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

hbutler at pol.net hbutler at pol.net
Tue Jul 3 01:05:23 BST 2007 

  Thank you.

> Yes. You can send anywhere you wish.
>
> K
>
>
> Sent via BlackBerry from Cingular Wireless
>
> -----Original Message-----
> From: <hbutler at pol.net>
>
> Date: Mon, 2 Jul 2007 07:56:36
> To:<trauma-list at trauma.org>
> Subject: Re: Universal Free Health Care (.......nanny and laundry)

>
> 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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