Thursday, June 28, 2007

Michael Moore’s new movie, “Sicko,” tries to convince us that health care in Canada, France, Britain and even Cuba is “free,” universal, excellent and everlasting — and because in America it is not, millions of our fellow citizens, even those who sacrificed at Ground Zero, are denied care and/or die for no fault of their own. Mr. Moore also has another, larger message: that socialism is nothing to be afraid of, but rather the administrative reflection of one human being’s desire to hug one another.

As with “Fahrenheit 9-11,” Mr. Moore never lets fact get in the way of his argument. The movie begins with two men dealing with work accidents. One is stitching up a deep cut in knee with needle and thread. The other sliced his middle and wedding finger ring off with a band saw. Neither have insurance. Ray, the guy who lost his fingers, is told by the hospital it can sew his wedding finger back on for $12,000 and the other for $60,000. He chooses the wedding finger and decides to lose the other.

But in Oregon, where Ray lived, you can buy a policy that covers such surgery for $90 a month. If he could pay for the surgery, why not the cost of the health insurance? And the guy stitching up his knee could have gone to any emergency room or health care clinic and received free care.

Mr. Moore tells the stories of folks who are denied care because they were obese, too tall, too sick as if this is the primary reason people are uninsured. With Moore you never get the full truth. The fact is, less than one million Americans are deemed medically uninsurable and many go on to get coverage anyway through special state insurance pools or laws that require insurance companies to provide coverage no matter what.

Ignoring the contradiction of highlighting women with cancer (why weren’t they denied coverage), Mr. Moore implies their cancer spread because insurance companies delayed or denied access to timely diagnosis or care. If so, studies show that is the exception, not the norm in managed-care settings.

Meanwhile, in the socialist paradise cancer care is an oxymoron. Worldwide, the maximum time cancer doctors want to wait from time they detect breast cancer until treatment is two weeks. Canada’s health system seems to think a month is ok. Either way, only 19 percent of patients are treated within the medically acceptable limit of two weeks. In American 90 percent are.

Or consider Herceptin, a drug that stops a certain type of breast cancer in its tracks; It’s standard treatment in HMOs. Britain’s NHS is supposed to cover Herceptin but often refuses to pay for it. As one bureaucrat sniffed: “Frankly, Herceptin is just about the worst thing I could choose to spend that money on.” Which explains why Britain’s five-year survival rates for all forms of cancer are among the worst in the West.

“Sicko” shows transplanted American yuppies sipping wine and extolling the virtues of French health and child care. He never cuts to the French doctors who strike regularly for higher wages or the 10,000 elderly people who died after a heat wave.

Mr. Moore admits there is rationing but says that socialized systems just need to spend more. All have. Waiting times for psychiatrists, diabetes experts, gynecologists, etc. have gotten longer in every country. In Britain they have just cut specialist use across the board. This past May an Ontario man with a fist-sized hole in his head due to a car accident had to wait one year for surgery to close it.

Finally, “Sicko” makes it seem that three Ground Zero volunteers got the hugs and care they needed in Fidel Castro’s socialist paradise that there were denied by an uncaring America. In fact, they all were screened — for free — and were eligible for free care from Mount Sinai’s Hospital WTC Health Effects Treatment Program.

The Cuban hospital they went to is for high-end medical tourism and government officials. Cuba’s most profitable medical service, and the one it heavily promotes to tourists abroad, is cosmetic surgery at cut rates. In the absence of Soviet assistance, breast implants are a major source of foreign currency.

After providing for the needs of tourists, top government officials and sympathetic movie directors, the health system has little left for the general public. National Post columnist Lawrence Solomon visited Cuba in 2003 and interviewed a physician called “Byron.” Mr. Solomon saw a man sitting on the pavement wrapping raw lesions on his foot with filthy rags. Byron identified the man’s malady as a disease slaves had brought to Cuba from Africa 400 years ago as one easily treated, but not with the medicines available in the local pharmacies.

“The government doesn’t [care] about the poor,” Byron said matter-of-factly. “The poor have no medicines, no painkillers, no nothing.”

“Sicko” resembles the Cuban health system: An attractive destination point for those ideologically motivated tourists that want to support the cause. Like the facade of health-care compassion offered to Ground Zero workers, both “Sicko” and Mr. Moore have little to offer most people except contempt and exploitation.

Robert Goldberg is vice president of the Center for Medicine in the Public Interest.

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