Wednesday, June 27, 2007

Film guts U.S. health care system

Film guts U.S. health care system
By Clarence Page
Copyright © 2007, Chicago Tribune
Published June 27, 2007

WASHINGTON -- America's got a terrific health care system, as long as you don't get sick.

That much, at least, seems to be conceded even by lobbyists for the nation's health insurance industry. That's judging by one of the few who showed up at Michael Moore's invitation for the Washington premiere of his new movie, "Sicko."

"Look, identifying problems in our health-care system is like shooting fish in a barrel," consultant Claudia Schlosberg was quoted as saying by the Washington Post. The real issue, she said, is finding solutions.

That's easy to say when you represent the industry that grew those fish in what's becoming a shrinking barrel. Numerous congressional proposals have offered wider, less expensive and more reliable coverage than Americans receive from our current patchwork, employer-based system.

But no matter how workable, practical or desirable the proposals may be, the insurance industry reliably shoots them down. Armed with billions of dollars for political campaign contributions, spin doctors and attack ads, the industry has largely steered the nation's health care debate for decades.

It's hard for the public to make an intelligent choice when only one side has the megaphone. Moore evens things up a bit. He uses the same pop culture that brings you Paris Hilton and "American Idol" to offer something truly valuable: a vision of a better American health care system than the one we have.

Moore is famous for his gonzo attempts to embarrass the rich, powerful or simply stupid on camera in his past documentary essays. This time he's a tad more serious and, I think, more effective. He allows the horror stories of lost coverage, lost limbs, lost homes and lost lives to be told mostly by the working-class people who suffered through them. He interviews a few whistleblowers who became fed up with helping insurance companies to grow their earnings by shrinking their care.

He offers something else that most Americans never see: how easily anyone -- including visitors -- can access good public health care in Canada and Europe and how satisfied those country's citizens are with their systems. Critics predictably charge Moore with sugar-coating his view of the other countries, particularly Cuba, where Castro's government still affords superior care to favored Communist Party elites. Nevertheless, having witnessed health care in each of the countries Moore visits, I think he got it about right. Politics aside, even Cuba shows how a remarkably universal system of education and health care can be produced by a country with a lot fewer resources than we have.

As for Canada and Europe, customer satisfaction is high, despite the drawbacks. Defenders of our health care status quo come up with one horror story after another of long lines, waiting lists, rising costs or rationed care. But they don't like to talk about the long lines, waiting lists, rising costs or rationed care that Americans face in our existing system. Moore's movie does.

Nobody's system is perfect. But despite the smear job that conservatives over here give to British health care, for example, stalwart conservatives over there aren't mounting much of an effort to change it. Similarly Washington's Medicare debate centers on how it should be run (How to pay for it? What should it cover? How can we contain costs?), not whether it should exist.

But that doesn't make Moore's argument any easier. Americans don't like to change, even when it is for the better. President Bush found that out when he tried to sell the opportunity for each of us to invest part of our Social Security contributions in the stock market, if we so choose. Not a bad idea, really. Nobody would be forced to do it. Yet, the more speeches he gave on the subject the less popular it became. (It's probably just as well that Bush in his younger days did not choose a career in sales. He might have starved to death.)

What is to be done? On his Web site Moore spells out his agenda in three simple steps: Free, lifelong universal health care for every resident, abolish all health insurance companies and "strictly" regulate pharmaceutical companies "like a public utility." Good luck. If Moore wants to abolish insurance companies, he's probably in for a big disappointment. Even President Lyndon Johnson, a maestro at legislative process, found he had to include insurance companies in his plans, strengthening their existence, just to get Medicare passed.

For solutions, "Sicko" diagnoses what's wrong, but leaves the details of prescriptions largely to the rest of us. That's wise. There are about 10 million more uninsured Americans today than there were when Bill and Hillary Clinton launched their health care debate in the early 1990s. If enough people are outraged, we can have a better one. Moore hasn't got all the answers, but he helps us to raise the right questions.

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Clarence Page is a member of the Tribune's editorial board. E-mail: cptime@aol.com

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