Michael Moore's 'Sicko' Scrutinizes Canada's Healthcar

[Renegade]

The amount of money we can spend on public heath care is finite which means the public system will have to make choices based on the best interest of society. Unfortunately, the best interest of society is not always the same as the best interest of an individual. That is why we need to allow individuals to purchase additional care if they find that basic coverage is not sufficient.

The system has been constructed so that the interest of society are essentially defined as the summation of the interest of groups of indivdiuals. Meaning if we look after the interest of enough people, we can claim to have satisified the "interest of society", and not have to give a damn about the minority.

This actually runs counter to universal healthcare as it would be sufficient to provide adequate healthcare for the majority, even if it meant providing none for the minority.

That said, the fact that perfection is not possible in a universal public system does not mean we should throw up our hands and not even attempt to come up with some definition of basic health care coverage for everyone.

I don't disagree with anything you have stated. It is both practical and justifiable to define what basic health coverage is. IMV, the bar in terms of what is provided as basic coverage "for free" is way too high. For most of the "free universal healthcare" crowd it doesn't seem politically correct to discuss restrictions on what is provided as a means to contain costs. To me it seems a complete violation of personal freedom that the people who pay for the system are not allowed to purchase superior care in the name of "equality".

[Pliny]

They are working on it. See UN Charter.

Un Charter directives are generally "motherhood and apple-pie" statements. They do not generally address the hard choices which have to be made to implement those initiatives.

Not yet, anyway.

[Pliny]

The amount of money we can spend on public heath care is finite which means the public system will have to make choices based on the best interest of society. Unfortunately, the best interest of society is not always the same as the best interest of an individual. That is why we need to allow individuals to purchase additional care if they find that basic coverage is not sufficient.

The system has been constructed so that the interest of society are essentially defined as the summation of the interest of groups of indivdiuals. Meaning if we look after the interest of enough people, we can claim to have satisified the "interest of society", and not have to give a damn about the minority.

This actually runs counter to universal healthcare as it would be sufficient to provide adequate healthcare for the majority, even if it meant providing none for the minority.

That said, the fact that perfection is not possible in a universal public system does not mean we should throw up our hands and not even attempt to come up with some definition of basic health care coverage for everyone.

I don't disagree with anything you have stated. It is both practical and justifiable to define what basic health coverage is. IMV, the bar in terms of what is provided as basic coverage "for free" is way too high. For most of the "free universal healthcare" crowd it doesn't seem politically correct to discuss restrictions on what is provided as a means to contain costs. To me it seems a complete violation of personal freedom that the people who pay for the system are not allowed to purchase superior care in the name of "equality".

At what point does the "interest of society" override "universal" health care? When they eat at Mc Donald's?

You are right the interests of society runs counter to universal health care. The minority would have to be the more well off who generally will pay for their own service either entirely or as an upgrade. Universal health care will always be an inferior product to what one could purchase if money were not an object.

There is no better way to waste a persons life; to make him feel worthless, than to provide him with all of his needs, and especially in combination with a refusal to accept any contribution he could make in return. Instructing people that because they exist they have a right to all their basic needs is socially and economically irresponsible. Do so and you are asking for chaos. For every person who demands those rights there must be a person to provide them. Have society fall upon hard times and see how long those rights will be rights.

[jbg]

You are fairly certain a single Mom would not get the same support a child of a middle class family in the suburbs would get. Well.....

If people knew they had to be responsible for themselves and knew that their welfare depended upon their relationships, their community and their contribution to both there wouldn't be too many single Moms around.

And I know you are probably thinking entirely of the woman in these matters but men would have to be a little more responsible as well.

The politically correct world of government problem solving would, of course, have us do whatever made us feel good. We would just be demanding our rights (food, clothing, shelter, health care, education) and blaming someone else or some nebulous entity like "society" for our situations. I think there are individuals that think food, clothing, shelter, health care and education are products of the federal government who have an endless supply of these commodities in stock and the ability to print money should keep the cupboards overflowing. Once the people that actually do supply these things start to find their work unrewarding or the majority of it is confiscated they will either leave for greener pastures or become one of those demanding their "rights" and blaming someone else for their problems.

One of the reasons I am a bit kinder to Bill Clinton than many conservatives is that he rearranged US welfare in exactly the manner so as to discourage the manufacture of babies by single moms. Surprise, it worked.

The details are that welfare, in our country "Aid to Families With Dependent Children" is limited to five (5) years. The fear of having a child unsubsidized by the government concentrates the mind wonderfully, even in the sack.

[Renegade]

At what point does the "interest of society" override "universal" health care? When they eat at Mc Donald's?

In my view society's interest always come first (to the extent they don't violate individual rights), even if it means imposing restrctions on healthcare so that it ceases to be "universal".

Universal health care will always be an inferior product to what one could purchase if money were not an object.

You are mixing two concepts. The quality of healthcare, and who it is applied to (ie universality). If money were no restriction you could buy top quality care and offer it univerally. But, money is always a restriction. Once you have squeezed the most efficiency you can, the only way to add more money is to take it from someone else.

[Pliny]

At what point does the "interest of society" override "universal" health care? When they eat at Mc Donald's?

In my view society's interest always come first (to the extent they don't violate individual rights), even if it means imposing restrctions on healthcare so that it ceases to be "universal".

Universal health care will always be an inferior product to what one could purchase if money were not an object.

You are mixing two concepts. The quality of healthcare, and who it is applied to (ie universality). If money were no restriction you could buy top quality care and offer it univerally. But, money is always a restriction. Once you have squeezed the most efficiency you can, the only way to add more money is to take it from someone else.

In my view society's interest always come first (to the extent they don't violate individual rights), even if it means imposing restrctions on healthcare so that it ceases to be "universal".

You are basically saying that someone in society make a decision who should and who shouldn't have the right to health care (as long as it doesn't violate individual rights). I do not believe that anyone should have the right to make that kind of decision.

Some believe health care to be an individual right.

Your argument means that there is a system of evaluation or judgment as to who should have health care. The only way to do that is to have someone make that judgment using criteria that measure the person's worth to society as compared to his cost, his contribution to the general welfare of society against the cost or whether resources warrant delivery of the service. Wouldn't that better be determined by nature rather than giving an individual that power?

If the health care system ceases to be universal then what is the point of creating a universal health care system such as we have in Canada?

Once you have squeezed the most efficiency you can, the only way to add more money is to take it from someone else.

Precisely. This is why it will always be an inferior product - that someone else will eventually balk.

[Renegade]

You are basically saying that someone in society make a decision who should and who shouldn't have the right to health care (as long as it doesn't violate individual rights). I do not believe that anyone should have the right to make that kind of decision.

No. I believe everyone has the right to access healthcare, but someone makes a decision on who has access to free or subsidized healthcare.

Some believe health care to be an individual right.

Some do, but in my view, no one has the individual "right" to healthcare for which they demand someone else pay for.

Your argument means that there is a system of evaluation or judgment as to who should have health care. The only way to do that is to have someone make that judgment using criteria that measure the person's worth to society as compared to his cost, his contribution to the general welfare of society against the cost or whether resources warrant delivery of the service. Wouldn't that better be determined by nature rather than giving an individual that power?

I'm all for removing individual evaluation from the process and letting "nature" takes its course, but would you or the rest of society really have the stomach for it? Letting nature takes its course means letting the old and weak die and concentrating resources on the strong and healthy. (in essence, survival of the fittest)

If the health care system ceases to be universal then what is the point of creating a universal health care system such as we have in Canada?

There is no point in creating a universal health care system. I would advocate for an efficient healthcare system, not necessarily a universal one.

Precisely. This is why it will always be an inferior product - that someone else will eventually balk.

How does one balk? Refuse to pay taxes and get thrown in jail? In our system today the government has the power to extract whatever they wish so there is very little option to balk.

Edited July 24, 2007 by Renegade

[stevoh]

Some do, but in my view, no one has the individual "right" to healthcare for which they demand someone else pay for.

If everyone has the potential to benefit, at some point in their lives, from the health care, then it is hardly a demand.

I'm all for removing individual evaluation from the process and letting "nature" takes its course, but would you or the rest of society really have the stomach for it? Letting nature takes its course means letting the old and weak die and concentrating resources on the strong and healthy. (in essence, survival of the fittest)

That makes no sense either, who would determine who is strong and healthy "enough". Who would determine who is too old or too weak "not to qualify". Too much potential for abuse. We treat the sick, period. Choices around who is and isn't treated should reside with the families, and with medical professionals, never with government or private interests.

There is no point in creating a universal health care system. I would advocate for an efficient healthcare system, not necessarily a universal one.

Any health care system should always be in the process of efficiency analysis and improvement, so that the dollars can be spent on better and better care.

A private health care insurance firm simply redistributes funds, from the healthy to the sick. The problem with private health care is the primary focus on profit over patient care. Patient care should always come first, and no company should EVER benefit from the denial of necessary treatment.

[Renegade]

If everyone has the potential to benefit, at some point in their lives, from the health care, then it is hardly a demand.

You assume that over people's lifetime everyone contrbutes equally and everyone benefits equally. This is not true. If I have never contributed or contributed very little and I consume healthcare, I am essentially demanding that someone else pay for it.

That makes no sense either, who would determine who is strong and healthy "enough". Who would determine who is too old or too weak "not to qualify". Too much potential for abuse. We treat the sick, period. Choices around who is and isn't treated should reside with the families, and with medical professionals, never with government or private interests.

To be blunt, society has an already built scoring system for people it values and it doesn't require individual decision-making. Its called money. Society rewards those it considers valuable and penalizes those it does not. If moralty were taken out of the equation, the simplest route for society to focus its healthcare resources on those it values is to give healthcare access to those who have money.

Any health care system should always be in the process of efficiency analysis and improvement, so that the dollars can be spent on better and better care.

You neglect to mention that maybe those dollars can be returned to those who pay.

A private health care insurance firm simply redistributes funds, from the healthy to the sick. The problem with private health care is the primary focus on profit over patient care. Patient care should always come first, and no company should EVER benefit from the denial of necessary treatment.

Simply you saying so, doesn't make it so. Experience has shown that any organization must have an incentive which is aligned with its goal. Organizations which provide superior service, whether patient care or resturant service, do so because that is the means to their incentive, profit. If you take away the incentive without providing a substitute, you will be guranteed at best, mediocre service.

[bush_cheney2004]

...A private health care insurance firm simply redistributes funds, from the healthy to the sick. The problem with private health care is the primary focus on profit over patient care. Patient care should always come first, and no company should EVER benefit from the denial of necessary treatment.

That's a recipe for business failure. Private health care underwriters provide policies with defined benefits and exclusions, not unlimited patient care. They absolutely should deny treatment within the defined and legal limitations of any such policy, or they will go broke.

[stevoh]

Simply you saying so, doesn't make it so. Experience has shown that any organization must have an incentive which is aligned with its goal. Organizations which provide superior service, whether patient care or resturant service, do so because that is the means to their incentive, profit. If you take away the incentive without providing a substitute, you will be guaranteed at best, mediocre service.

You act as if money is the only possible motivator for good service. Many of those in the medical profession find curing the sick and saving lives a different more meaningful reward.

That's a recipe for business failure. Private health care underwriters provide policies with defined benefits and exclusions, not unlimited patient care. They absolutely should deny treatment within the defined and legal limitations of any such policy, or they will go broke.

The problem with that is that it is in their best interest to find a way out of paying a claim. Less claims paid = more profit. The primary goal has to be patient care, as soon as it is secondary, there are financial and other factors that will influence the ability of paying policy holders to get treatment. Hospitals should not be a business.

[SkyhookJackson]

...A private health care insurance firm simply redistributes funds, from the healthy to the sick. The problem with private health care is the primary focus on profit over patient care. Patient care should always come first, and no company should EVER benefit from the denial of necessary treatment.

That's a recipe for business failure. Private health care underwriters provide policies with defined benefits and exclusions, not unlimited patient care. They absolutely should deny treatment within the defined and legal limitations of any such policy, or they will go broke.

And that, in a nutshell, is why "for profit" health care providers need to be taken out of the mix. It's their mission to make money for their investors, not provide health care. The more coverage they can deny, the more money they make. There's an article you should read in this week's Newsweek that makes the point that even if taxes are raised to fund health care, at the end of the day you'll have more money in your pocket because you're not being shaken down by the insurance industry. It's not rocket science. http://www.msnbc.msn.com/id/19886686/site/newsweek/

[Renegade]

You act as if money is the only possible motivator for good service. Many of those in the medical profession find curing the sick and saving lives a different more meaningful reward.

No, what I said was you needed an incentive. Profit is one such incentive. You seem to be proposing building a healthcare system where the primary incentive is altruism. If so then I suggest the pool of available healthcare professionals would be much smaller and I can't see how you could provide sufficient resources to provide adequate care.

IOW, I'm not saying the profit is the only possible incentive, but you need to provide an alternative and I highly doubt altruism is suffient.

[bush_cheney2004]

The problem with that is that it is in their best interest to find a way out of paying a claim. Less claims paid = more profit. The primary goal has to be patient care, as soon as it is secondary, there are financial and other factors that will influence the ability of paying policy holders to get treatment. Hospitals should not be a business.

It's not a problem at all. The primary goal is to stay profitable or perish. Even the "non-profits" deny subscriber claims. Hospitals are a business as well, and if poorly managed they will fail. "CommieCare" cannot pay the freight, just visit Cuba to find this out.

Patients do not have a right to claims for excluded treatment. The courts and arbitrators decide any disputes.....even in Canada (try to get a provincial claim settled for care received abroad without prior authorization).

[SkyhookJackson]

The problem with that is that it is in their best interest to find a way out of paying a claim. Less claims paid = more profit. The primary goal has to be patient care, as soon as it is secondary, there are financial and other factors that will influence the ability of paying policy holders to get treatment. Hospitals should not be a business.

It's not a problem at all. The primary goal is to stay profitable or perish. Even the "non-profits" deny subscriber claims. Hospitals are a business as well, and if poorly managed they will fail. "CommieCare" cannot pay the freight, just visit Cuba to find this out.

Patients do not have a right to claims for excluded treatment. The courts and arbitrators decide any disputes.....even in Canada (try to get a provincial claim settled for care received abroad without prior authorization).

You're one of those Republicans who think people deserve only the health services they can afford to pay for . . . right? Be careful what you wish for. You might find yourself mowing your own lawn and tending your own kids when all us poor folk drop by the side of the road.

[bush_cheney2004]

You're one of those Republicans who think people deserve only the health services they can afford to pay for . . . right? Be careful what you wish for. You might find yourself mowing your own lawn and tending your own kids when all us poor folk drop by the side of the road.

And you might be mistaken....I mowed other people's lawns to pay the rent. The products and labor of the health care "industry" are not rights for rich or poor folk alike. However, government is more than happy to provide the side of the road.

[SkyhookJackson]

You're one of those Republicans who think people deserve only the health services they can afford to pay for . . . right? Be careful what you wish for. You might find yourself mowing your own lawn and tending your own kids when all us poor folk drop by the side of the road.

And you might be mistaken....I mowed other people's lawns to pay the rent. The products and labor of the health care "industry" are not rights for rich or poor folk alike. However, government is more than happy to provide the side of the road.

Surely you're not referring to our socialized highway system . . . are you? (Along which our socialized police and fire departments travel and our commie school buses haul kids to "public" school. Speaking of kids, do you support the Bush veto for extending SCHIP benefits to more poor kids? I can imagine you throwing older people out with the trash, but even you must have enough of a heart not to abandon kids.)

[Pliny]

Simply you saying so, doesn't make it so. Experience has shown that any organization must have an incentive which is aligned with its goal. Organizations which provide superior service, whether patient care or resturant service, do so because that is the means to their incentive, profit. If you take away the incentive without providing a substitute, you will be guaranteed at best, mediocre service.

You act as if money is the only possible motivator for good service. Many of those in the medical profession find curing the sick and saving lives a different more meaningful reward.

That's a recipe for business failure. Private health care underwriters provide policies with defined benefits and exclusions, not unlimited patient care. They absolutely should deny treatment within the defined and legal limitations of any such policy, or they will go broke.

The problem with that is that it is in their best interest to find a way out of paying a claim. Less claims paid = more profit. The primary goal has to be patient care, as soon as it is secondary, there are financial and other factors that will influence the ability of paying policy holders to get treatment. Hospitals should not be a business.

Let's face it Steve, is there anyone in today's society that doesn't need to make money or a profit? If you think that there should be no profit in delivering health care, let's ask the doctors to be put on a salary, of say, ooh...let's make it equal to the average salary of the nation. Anyone can live on that. Nurses and all health care workers should also have regulated salaries.

Sorry, but if we did that, as much as supporters of Canada's health care system (and the staunchest supporters of the system are health care workers and suppliers to the health care industry) decry the profit motive, few would remain working in the health care industry. Now don't go saying patients support the system as well. They support getting treatment and the system is not relevant to them as long as they do get treatment. If it is "free" all the better.

[Pliny]

...A private health care insurance firm simply redistributes funds, from the healthy to the sick. The problem with private health care is the primary focus on profit over patient care. Patient care should always come first, and no company should EVER benefit from the denial of necessary treatment.

That's a recipe for business failure. Private health care underwriters provide policies with defined benefits and exclusions, not unlimited patient care. They absolutely should deny treatment within the defined and legal limitations of any such policy, or they will go broke.

And that, in a nutshell, is why "for profit" health care providers need to be taken out of the mix. It's their mission to make money for their investors, not provide health care. The more coverage they can deny, the more money they make. There's an article you should read in this week's Newsweek that makes the point that even if taxes are raised to fund health care, at the end of the day you'll have more money in your pocket because you're not being shaken down by the insurance industry. It's not rocket science. http://www.msnbc.msn.com/id/19886686/site/newsweek/

There is no doubt that insurance contributes to increased costs in providing health care - both private and public insurance. Public even more so because money is no object to governors of a public system.

Canada's system fails because it is basically a public system providing a private service and it holds a monopoly on the purse strings without accountability.

The author of the article you posted is an Economist of the Keynesian persuasion and most governments today employ the theories of Keynes because it gives them tools to manipulate an economy. My opinion of them is that they are glorified accounting mathematicians to whom business is merely about numbers, knowing the price of everything and the value of nothing. I don't doubt she would support government's ability to run the affairs of people's lives better than they can themselves.

A good joke about an Economist runs like this. A man spotted a twenty dollar bill on the sidewalk and nudged his Economist friend saying, "Look! There's a $20 dollar bill on the sidewalk." The Economist didn't even bother to look because he knew that if it were true someone would have picked it up already.

[stevoh]

Let's face it Steve, is there anyone in today's society that doesn't need to make money or a profit?

On an individual level, everyone needs to make money to function in our society. On a larger level it is not necessary for an business to make further money to survive. If the workers and owners of that business are making enough money to earn a decent paycheck, and afford all overhead and expenses, the business itself does not need to make additional "extra" money (profit), to survive. Certainly, not a great incentive for investment, but possible.

Lots of "not for profit" charities exist that do pay their employees a salary and continue to survive. It is not necessary to make money to be functional.

Everyone in society needs to have an income source to survive. Not every organization in society providing a service or product needs to make additional funds (profit) over expenses to survive.

If you think that there should be no profit in delivering health care, let's ask the doctors to be put on a salary, of say, ooh...let's make it equal to the average salary of the nation. Anyone can live on that. Nurses and all health care workers should also have regulated salaries.

I have no problem supplying doctors and nurses with a reasonable and competative salary. They deserve it. But further money for other reasons, such as investors or shareholders? Not necessary in the medical system.

Sorry, but if we did that, as much as supporters of Canada's health care system (and the staunchest supporters of the system are health care workers and suppliers to the health care industry) decry the profit motive, few would remain working in the health care industry.

Never made that leap. Not for profit health care does not mean those working in that industry don't earn decent money. It means stakeholders and investors don't exist, so "additonal" money beyond the salaries and costs of the system aren't required.

Now don't go saying patients support the system as well. They support getting treatment and the system is not relevant to them as long as they do get treatment. If it is "free" all the better.

Every potential patient supports the system through taxation. Nothing is free.

[bush_cheney2004]

On an individual level, everyone needs to make money to function in our society. On a larger level it is not necessary for an business to make further money to survive. If the workers and owners of that business are making enough money to earn a decent paycheck, and afford all overhead and expenses, the business itself does not need to make additional "extra" money (profit), to survive. Certainly, not a great incentive for investment, but possible.

This is a false premise and recipe for business failure. Non-profits have distinct tax advantages that for-profits do not have. Without working capital, a business cannot make investments for growth or survive business downturns. Capital can be borrowed (profit for somebody else), or developed with adequate product or sales margins. Shareholders who provide working capital deserve a return on their investment.

Anything else smacks of communism. And that won't play in Canada or the USA.

[stevoh]

This is a false premise and recipe for business failure.

Not necessarily, many "Ma and Pa" stores exist (or used to exist) that, as long as they maintained stock and made a reasonable salary, were content to simply exist. Hobby stores can also be run by enthusiasts that are not in it to make lots of money, but are in it because they love the hobby and being involved in the community. As long as they are making enough money to get by, they are quite happy to continue to run their businesses.

Non-profits have distinct tax advantages that for-profits do not have.

If they are officially designated as non profits. Other businesses exist and survive without those tax breaks (see above)

Without working capital, a business cannot make investments for growth or survive business downturns.

Capital re-invested in the business to allow growth is not the same as profit, ask any small startup business owner.

Capital can be borrowed (profit for somebody else), or developed with adequate product or sales margins. Shareholders who provide working capital deserve a return on their investment.

If that is how the business is set up, fine. But profit and shareholder support are not necessary to create a viable business.

Anything else smacks of communism. And that won't play in Canada or the USA.

And next on fox news...

[SkyhookJackson]

Sicko finally made it to the hinterlands and I saw it this afternoon. Now I'm more cranked up than ever (and more grateful than ever my husband was born in Canada). How anyone can see this film and not question the sanity of our "for profit" system is beyond me. Re the previous post about businesses and tax advantages: everyone who paid more income taxes than Rupert Murdoch last year, raise your hand (if you paid a dollar, that hand needs to be up).

[Guest American Woman]

Sicko finally made it to the hinterlands and I saw it this afternoon. Now I'm more cranked up than ever (and more grateful than ever my husband was born in Canada). How anyone can see this film and not question the sanity of our "for profit" system is beyond me. Re the previous post about businesses and tax advantages: everyone who paid more income taxes than Rupert Murdoch last year, raise your hand (if you paid a dollar, that hand needs to be up).

If your husband is a Canadian, why can't you, as his spouse, get healthcare there?

[Riverwind]

If your husband is a Canadian, why can't you, as his spouse, get healthcare there?

You have to be a resident of a Canadian province to qualify.