experiencing that my happiness 6 months later is not consistently higher, to REALLY really convince me)


I didn't get whatever was your point here, Spartacus, but when it comes to the cost of healthcare in this country, it seems accepted that it will escalate unendingly in cost, and that the citizenry must accept that and come up with a way to fund it or either do without. I reject that tenet as Moore seems to do.

The cost of healthcare at some point in the US must be controlled--period.