Saturday, June 30, 2007

Review: Sicko

I'm still in shock after watching Sicko, the new Michael Moore venture, last night. The shock wasn't his idealistic portrayal of the Canadian health care system, or the horror stories of the completely uncompassionate American way (which includes a classic recording of Ronald Reagan ranting against the introduction of Medicare for seniors in the 1960s as "socialized medicine"). It was how far ahead the British and French are with their systems and how Americans have flocked to those countries precisely because of that. And how compassionate the Cuban way is despite their oppressive regime. I think some of the ways of the world may have relevance for Canada.

Britain's system, the NHS, is certainly fraught with flaws. But fully a decade and a half before Tommy Douglas, a country still ravaged by the shock of war decided to pull together and make good health a right rather than a privilege. Not only is basic health coverage free, but there are relatively low co-payments for dentistry, opticians and prescription drugs. I was stunned to learn the standard fee for a prescription is just under £7 (the £6.65 co-pay quoted in the film went up 20p a couple of months ago). There is a measure of private health care in the UK, but the NHS is the third rail of that country's politics. Even Thatcher, it was mentioned, refused to do away with it all together. The rim shot moment came when Moore came to the cashier, convinced patients had to pay something. Instead, the hospitals were paying patients who had to travel to get their health care -- covering their transit costs.

What was most impressive, though, was that doctors there get paid bonuses if they can get their patients to adopt healthier lifestyles -- quitting smoking, lowering their body mass index, etc. The poorest Brit is actually healthier than the richest American. Why? Because a Brit will go to the doctor if something is wrong rather than waiting until it's too late like Americans do.

France's system is even more comprehensive. Not only is everything free, but people get paid vacation time, full 100% maternity leave benefits (it's only about half that in most of Canada, somewhat higher in Québec), nannies on call. Universal day care (are you paying attention, PMS?)! And how about this: Physicians who are on dispatch to make house calls 24/7? (This one was created in the 60s by a doctor who felt if a plumber was available around the clock, so should doctors.) And like the British, the French are substantially healthier than most Americans -- even with their wine and pastry rich Mediterranean diet.

Most telling in the France segment were a group of Americans who told Moore, flat out, that American politicians from both parties lie about family values. France values families, in their opinion, and they'd rather live in Paris or Marseilles than Boston or Los Angeles.

Moore's ultimate stunt was bringing 9/11 volunteers -- who were shut out from benefits because they didn't work for the police or fire brigades, something which even George Pataki, a Republican, found repulsive -- to Gitmo for health care. They were refused so Moore then went to Havana with the gang and a couple of other patients. The care was, as I wrote above, uncommonly compassionate and first rate. Some patients were able to get off unneeded drugs all together -- presumably, their doctors back home were consequently denied payola. The drugs were extremely inexpensive -- five cents for an inhaler that cost 120 dollars in America.

But the most emotional moment was when a fire crew in Havana paid tribute to their colleagues in New York -- saying were it not for the trade embargo they would have been on the first flight out on 9/11 helping out at Ground Zero and the Pentagon. That's the kind of fraternity the Cuban-American lobby is so dead against, and those hypocrites should be ashamed of themselves.

So what can Canada learn?

I think the following points are critical.
  1. There's been talk of setting up a parallel system to clear up supposed "backlogs". I may be biased but my father's recent experience after nearly dying tells me he would not have received any more care or faster if there was a private hospital in town. My sense is, if people want to opt out then they should go all the way -- and that includes turning in their government issued health card. You're either in or you're out.
  2. Canada needs to have pharmacare, across Canada. If it's good enough for British Columbia and Québec it's good enough for the whole country. Surveys consistently show people would be willing to pay higher taxes if it means better health care. Further, we need to go to universal dental and optical coverage too. We can afford it.
  3. Healthy lives are only possible with healthy starts. We need to stand up to the Fraser Institute and other right-wingers and say that kids come first and if that means either universal day care or universal access with charges based on the ability to pay then so be it. And I'll say it again: We need to enhance the Child Tax Benefit and eliminate poverty among minors, once and for all.

Another home run for Moore. 4 stars.

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1 comment:

Single PAP said...

i know, i know. i left that movie depressed. i am american and have had issues with my health coverage (denails, etc) but thankfully not for anything catastrophic in nature. of course i worry though about things that might crop up in the future either for myself or someone in my family. i am seriously looking into moving abroad... it's just not worth the risk.