Michael Moore's "SiCKO"

So Sheena and I just finished watching Michael Moore's SiCKO, which I know is not new and everyone's seen it, but I think we have a unique opinion as we are currently living in one of the countries Moore mentions with socialized healthcare. In the past I've been skeptical about Michael Moore's selective reporting of facts, and I think there's definitely some polishing going on here, but I will say that from our experience with the UK's NHS (socialized healthcare system), the level of care we've received from our doctors here is at least as good as we had in the States, the time from when you first call for an appointment until you are in the examination room is usually much shorter (within 1-3 days in the UK whereas it could be many weeks in the States if it's not urgent), and the pharmacies are indeed very inexpensive. The NHS is actually a very popular system with most people quite happy about their level of care. Europeans, in general, do obtain travelers insurance prior to visiting America for fear of taking ill and being left to die on the streets because they lack HMO coverage. Michael Moore had all these things right so far as we can tell. I would say that there is some concern among the healthcare industry that NHS doctors are stretched too thin and paid too poorly, but this is not typically front-page news and gets nowhere near the press that the negative impact insurance fees have had on doctors in the States does.

The things Moore didn't mention that I think are worth covering are:

(1) UK medical students pay little-to-no fees for their education, covering only their living expenses. These are often paid by parents, through loans, or through state-funded scholarships which appear to be more available here than in the US. They graduate from medical school at the same time that US students are finishing their bachelor’s degrees, so they should have a much longer earning potential making up for the possibility of per annum (pa) wage deficiencies. For example, assuming doctors in both the US and the UK are able to retire at 60, UK doctors making the equivalent of $100,000pa will make $3.5 million. A US doctor making $120,000pa (from payscale.com) will begin working at least 5 years after their UK counterparts, and graduate with an average debt of $200,000. By the time they are 60, US doctors will have grossed only $200,000 more than their UK counterparts ($3.7 million) or much less if you consider loan interest rates, the fact that medical school debt has increased 8.5% per year according to the AMA, and reductions due to the high cost of US malpractice insurance.

(2) Moore mentions that people in the UK have lower incidence of disease in almost every measurement than Americans, but he doesn't mention whether this is due to lifestyle differences or the healthcare system being of a higher caliber. I tend to think it is a matter of the NHS focusing on preventative healthcare much more than US HMOs. People in the UK drink and smoke much more on average than in the US and have a definite passion for meat and pastries (or “pasties”).

(3) Moore visits France and finds that things are better there than they are in the UK, after having just shown the benefits of the UK’s NHS over the US HMO schemes. This is likely true, but there are huge cultural differences between the French and the Americans that are probably behind the differences he finds in healthcare and social services. The emphasis in America at all socioeconomic strata tends to be on acquiring material wealth at the cost of day-to-day quality of living. I think the best example of this is that most Americans work 8-10 hour days and 5-6 day workweeks with it becoming commonplace to work from home. After these long days/weeks, Americans indulge in more fast food than any other country as well. Meanwhile, the French are currently transitioning to a 4-day workweek and are not working 10-hour days to make up for it. They believe improvements in efficiency over a shorter week will make the system more effective for everyone involved. The idea underneath this is that the French are trying to achieve the same standard of output by the most efficient means, whereas American industry is continually looking for increased productivity/output by whatever means possible. Where efficiency is lost in the American system, it is made up for by increased work hours and in many cases, increases in work days over each week. This results in huge per capita work increases with much smaller productivity gains.

Anyway, this has gotten into a long polemic, but I feel this is an important problem for America, and one that the Democratic campaigns have decided is finally worth taking a stand on. Hopefully, when we return to the States in 2012, we’ll find a much different system than we left, not that I’ll be holding my breath.

P.S.: Happy Groundhog Day(!), and the photo at the top is from our family trip to Alaska last Summer.