By Cyril F. Chang
Special to Viewpoint
July 8, 2007
Is American health care really as bad as portrayed in Michael Moore's
movie "Sicko"?
Moore tells the viewers that there are 50 million uninsured Americans
who cannot afford health care and that American health care is only
concerned about profits and cannot care less about human lives.
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As a provocateur, Moore did a skillful job pointing out the many
problems facing the health care system of this country.
Yes, health care is too expensive, the system is inefficient, and too
many people have no health insurance. But health care is too serious a
matter to be discussed in public using half-truths, misleading facts and
omissions.
For example, Cuba does have universal health care, as Moore suggested.
But he failed to tell us that the supposedly egalitarian health care
system in Cuba actually delivers services that are equally bad for everyone.
Equally misleading is the insinuation that it is the health care
industry's fault that 18,000 people die each year for lack of insurance
coverage. It is true that people die in hospitals every day, and many of
the deaths are potentially avoidable. But to use this tragic statistic
to indict the whole health care industry is like blaming the federal
government for highway fatalities because speed limits are set too high.
What is the truth about American health care?
The truth is that the United States has the best medicine that is
technologically possible and that Americans on average use far more
health services than people in most other developed countries. The
United States has the best care for heart problems and our trauma care
is the envy of the rest of the world.
It is also true that the high and rising per capita spending on health
care has not produced impressive health outcomes, such as increased life
expectancy and reductions in infant mortality, for Americans. Our
complex and fragmented health system causes confusion for patients and
requires doctors and hospitals to spend too much time dealing with
insurance companies.
But these imperfections do not prove that the system is full of
corruption or that the men and women who work in the health industry
care only about money.
The opposite is true. In the United States, 50 million low-income
individuals are covered by Medicaid, which requires no premium, no
deductibles and very little co-pays. Another 41 million elderly and
disabled individuals are covered by Medicare, which is subsidized by the
federal government. In addition, federal and state governments have a
variety of programs that support regional and local safety-net health
care systems for the uninsured. Judged by the amount of funds raised
from one group of individuals and used for another group's health care,
it is baseless to suggest that Americans are a heartless people.
Do Canada, England and other European countries have a better health
care system? No country can claim that it has the best system and every
country is struggling to do the best it can within its own legal and
financial constraints.
Canada's single-payer system has been hailed by many in this country as
a model to emulate. But bear this in mind: Americans who are accustomed
to our system, which offers choices of doctors and hospitals and makes
high-tech procedures readily available, will not like the Canadian
system that places restrictions on access and asks patients to wait in line.
Health care is a complex national issue that deserves greater attention
for a more informed discussion. However, one-sided portrayal of the
issues and simplistic prescriptions for a multifaceted problem will not
bring us closer to a sensible solution.
Cyril F. Chang is a professor of economics and director of the Methodist
LeBonheur Center for Healthcare Economics at the University of Memphis.
http://www.commercialappeal.com/mca/opinion/article/0,1426,MCA_536_5618337,00.html
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