Liberty and Medicine

Tuesday, June 12, 2007

Michael Moore fictionalizes socialized health care.

Michael Moore produces some of the most popular fictional films around today. Unfortunately he pretends they are based on reality. He prefers that everyone else pretend they are based on reality as well.

Recently he got a bit miffed because Canadian journalists were less than laudatory in discussing his new attack on America's quasi-private health care. Moore’s film promotes Canada, along with communist Cuba, as being his role model for health care. He simply overlooks the massive problems with Cuban health care.

The Canadian journalists knew his hype about the wonders of Canada’s system was a distortion of the facts. One journalist explained: “We Canucks were taking issue with the large liberties Sicko takes with the facts, with its lavish praise for Canada’s government-funded medicare system compared with America’s for-profit alternative.”

Moore implied that Canada provides all the health care people need or want. That is false. Every country, without exception, has to restrict access to health care. Advocates of state care brag that their care costs less than America's semi-private system. But they don’t admit that this is done by simply denying health care in one form or another.

Most countries, Canada included, reduce the demand for health care by forcing people to wait for care. Often people wait right up until they die. When they do die they are taking off the waiting list and politicians call that an improvement.

These systems forbid certain treatments or medicines outright because they cost too much, even when they are precisely what the patient needs and even if the cheaper alternatives don't work as well. Some countries, like Germany, also pay very low wages to the health care professionals. In a sense they move their expenses off the books. Instead of paying market wages to doctors and increasing taxes they reduce the wages of physicians. They indirectly impose high taxes on doctors. Thus they can pretend the health care is “cheaper” than it is in reality.

The New York Times mentioned how Canada’s health care system was a major election issue there. Why was that the case? If the system is as wonderful as Moore pretends what was the problem? According to the Times it was because of growing “waiting lines for care” and because “doctors and nurses [were] becoming sparse.” Every year or so the Canadian politicians make large promises how they will reduce the waiting lines for care. But the lines don't get shorter.

It is important to remember that Canadian health care costs are also kept artificially low because Canadians are forbidden by law to have private health care. One survey of just three American states found an average of around 1,000 Canadians per year seeking treatment, at their own expense in US facilities. Their spending is then listed as US spending and not as Canadian expenditures.

This was a study, that while claiming it was impartial, was constantly worded in a way which tried to down play the problems in Canada. They also cited a survey which showed “only 20” out of 18,000 Canadians sought care in the US. If that is the case that would be about 2,000 per year. This would be equivalent of 20,000 Ameicans per year running to Canada for their operations -- if that happened you can be assured it would widely publicized and Moore would feature it heavily in his film.

Why are 2,000 people a year seeking health care in the US when it’s “free” at home? Remember private health care in Canada is illegal. While it is not a crime to seek that care outside Canada how many people understand the distinction? Would people be reluctant to admit they sought care in the US due to fears, unfounded as they would be, about breaking the law? And this survey only shows how many actually went through the bother of traveling outside their own country to seek health care. It doesn’t show how many would have done so had they the means to do it.

What I run into from apologists for socialized service is that the reason for these problems is a shortage of funding. Now think about that for a second. They are saying that if they spent more money then state care wouldn’t have to be rationed out. And no doubt some of the problems would be solved by spending considerably more.

But so often they start out with an argument that socialized service is preferred because it is cheaper. Then they excuse the problems created by socialized medicine by saying these problems wouldn’t exist if it were more expensive. Doesn’t that undermine their original claim?

Assume they doubled the budget of health care thus making socialized care far more expensive than private care. Would that eradicate the waiting lines? It would not. Demand would continue to expand. People would still want more than they received and they would seek that extra treatment. Once again they would be rationing care. One reality of economics is that if something is free, and valuable, people will want more than exists. One way or another there is always rationing.

The problems of health care rationing and the ban on private care went all the way to the Supreme Court of Canada. In Quebec the province allowed private insurance only for procedures not covered by the socialized system. One elderly man, George Zeliotis, needed a hip replacement. But the socialized system had him wait for over a year. He wanted private treatment which he would pay for out of his own pocket and was told it was illegal. He went to court and the Supreme Court wrote a blistering ruling. They ruled:
“The evidence in this case shows that delays in the public health care system are widespread and that is some serious cases, patients die as a result of waiting lists for public health care.”

“In sum, the prohibition on obtaining private health insurance is not constitutional where the public system fails to deliver reasonable services.”
No wonder Canadian journalists were a bit testy with Mr. Moore and his praise for socialized health care. I’m sure Moore will have an explanation on why he is a better judge on the matter than the Canadian Supreme Court. And the explanation would be about as fictional as most his other work.

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