I just went to see Sicko, the new project, documentary regarding America's healthcare system, concieved and directed by Michael Moore. Overall it was an extremely interesting and surprising experience.
To start with, it was being shown at the Varsity Theatre in downtown Chapel Hill.
This is the Varsity. It's pretty much unchanged from when it opened, the Marquee is the original. It is on Franklin Street, the main college drag if you will in Chapel Hill. While it has been known to show some mainstream films, it caters to the less popular, more funky/artsy type films, not film noir, but not "Pixar" variety either. It's one of the few places around that really doesn't care if you walk in holding a cup of coffee from next door.
I went to a 4:30 matinee so I could have the "cheap (six dollar!!)ticket!. I was immediately struck by the audience. At least 80% were silver haired senior citizens. As we found seats in the theatre, people were talking and waving to each other. It's summer time, the time we townies let our hair down and there are relatively fewer students crowding the streets. They started to show previews, and I found myself wanting to see You Kill Me, but not the others they previewed. The projectionist accideently turned on the pre-views too early, had to cut them off, and wait 10 minutes to turn them back on, much to the attendees amusement. The theatre was packed to actually standing room only.
The the film started. Being in health care, and working pretty much in Emergency most of my life, I have seen all sort of wierd medical horror stories. So I was keenly interested in the film. I have always pretty much believed in the American health care system. I admit I voted for Clinton back in the day in hopes that we would have universal health care, but as that died a slow and quiet death, I felt like I enjoyed really top notch health care, but of course, I've pretty much always been insured one way or another. This film, however, was about the insured in America. I would also like to say that I have NEVER in all my years working in hospitals, seen a patient be sent to another hospital before they were stablized (as was apparently the case in the 18 month old who died.) Nor have I seen a surgeon discuss with a patient costs to reattach fingers before it was done. (And we do a ton of limb replants emergently here because we have an excellent surgeon). So that part stunned me, and made me wonder when these things occurred and how exactly. The other one thing that I would like to mention is that Moore refers to infant mortality rates multiple times through the film. He fails to mention/explain that US infant mortality rates will be higher because we are able to keep preemies alive outside of the uterus longer than a lot of developing countries, we are able to help many very threatened pregnancies deliver, and we sometimes deliver very sick babies. The Infant Mortality rate county by county in my states is skewed in this way, both counties with the super-intensive care nurseries have higher infant mortality rates than some very poor counties with less facilities…all the very high risk pregnancies are transferred into those counties, so, I took issue when he stated that infants in some third world countries had better survival rates. It's not the whole story. Other than that, I found it to be chillingly accurate.
It's hard to say there is a plot perse to the film. Essentially Moore describes health care practices in America and then shows health care practices in Canada, France, the UK, and Cuba…with that side trip to Guantanamo bay.
He manages to do this all while being very very funny. I laughed a lot during the film. I also cried a lot because the situation so depresses me.
Using examples, Moore shows how American HMO's and insurance companies work. This was not news to me, because of my Public Health Administration Education, the bottom line is the bottom line. It is unfortunate though that the bottom line has to be so low, and harsh. It is true that there is a lot of abuse and overuse of healthcare resources, however, I think it's truely unfortunate that Insurance companies rahter than Health Care Professionals are the ones deciding if I needed a test or a treatment, I mean where is the sense in that? Physicians who are preferred physicians are actually given bonuses for lowering costs. This is true of physician reviewers who deny coverage (as is shown in the film) but also of physicians working in offices who make attempts to lower costs, perhaps by not ordering tests etc.(This was not shown in the film, but I know it because I was taught this in school.)
After this he shows one American attempting to illegally obtain healthcare in Canada. He speaks with several Canadians about their experiences with the Canadian HealthCare system. All of them appear pretty happy.
He then goes to the UK and again, people are very happy with the healthcare.
Similar in France….
After Canada and the UK i found myself wondering if the film was about over. At first I thought it was just my ADHD tendencies kicking in, but then I realized that I was just simply uncomfortable because clearly these countries are doing a better job at delivering care to citizens, especially preventative medicine.
It does seem odd to me that Moore found no one that had trouble with the systems in these countries. I have had friends tell me they have had to wait weeks to see specialists, and months to be approved for physical Therapy in the UK. They were none too pleased. Similarly there have been problems of delayed care. Mr. Moore asked people in a waiting room how long they had been waiting, but he didn't talk to someone who had been on a waiting list.
Still overall, It is embarassing that we do so poorly with healthcare in the US.
In the theatre we applauded loudly in the middle of the film when Tony Benn stated, " If you can find money to kill people, you can find money to help people."
The highlight of the film of course was the crowning moment when after hearing that the quality of medical care at Guantanamo Bay is higher than care that some Americans recieve in the us, Moore and several 911 rescue workers and other "sick people" board a boat and attempt to enter the Gitmo hospital. Moore says, " I have 3 911 rescue workers here, they just want the same health care that Al-Quaida is getting here" The sick people and Moore end up in a hospital in Havana, where they all recieve treatment free of charge. A touching moment is when the 3 rescue workers are recognized by the Cuban Fire Department. All of them state they are feeling better at the end of their stay in Cuba.
But…the biggest revelation for me was actually when Moore queried the British Physician about his quality of life. Most of the physicians I know say they could not survive Socialized Medicine due to the high cost of their educational loans. This Family Physician drove a very nice audi, and lived in a one million dollar home in London. I could see that this argument wasn't going to hold water. Moore, however does not address how this man obtained his education, or his debt status, so I am still not sure its comparable. But…I see that it is possible to do quite well on a socialized medicine salary.
I really started to cry and feel very upset during the film, because it makes no sense to me at all. Why do we allow this in this country? I just don't get it at all. If Cuba can have universal health care, it makes no sense for America not to.
This does give me another reason to head to Havana, if I ever get the chance.
I'll be curious to see what the reaction is to this film as it gets wider circulation.
I for one, will be lobbying more for a Universal Healthcare system….
What do you think can be done to fix the problems faced by the US healthcare system??