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June 18, 2007

Rejoinder To "Sicko's" Boosterism of Candadian Health Care System

So I'm told. I haven't watched it yet.

I stopped watching Sicko after it went into Michael Moore's comfort zone of conspiracy theories and Republican-bashing. The early parts about health insurance companies aggressively looking for any pretext to deny coverage they were, in fact, lawfully contracted to provide were effective, I thought. Seems to me that if you are lucky enough to have health insurance, and to be paying for that service out of your own pocket (and if your employer pays, it's still your pocket-- that's part of your salary), you have the right to expect them to actually give you full value on your premiums, as Paul Anka would say.

In an effort to reduce costs, they seem to arbitrarily deny coverage to whomever they can. That's wrong -- if paying the true costs of covering everyone they've contracted to cover would require raising rates, then they should actually raise rates, rather than simply look for random people whose coverage they can deny. While I'm sure that Moore's evidence is highly selective and also anecdotal, it can't be denied he had on one former health industry worker explaining that whenever an insured actually required costly treatment the insurer had contracted to pay, a "hit team" went after his application looking for any plausible, or even implausible reason, to claim fraud in the application process and thereby deny all coverage.

Many Americans don't have health coverage. They know they're not covered. That's bad, but at least they know what they can expect (i.e., nothing).

On the other hand, many Americans do have health coverage. They know they're covered... except they're not, not quite. They're covered if and only if the insurer cannot contrive some reason to deny them coverage when they actually need it.

Whether Moore's evidence here is no longer operative, I don't know. Has the health insurance "bill of rights" corrected these wrongs? Again, I don't know. But denying a woman continuing coverage because she failed to disclose she'd once had a yeast infection -- a yeast infection! -- is pretty egregious.

Previews of more anti-socialist medicine short films can be seen here. They'll be released in full next week.

A Right Wing Blogger Confirms The Gist Of Insurers' Determination To Deny Insurance To The Insured: Robbie from the Malcontent:

I work with insurance, and I found the scenes involving the American insurance industry to be convincing and factual. Sure, Moore is going to find the most egregious and infuriating examples of what insurance companies can (and will) do to save themselves money. But the gist of it is true: You may think you have insurance, but if you make even the slightest and most innocent of mistakes on insurance applications, the company can and will pull that coverage if they're in the mood. (And they're almost always in the mood to find ways out of six and seven figure claims).

On the other hand, he finds Moore -- get this! -- to be either childishly naive and/or deliberate mendacious as regards socialized medicine:

However, Moore lost me when he decided to go on his "The rest of the world is a health care wonderland!" jaunt. I've lived in Britain. I have stories about Britain. Among them, all of the private dentists in the area I lived had years-long waiting lists. That doesn't exactly speak well of the kind of treatment people receive within the NHS. Of the people I knew in England who could afford regular private medical treatment, almost every single one of them opted for it.

Brown Line contradicts Moore's claim that there are no long queues for treatment in Canada:

As for the Canadian health system, both my wife and I have lived in Canada; and among my friends are Canadian physicians. Just try getting a doctor, even in a major metropolitan area like Toronto: good luck. Single-payer plans are not immune to controlling costs by restricting access; in fact, that's their principal means of doing so. They don't forbid you from having anything you need; they just make the queue unreasonably long. And given that there's no competition, users have no recourse when they're screwed.

If you like to discuss public policy based on what you see in the movies, I strongly suggest viewing the opening ten minutes of the Canadian film The Barbarian Invasions, which walks the viewer through a (fictional) oncology ward in a Montreal hospital. Consider, too, the scenes where palms have to be greased to get what we would consider an acceptable level of care, or in which a patient has to be taken across the border into the US, at his own expense, to receive diagnostic radiologic procedures in a reasonable amount of time, ie, while he's still alive.

There are plenty of problems with our health-care system. But Canadian-style socialism would only make matters worse.

I accept this all as true. What I found compelling -- and infuriating, even as a heartless rightwinger -- is that companies with whom you had contracted, and paid!, to deliver a service were/are constantly trying to weasel out of their end of the bargain on the shoddiest of pretexts.

Left-wing bleeding heartism aside, that's a basic violation of right-wing rule of law-ism.

I think some readers think that because I think Moore has successfully illustrated a problem, that means, ipso facto, I've bought into his "solution."

Not so. As I said, if insurance companies cannot provide the catastrophic coverage they've contracted to provide, they should either stop offering it (and stop taking premiums for it) or else raise rates to more accurately reflect the cost of actually providing the service. I find denial-due-to-sham-pretext system repulsive on numerous grounds. Even if it "keeps costs down," it's doing so in the worst way possible -- not by generally reducing benefits on all (increasing copays, etc.) but by striking like lighting out of the blue to deny this person and that person coverage completely based upon a meaningless failure to disclose something as innocuous as a yeast infection.

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posted by Ace at 03:40 PM

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