Columns » Ernest Dumas

'Sicko' is boffo

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A century has passed since the literary screeds of Lincoln Steffens, Ida Tarbell and Upton Sinclair moved government to protect consumers and workers from unfettered capitalism, and 45 years since Rachel Carson’s “Silent Spring” almost directly gave us the clean air and water acts and a great progeny of environmental regulation.

It would be a wonderful thing if a fat rumpled moving-picture genius could do the same now for universal health care. “Sicko,” the Michael Moore film in theaters now, is far more compelling than “The Jungle,” “The Shame of the Cities” or “The History of the Standard Oil Company,” but greed also is better entrenched and the democratic process more impenetrable now than in 1907 or even 1962.

If the best rebuttal to Moore comes from presidential candidates Mike Huckabee and Rudy Giuliani, we could be home free. But the pharmaceutical and insurance industries are smarter and more resourceful than Huckabee, who is always willing to use his gift for pointless gibes in the service of bad causes.

The former governor said fatsos like Moore were one of the big problems with the health-care system — they won’t take care of themselves like Huckabee does — so his film should be given no credence. It was a curious jeer from a man with Huckabee’s family profile. But Huckabee is at least in sync with President Bush on health care: They think the people who are to blame for the health-care crisis in America are sick people.

Moore did not respond but his publicist showed Huckabee flair of her own. “Maybe if Mike Huckabee and his Republican friends stopped sucking up to health-insurance campaign contributors,” she said, “they wouldn’t feel the need to blame Americans for this crisis. Just because he stopped eating Twinkies by the bushel doesn’t make that an outline for a national health care plan.”

Here is the other difference between health care in 2007 and American industry at the turn of the 19th century: Americans were largely unaware of the conditions in the packing plants and the machinations of the Standard Oil trust, but Moore’s mocking film tells people nothing about the U. S. health-care system that they don’t already know, often by personal experience. Moore’s stories are mainly not about the millions of people who do not have health insurance but those who do and aren’t served by it. His examples may just be a little more macabre than our own: The woman, for example, who lost all her medical benefits when the company found that she had not mentioned an ancient yeast infection when she filled out her insurance application.

People also are familiar with the basic lineaments of the problem, as Bill Clinton, not Michael Moore, described them this spring: “We pay more than everybody else in the world for less.” The United States spends 16 percent of its national income on medical care, far more than Canada and Switzerland, which are next at 11 percent, but it ranks only 37th in the world in the overall quality of health care, insures fewer of its people and pays far more for drugs.

The reason, which the film explores with deadly poignancy, is that administrative costs consume a third of all that spending: primarily on the efforts by insurers to avoid paying for care.

Moore’s point is that the most economical and moral way for the richest country in the world to treat its people humanely is a single-payer system like Medicare and like all the other countries that now insure every single resident.

Giuliani and Fred Thompson, the only other presidential aspirant to weigh in so far, say that government insurance would not be as efficient as the current free market in health care and would lead to rationing.

The issue, however, is not whether government should intervene in health care but how and on whose side — for the insurance and pharmaceutical companies or the patients and the caregivers. A big way government participates now is the government-imposed drug patent monopoly, which accounts for the high cost of prescriptions.

And here’s an idea that could help consumers like the woman who lost her benefits when her past yeast infection turned up on an old medical report. Congress could adopt a law like the one Newt Gingrich pushed through in 1995 to protect corporate executives and boards from shareholder lawsuits. Reverse the current law and make the insurance companies prove that a patient’s omission on a contract was intentional, fraudulent and meaningful and not an oversight, just as corporate shareholders have to do.

One central point of the film may be fresh for people, who have been told the lie that despite the problems we have the best system in the world and that in all the other developed and undeveloped nations (like Cuba) people have to wait months or years to get substandard care.

People know better now, and polls show that they overwhelmingly want an efficient and universal system like Medicare, but how will they possibly get their representatives to overlook their campaign gifts and get it done?

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