Sunday, June 24, 2007

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Moore's one-sided view tells some truths


Sicko
is sure to prompt a healthy debate about the U.S. health care system. But it tells only one side of the story.

Michael Moore's latest documentary is partly a diatribe against insurance companies and drug makers. It recalls outrageous examples of treatments denied that led to death, disfigurement or bankruptcy.

The film also is a paean to government-run systems that offer, in Moore's words, "free medical care for everyone." It suggests that even terror suspects held at Guantanamo Bay, Cuba, get better care than some Americans.

Sicko uses omission, exaggeration and cinematic sleight of hand to make its points. In criticizing politicians, insurers and drug makers, it says little about the high quality of U.S. care. In lauding Canada, Great Britain, France and Cuba, it largely avoids mention of the long lines and high taxes that accompany most government-run systems.

"Obviously, it's not free," says Michael Cannon of the libertarian Cato Institute. Those countries "have unleashed demand, and they're capping supply. When you do that, you get lines."

In Canada, even the anti-privatization Canadian Health Coalition laments long lines. In France and Britain, the tax burden is 42% and 27% respectively, as opposed to 12% in the USA, according to the Organization for Economic Cooperation and Development. In Cuba, equipment and drugs are scarce.

The film tells the truth about many of the U.S. health care system's problems. Are there really 18,000 deaths each year because people lack health insurance? The Institute of Medicine says so.

Moore says that for all its health care spending, the USA's life expectancy rates are lower than the other four countries. The World Health Organization says U.S. males at birth are expected to live to 75, compared with 77 in Britain and France and 78 in Canada. Females have a life expectancy of 80 here, 81 in Britain, 83 in Canada and 84 in France. Cuba is virtually tied with the USA.

Some facts and figures in Sicko are misleading. The film says nearly 50 million Americans have no health insurance; 44.8 million people were uninsured in the USA in 2005, including non-citizens, the Census Bureau says. The film says health care costs $7,000 a person each year; the World Health Organization says it costs $6,100.

Moore reaches back more than a decade for gripping stories of care denied by insurers and HMOs — stories that were more common in the 1990s. He cites the case of a man in 1987 who was denied coverage for a heart transplant, and the subsequent congressional testimony in 1996 by Linda Peeno, who says her job at the insurer Humana was to deny as many claims as possible.

Then there are cinematic techniques, such as "posing" former congressman Billy Tauzin with a $2 million check from his new employer, Pharmaceutical Research and Manufacturers of America. A lengthy list of medical conditions that Moore says are not covered rolls by; the list comes from one employer.

"This piece is an editorial," says Karen Ignagni of America's Health Insurance Plans. "There was no effort by Michael Moore to get the view of our industry."