USA: Mercenary medicine By Max J. Castro
- From: periodistalibre@xxxxxxx
- Date: Fri, 13 Jul 2007 07:11:20 -0700
PROGRESO WEEKLY /
July 13, 2007 /
http://www.progresoweekly.com/index.php?progreso=Max_Castro&;
amp;otherweek=1184302800
http://tinyurl.com/2ccrkh
By Max J. Castro -
majcastro@xxxxxxxxx -
Last month, the Health Council of South Florida issued a report card
on
health care in Miami-Dade County. The grades in the eight areas rated
ranged
from failing to mediocre. The study accurately reflects the reality
that the
condition of health care in Miami is critical. The biggest problem is
lack
of access. More than one in four, 28.6 percent, of county residents do
not
have health insurance and "...an even greater number have difficulty
accessing
health services or obtaining quality care..." This results in
"significantly
higher rates of hypertension, low birth weight babies, diabetes,
asthma,
cervical cancer and low levels of access to oral health care and
elders who
have received influenza vaccination." Further, "63.2% of individuals
in
Miami-Dade County reporting depression did not seek professional
help,"
which places "an enormous social and financial burden on the Miami-
Dade
community with consequences particularly effecting women, low-income
individuals, Hispanics and Blacks."
Miami-Dade is not atypical of the United States in the first decade of
the
twenty-first century, where between 45 and 50 million people lack
health
insurance. The high proportion of Hispanics and immigrants in South
Florida
-- the two groups with the lowest health insurance enrollment rates in
the
nation -- makes the problem somewhat more acute in Miami than in most
other
places. But the situation is worse in some inner-city areas in other
cities,
and nationwide the picture is almost as bleak as in Miami.
Topicality is only one of the virtues of "Sicko," Michael Moore's
latest
movie. A more important virtue is that it shows that while the woes of
the
uninsured are real and widespread, they represent only the tip of the
iceberg of a thoroughly dysfunctional health care system. It is a
system
designed to maximize profits even at the expense of the well-being,
and not
infrequently the lives, of patients.
Anyone not in a state of terminal denial who has seen "Sicko" will
have a
hard time thinking of the current U.S. health care crisis as a problem
that
affects other people, mainly the improvident, the underclass, and the
disreputable. That is because "Sicko" does not focus on the uninsured.
Instead, Moore depicts case after heart-rending case of what happens
to
"good, decent, middle class people" with health insurance coverage
when
their medical conditions become an impediment to a bigger bottom line
for
their insurance companies. The devastation ranges from bankruptcy to
loss of
limbs to unnecessary death.
To Moore's credit, "Sicko" does not stop at denouncing the inequities
of the
U.S. health care system. Rather, it shows convincingly, in myriad
ways, and
through a variety of narrative devices, that it definitively does not
have
to be this way. One segment shows what happened to a man in the United
States who lacked health insurance when two of his fingers were
partially
severed by an electric saw: he lost part of his middle finger because
he
could not afford the $60,000 the hospital wanted to charge him to
reattach
it. A later segment shows what happened to a man in Canada who
suffered a
much worse accident in which all five fingers in one hand were
severed. In
the Canadian case, doctors successfully reattached the fingers; the
patient
retained his digits and paid nothing.
"Sicko" compares the health care system in the United States with that
of
Canada, the United Kingdom, France, and Cuba. The point that emerges
from
the comparison is that all of the rich countries of the world, except
the
United States, provide universal access to health care. Even Cuba (a
country
with a GDP per capita one tenth that of the United States) provides
access
to health care to all of its citizens, despite a tightening embargo
and the
economic crisis that afflicted the country after the Soviet collapse.
Only
the United States has a health care system based on a mercenary
conception
of medicine. Despite differences in ideology and level of development,
the
medical systems in Canada, the UK, France, and Cuba all are based on a
notion of solidarity. Contrary to the propaganda widespread in the
United
States, the citizens of these countries -- conservative, liberal,
socialist,
and communist alike -- like their socialized system of medical care
and
would throw out any politician who threatened to destroy it.
The same could not be said of our own mercenary medical system. It is
no
wonder because Americans pay more for care and are less healthy than
their
counterparts in other developed countries. Many Americans die
unnecessarily
solely because our health care system is run for the purpose of
profiteering
by the insurance, pharmaceutical, and managed care industries.
That last point is driven home dramatically by archival footage of
Congressional testimony by Dr. Linda Pino, formerly the medical
director of
a managed health care company. Pino called her testimony "a public
confession." What she confessed is that she denied life-saving surgery
to a
man in order to save her company $500,000. This decision earned Dr.
Pino
promotion and ever-higher compensation. The company even offered
higher pay
to those who denied more claims.
Pino's testimony is supplemented by interviews with other contrite
former
insurance company hit men and women whose job it was to deny people
insurance coverage and health care.
One of the film's strengths, aside from the humor, is that it covers
so many
bases, from the ideological origins of our current medical mess to the
criticisms usually leveled at the health care systems of such
countries as
Canada and the UK. There is even a taped 1971 conversation between
Richard
Nixon and John Ehrlichman, a Nixon aide later convicted in the
Watergate
scandal. It reveals the cynical logic at work at the very creation of
what
would become our medical-corporate complex: less care and more
profits. "The
less care they give, the more money they make," says Ehrlichman about
managed care. "The incentives are all in the right direction," he
adds,
eliciting Nixon's approval. This logic, the less care they give the
more
money they make, drives our mercenary medical system to this day, with
devastating consequences.
Michael Moore's relentless depiction of the awful consequences of a
health
care system run primarily for profit qualifies his latest documentary
as a
horror movie. Yet it is not exaggerated or inaccurate, and critics who
have
scoured the movie in order to discredit it by exposing factual errors
have
failed. Then there are those who would want to cast doubt on the
central
issues presented by quibbling with side questions, especially
regarding the
Cuban medical system. Some others who are sympathetic to Moore's view
nevertheless see the inclusion of the Cuba material as a mistake, one
that
gives Moore's detractors much useful ammunition. Yet, they seem to
have
missed Moore's point, the senselessness and puerility of the American
proclivity for demonization -- of British and Canadian socialized
medicine,
of the French more generally, of Cuba, that ultimate bête noire -- in
the
face of our own shameful failure as a society to provide a decent
level of
care to so many of our own people in spite of the bountiful resources
and
the advanced technology that would enable us to do so.
"Sicko" is not a perfect film; at points Michael Moore succumbs to a
tendency toward manipulation. But "Sicko" is head and shoulders above
the
usual drivel that comes out of Hollywood.
It will be good news if "Sicko" does even better at the box office
than
Moore's earlier films. It would be even better news if it becomes a
manifesto for a campaign to replace our mercenary system of medicine
with
one based on respect for human life and dignity. It will be a miracle
if
"Sicko" shames the Democratic presidential candidates into moving
beyond the
timid reforms they are now proposing.
Will that happen? Reviewers have rightly pointed out that "Sicko" is
less
strident and partisan than Moore's other movies, implying a broader
appeal.
But there is a less optimistic scenario. Moore's earlier films go
after
specific political or economic actors, such as the Bush
administration, auto
industry executives, and the NRA. Bush, Detroit, and the NRA are
powerful,
but there is a wide sector of the public that is skeptical or outright
despises them. This is the audience for Moore's films.
"Sicko's" challenge, however, is broader and more radical. The film
ultimately questions not just the insurance companies or even the U.S.
medical care system as a whole. It dares critique more deeply rooted
and
very broadly held American modes of thinking: radical self reliance
and the
conviction that the United States is, in each and every conceivable
way, the
best country in the world if not best country possible. It is these
modes of
thinking, along with the ease with which money can be converted into
political capital in the United States (in contrast to other Western
countries) that allow the profiteers to defend and maintain a
mercenary
medical system at odds with basic humanitarian and ethical
principles.
Americans may be sick of the insurance companies and increasingly
angry at
the whole medical system. But are they also ready to give up some of
their
individualism and the myth of American exceptionalism?
.
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