Sicko-Bizarro World

July 9, 2007

Although Diane and I rarely go to the theater to watch movies, we try to have “movie night” at home at least once every weekend. Actually, we probably have movie night precisely because we find little that we just have to watch in theaters. The last few movies we saw included Casino Royale and The Good Shepherd, both films with some kind of cloak-and-dagger intrigue. Last weekend, we saw Michael Moore’s new film Sicko, a scarier cloak-and-dagger film with real people. Criticism of Sicko ran rampant a few weeks ago. However, now that it has come to theaters, people can see the film for themselves and justify their opinions about it.

Everyone knows Moore’s political leanings, and that he might be stretching the awful truth a bit. If that’s the case, Moore doesn’t seem any different from the likes of Bill O’Reilley, Rush Limbaugh, and Ann Coulter. Some also claim that Moore doesn’t believe what he’s saying, but I have more serious doubts about the near-crazy blather of his aforementioned counterparts. Compared to Moore, they come across as pathologically obsessed with beating opponents into submission. Some conservatives have disavowed the more extreme among their ranks, as in the case of Coulter several years ago. This should come as no surprise, even to those who conflate Coulter, Limbaugh, and O’Reilley with more thoughtful conservatives like Anthony Daniels (who uses the pseudonym Theodore Dalrymple).

One could argue that Moore likes to browbeat his opponents as well. However, even if he has moments that may seem pushy or “over the top,” he generally strikes me as a concerned citizen trying to learn the truth, even if his liberal agenda seems obvious. After all, as conservatives point out numerous times, liberals keep wanting to push “an agenda,” while conservatives just want to do what they consider best for the country.

We have heard horror stories about socialized medicine, which some have equated with the horrors of Communist regimes. I don’t doubt that such systems may have the usual problems outlined by detractors, such as long waits for care. Whatever one’s political beliefs, one can’t help but have some fellow-feeling for the people Moore profiles in his film: someone who stitches their own wound to avoid a costly visit to the hospital; another who had to decide which one of two fingertips to have restitched after an accident; a couple that moves into their daughter’s storage room after a string of bad luck with their health; a woman whose $7,000+ hospital bill didn’t receive coverage due to a relatively common pre-existing condition; a mother who had to take her daughter by car to another hospital because the first one she visited was out-of-network; and so on. Although these stories sound similar to what one might hear about socialized medicine, they all happened in the United States. A few of the people mentioned didn’t have insurance, but many others had to contend with the “goals and objectives” of insurance companies… enabled by politicians who buy the party line of maximizing profit, and who profit from that notion themselves.

Speaking from personal experience, I have had little need for health insurance yet (knock on wood). I had to visit the doctor a few years ago for strep throat (or, more accurately, strep cheek), but that’s pretty well it. As for vision insurance, I have had the good fortune of being on the Superior plan. For a premium of just over $7.00 per month, I get excellent coverage for all aspects of basic vision care. Recently, I paid $35 for an eye exam, and I got a new pair of glasses yesterday for over half of what it would have cost (which means I’ll need to change my photo soon). In contrast, Diane is on a different plan, and a store sale on glasses proved cheaper than the coverage on her insurance.

Diane has also had bad luck with oral surgeries getting covered. She had jaw surgery back in high school, and her mother had to fight to get the insurance company to cover it. A few years ago, her dentist and orthodontist recommended an implant to replace a tooth. They said that a “bridge” would start to fall apart after several years, but the implant would be permanent. Most importantly, the implant would prevent the area around the lost tooth from collapsing. The false tooth cost a few hundred dollars, which would seem reasonable to pay if one considers cosmetic procedures unnecessary. However, the implant within the jaw itself cost thousands of dollars, and it still wasn’t covered. Although two medical professionals found the implant medically necessary, it was accorded the same “cosmetic” status as the tooth. To add insult to surgery, the implant and tooth are currently in the back part of Diane’s mouth. Even up close, I couldn’t even see the gap for the $200 tooth unless Diane opened her mouth wide.

Getting back to the film… As a contrast to the stories about private health insurance in the U.S., Moore shows health care systems in Canada, Britain, and France. Everyone with whom he spoke seemed content with those systems, which have relatively straightforward rules and procedures ensuring that everyone receives the care they need. This means no figuring out which digits to reattach; no falling into financial ruin due to bad luck with one’s health; no denials of coverage based on pre-existing conditions; and no referrals to other hospitals due to some “out-of-network” blather. In addition, at least one British doctor expresses contentment with his yearly income and lifestyle, which one couldn’t imagine if relying on detractors of anything even remotely resembling socialism.

Of course, no Moore film would be complete without a coup de grace (though no coup just yet). Learning about the high quality of care given to enemy combatants at “Gitmo,” Moore leads a small flotilla there with a number of sick people, including three who helped with rescue and clean-up after the World Trade Center collapse. They have no luck, but they end up finding inexpensive care within Cuba itself. Even fans of Moore have difficulty wrapping their minds around this portion of the film, especially due to Cuba’s poor reputation with regard to human rights. One does have to wonder why the Cuban doctors “reached out” to U.S. citizens. Goodness? Propaganda? Wanting to climb up a few numbers from #39 on the list of health care rankings to outmaneuver the U.S.’s #37? We’ll probably never know. I certainly want to believe that a sense of fellow feeling motivated the treatment, and not cynical maneuvering on the part of Castro’s cronies (which I’m sure some pundit will purport to unearth, if they haven’t done so already).

However one feels about Moore, one can’t help but wonder why a good number of health insurance companies in the U.S. feel compelled to deny a number of claims that most people couldn’t even begin to afford without going into serious debt or losing everything. Do these companies not have enough money to cover everyone? Do they have just enough money to hire lackeys who track down customers’ pre-existing conditions, and who can somehow “interpret” the slippery wording of health insurance policies so that the companies don’t have to pay on claims? Oddly enough, all this sounds suspiciously similar to insurance companies denying compensation to Katrina victims by splitting hairs between wind and flood damage.

After watching Sicko, I still wasn’t sure whether to believe that socialized medicine would actually work in this country. Nevertheless, the film, as well as Diane’s own experiences and other things I’ve heard about health care, did convince me that health insurance companies need one of two things: closer monitoring by an external party, such as the government (Gasp!), or a healthy dose of ethics and compassion… whatever would ensure that customers will receive the kinds of services they think they should get.

Although I’m not sure how and if socialized medicine would “work” here (as in how much we’d be willing to pay or go into debt for it), I don’t care who offers decent coverage. As long as the premiums or taxes seem reasonable and justifiable, the policy language is straightforward, and the coverage is comprehensive, that’s all that matters to me… and probably to most people. However, one does have to wonder if the insurance companies are up to the task. Unlike industries where one could easily name the best companies (as in the case of vehicle manufacturers), I think many of us would be hard-pressed to name a private health insurance company that distinguishes itself by providing comprehensive coverage at a decent price, and without using confusing jargon and formulas of coverage that can overwhelm the most intelligent of customers. If I want challenging reading, I’ll turn to Vladimir Nabokov or Salman Rushdie. The difference is that reading their works offers numerous intellectual rewards. Ploughing through insurance policies does not, and can only lead one to have an aneurysm… which requires a 20% co-pay for a hospital stay that increases to 40% after 10 days, which invalidates coverage for an ambulance ride that we’ll cover but only with advanced notice, but which will not be covered if you have had a severe headache sometime within the past year, except maybe during the holidays when relatives can drive you crazy. Visting a counselor will most certainly not be covered.

When I try to read health insurance policies, I start to wonder if the company will actually cover something serious, or if it will leave one hanging due to the listing of numerous exceptions that somehow invalidate coverage. Something doesn’t seem right when a U.S. citizen can get free or cheap treatment for a boneheaded stunt in Britain, but not for cancer in their own country. In places like Britain and Canada, even conservatives don’t seem to mind the idea of socialized medicine, including Margaret Thatcher of all people. Of course, as Thatcher said, there is “no free lunch,” which means that funding health care would require more of one’s tax dollars (or pounds) to maintain it. However, considering the horror stories of the people featured in Sicko, I would willingly pay a few dollars more in taxes so that no one would have to worry about health insurance company bureaucracy. Yes, I said “company bureaucracy.” People complain about government bureaucracy, but businesses can also make customers jump through various hoops to get the goods and services for which they pay. Automated menus found via “customer service” phone numbers for banks, various utilities services (phone, cable, electricity), and credit card companies offer just a few examples, as do the aforementioned problems with medical services.

As Moore points out, we don’t question government funding of fire and police protection, and (at least to a lesser extent) many of us still see free education and libraries as good things. When will we see health care as something that the government could also take a more active role in handling, at least when private companies fail to provide decent service to those who need it the most? In my opinion, the issue goes beyond some narrow-minded concern about an obligation to “shareholders,” because all of us will need serious health care sooner or later, and none of us should have to wonder whether we will get the care we need without choosing between financial ruin and poor health… or even death. After all, if the government can step in on behalf of Terri Schiavo, why can’t it help those who may actually have a better chance of reclaiming a decent quality of life?

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: