SiCKO: Michael Moore’s latest fantasy Michael Tanner

ichael Moore’s newest film, Prize in Medicine are either US citizens or healthy Canadians who claim that they have Sicko, opened in June in the work there. With no price controls, free- no problem getting care. Yet nearly 800,000 MUnited States, and will open in market US medicine provides the incen- Canadians are not so lucky. No less an au- Australia in August. As one might expect of tives that lead to innovative breakthroughs thority than the Canadian Supreme Court a film attacking the US health system, the in new drugs and other medical technolo- has pointed out that many Canadians wait- early reviews have been close to ecstatic. But gies. US companies have developed half ing for treatment suffer chronic pain and perhaps the most telling review came from of all the major new medicines introduced that ‘patients die while on the waiting list’. Time magazine reporter Richard Corliss, worldwide over the past 20 years. In fact, Similarly, Moore shows happy Britons who rejoiced that ‘the upside of this popu- Americans played a key role in 80 per cent who don’t have to pay for their prescrip- list documentary is that there are no policy of the most important medical advances of tion drugs. But he didn’t talk to any of the wonks crunching numbers…’ the past 30 years. 850,000 Britons waiting for admission to Of course. We wouldn’t want anyone Instead, Moore focuses on life expec- National Health Service hospitals. Every who knows something about health care tancy, suggesting that people in Canada, year, shortages force the NHS to cancel as messing up Moore’s fantasy with facts. Britain, France and even Cuba live longer many as 50,000 operations. Roughly 40 No-one would deny that there are seri- than Americans because of their health care per cent of cancer patients never get to see ous problems with the American health care systems. But most experts agree that life an oncology specialist. Delays in receiving system, and Moore effectively dramatises expectancies are a poor measure of health treatment are often so long that nearly 20 the suffering of people caught up in it. care, because they are affected by too many per cent of colon cancer cases considered Yet he frequently exaggerates those exogenous factors such as violent crime, treatable when first diagnosed are incurable problems. For example, he often refers to poverty, obesity, tobacco and drug use, and by the time treatment is finally offered. the 47 million Americans without health other issues unrelated to a country’s health Moore calls the French system ‘free’, insurance, but fails to point out that most system. When you compare the outcome conveniently ignoring the 13.55 per cent of those are uninsured for only brief peri- for specific diseases, for example cancer or payroll tax, 5.25 per cent income tax, and ods, or that millions are already eligible for heart disease, the United States clearly out- additional taxes on tobacco, alcohol, and government programmes but fail to apply. performs the rest of the world. pharmaceutical company revenues that Moreover, he implies that people without Take prostate cancer, for example. Even fund the world’s third most expensive health insurance don’t receive health care. though American men are more likely to be health care system. (Despite the high taxes, In reality, most do. Hospitals are legally ob- diagnosed with prostate cancer than their the system is running an €11.6 billion an- ligated to provide care, regardless of ability counterparts in other countries, they are nual deficit.) The French system is not even to pay, and while physicians do not face the less likely to die from the disease. Less than free in terms of what patients pay. There are same legal requirements, few are willing to one out of five American men with prostate high co-payments and other out-of-pocket deny treatment because a patient lacks in- cancer will die from it, but a quarter of Ca- expenses, and physicians are able to bill pa- surance. Treatment for the uninsured may nadian men will and, even more ominously, tients for charges over and above what the well mean financial hardship, but by and 57 per cent of British men and nearly half government reimburses. As a result, 92 per large they do receive care. of French and German men will. Similar re- cent of French citizens have private health On the other hand, Moore ignores the sults can be found for other forms of cancer, insurance to complement the government positive side of American health care. For all AIDS, and heart disease. It is notable that system. Despite this, there remain shortages its problems, the United States still provides when former Italian Prime Minister Silvio of modern healthcare technology and a lack the highest quality health care in the world. Berlusconi needed heart surgery last year, he of access to the most advanced care. Eighteen of the last 25 winners of the Nobel went to the Cleveland Clinic in the United Countries all over the world are debat- States, not to France, Canada, or Cuba—or ing how to reform their health care systems. even an Italian hospital. But Michael Moore’s demagoguery and his Michael Tanner is director of health While overly critical of US health refusal to address the facts will do little to and welfare studies with the Cato care, Moore overlooks the real flaws of other contribute to that debate. Maybe he could Institute in Washington, DC, and countries’ national health care systems. have used a few policy wonks after all. co-author of Healthy Competition: Moore downplays waiting lists in Canada, suggesting that they are no more than in- What’s Holding Back Health Care I P A and How to Free It. conveniences. He interviews, apparently

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