This summer, I saw Michael Moore's Sicko
, which compares the American health care system to that of Canada, France, the United Kingdom and Cuba. In this time of political campaigning for the primaries, it is a major topic of discussion. In fact, next to the war in Iraq, it is the most important issue to the American voter and the top domestic concern
. Even when concern about the U.S. economy is cited, it is often linked to worries over health care
With about 50 million Americans without health insurance (47 million
to be exact) and one in four Americans underinsured (meaning they are often using up their savings or turning to credit cards to cover medical expenses). In fact, This means that some 40 percent of Americans between the ages of 18 and 64 have inadequate access to health care. (Wash. Post
Moore has his figures right.
The United States spends more than 15 % of its GDP on health care -- more than any other other nation (France spends about 11 %, and the Canadians spend 10 %) but according to the World Health Organization
, it comes in at No. 37. while the French and Canadian systems rank in the Top 10 of the world's best health-care systems.
And everyone knows someone who has a horror story about their HMO
and indeed, Moore's documentary has some very scary ones, really worth watching. My problem with Moore is that his biting presentation can be simplistic at times if not ridiculously caricatural. Granted, this comes with his style, still.... it borders dishonesty.
His presentation of the French health system, which I happen to know quite well is particularly bias and naive. His insistance on "free" health is misleading - there is no such thing as "free" health care. It is funded by payroll and wage levies and it is said to cause employers' unwillingness to hire.
This article in the Boston Globe,
while being short is the first one I read in the American press which gives a good assesment of the French system: what it flaws are and why it also nonetheless works better (which is undeniable).
It debunks the myth of socialized medecine (i.e "socialist", i.e. "anti-democratic" and evil") :
An understanding of how France came to its healthcare system would be instructive in any renewed debate in the United States.
That's because the French share Americans' distaste for restrictions on patient choice and they insist on autonomous private practitioners rather than a British-style national health service, which the French dismiss as "socialized medicine." Virtually all physicians in France participate in the nation's public health insurance, Sécurité Sociale.Their freedoms of diagnosis and therapy are protected in ways that would make their managed-care-controlled US counterparts envious.
Oh, the irony!