Michael Moore wants socialized medicine in the United States. It would, as his film Sicko suggests, give us a system that better delivers healthcare to those who need it. Although Moore effectively documents some deficiencies in American health care, his message is undermined by misinformation, inconsistent rhetoric, and a disingenuous agenda. Moore's plan would result in worse, not better, health outcomes for Americans – including the poor and underserved.
As a hand surgeon who treats many traumatic injuries, Moore's portrayal of a patient who amputated his middle fingertip captured my interest. He depicted this uninsured man as required to pay $23,000 to have his finger "saved." Moore lost considerable credibility here. Most hand surgeons would never consider micro-surgically replanting this table saw injury at the finger nail base. Rather, this unfortunate injury would have been comfortably and safely treated – without reattachment of the severed bit of finger – in an office procedure room for $1,000 or less.
In Sicko, Moore consistently equated lack of insurance with inability to obtain care. In Grand Rapids, Michigan, where I practice, a sign on the front door of Blodgett Hospital, in English and Spanish, indicates patients will not be turned away for lack of ability to pay. This is policy across the United States.
We hear a lot about the nearly 50 million Americans without health insurance. However, approximately half of them are insured six months later with new jobs, suggesting more of a problem with our employer-based health care system than with affordability.
Moore harshly criticizes the U.S. government. Yet he is arguing for a centrally controlled allocation of healthcare resources. Who does he want to run healthcare in this country? Medical resources are not unlimited. The combination of aging demographics, technological advances and unconstrained consumption within our third party payment system has led to an unsustainable trajectory of ever-increasing spending. It is already clear that price controls have created strong disincentives to debt-burdened students considering careers in primary care. Yet Sicko gives market oriented solutions no consideration.
Three individuals with ailments after admirably serving in New York rescue and recovery efforts after September 11, 2001, were transparently used in Sicko to promote Moore's agenda. This manipulation was as revolting as the stories of individuals egregiously denied care by insurance companies. Transported to Cuba, the three 9/11 patients were shown to Cuban doctors who (while cameras were rolling) appeared more than happy to provide care and subsidized prescriptions. This contrasted with a California hospital denying care to a child with a severe infection and a sick, elderly woman dropped off by a taxi in front of a rescue mission while still in her hospital gown. The latter two tragic situations were portrayed as illustrative examples of our domestic medical system.
There is no question we need major improvement in U.S. healthcare. To use a few outrageous anecdotes to argue for a socialized solution, however, is a non sequitur. Despite ostensibly compassionate intentions on the part of its backers, greater harm would result from centrally planned and controlled healthcare. Canada and the United Kingdom provide contemporary models: rationing occurs by decree and delay. Even the Canadian Supreme Court, when ruling against Canada's single-payer law prohibiting private payment for healthcare in 2006, stated, "access to a waiting list is not access to health care … in some cases patients die as a result of waiting lists for public health care ... and many patients on non-urgent waiting lists are in pain and cannot fully enjoy any real quality of life."
Pope Benedict XVI wrote in his recent encyclical Deus Caritas Est, "We do not need a State which regulates and controls everything, but a State which, in accordance with the principles of subsidiarity, generously acknowledges and supports initiatives arising from the different social forces and combines spontaneity with closeness to those in need." Moore and his allies would do well to take this exhortation to heart. We now have unsustainable consumption of medical resources, with third party responsibility for healthcare expenses. A socialized system would increase state dependency and diminish motivation for charity. Greater government bureaucracy would increase inefficiency and waste compared to doctor-patient "two-party" interaction. Socialized medicine violates the social justice principle of subsidiarity by interfering with the family, churches, charitable clinics, and other intermediate organizations attending to those who are most in need.
The common good would be better served with medical insurance purchased, like other insurance, outside the workplace. Tax law changes could help improve insurance portability and affordability. Insurance industry reform, including measures increasing interstate competition, could decrease premium cost. Greater competition from patients directly paying premiums would lead to stronger demands for quality and less egregious denials of care. With improved alignment of responsibility for personal health choices and medical care consumption, scarce health care resource allocation would improve. There is significant opportunity for recovery. Market oriented reforms, with compassionate consideration for those without means, deserve far greater consideration than Sicko's deceptive solution.
