SICKO

My wife, son and I went to see Michael Moore's Sicko last weekend. While I have generally agreed with most of Moore's positions over the years, I have not been a fan of his modus operandi. His prior films have depended largely on cheap shot humor and guerilla or predatory journalism. While Sicko includes some of that, overall it depends far less on those tactics than Moore's prior work.

I liked this film. Approximately the first half of the picture is spent illustrating the limits and shortcomings of the current American health care system. Much of the remainder of the film focusses on health care systems in other countries including Canada, England, France and Cuba. Yes, Cuba.

I have read a number of the reviews and other discussions of this film. Detractors are quick to point out how the film tells only partial truths, ignoring good things about American health care and passing over the bad aspects of the systems in the countries noted above. I don't doubt the truth of many of these charges. As with his previous works, Moore doesn't claim to be unbiased. He doesn't even claim to be fair.

The fact is that no health care system anywhere, especially those of countries having relatively large populations are perfect. Not even close. However, the question remains: Which system or systems are the most equitable, the most workable, resulting in the optimum healthcare for its citizens?

I am certainly not prepared to answer such a question. But it is impossible to ignore the glaring shortcomings of the American system which for the most part remains a "for profit" industry. Therein lay the core of the problem. As long as medicine and medical care - all aspects of it from individual medical practices, emergency care, hospitals, rehabilitation centers, drug manufacturers and purveyors remain in the private sector, with pretty much all of it concomitantly under the thumb of the insurance industry - the primary focus of their efforts being a positive bottom line and paying dividends to share holders, medical care in this country will continue to be second rate for many, and effectively unavailable to many more. As with so much in this country, profit is the holy grail. Everything else is secondary - even life and health.

I know this is an old, but nevertheless, an ongoing argument. To suggest that all or any of the medical industry be nationalized is anathema to most hard core, and even not so hard core capitalists. Just the thought of - dare I say it? - socialized medicine is enough to send these folks into apoplexy, wildly gesticulating as they drop, spittal spewing from their contorted mouths, veins popping from their crimsoned temples.

I've no doubt that there are gaps and failures in the best of the nationalized health care systems. The draw back most often cited is long waits for care - especially non-emergency surgery and other specialized care. I don't know if that particular problem is ubiquitous with all nationalized health care, perhaps it is. Of course another, and larger complaint is the resultant increase in the tax burden. Given the often incredible costs for even routine medical care today, a significant hit from the tax man is probably unavoidable.

However, if there is to be any significant improvement in the quality and availability of health care in this country, hard decisions must be made. What is of most importance to us? Wealth or health? How many of us might be willing to give up trophy houses, having expensive "toys," and generally living lavishly to help insure that the greatest number of our country men, women and children have access to the best medical care? So far, and sadly, it is apparent that not many are so inclined.

I am not a glutten for punishment. I do not wish to be taxed out of existence. My son in Germany pays taxes at around 41% of his gross income. Some European countries have much higher tax rates. It's a hard nut to swallow. However, the populations of these countries seem to have adjusted to it, some perhaps kicking and screaming, but most in relative quiet, in the knowledge that they can obtain health care, along with other services and benefits with little or no additional cost. As an example, in Germany if someone, owing to the effects of aging or poor health, is forced into a nursing home or some other type of full or intensive care facility, they are not required to divest themselves of everything they own in order to qualify for government aid. It is all simply paid for by the government through taxation. Such people are not required to sell hearth and home, their other worldly goods and empty their bank accounts. They can actually retain their estates.

I hear people in the US complain that they don't want to pay for someone else's medical care. Others complain about paying taxes that support public education, if they have no children, or no school aged children. The fact is, though, that we all pay for any number of government services that we never use, and/or receive no benefit from. Why not education? Why not health care? The better educated and healthier our population, the more productive we will be as a nation.

While I don't for a moment imagine that designing an efficient, responsive and equitable national health care system for a country the size of the U.S. of A. would be easy, I find it hard to believe and, frankly, disingenuine of people to claim that it can't be done. Of course it can, and it has. Is it beyond the possible for the best minds in medicine, business, industry and government to come together and study the world's many and varied medical systems and come up with a workable solution for the U.S.? Pick and choose what works, dispose of what doesn't. At the outset, there would no doubt be problems. Complaints would run rampant. Some heads would probably roll. There would be significant growing pains. It would never be perfect or cover all the bases. But the status quo just can't be allowed to continue. Far too many people are falling through the ever widening cracks in the current system. The primary purpose of health care should not be to line the pockets of insurance company CEOs or their share holders. Its purpose should not be to enable doctors to join the best country clubs. The primary purpose of health care should be the improvement and maintenance of our citizens' health. Period.

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