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Universal Free Health Care (.......nanny and laundry)

hbutler at pol.net hbutler at pol.net
Mon Jul 2 12:56:36 BST 2007 

May I copy your letter to a web site?

>
> I have now seen the movie, SiCKO, in its entirety, twice  - once on the
> small  computer screen and then, today, in a theater.  I went to the
> theater to see  the people,  listen to their reactions, and also see and
> hear the movie in a  big screen  setting.  And, indeed, some of the
> material is better appreciated  in the theater, rather than on the small
>  screen.
> First, someone has changed the image of the producer,  Michael Moore.
> Both  in the movie  and on the publicity talk shows, he is less angry,
> less hostile,  and has  “cleaned up” in speech and appearance since
> his previous movies and  books.  He is a producer and was very, very
> specific in what he wished to  create, and he created it.  He knew just
> what he needed to show,  what he needed  NOT to show, and in what order
> he needed to show the  material.    Unfortunately, the movie approaches
> an extremely complex and many-faceted   issue in a totally superficial
> manner, the goal being to elicit emotions and   reactions with regard to
> the dismal state of health care in the  United  States.
>  Many of the essential elements for the success of our health care
> network
> were totally omitted.  Just a few of  these omitted issues include:   1.
>                    Biomedical research,
> 2.                    the long list of medical educational issues
> (nursing,   allied health, pre med, medical school, graduate medical
> education, continuing
>  education, etc.),
> 3.                    Critical Care and all of its  ramifications  a.
>    Sepsis
> b.      Futility
> c.       End of life expenses
> d.      Demands of families regarding doing “everything” in
> critical care  4.                    Complex operations done (and
> expected) almost   exclusively in the United  States, such as
> thoracoabdominal aneurysms,  etc.    5.                    Regulatory
> Industrial Complex and its contributions  to  the cost of health care in
> the United States
> 6.                    Medical legal issues, although MM has talked about
>   medical legal issues in the talk shows
> 7.                    Costs of new pharmaceuticals (the majority of
> which   are developed at great research and safety costs in the United
> States)  8.                    and many many others
> I was sympathetic and in agreement with a number of  points that the
> producer  made repeatedly.  These include:
> 1.         Condemnation of the greed, cold-bloodedness, profit motive of
> the   insurance industry
> 2.         Condemnation of the same thing in HMOs
> 3.         Condemnation of managed health care in general
> 4.         Criticism of big money that the pharmaceutical industry
> throws at   politicians (and the politicians who take it)
> 5.         The hundreds of millions of dollars spent by insurance, HMOs,
> and   industry for LOBBYING
> 7.         Condemnation of Sen HR Clinton for her greed in receiving the
>  second  highest amount of lobbyist money AND in her ineffectiveness in
> addressing  health  care reform in the 1990s.
> 8.         Hassle factor in the sea of paperwork
> 9.         Condemnation of insurance and HMO medical directors and
> doctor  reviewers  who are rewarded for DENIALS
> The producer’s main point throughout the movie and in his final scene
> was  a  plea/demand for UNIVERSAL FREE HEALTH CARE FOR ALL (and he
> tossed in free day   care, free college, and free nanny visits to new
> Mom’s).  This is where I  totally part ways with  his views and
> motivations.  No  service is FREE.  He  visited 5  countries to prove
> his point about “free” care – UK, Canada, France,  and Cuba and
> the US.  Both access and quality of care in the  UK, Canada,  France and
> Cuba, according  to what was presented in this movie, are superb.
> Furthermore, patients and physicians in  these countries could not be
> happier with  their respective systems.  Based on this movie, the
> paperwork  hassle factor  that both docs and patients deal with in the
> US is  nonexistent in these  countries.  Also, based on this movie, the
> cost of all these government provided   services is not a hardship on
> anyone or any group.  Not a single person  interviewed in any  of these
> countries had a remotely negative thing to say about  care, quality or
> even taxes to support the system. Contrarily, ALL interviews in  the US
> were  totally negative – not ONE success story was presented.  Hence,
> my greatest criticism of this  movie – bias to the point of deception.
>  There appeared to be a good bit of manipulation of timing  of events to
>  support the producer’s position.  For instance, when attempting to
> present  the AMA  as an organization opposing “healthcare for all,”
> he showed a portion of  a  speech from Dr. Annis, President Elect in the
> AMA in the EARLY 1960s.  This  was more than 40 years ago.  Such mixing
> of past and present was  common  throughout the movie.
> I listened to and watched the views of the people who accompanied Mr.
> Moore  to Cuba.  I have tried to read in the newspapers  about just what
> was done for  them in Cuba which they did not get in the United  States.
>  One was  apparently given a diagnosis of sarcoidosis, which he did not
> have prior to going  (although sarcoidosis is often a dx of exclusion).
> One was taken off a couple of  her  medications, something we all do
> when we see a referred patient.  Others  were given outlines of
> treatment  plans for them to try when they go home.   What else is new?
> When any  patient presents with continuing symptoms, we  manipulate
> their treatment plans  and their medications if there is not an
> operation or directed acute  interventional treatment which is
> indicated.  Quite  frankly, I saw nothing in the  Cuba trip that gave
> anything new to  any of those  accompanying Mr. Moore.  I was impressed
> that while in Cuba, I saw none of them  appear to be  dyspnec, or
> lacking energy.  I was  impressed with their HIKE  down the hillside to
> the Navy Base.  Interestingly, neither of the two  “patients ” with
> lung problems (and obese) exhibited shortness of breath.  I also know
> that the Cubans would also  go out of their way to maximize the
> propaganda  opportunities of this visit.  Many on this list have been to
> medical  or surgical  meetings in Cuba, as have I.  The Cuban doctors
> are very dedicated and   hungry for new knowledge.  Many of  their
> facilities are often not as well equipped  as ours, and I have seen
> hospitals far different from the examination rooms  shown in the Havana
> Hospital in this movie.  If all I had to base my reactions  of  medicine
> in Cuba was this movie, I would “know”  that there is a state  of
> the art hospital and virtually free pharmacy on every  corner and
> available  to any and all who need services.
> There are members of this list server who reside in  Canada, Cuba,
> United   States, France, and England, and we  all respect each other.
> Each of us  knows  the many differences in our “systems,” both good
> and bad.  We know the many  frustrations with our  own “system”.  We
> know of two,  three, or even four  tiers of care in EACH of the cited
> countries.  We know of rationing by various  means  and limitations.
> None of the  negative issues in any country except the  US were even
> mentioned, much less openly discussed.  I have been told by  Canadian
> physicians  and patients of various problems with that system. I have
> just been in London for a week and  heard about the frustrations and
> regulatory  difficulties of the NHS from the  physicians’ points of
> view.  AND I  have  gotten an “ear full” of the frustrations from
> French surgeons I know, all  of  whom have second offices to see
> “private patients” who pay cash.  Mr. Moore  cited none of this
> other  side.
> This is not the time and place to criticize other  country’s health
> care  delivery system, for we all have our share of horror  stories and
> difficulties, as  well as great successes.  I have cited many of the
> problems in the  United   States, and Mr. Moore re-stated many of the
> problems many on this list have  expressed in the past.  However, he
> only gave one side of the  story – his side  - to push his vision of
> FREE CARE (up to and including the  government doing  his laundry) for
> ALL.
> Most of the members of this list server have at one time or another been
>  on  a debating team.  One overstates  a point to make a point and picks
> the most  extreme examples of good and bad that  can be found to
> accentuate the point to  be made.  Mr. Moore has done that in SiCKO.  I
> would have found this an  exceptional  piece of film and, indeed an
> historical event, had he had the insight,  intellect  and integrity to
> just as aggressively present the opposite side of  the debate.  In that
> way, the American people  and the world could have seen  and possibly
> comprehended the many complicated  aspects of health care and come
> closer to a solution.
> I was interested to see who attended the movie.  This is the second day
> that  SiCKO is  showing in Houston and is in three movie theaters.  I
> went at a “ popular movie going  time.”  Several of the 15 movies
> showing were sold out  15-30 minutes before the show started.  SiCKO was
> shown in one of the smaller   rooms and was only about 25%-33% full.
> About 15% of the attendees were Medicare  age, and 2 people were
> receiving  supplemental oxygen.  I was a bit  amused to  see a lady come
> in on a “Hover-Around.”  I wonder how many people in the   UK,
> Canada, Cuba and France have those paid for by their  governments?  I
> saw NO  other doctors  in the room that I recognized, and I do know many
> of the  Houston doctors.  I estimate that about 30 nurses were  present,
> as they were  carrying the flyers sent to nurses across the country by
> the California Nursing  Union.  Every  time a statement was made about
> giving FREE anything, such as  child care,  laundry, cooking, extra
> vacation time for a honeymoon, (anything to  be paid by  the
> government), there were murmurs of approval, sometime  clapping, in the
> theater.  Based on the Houston attendance, I  would not think this  show
> will have a very long running at the box office.  Because it presents a
> “ you can and  should have it all at no real cost to YOU,” I have no
> doubt that  many  individuals and groups will “latch” onto this film
> and champion it.  I  cannot envision it having any long  term real
> societal impact on health care,  simply because it does not present
> anything new or offer solutions on HOW we  reach this nirvana state that
> is  enjoyed in France,  UK, Cuba and Canada.    At one point, Mr. Moore
> emphasized that the US is a country where people are “ afraid of
> government,” afraid to speak out and demonstrate – implying this
> was quite  different in France,  Cuba, Canada and the UK.  I’m still
> puzzled  by that premise. When  in recent history have Americans had ANY
> reticence about  speaking out and  demonstrating???
> I will admit again that some of the central core  complaints are common
> among  patients, nurses, doctors, organized medicine, and  medical
> professional  groups.  Those  core issues about which there is agreement
> were cited in the first  paragraphs of  this review, and I will not
> repeat them.  It would be  wonderful if we could unite in addressing
> THOSE core issues  with a massive  communication effort to policy makers
> (inside and outside the  government).  I am afraid  that the  solutions
> are going to be very complex and multifactoral and not as  simple as
> getting the “government to give you free drugs, free doctors, free
>  hospitalization, and free laundry services.”
> Kenneth L. Mattox, MD
>
>
>
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