Sunday, July 22, 2007

Healthy Response To "Sicko"

What most surprised me about "Sicko" was how it was funny and entertaining even as it packed a powerful message. It is doing well at the box office with current revenues of $19M according to Rotten Tomatoes, and as significantly, has been getting very good reviews both from critics as well as from users.

The other notable thing as I mentioned in my earlier post was that contrary to Dr. Sanjay Gupta's and CNN reports it was surprisingly free from any factual errors. I had thought of Michael Moore as a kind of a liberal rabble-rouser who would bend statistics to overstate his case. But he didn't. What he did do of course was to play up that hilarious trip to Guantanamo Bay and Cuba to highlight how Americans without coverage are worse off meeting healthcare needs than the denizens of both those places.

Other countries that he featured certainly have their shortcomings and it is an imperfect world. But they manage to achieve a lot more with their resources, and tellingly, those from Canada or the European countries would never trade their healthcare system for ours.

"Sicko" almost exclusively concentrates on two aspects of US healthcare - the role of private insurers and the pharmaceutical companies. These are responsible for about half the price differential between the US and Europe (where prices are roughly half those in the US.) The other two factors that "Sicko" doesn't mention contribute the same amount to higher US prices. These are malpractice laws and litigation (that leads to defensive medicine and other forms of waste) and artificially induced doctor scarcity that I have talked about earlier.

Still, I can appreciate why Moore stuck to two causes instead of trying to deal with all sources of US healthcare woes. There's only so much you can put into a two hour movie without over-burdening the audience. He did emphasize the high US costs, and didn't want to dilute the basic message of the need for universal coverage.

In short, I highly recommend the movie, whether you watch it in theatres or subsequently on DVD.


kenrod said...

What Moore constantly belittles is profit. He claims insurance and drug companies are demonic because they make a profit for their shareholders, and thus, should be constrainted to roles as utility companies.

I want to relate a story of why the opposite is true. In the early 1980's a company called Amgen based in California was given less than 2 weeks to shut down if they couldn't get their drug approved by the FDA.

There was this Chinese scientist who had a lot of Amgen stock options that was going to become worthless. He stayed up 72 hours straight in the lab and got the stroke clot buster drug called TPA approved. Do you think he did that for altruistic reasons? Not a chance. He was profit motivated and there's nothing wrong with that. Today Amgen has grown to a multibillion dollar pharma with several blockbuster drugs.

Melvin Bragg, in his book "12 books that changed the world" outlines a dozen concepts that made a difference. Of course, there is Faraday who brought about electricity. There is Newton without who, cars, rocketships etc would be impossible. There's Shakespeare who help us understand the human nature. And the Football rulebook which help us put down rules for all sports.

But the one I want to highlight here is Adam Smith's, "Wealth of Nations." In this book, Smith describes how profits stimulates the economy. While everyone from the baker to the farmer is "selfishly" runs around taking care of his own pocket, the society as a whole benefits.

What is remarkable is that before this Adam Smith, poverty was widespread. People didn't understand markets or profits. Now we accept it as if as common sense and why does Moore want to go backward?

Sandip Madan said...

I didn't see it reported (or even implied by him anywhere) that Moore regards all profit as bad. That makes as little sense as saying all profit is good. You cite a good instance of how profit can be a powerful incentive for research. That's why we have laws to protect IP.

There are no universal truths. The healthcare debates are about what services or goods are better provided by public bodies or funding as opposed to the private sector. The answers even within each sub-category may be quite nuanced.