Over the weekend Jim and I watched the Michael Moore documentary, Sicko. It was both fascinating and very, very disturbing. I can now see more clearly the opposition to “two-tier” healthcare in Canada (privatization of some procedures), and have come to the conclusion that medical care (and health insurance) cannot ethically be run for profit. The Hippocratic oath—first, do no harm—seems to me incompatible with trying to maximize profits for shareholders of HMOs. Asking someone in dire medical need to switch to an approved hospital, or not treating until proof of payment (or demanding pre-payment), or denying necessary medical treatment, does them harm!
Some of the bits that I am still mulling over:
The major cause of bankruptcy in the US medical bills. And 75% of those so affected had health insurance!
The personal stories are heart-breaking: Health insurance companies in the US denied coverage for procedures recommended and argued for by one man’s doctor; he died shortly thereafter. Another woman’s 18-month-old daughter died after she had taken her to hospital with a temperature of 104F. Medical personnel would not care for the child as they phoned the HMO who insisted she be transferred to a different hospital. The child died in cardiac arrest. One woman’s costs for an ambulance ride after a serious car accident in which she was knocked unconscious were denied because she had not called the insurance company to pre-approve the ride; another was made to pay back money for a totally unrelated procedure because she had failed to disclose a trivial yeast infection years earlier. And the videos of patients who cannot pay being “dumped” by hospitals—literally, out of taxis on the street in front of homeless shelters in skid row—stunning. I am grateful that I cannot fathom these things happening in Canada.
But don’t get too smug fellow Canadians. Moore visits our country and is perplexed that his Canadian relatives will not even visit his home for a day in the US without taking out additional travel health insurance (though most Canadians have heard the horror stories of the heart attacks in Buffalo on a shopping trip that destroyed a families’ savings, so we understand.) He presents the Canadian system in a favourable light—but then he goes and visits Britain and France. Unlike in Canada, in the UK dental is included in universal health, as is drug coverage—all prescriptions have a standard low charge. And France? Don’t even get me started about their family-and-health friendly policies. It puts us to shame, Canada. Perhaps we ought not to always look south of the border for ideas, or to assess how we are doing in the world. I am very grateful to live here, but there is definitely room for improvement.
Moore’s final visit is to Cuba, where several Americans get the treatments they have been unable to access or afford at home. And you can see the confusion in their faces as one thing after another that Americans have been told about Cuba are challenged by their own eyes. (Again, Cuba is one of the most popular destinations for Canadians for winter vacations, so our perspective and knowledge about Cuba is somewhat different).
In sum, go watch this movie—and all the additional material (some really interesting stuff there too). It makes you think, no matter which side of the border you live on.