Libertarian Girl

I laughed, I cried, and I mentally composed this post while recently watching Michael Moore’s documentary Sicko.

After watching the movie, I have ten questions Michael Moore didn’t address extensively enough in the movie.

1. Can PT Barnum-style entertainment translate into actual health care policy?

Moore is a good filmmaker, and he does make a compelling emotional case for some general type of entity (he’s fuzzy on the details) called “universal healthcare.” It was entertaining, and I did enjoy his foray to Guantanamo Bay and then to Cuba. Pure genius. It does seem jarring that law-abiding Americans (and in this case, people hailed as heroes) would not be able to receive proper health care for their problems, while (alleged) terrorists and murderers can.

In the process of stating his case, though, Moore sometimes resorts to generalities and overreaching statements that just aren’t true or are misleading. He’s certainly better at filmmaking than economics. He focuses on those who have private or government health insurance and are failed by it, rather than those who don’t have any insurance at all (which implies that maybe it’s not that bad to not have health insurance, since when you need it, you won’t receive any benefits anyway). Moore doesn’t ever say exactly what the solution to America’s healthcare problem would actually be, although he seems to be hoping for single-payer systems in the style of Britain, Canada, and especially France (which doesn’t actually have a single-payer system, but I’ll cover that in a follow-up post).

2. Would the Democratic presidential candidates’ plans solve these problems, or make them worse? One thing is not in question after seeing the documentary: Michael Moore is a Democrat, and he seems to like what Democratic candidates may offer in regards to health care. Moore fails to mention that the first Clinton health care plan he seems to adore so much was not a single-payer system at all; neither was it anything like that found in the UK or Canada.

The first half of the documentary is a litany of the many sins of insurance companies far and wide; the biggest gripe is that insurance companies are out to make a profit at the expense of their clients. No mention is made regarding how this situation may get worse under Hillary’s current proposed health care plan, in which all Americans will be required to deal with the horror that evidently is private American medical insurance. The current plans of the other Democratic presidential candidates also revolve around mandating these types of private health insurance from these same companies, rather than instituting any form of single-payer health care. Under the plans of Clinton and Edwards, Americans would be forced to pay for insurance under these programs if they could afford it, and if they could not, the government would pay for them.

But wouldn’t insurance companies still have to make a profit to exist? Wouldn’t they still decline certain services as “experimental”? Do you really think the government is going to pay for a procedure that private insurance has officially deemed “experimental”? The FDA often won’t even approve drugs shown to be effective in clinical studies because they want to remain on the cautious side, especially in these post-Vioxx days.

One of the most common ways mentioned of implementing universal healthcare in America is by just expanding Medicare to cover everyone, not just the elderly and disabled. That wouldn’t help people like Paul, the elderly grocery store worker in Sicko, who according to Moore, is covered by Medicare but still has to work to afford his medicine. What’s the solution? Medicare doesn’t cut it for Paul and his wife, so why does Moore think that another government-run program would do any better?

3. OMG, Nixon started HMOs????

I would have been surprised by this as well if I hadn’t read Ron Paul’s take on free market health care a few months ago. Congressman Paul explains that HMOs were actually mandated by federal law, a regulation which many believe has caused our current healthcare industry’s problems. OK, so Congressman Paul (who is running for President, by the way) has gone on record as wanting to repeal the laws requiring the existence of HMOs. Will the other members of Congress running for President, Obama, Kucinich, Clinton, Dodd, Biden, McCain, Tancredo and Hunter, do the same? If not, why? Are they all receiving the same huge amounts of campaign donations from the healthcare industry that Moore reminds us Hillary is?

The Sicko physician who worked for the insurance industry and testifies to lawmakers that her actions resulted in the death of at least one person asks, “Who invented this system?” The answer is the government, and it then bears asking, “Can we really trust the government to solve this for us?” Is socialized medicine administered by the government going to be any less corrupt, bureaucratic and wasteful than any other government program? Or is it just going to be more of the same—rampant opportunities for cronyism, overspending, no-bid contracts, huge amounts of money embezzled with no one noticing, and bankruptcy (which France’s system has already experienced)?

I also find it interesting that Nixon is universally reviled for covering up Watergate, but his true disasters as President were, in addition to the inherited quagmire of Vietnam, creating the HMO mess and taking the US completely off the gold standard, which has caused wild inflation ever since.

4. Are the higher tax rates other countries experience worth the cost (and benefits) of socialized medicine?

Some have said that income tax rates among the UK, France and the US aren’t all that different. Sure, someone who makes $50,000 in the UK and has an additional $1,211 (according to the calculations in this post) in pure income tax taken out of their salary may not notice the difference, but do you think they ever notice the 17.5% Value-Added Tax (VAT), a national sales tax placed on everything they buy, or perhaps the thousands of pounds in council tax they have to pay each year to their local government? Council taxes are the British form of property taxes, but they are paid by everyone, even renters.

My British friends may not complain about their health insurance rates, but they do complain about their taxes, especially council tax. Let’s imagine you’re a poor working person, which means that you’re probably a renter in either country. Add in another $4,000 in council taxes paid yearly by a renter in the UK and an estimated $2,000 a year in VAT, and that extra $1,211 more paid in income taxes each year actually turns into an additional $4,411 per $50,000 in income, when $3,000 per year in state income tax is figured in for the American. For some people, perhaps with families and spouses on their health insurance and perhaps with pre-existing medical conditions, an extra $4,411 per year in taxes would be a great bargain in comparison to the premiums and deductibles they’re paying now. But for younger people, and those who choose not to pay for monthly health premiums in America now, an extra $4,411 (or $7,411 for those living in states with no income tax) paid per year in taxes could be unfathomable.

5. Should I move to Paris to get those five-week vacations and the perfect life the French seem to have?

The American expats featured in Sicko, while saying that newlyweds get an extra week off in addition to the many weeks of vacation a French worker also receives, conveniently forget to mention that French people couldn’t work more if they wanted to, with an unemployment rate which has traditionally been higher than 10%.

But what about that amazing French “middle class” family Moore shows us, the one who makes $8,000 a month and seems to live in complete luxury (with their biggest expense being fruits and vegetables)? According to Donald Luskin, (with credit given to Bruce Bartlett) a 2004 report by a European company states that “total private consumption per capita in France is about half that of the U.S. The average French family has a lower standard of living than Americans living below the poverty level. Impoverished Americans have 16% more dwelling space per capita than the average French; the American poor are more likely to have a car, a dishwasher, a microwave oven, a personal computer, and a clothes drier.”

Questions 6 through 10 can be found in Part 2 of my thoughts on Sicko.

This entry was posted on Sunday, November 25th, 2007 at 10:02 am and is filed under Healthcare. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.