Sicko

Wow, if I’ve learned anything in these past few weeks (and, believe me, I have) — it’s that having a new baby really takes up a lot of your time! My “regular” posting to this blog (and even worse, to my work blog) have suffered quite a bit in the run-up to Gabriel’s arrival and the weeks since. But… with apologies to my faithful readers… it’s worth it. Spending time with the little guy is super cool. 🙂

Anyway, back to the alleged topic of this post. Michael Moore’s movie “Sicko”. Jodi and I saw this one probably 2-3 weeks B.G. (yes, Before Gabriel) and I never got around to writing it up. In the interest of time, I’ll keep it short…

Like all Michael Moore movies, folks on the right (and even some in the center and left) immediately pounced on every possible thing in the movie that was inaccurate or could be misconstrued to be inaccurate. By this point anyone who has kept up with his history should not be surprised by this. Michael Moore always pushes the envelope: both in terms of the topics he chooses and also in the way he presents the topic.

Once again, the “haters” came out in full force — decrying the folly in this point, the impossibility of that point, etc.

Which leads to MY point. Sure, it’s easy to find fault with one or many of the examples he provides. It’s easy to point out that the Audi driving doctor probably has supplemental income to be able to afford his fancy lifestyle and $1mil apartment. Sure, it’s easy to recognize that Canada and France and England (and every other civilized country in the world) have system which are imperfect. But what’s not so easy is effectively dismissing the REAL point of this movie: that our system is falling apart – bursting at the seams, that we spend more than other countries per-person and don’t even cover everyone, that we have recently (bankruptcy bill changes) made it even more likely that huge medical bills will unravel the finances (and financial future) of more and more families.

A couple of things (myths?) in particular about single-payer medicine as it exists today — basically, everywhere in the world except here:

  • Waiting for service. Sure, people have to wait for non-emergency service in Canada, England, etc. But, realistically, you have to wait for non-emergency service HERE too. I have great insurance and I still have to schedule out my non-emergency medical visits from a few days to a few months, depending on who I’m seeing and what is the issue. It’s disingenuous to pretend that we’d suddenly have to start waiting for non-emergency service if we changed our system. And, to be clear, you don’t have to schedule your emergency service in Canada/England/France. Come on now.
  • Doctors make no money. Actually, it’s a little unclear to me why the average person would care about this (the average person not being a Doctor). Most of the Doctor folks I know either have no reasoned opinion about Single payer or they are at least tentatively supportive, so it’s not really something I’ve heard from a bunch of Doctors either. And yet, this is one of the common concerns you hear about single payer. I think it’s quite likely that Doctors, generally, would make less money under single-payer system. Less money. But, as highly trained, highly in-demand professionals, it seems quite likely they would still make an excellent, high-end salary. Many regulated industries have employees who receive high salaries: airlines, government. Now, would a superstar specialist surgeon make $750k/year? Maybe. It seems quite likely that our system would not tolerate anything other than a merit-and-workload-based compensation strategy, so maybe this *IS* possible. It’s fundamentally a function of how reimbursements are structured. What WOULD likely change is that if we have more broad patient coverage, we would (hopefully) see less need for highly invasive (and expensive) work to be done — due to better preventative care earlier in life, etc. In that way, indirectly we might see doctor salaries decrease as there’s more need for internal medicine and family practice physicians and less need for heart bypass surgeons. Or maybe that’s just wishful thinking. 🙂

Oh well, that’s enough on the point. I’m glad to see this topic being discussed – at least by the Democrats (the Republicans, in a recent debate, wouldn’t even consent to discussing the topic; just all are against it).

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