Michael Moore's new documentary, "Sicko," presents an overwhelmingly one-sided view of the American health care system. It fails to depict the real situation, it prevents honest discussion, and it risks inspiring fanaticism.
Moore believes our health care system is abysmal. "Sicko" documents the tragic stories of both the insured and the uninsured as they fail to find care in our hospitals. Profit-grubbing insurance companies, unreasonable prices and an inherently flawed system stand in their way.
But in Moore's style, we don't see the other side. The movie ignores the superior technology, practitioners and patient experience in the United States. Moreover, it paints a ridiculously unrealistic picture of life in Canada, France, and Britain.
The United States has better medical technology than any other country in the world. John Goodman has shown that we have twice as many CAT scanners as Britain despite the technology being invented there. In 2004, The Fraiser Institute found that 25.5 MRI exams, 87.3 CT exams and 45 in-patient surgical procedures were performed per 1,000 people in Canada versus 83.2, 172.5 and 88 in the United States. But does our technological superiority produce results?
Yes. In the United States, one-fifth of women diagnosed with breast cancer die. In contrast, one-third die in France and in Germany while one-half die in the United Kingdom and in New Zealand. Similarly, in the United States one-sixth of men diagnosed with prostate cancer die. In Canada one-fourth die, in France one-half die and in the United Kingdom more than one-half die.
If we are better at treating cancer, why do we have worse infant mortality and life expectancy than most other Western nations (and therefore a lower World Health Organization ranking)?
Four reasons. One, other countries intentionally deviate from the United Nations definition of a "live baby" to increase their numbers (i.e., Switzerland defining a live baby as being 30 centimeters or longer). Two, due to lifestyle choices (smoking, obesity and diabetes) American hospitals face more complicated births than in most Western countries. Three, Americans' choices lead to shorter life spans (Nicholas Eberstadt). Four, America's diversity lowers life expectancy because certain groups of people live longer than others.
But even with worse statistics in certain areas, we shine in others.
One detail Moore "forgets" to mention is that Americans are more satisfied with their care than anyone else. In the 2000 U.N. World Health Report, America ranked first in patient satisfaction. In contrast, Canada ranked seventh, France 16th, Britain 26th, and the "inspirational" Cuban system 115th, tied with Guatemala and Yugoslavia. How can this be?
Despite anecdotal evidence of "20 minute wait times" in Britain and Canada, the real situation alarms those governments. At any given point there are 1,000,000 people on the wait list in Britain and 900,000 in Canada. The average wait time in Canada between a family doctor referral and a specialist increased from 3.7 weeks in 1993 to the current 8.3 weeks (Fraiser Institute). Canadian and British doctors must also deal with 50 percent more patients than their American equivalents. What's the solution?
Mixing in private elements. Clifford Kraus wrote in the New York Times (Feb. 26, 2006) that in Canada "private clinics are opening around the country by an estimated one a week, and private insurance companies are about to find a gold mine." The British system also allows for private care.
But what does this all mean? It means that many patients can receive better health care here than anywhere else. Dartmouth students can go to Dartmouth-Hitchcock Medical Center themselves to see the incredible facilities. Does this mean our system works perfectly?
No. There are many problems with our health care system. Moore presents some of them quite clearly. But without mentioning the strengths of American medical care, people gain false impressions. Thus, they enter discussions with erroneous assumptions and misinformation. Worse, they can take serious action without ever understanding the other side. If anything, one-sided paradigms lie at the core of what we call fanaticism.
I completely support an honest debate about American health policy. But only if both sides are presented in a fair manner. Moore had a chance to raise awareness about real issues. Instead, he made money by sensationalizing certain stories. In the end I think we, the American public, are left worse off.
