Sicko Makes Me Sick To Be An American
I recently watched Sicko, the new documentary by Mike Moore. While it focuses much of its attention on the American healthcare system, it makes most of its argument by comparing it to the healthcare systems of countries with socialized medicine, such as Canada, Great Britain, France, and Cuba. I’m not going to get into the details, mostly because this isn’t a “hot button” issue for me (except in the abstract), but let me say this about the movie. It’s making Dawn and I question our desire to start a family in the United States of America.
As Mr. Moore says in the documentary, the difference between the American system and some of the social democracies around the world is that in the United States, we’re taught that it’s all about “me,” whereas in those societies, they’re taught that it’s all about “we.” Furthermore (and this isn’t explicit in the documentary, though it’s there too), in the U.S., you’re only good for one thing: Your worth as an employee. The whole system is based on creating and maintaining a workforce. In some of these other countries though, your worth comes from your status not as a laborer, but as a human being.
One argument against what I’m saying is that your “society” is only as big as the people you interact with. If I want to live in a society that focuses on “we” more than “me,” then I am free to create my own little commune up in Vermont where I don’t have to be subjected to the media’s endless coverage of morality-challenged celebrities, where I don’t have to interact with angry and ignorant Americans, and where I can ignore the scare tactics of my government.
That argument has been my argument for the last few years. It’s not why I moved to Vermont, but it’s one of the reasons I love this beautiful state.
But there is a time–and it’s coming–when I’m going to have to leave my little utopia and seek the help of the society at large. It could be because of some tragic accident. It could be because my wife and I decide to have a child. It could be because of cancer. I don’t know. What I do know is that whatever happens, there is a strong chance that it could bankrupt my family.
Don’t misunderstand me. I have health insurance. But what Sicko makes you realize is that insurance doesn’t matter. The healthcare system of America is a for-profit system, where the practitioners are rewarded for denying aid to the sick and injured, because if they do so, they’ve saved a company from spending money. In the movie, Mr. Moore speaks to a doctor in France, who says that, under their system, practitioners are rewarded for having healthy patients: if he gets his patients to stop smoking, if he gets them to lose weight, if he lowers their cholesterol, etc., he makes more money. In the U.S., doctors who refuse to spend money on their patients are rewarded with six-figure salaries and a prestigious career.
Here’s my own little health insurance story. It’s not much, but it’s something.
About six months ago, I went to the doctor for a regular check-up. I hadn’t been in about five years, and I wanted to get the whole work-up (i.e., blood tests). I went to this particular doctor because she was in my HMO’s network. The total cost to me should have been a $20 co-pay. No big deal. So I go in, and she does the regular stuff, and then she says, “Have you had anything to eat in the last 12 hours?” I’d had dinner the night before, so I said, “Yeah.” Then she tells me how I have to fast for 12 hours before they can do the blood work, so we make an appointment for the next week, where I’ll come in, they’ll take my blood, and off I’ll go. The whole thing will be no more than five minutes. No problem, I say. And when the appointment comes, that’s exactly what happens.
Cut to about a month later. I get a letter from my insurance company that says that the lab where my blood was sent is “out of my network,” and they won’t cover the $200 the medical center is charging. Here’s the thing though: the lab is in the same medical center where my doctor works!
That’s just the hassle for blood tests. Imagine if I had a serious injury or illness. I’m scared to think about what else they won’t cover.
I know, I know. You’re saying, “You’re going to leave the country because we don’t offer free healthcare? That’s stupid.”
But is it really? We’re talking about healthcare. This is literally a life or death issue. Not just for me. As I said before, I’m stupid enough to think nothing bad is going to happen to me (despite the fact that I don’t exercise, I eat too much meat, and I drink too much coffee and beer) or to my wife (despite the fact that she smokes cigarettes). I’m talking about my (unborn, unconceived/unadopted) children.
There was a story in Sicko about a woman (with insurance) whose infant daughter came down with a high temperature and was having trouble breathing. She called 911 and the ambulance took her to the nearest hospital. They started treating the girl, but then they found out that the woman’s insurance company wasn’t going to pay them for the treatment because the hospital was out of their network. They stopped treating her and sent her to a hospital that was in her network. By the time they got there, her daughter went into cardiac arrest. She died. Dead.
We live in a society that lets that happen. Plain and simple.
The question is: Does my family stay in the United States and hope (and work) to change that, or do we move to a country where the value of a human life is never a question of an insurance company’s bottom line?
Before I go, here’s the World Health Organization’s rankings of the world’s health systems. Here are the countries that come ahead of us:
- France
- Italy
- San Moreno
- Andorra
- Malta
- Singapore
- Spain
- Oman
- Austria
- Japan
- Norway
- Portugal
- Monaco
- Greece
- Iceland
- Luxembourg
- Netherlands
- United Kingdom
- Ireland
- Switzerland
- Belgium
- Colombia
- Sweden
- Cyprus
- Germany
- Saudi Arabia
- United Arab Emirates
- Israel
- Morocco
- Canada
- Finland
- Australia
- Chile
- Denmark
- Dominica
- Costa Rica
- United States of America
Yes, you read that right. Costa Rica has better healthcare than we do. You know who’s #38? Slovenia. And #39? Cuba. Isn’t it great to live in the “richest” country in the world?
Okay, okay. I want to talk about one more thing.
In 2006, the state of Vermont passed began the 2006 Healthcare Affordability Act, which set up a state-run health-insurance plan, called Catamount:
The 2006 Health Care Affordability Act is a first step toward achieving the goal of quality, affordable health care for all Vermonters. This legislation has one overriding goal: controlling the steeply rising costs of health care. It accomplishes this in two ways: by better managing chronic care and making health care affordable and accessible for all Vermonters. Catamount Health will be offered to eligible Vermonters in October 2007.
But what does it take to be an eligible Vermonter? “You may purchase Catamount Health if you are an uninsured Vermont resident and do not have insurance through an employer.” Uninsured means:
- You have insurance which only covers hospital care OR doctor’s visits (but not both)
- You have not had private insurance for the past 12 months
- You had private insurance but lost it because you lost your job, got divorced, had insurance through someone who died, are no longer dependent upon your parents, graduated or took a leave of absence from college
- You had VHAP or Medicaid but became ineligible for those programs
In other words, you can’t choose to be on Catamount. You can only have it if you have no other options.
Don’t get me wrong. That’s a good thing. A great thing, even. But as the legislature says, it is only “a first step.”
What’s more though: You have to pay for it (the rates are on a sliding scale based on your salary). When you go to the doctor, you still have a co-pay. And there is an “out-of-network” fee that doubles the cost of your deductible. There’s a co-pay for prescriptions. Etc.
Compare that to France, Canada, or even Cuba, where you never need a checkbook to go to the doctor. In Britain, the co-pay for prescriptions is 6.65 pounds, which is like $10. That’s a co-pay that never goes up, regardless of how many pills you need or what kind they are. When I was done with my check-up, I had two prescriptions I had to get. One of them was a standard co-pay of like $10, but the other cost $35. That’s a couple of days worth of groceries to some families.
So yes, Vermont and other states are trying to take the lead on this issue (with Massachusetts’ new system at the helm), but what they’re doing barely even brings us close to the systems enjoyed by the citizens of other countries.
There was one guy, an older Brit who lived through WWII, who said that after the war, the country decided that if they could spend all that money to kill people, then they could definitely spend that same amount of money to save people.
The United States spends OUR TAX DOLLARS on waging an immoral war. According to the Project on Defense Alternatives, the President’s FY 2008 budget requests $483 billion for the Defense Department. This does not include the cost of waging war in Iraq and Afghanistan, nor the costs of general counter-terrorism operations, for which the President has requested another $141.7 billion. “It does not include non-DOD expenditures for homeland security ($36.4 billion) or the Veterans’ Affairs budget ($84.4 billion). Nor does it include the request for supplemental funds for outstanding FY 2007 war costs ($93.4 billion).” When you factor in everything, from the wars to the DOD budget, to the VA budget, etc., the President is requesting $861.5 billion for expenditures related to the military.
The American Academy of Family Physicians, meanwhile, reports that:
President Bush’s proposed budget cuts renege on the promise made to seniors by reducing how much Medicare will cover for their medical services and increasing their premiums and co-pays. The Bush budget would cover fewer children rather than more, reduce access to preventive care, and do nothing to facilitate the transition to electronic health records….The 2008 budget proposal would sharply decrease Medicare reimbursement for health care provided to seniors by primary care physicians. According to an AAFP survey of more than 2,000 family physicians, one out of five family doctors have had to stop seeing new Medicare patients because of payment reduction….The White House’s proposed elimination of funding for essential primary care training programs would mean fewer doctors to care for underserved populations – the elderly, poor, disabled and those who live in rural areas and the urban core. By zeroing out all funding for these Health Professions Grants for training in family medicine, the Administration is compromising access to quality, affordable heath care for Americans.
In this country, the national government is CUTTING healthcare spending and INCREASING our military spending. This the action of a system that favors death over life.
As I said before: Does my family stay in the United States and hope (and work) to change that, or do we move to a country where the value of a human life is never in question?