The Best 'Health Care System?' - Not a Chance

A persistent claim by many politicians opposed to major health care reform - most of whom are Republicans - is that we here in the United States already have the best health care system in the world. Their hope is that if they can sell the American people on this feeble myth, they will be able to preserve a system they amazingly see little wrong with.

Senator Chuck Grassley (R-Iowa) said something very stupid. Like telling Americans they can have good health care coverage too if they just "went to work for the federal government." Senator Mitch McConnell (R-Kentucky) also said that people without insurance are not really denied health care because all they have to do is "go to the emergency room." Not only do these idiotic remarks need no elucidation, they are indefensible.

What are these detractors referring to when they make this claim about Americans having the best health care system in the world? What is clear is that the United States can deliver the best emergency care of any country. "Highly trained American doctors can summon Star Wars-type technology in saving patients who have become seriously injured or critically ill." (Myth: The U.S. Has the Best Health Care System In the World)

What this means is that from a strictly medical perspective, i.e., economic considerations aside, we have the best doctors and the best system for providing high-end, complicated care and procedures to people in critical situations. As remarkable as this ability is, it has little effect on the issue of providing coverage and delivering services to the every day masses who are in need of more routine - but nonetheless important - medical care including preventive medicine. Being able to safely perform quadruple-bypass surgery or highly complicated neurosurgery is great, but what about the uninsured individual who simply can't find a primary care physician?

A sustainable, profit-driven model has yet to emerge as a viable option for providing comprehensive health care to an entire society because covering everyone for all conditions would eviscerate the bottom line of any profit-driven scheme. In other words, to realize a profit in the business of health care delivery, coverage must exclude certain conditions as well as a certain segment of society.

If the goal of making any public option a self-sustaining one is to be realized, there may be no alternative other than to tax high income earners enough to achieve this. As the United States has the world's worst income disparity between rich and poor, such a tax would serve to mitigate this cruel inequity. Further, young and healthy people should be legally obliged to participate in a health insurance program because their contributions are necessary to provide for the poor, sick, elderly and indigent among whom they will one day be counted.

The American health care industry may well be profitable, but its health care system is loathsomely deficient.

"Sicko": An Indictment Worthy of Airing

This review may not exactly be timely, but - better late than never.

Documentary film maker Michael Moore may have trouble hiding his biases and political prejudices, but he nonetheless has a way of making people sit up and take notice. In his 2007 release, Sicko, he adeptly tugs at the emotional strings of his viewers in order to make his point that something is very wrong with the American health care system.

Pointing out it's bad enough nearly 50 million Americans are without health care insurance of any kind, Moore goes on to expose what many people who do have health insurance have known for a long time: they have to fight routine denials of coverage they believed they were entitled to. Trotting out industry insiders-turned-whistleblowers, Moore makes plain the Achilles heel of the profit-driven scheme: that denying coverage is an integral aspect of the plan to achieve a favorable bottom line. During one interview, Moore listens as an HMO specialist reveals an incentive scheme in which bonuses are paid out to managers who deny the most in claims.

For contrasting effect, Moore takes a look at the health care systems of England, France, Cuba, and - for humorous emphasis - the medical wing of the Guantanamo Bay Naval Station's detention center where al-Qaeda terror suspects, of course, receive free medical care.

Moore glosses over the real cost of universal health care in these countries, which is of course very high taxes. What becomes plain in Sicko, however, is that the people in these countries seem more than willing to live with the system they have erected and appear to have few complaints. In other words, the free delivery of comprehensive health care is made a priority.

In responding to critics' fears of "socialized" medicine, Moore points out that here in America we are already perfectly willing to socialize a few things we deem to be of sufficient priority like fire protection, police protection, primary education, etc. The inference to be drawn is clearly that Americans have yet to reach the point where health care is seen as the same kind of necessity - a nearly absolute one. Or maybe they have, but the profit-minded behemoths protecting the system presently in place are too well connected politically to allow the changes Americans seem to be wanting.

Sicko lays bare many of the fissures in the present American health care system. What it does not do - nor does it purport to - is offer details for an alternative plan. Moore simply puts on display the benefits of a free, universal system and ponders what Americans could achieve if they could muster the political will to abandon the dysfunctional status quo.