I went to see Michael Moore's new film SiCKO last night, and I was wondering what everyone's thoughts are on the healthcare crisis in the United States, be those thoughts from inside the US or outside. I thought the audience here, in particular, may have some interesting observations on the state of healthcare in other non-US industrialized nations where healthcare is socialized and/or universal.

I won't go into a long review of the film, as I think the reviews on the Rotten Tomatoes page linked above do that better than I could. Suffice it to say that I found it remarkably informative, persuasive, and entertaining, and I think everyone should see the film, regardless of what you think about the role of government/private enterprise in ensuring access to affordable medical care.

Will I get much out of the film if I'm already upset about the state of health care in the US and can't stand Moore's methods? I gave up paying attention to him after Bowling for Columbine. This was because I felt he ran with the whole gun issue as a big part of the film without really ever coming to a proper conclusion as to why the Columbine shootings occurred. He also came off to me as someone very one sided in his reporting of information, and I've moved away from any news source like that, preferring to get both sides of the issue and make my own mind up.

Italian Health Care has always been "socialized".

Today, after 50 years of such system, you
1. go to a private dentist if you don't want to wait two months.
2. do the same for echographies, radiographies, most exams that are somewhat more than a blood test.
3. I you can afford, you end up using private hospitals for surgery.
4. Possibly, you end up getting a privateh health insurance.

"Public" healthcare, as state-run health care is usually referred to, here, is simply, generally speaking, less efficient and lower quality. That's an undeniable fact, here. The worst cases, the most negative extremes that end up on the news, are just unbelievably scary. You read of rats running in corridors in some of the worse hospitals. And, it is not unfrequent, expecially in southern hospitals, to see several patients sleeping in the corridors (with rats?!) due to lack of rooms.

Understandably, people is quite unhappy with state-run health care. While some defend its importance, I personally find that's mostly due to mere ideology.

There are exceptions. Some excellent doctors in state-run hospitals give great reputations to them, while some private institutions are there simply to profit illegally on ignorant patients. Still, generally, it is the opposite, and quite obviously so.

Happy Birthday!

What about the poor people of Italy? Do they have access to free health care, even if it is not as good as what you might pay for privately? Are they likely to die because they cannot get treatment or prescription drugs? Can they go to a clinic for illnesses rather than go to work sick or simply miss work until they get better on their own?

In my opinion, universal health care in the US shouldn't be primarily geared towards reducing the cost of health care to those who currently have it, although that should be a prime secondary consideration, but, rather, providing health care to those who are not able to afford it now. Currently about one-sixth of the US population has no health insurance at all, and they are, by and large, poor. And despite the lack of universal health care, the US government spends far more per person than any other country in the world on health care, which has been posited to be because of the quickly rising cost of letting illnesses go untreated until emergency room visits and expensive procedures are required. Imagine, for example, the cost differences between having a malignant melanoma excised and being treated for metastasized cancer.

Bitt,

Thanks!

Now, I had a long post I just lost. Yes, I know about the thread on how to avoid this. I'll fix the problem. I should've done so before.
However, for now I have to give up and promise I'll be back with hopefully interesting considerations about your questions.

This is a long debated issue, and even more so here in Italy. I'll be happy to bring it here and read what you guys think.

I'm certainly interested in other points of view, especially those from a country with socialized medicine other than Canada -- we hear those all the time.

Healthcare in Canada isn't all it's cracked up to be unfortunately. You may already know that though. If something serious/complicated is wrong and needs expedited attention, a lot of people still go to the US and pay for treatment.

Is it normal in many (any?) parts of the US to wait 2 to 3 weeks for an MRI for something as urgent as a just-discovered brain tumor?

Wow. My wife's doctor decided she needed back surgery. She had an MRI in 20-30 minutes. She had surgery 3 days later.

"Yeah, but there are long lines in $name_of_country_with_socialized_medicine" is one of the most often-cited reasons why America shouldn't move more in the direction of socialized universal healthcare. Here are a few reasons why it's bogus:

1. The reason lines are shorter in America is not because our system is better or more efficient. It's because those who are covered are hesitant to go in for routine preventative checkups, or even for significant procedures they know they need, just because they know that (a) they'll have to pay a large co-pay and (b) the HMO/PPO is almost guaranteed to try to stick them with a giant bill. The HMOs and PPOs know this, and the simple threat of the healthcare consumer having to pay what could amount to thousands of dollars is enough to keep them away, raising profits for the healthcare provider, and yes, Virginia, making sure those lines are shorter for those lucky folks who have good health plans (or just haven't been fucked by theirs yet.)

2. Another significant reason the lines are shorter here is because 47 million of us, one out of every six, can't get into those lines because they have no coverage and no ability to pay the bill themselves.

3. The United States is a country of enormous means. If we simply stole the blueprints for any moderately-successful socialized medicine plan, with no changes at all in terms of its policies, administrative costs, etc., we would come out ahead, because we can afford to spend more per person on healthcare.

How do I know that? Because we already do. Americans pay way more than most countries with socialized medicine, yet receive less care. If we spent what we spend now, but the HMOs and drug companies weren't taking their enormous piece of the pie, Americans would have better care. The difference would be that the costs would be predictable (taken out of taxes) so nobody would ever be surprised/bankrupted by unforeseen medical expenses, which is important, given that the #1 cause of bankruptcy in this country is inability to pay for medical expenses.

The free market is good for many things, but for healthcare, it has proven to be a catastrophic failure. We got this one wrong, and we shouldn't be ashamed of borrowing ideas from others to make it right

I was going to say that the reason there are waiting lists for scanners is because they are there and "free" for the NHS to use, so they are used whenever they might be useful in a medical diagnosis. The waiting lists are for non-time critical cases and anybody who needs one urgently will get seen as soon as possible.

IMHO, the experts already know our system is fucked and that there is definitely a better way. Sicko does well to bring the issue up for discussion but unfortunately, the sad truth is that there are way too many lobbyists with way too much power and money that will never allow the U.S. to change its current system.