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You are going to see SiCKO, aren't you? Of course you are.

In response to the arguments in this movie, expect a lot of conservatives, both Republican and Democratic ones, to tell you how much more efficient private health insurance companies are than any government-run health plan could possibly be. They'll tell you that any health plan, government or private, has to ration health care because there simply isn't enough money to give everybody everything they could possibly ask for. And that part is true. But then they'll tell you that any private health insurance company has to, by definition, be more efficient than the government at doing that rationing because they can't dump any excess costs onto the taxpayers. Don't believe it.

Let me tell you a story of something that's happening right now to a talented (and good looking) semi-professional animé cosplayer I know; I'd give you her LJ handle, but I don't have permission yet and I don't know how widely she's willing to be publicized. Right now, she has been in more or less constant pain for several weeks. She desperately needs surgery on her wisdom teeth. If she doesn't get it soon, the pain will probably increase until she is unable to work. Her health insurance has offered to cover the several thousand dollar cost of the surgery ... but not the $500 or so cost of the anaesthesia. That's right: they are offering to pay for it if she is willing to have her jaw cracked open and major, painful surgery done on head, if she's willing to have it done while she's awake and feeling every bit of it that ordinary novocaine can't numb. Do I have to say why they would cover one but not the other? You and I both know why not: they know damned well that nobody will do that, which gets them off the hook for having to pay for the surgery. That way, her pain will increase until she's unemployed, and therefore no longer on her employer's health insurance plan. Then they can collect the premiums on whoever her employer hires to replace her, up until they get sick and get replaced too, without ever having to pay out. And they won't be the one who picks up the tab for the payroll and Social Security taxes she would have paid. You, the taxpayer will. And they won't be the one who pays for her unemployment payments. You, the taxpayer, will, through higher unemployment premiums through your employer. If, and I assume it won't come to this but if, she ends up crippled or brain damaged from the infection and ends up on permanent Social Security Disability Insurance for it, it won't be her health insurance company that pays for it. It'll be you, the taxpayer.

So why would anybody pay for this? Why do they? Aren't the insurance companies afraid that you'll go elsewhere? Please. Consider, if you will, the classic 1920s to 1970s Mafia protection racket. You own a store or a restaurant or a bar; the Mafia sends a couple of guys in and they say, "Nice place you got here. Be a shame if anything happened to it. You should pay somebody to protect it." This being the 1920s through the 1970s, the cops aren't going to do anything about them, so you pay. But if somebody other than the Mafia breaks in, are they going to protect you? If the place accidentally catches fire, are they going to put out the fire? As if. You pay for "protection," but they don't have to provide actual protection. They just have to scare you with fears of how much worse it could be if you don't pay. And that, my friend, is everything you need to know about private health insurance.

Don't believe me? Let me offer you two interesting American examples. First of all, consider that one of Michael Moore's publicity stunts involved ferrying victims of the 9/11 terror attacks down to Camp Delta at the Guantanamo Bay Naval Air Station, where the supposed 9/11 mastermind is being held, to try to get them government-provided health care that's at least as good as the health insurance that they're giving Khalid Sheik Mohammed. Hah, hah, very funny. But think it through one step further. This is George Bush's America. If some private health insurance company wanted to collect taxpayer premiums for providing the health care to Gitmo detainees, I guarantee you the Pentagon would write that contract, probably even without competitive bidding. If private health insurance is so much more efficient than government health care, why hasn't any private insurance company offered to pocket what it's costing the government and get rich off of the difference? I'll tell you why not. Because if they denied health care to the alleged terrorists at Gitmo as cavalierly and routinely as they deny health care to their "customers" in the US, the International Committee of the Red Cross would be all over them like a cheap coat of paint. Because providing health care to prisoners of war as bad as the average working class American gets would get you sent to jail for the rest of your life. Private health insurance is, literally, a crime against humanity -- but it's supposedly good enough for you.

Think I'm wrong? Consider this. Nobody should ever expect members of Congress to offer health insurance to the public that's as extensive as what they get. Face it, most of them were millionaires before they went into politics, and all of them are at or near the top of a very competitive professional field, so by definition their salary and benefits are more than yours. But ask yourself this: if private insurance is by definition more efficient than government health care, why doesn't Congress buy a private insurance program for themselves? Why aren't they paying premiums to Aetna or Kaiser Permanente or somebody? If private health insurance actually could deliver better benefits for the same price than government run health insurance, why don't they sign themselves up for better coverage at the same price? I'll tell you why: because they're lying to you. Every single politician who tells you that private health insurance is actually better than government run health care for the same price, or offers a lower price for the same quality of service, knows that it isn't true, and you can tell that because that's not what they vote for themselves if they have the choice.

Enjoy the movie.

Comments

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kauricat
Jun. 29th, 2007 05:40 am (UTC)
Wow, she must have a really unusual case. My husband and I both had our impacted wisdom teeth cut out on only novocaine. We both pulled through just fine.

I'm not saying that there aren't cases where more anesthesia is necessary, but as you imply, insurance companies make decisions based on numbers. From the point of view of the insurance company, the majority of cases probably don't require anything more than novocaine, so they don't generally cover it.
caraig
Jun. 29th, 2007 05:53 am (UTC)
Well, my own wisdom teeth were removed by a combination of novocaine and nitrous oxide. Nitrous is wonnnnnnnderful stuff, I now swear by it. They had what felt like a Jaws of Life and I? I had noooo care in the world. At least until the nitrous started to stop flowing. Then I started getting a little concerned. Until they put a NEW NO2 bottle in and I was feeling niiiiiice again.

I'm not sure what the procedure with nitrous would cost, but I was told that they did it in the dentist's office so that they didn't have to pay for an anesthesiologist. That being said, that a for-profit entity can have any say in the proper health care of a person is abominable. And this is coming from someone who hasn't been under insurance but for one year since early 2006.
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atomicat
Jun. 29th, 2007 05:45 am (UTC)
But... but... HOW can the richest nation on earth possibly pay for medical care for all it's citizens? Hmmm... guns or butter, guns or butter. I'm sure you'll get more than a few "This happened to me" stories but I just have to put my $250,000 in. I haven't the faintest what 50 days in intensive care and 100 in rehab costs, what's your guess? That's the bill I racked up in 2005. I haven't the faintest, because I never got a bill. I do know how much my meds cost now though, around $1,500 a month. The prices are on the bottles but no, I don't dip into my pocket for it. Oh, I get air miles on it too.

What am I doing now? Well, trying to get my health back so I can work towards contributing my share of the social contract to this godless frigid socialist dictatorship hell-hole I'm forced at gunpoint to live in, my home and native land.
dkmnow
Jun. 29th, 2007 10:37 am (UTC)
Save me a flop in the gulag, eh?
crasch
Jun. 29th, 2007 05:55 am (UTC)
Let's grant for the moment the cupidity of the insurance companies. Now imagine that they were allowed to merge to form a single giant insurance monopoly. Also, let's give that monopoly the power to kill you if you don't pay your premiums. Do you think the quality of service of this monopoly would be better than the quality of service provided by the previously independent companies?
bradhicks
Jun. 29th, 2007 07:14 am (UTC)
If that monopoly had to answer to the voters every two years? Yes. Why do I think that? Because that's how it works in every other country in the world.
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jsl32
Jun. 29th, 2007 06:01 am (UTC)
america is simply not comparable to most socialised-health countries.
as several reviews noted regarding sicko, what's health care like for those in the banlieues?

how generous is the health care for non-citizens who aren't americans?

can anyone give me an example of an ethnically and culturally heterogeneous country with health care comparable to the standard lists of homogeneous socialised-health countries?

i don't believe in giving michael moore money, not least because he plays very dirty pool in his films.

i like the german healthcare system very much, but turks certainly don't get to participate in it, as one of many european cases in point.

american is truly ethnically and culturally heterogeneous, which makes discussions about 'why can't america do like all these homogeneous countries' a wee bit disingenuous.



kitrona
Jun. 29th, 2007 06:30 am (UTC)
Re: america is simply not comparable to most socialised-health countries.
I've heard only a few complaints about Canada's system, and they're quite heterogeneous. Most people I've talked to love it.

Meanwhile, I've been trying for almost seven months to get to a therapist that's on my insurance, with no luck, and it took six months for me to get back on my meds. Some of my insurance's policies are really ridiculous, and I keep getting bills in the mail for things that I thought were covered. :/ For this my husband is /paying/?
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platypuslord
Jun. 29th, 2007 06:24 am (UTC)
Think I'm wrong? Consider this. Nobody should ever expect members of Congress to offer health insurance to the public that's as extensive as what they get.

I don't follow. What health insurance plan do Congress members get? Is this something that was covered in the movie?

Web search for "congress health insurance" yields this page, which seems to claim that congress members do get private health insurance plans (except that the government pays most of the premium). How is this different from what most people get?
kitrona
Jun. 29th, 2007 06:31 am (UTC)
I wonder what company they go through...
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warphammer
Jun. 29th, 2007 07:32 am (UTC)
It's also in a way a racket played on both ends...

Take me for example. I'm middle-class. Some might say upper-middle-class. I'm single, therefore I can get the 'good stuff' as far as health insurance goes.

2005ish I went to the hospital for the first two times in my life. I duly paid my copayments, etc, etc - a bit more than I thought I should have to pay for the services, but understandable. And then I looked real hard at the bills.

These hospital stays (one short-term, the other basically an ER visit) were paid for, in the vast majority... by me. My insurance company threw in a couple bucks here and there, and the vast majority of the rest were... Discounts. Basically the 'I have this card, so you have to play THEIR game now' discount. Certainly, I'm glad that I had the insurance - I'd be looking at about $12000 worth of bills, if I remember right, instead of about $700 - but it was interesting to see just how the racket works. And a bit more shocking to see how much I'd be screwed for if I didn't have it - I imagine in order to subsidize what I *don't* have to pay.
pixxelpuss
Jun. 29th, 2007 05:58 pm (UTC)
It's absolutely a racket. That's why people don't seem to get how horrible it is not to have insurance. It's all about group rate negotiation. A large insurance company negotiates with healthcare providers based on numbers and what they're willing to pay. Healthcare providers (profit motive) raise their prices in order to pull up the negotiated price. People who don't pay the negotiated price (the uninsured) pay the inflated price without the negotiated discount. The whole thing is a fucking travesty. Because I have good benefits, my surgery ends up costing $800 instead of $15,000. Who gets stuck paying the extra $700? The people who can least afford it, the working poor and lower middle-class.

If functionally all comes down to two things: Is healthcare a citizenship right or is it a consumer good? And does the profit motive actually make things cheaper or does it drive UP the price? Well, every other wealthy nation thinks it's a citizenship right. And Canadians pay less per capita (including government contributions and taxes) for their healthcare, and almost all of the savings comes from the billing end (fewer people need to be paid to bill people individually).
wolfwings
Jun. 29th, 2007 07:57 am (UTC)
I'm planning to see it in a few hours.
But I agree with some of the comments on the site: My solution for the last few years has been to not have insurance. Between the co-pays and limits on where I can go and what they'll pay for, none of my jobs offered insurance worth getting. And if I need to go to the hospital it won't be unless I believe I need stitches or above, and even then I won't go myself. Someone else drives me, and I leave all my ID's at home, and bring a wad of cash. If I'm in no state to do that, I have far larger issues than if I can avoid declaring Chapter Whatever after the fact.
nancylebov
Jun. 29th, 2007 09:30 am (UTC)
At this point, the US has a remarkably corrupt health industry, and it *will* have input into any single payer system. What sort of single payer system we'd end up with is something of a crapshoot.
pope_guilty
Jun. 29th, 2007 11:14 am (UTC)
What people need to keep in mind is that American Health Insurance companies are pretty much the only companies that exist which can take your money and refuse to give you anything for it without fear of consequences.
kitrona
Jun. 29th, 2007 06:19 pm (UTC)
You ain't kidding.
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writerspleasure
Jun. 29th, 2007 11:37 am (UTC)
Private health insurance is, literally, a crime against humanity

then socialism is a crime against the individual - a far worse thing.
_pyromancer_
Jun. 29th, 2007 12:06 pm (UTC)
Socalism isn't a crime against anything bar common sense - like most "isms" it fails because it doesn't properly account for human nature.

But you can have a state funded healthcare system without being any kind of socialist country. The UK certainly isn't socialist, for the most part we're full-on capitalists with a low-tax ecconomy and plenty of incentive for enterprise and private capital and investment. But some things just work better when centrally run, health is one of them, public transport is another. We tried privatising the railway system for dogmatic reasons (the corupt and dying days of the last Conservative administration), and the result was monumental waste, costs increasing by an order of magnitude, and some of the worst crashes of recent times, all down to shoddy maintenance. It's taken 10 years, and about 10 times the subsidy of the old days, to get back to what the old state-run system used to acchieve.

A truly civilised country will keep private what works well private, and make public what works better under state control.
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netaria
Jun. 29th, 2007 12:21 pm (UTC)
The other thing having a national health care system would take care of would be those who have none.

When my wisdom teeth came in I was still in the interum period at a new job and thus was waiting for dental/health insurance to become mine. :( My mouth was too small and couldn't make room for the 4 new teeth and thus two of my molars shattered(yes, literally) from the pressure. I had to muscle most of it out while taking an assload of pain meds (advil until my dentist rec'd aleve) and continuing to work. By the time my insurance kicked in I needed two root canals and (obviously) to have the wisdom teeth removed.

Also, a friend of mine recently lost his best friend due to insurance company ass holery. If there was some sort of a standard and accountability what happened to that man never would have. He'd be here now and probably for a long time yet.
minidoc
Jun. 29th, 2007 12:34 pm (UTC)
I can't speak for the members of congress, but many of the goverment workers have private health insurance, among the best of it is the gold standard blue cross blue shield. It has coverage that is so extensive, you literally can't find another plan like it in most jobs.

While I think that every one should have access to healthcare, I'm more than a little leery about our government taking over. My father worked for the government as a physician, and I've trained and worked at the VA hospitals. I've seen the kind of ridiculous beaurcracy that the government has put into care and it can be frightening.
In some cases the care is excellent, in others it is shameful. I'm not sure I want the VA system or medicaid as the example of what to get everyone. The medicaid system is so broken because the reimbursements are so low, few are willing to deal with the paperwork to see patients that actually cost them more to see due to overhead and paperwork. In many cases practices are closing if they have too many medicaid patients and the patients suffer because no one will see them. Primary care is difficult and you can nearly forget about finding a timely subspecialist to see you.

Much of the public really doesn't know how much medicaid, and even more so medicare policy drives how the insurance game is played as far as what is allowable and not in some instances. I didn't realize until I had to essential do my own billing and get tangled with the rules and the immense beaucracy. I spend an incredible part of my day doing stuff to "comply" with medicare versus true patient care in many cases.

Then of course is the other example of parts of medicare supplement/hmo's that were offered to the private sector and initally the insurance companies jumped to get in on the action, many of the did not do well and left the government holding the bag when they couldn't offer what the stated and got out of their contracts.

Another part of the problem is that the insurance companies are powerful lobbiers and have the system working for them. For example, if I recommend that someone get say a CT scan to evaluate for weight loss and a possible mass in the chest for possible lung cancer and it gets denied by insurance and the patient does have cancer and dies. Guess what I can be held liable the the insurance agency has NO liablity what so ever. Often I get to talk to someone with barely a high school education to get approvals and often get turned down. I've spent more than 24 yrs in school/training to be told by someone with far less training/experience and who does not know and has not examined the patient something is not "MEDICIALLY NECESSARY". It is sick. After all, when they turn you down, they profit.

I get to deal with all kinds of guidlines/laws such as the Stark laws for self referrals, kickbacks etc but they have really no kind of oversight to regulate their ethics. Insurance companies can cherry pick who they cover, refuse to cover and what they pay. IF they owe us money it takes months, but if they want their money it's always RIGHT NOW.
or there's a late fee or penalty or we'll sue you.
monkeyd
Jun. 29th, 2007 04:57 pm (UTC)
It's what cost people want to bear, at the end...
Most of the gaps in coverage, within my experience as a mental health claims liason for one of the larger carriers of such, is due to shortfunding of the benefit fund. Since there is a large bulk of this industry that is self-funded by the group, it really is a case of figuring out where at the end of the day to point the finger. From my perspective, the policy terms for larger groups, like certain big union plans, beat the pants off of other self-funded plans for big business where no union is involved. Beyond that, there is great deal of difference between plan specific rules between such plans, as well. On self-funded plans, where someone isn't watchdogging the business, it really seems as though there is an intentional effort in the plan design to keep the fund as full as possible, and limit payouts. As an industry, this is what insurance carriers are paid by our clients to do. If you change the underlying model, it can help in all sorts of ways.
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neowiccan
Jun. 29th, 2007 01:45 pm (UTC)
i can totally understand the fears of having our unbelievably bloated, waddling, corrupt, inertia-riddled government take over our health system. it's terrifying. they will bollux it up. it's a given.
the only thing worse is what we've got now.
khairete
suz (who was put under to have all four wisdom teeth pulled)
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snowcalla
Jun. 29th, 2007 03:16 pm (UTC)
Here is why I firmly believe that Universal Healthcare, like what they have in other countries, won't work here.

1. They can, will, and do withhold healthcare from people in other countries. If it is thought that you don't have a very good chance or recovery, or that you will be a continous drain on medical benefits - the government withholds care. Look at cases in Europe and the UK where premie babies receive no care and are allowed to die because their chance of survival is low. Or cancer patients who are not given treatment to extend their life, when they want to, because it is a waste of medical resources. Why don't you hear bitching about that from those who live in Europe, UK, and Canada? Because, with culture of pacing more value on society as whole, it fits. In our culture, the individual and thier rights have a higher value. I'm not saying either one is right or wrong...I'm saying that the first time a baby is one the news, dying, and the tearful parents are being interviewed about how the governmnent is withholding care, is the day it falls apart.

2. Alternative Medicine
Alternative medicine is very common, used, and accepted most everywhere but here in the USA. Here in the USA it is looked at as total bullshit, and that view is reinforced by our medical community. Ask someone in Germany what herbs and teas are good to use for different minor ailments. We would have a HUGE task of education ahead of us before we could move towards Socialized Medicine. This ties into the next point...

3. Use of Medical Services
While we don't go to the doctor more than any other country...we go an average of 5.8 times per year, per person. That number is brought down sharply by the fact that those who are uninsured go to the Dr. only 1.6 times per year. If we throw them out and assumed that now we ALL have insurance...the average would be closer to 8 times per year and that would put us WAY ahead of any other country. In our culture, if you have a sniffle and you have insurance - you go to the Dr. The number 2 reason for seeing a Dr. in the USA - the common cold. 2/3rds of the time drugs are presribed.

4. Lifestyle
Let's face it, except for smoking the USA has the worst health style. We are fat, we eat shit, and we don't move - let alone exercise. Are we willing to change our lifestyles? I hope so, but from looking at all the really fat kids, I don't think so. This means our medical needs will increase big time in the years to come. Can ANY system take what we are going to be sending them? I doubt it. If we have Socialized Medicine, sooner or later the government will start addressing the problem, and they will do it wil laws. Think the proposed law against Transfats in New York was stupid? You will see that and more and it will become legal to do so as it will impact the cost of Socialized Medicine.

I don't think it is exactly the finances or the administration that hamper us from moving to Socialized Medicine...it is our culture. And that won't change overnight.
pixxelpuss
Jun. 29th, 2007 06:12 pm (UTC)
Out of curiosity, can you cite ANYTHING to back up claim number one?

The thing about US culture that is broken re: healthcare is that it thinks of healthcare as a consumer good rather than a citizenship right.
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