Continuing On Our Sicko Journey

Yesterday I pointed out some of the more interesting facts in Michael Moore’s movie Sicko. Like I stated yesterday, I actually enjoy Moore’s films, I find them amusing as long as you don’t buy into his one-sided propaganda. However, I did not find that to be the case with Sicko, which was all propaganda and no style.

I guess success has gone to Moore’s head, and he no longer feels he has to mix propaganda with humor to sell his point, rather that we will simply all bow and pray at the alter that is Michael Moore.

And like I said yesterday, I am not trying to make light of the subject of Mr. Moore’s film. We have serious healthcare issues in America, and they need intelligent debate to find solutions. And ladies and gentlemen, Sicko is not intelligent debate. Sicko is snake oil.

You know what, I’m not even opposed to a national single-payer healthcare, if that in fact is the right answer. Of course, I am not yet convinced that that is the right answer. Granted, the system that we have right now is not the right answer either.

The way I see it, there are two things that need to be discussed: Coverage, and costs. And we will discuss that in just a minute, after I discuss a couple of other points that Moore brought up.

First of all. At one point Moore tells us that “Every year 18,000 Americans will die simply because they don’t have health insurance.” And that’s the end of that argument. No proof, no citing where this information came from. But if Michael says it, the left believes it.

We are treated to several stories of individuals who were denied certain procedures because they were “experimental”, and some of these individuals later died. The conclusion that Moore reaches is that if the insurance company had just approved the procedure, those people would be alive today. The simple truth is that even if all of those procedures were approved, almost all of those people would have died. But Mr. Moore conveniently left that part out.

The widow of Tracy Pierce, the man who died from end-stage renal cell carcinoma, discussed in Sicko how her late husband was denied numerous treatments for his cancer. Presumably, his oncologist wanted to experiment with cancer therapies not commonly used (or approved) to treat his type of cancer. Many of the newest therapies are very expensive - a regimen can cost $50,000 - yet have little clinical evidence to suggest a benefit against a cancer they were never proven to treat.

In Moore’s movie, we’re told that Tracy’s Dr. claimed that if they could find a donor, “there were promising bone-marrow treatments for beating Tracy’s cancer.” Now go back and reread that sentence. If I, as a doctor, told you that, wouldn’t you feel hope. The truth is, while some studies show promise in developing bone marrow transplants to cure kidney cancer patients, that kind of medicine does not yet exist. In other words, as hard as it is to take, Tracy was going to die with or without the transplant.

The truth is American health care system treats serious diseases more aggressively than national health systems. The health care systems in Canada, Britain and France would not routinely cover this experimental therapy either. But again, Mr. Moore fails to mention this.

When Moore speaks to a Canadian who states that the system should look out for all, Moore asks him if he is a socialist. He responds that he is a conservative, and asks Moore “is that bad?”, to which Moore responds, “No, It’s just a little confusing?” That’s right Michael, because we all know that conservatives want nothing more than to build a great big bonfire made out of the bodies of the poor, while maybe using gays for kindling. Sheesh…

Look, We all know that healthcare is a mess, and if you could convince me that national healthcare would give me the same coverage for the same cost without losing anything, I’d be all for it. But the truth is, all of the talk of national healthcare during this election cycle has left out one tiny thing: The Details.

I can give you several examples of why health insurance costs so much more than it used to, and yes greedy insurance companies pay a role, but the main reason is advancement in technology. Look, when I was a kid we had a family doctor – Dr. Penly. I would visit his office on College Hill, and in that office the most advanced piece of technology was probably the scale he weighed us on. Nowadays Drs. load up on the latest and greatest equipment at the tune of hundreds of thousands of dollars, and then to justify that equipment, they use it. My daughter recently fractured her risk, and when the cast came off she was still in pain. The doctor’s recommendation: She needs an MRI. The cost? About $3,000. We decided to wait (even though our insurance would have covered the MRI), and a week later she was fine.

I wondered what Dr. Penly would have said to my parents if I complained that, having just had the cast taken off from my fractured wrist, my wrist hurts. He would have said “Of course it hurts, it’s been fractured and immobile for four weeks. Heck, take a healthy wrist and immobilize for a month and it’s going to be sore. Just take it easy at first, and if it still hurts in a week or two, let me know.”

When I was a freshman in college I bought my first “new” car, a 1979 Chevy Monza, for about $3,300. It wasn’t the cheapest car available, but close. That year I could have bought a very basic Chevette for $2,595. Today, the cheapest new car out there is a Chevy Aveo, for $10,595. Now if you put those two cars next to each other, the cheapest car today is much better than the cheapest car from 1979. The gas mileage is better, there are airbags in today’s car. Even the stereo is better. My point? Prices are going up because the product is getting better, and today we are paying for equipment, drugs, and other things not available 30 years ago, and the result is we are living longer. And yes, it costs us more.

But that doesn’t mean that were getting what we paid for. When I was a kid, people had insurance, but not like we have today. We had catastrophic insurance, which was to say we had insurance to cover major illnesses and hospital stays, but everyday medical costs, from physicals to a Dr. visit when you had a cold, were paid for out of pocket. Yes, this means out of pocket costs are higher, but insurance was much, much cheaper.

Today a family of four pays about $12,000 a year for insurance (in most case your employer pays the majority of this). Assume that I offered you catastrophic insurance for ½ that price, and you covered “regular” expenses. And assume that seeing the doctor averaged $200 a visit. Now that’s a hell of a lot more than a $10 or $20 co-pay, but your family would have to visit the doctor THIRTY times to spend the same money that you are spending now. Assuming that everyone in your family visited the doctor twice a year, you could save $4,400.

Look at it another way. Right now you have auto insurance on your car, and lets say you pay $600 a year to cover your car, with a $500 deductable. And if you are like me, you hope that you never have to use that insurance. Now lets say I come along and offer you a new kind of car insurance. It will still cover the things your old plan did, but at the same time it will cover oil changes, tires and breaks, and any other maintenance needed. How much do you think that insurance would cost? And if you had it, how much would you use it.

There are a ton of reasons – both good and bad – that we pay what we pay for insurance. And I’ve just touched the tip of the iceberg. As for coverage (who gets it and who doesn’t), that will have to wait until tomorrow.