SiCKO. Need We Say More?

So Michael Moore brought his latest film to town on Wednesday for a well-publicized preview. SiCKO seems to have pushed most other serious health policy discussions off the agenda this week, even while key congressional committees were voting on more than a dozen important health care bills on prescription drug safety and health spending.

Heaven forbid that we would wind up making policy by propaganda, because that is exactly what would happen if anyone were to base any serious health reform proposals on Moore’s film.

First, he makes the ridiculous assertion that Cuba’s government-run, single-payer health care system is far superior to the United States. Give me a break! Cuban doctors even botched surgery on Fidel Castro, and a Spanish surgeon had to be called in to try to repair the damage.

In a film scene reminiscent of the Keystone Cops, Cuban doctors dash around to care for several American patients (9/11 rescue workers) that Moore has brought over on a fishing boat he commandeered. The care they get is purported to be representative of the care that anyone in the socialized health care system in Cuba gets. Credible? You tell me.

Moore has also been doing the TV interview circuit, and one question he was asked seemed to get to the heart of his incongruity. An interviewer for FoxNews asked why he would be calling for a health care system run by government when he is so opposed to government in the first place. ?Good question,? Moore responds. He then uses the opportunity to slam the Bush administration, saying that government used to do things right before the current administration took over.

Exactly when was it that we had that perfect government?

Today, it is overwhelmed just trying to issue passports. Could any government magically run an infinitely more complex health care system for 300 million Americans?

The Cato Institute held a forum on Capitol Hill on Thursday morning to show clips of SiCKO as well as clips from several other films which tell the other side of the story.

One of the presenters was filmmaker Stuart Browning of the Motion Picture Institute. He has produced a series of films at www.freemarketcure.com using interviews with patients to show the limits, restrictions on access, and rationing of care in single-payer health care systems, especially Canada.

Another film is in production to answer Moore. Called Sick and Sicker, producer Logan Darrow Clements is filming in Canada right now and has interviewed a number of us from the free-market policy community to talk about the value of a free-market health care system that values people and progress. The inimitable John Stossel of ABC News also is working on a major hour-long special this summer to offer what surely will be a more balanced portrayal of the U.S. and other health care systems.

One of Moore’s core arguments in SiCKO is that profit in the health sector is evil. It is a view also shared by the chairs of many congressional committees and several presidential candidates.

They believe that the health sector can be forced to operate under a different set of rules than those which govern the rest of our economy.

But everywhere, profit is the reward that we give to the innovators, entrepreneurs, and risk-takers in our economy for offering something new or better. And the marketplace is where the conversation takes place between buyers and sellers to see if what they are offering has value and, if so, at what price.

That’s the genius of our economy and how progress works. But a government-run system stops this conversation in its tracks and replaces it with price controls, centralized decision-making, and government micromanagement.

Single-payer advocates argue that we since we are such a rich country that wouldn’t happen here – – that there is enough money for everyone to have all of the health care they need for the money we spend now.

But we do have centralized micromanagement of decisions and price controls in our own government-run health care systems — Medicare, Medicaid, and the VA for example. Government makes decisions about what will be covered, under what circumstances and for whom, and how much doctors and hospitals will be paid for their services. And government seldom gets it right — overpaying for some and underpaying for others, but also inducing huge demand for over-consumption of health care.

Earth to Michael Moore and crowd: The problems with the U.S. health sector aren’t that it needs more government control and regulation but less!

In a system governed by free-market principles, people won’t be asked to make decisions about their medical treatment when they are on a gurney in an emergency room. But they would make decisions about the kind of health insurance coverage they want to protect them if that happens, and they would gain more control over their routine and non-emergency care.

You do have to admit, however, that Moore is a master of publicity. He has created so much hype for his film, first premiering it before the liberal entertainment world at the Cannes Film Festival. Now, after a preview showing in Washington this week, he plans to open it in just one theater in New York today. And what will the cameras show? Long lines of people waiting to see the film, suggesting to all of the rest of us that this is a must-see movie.

Don’t believe it.

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And if you see this in time, I am scheduled to be on CNBC’s Power Lunch today at 1:20 p.m. Eastern time to, once again, talk about Michael Moore and universal health coverage.

Grace-Marie Turner

RECENT NEWS ARTICLES AND STUDIES:

  • Competition: A prescription for health care transformation
  • Maxing out on debt hysteria
  • TRIM3 Simulations of Full-Year Uninsured Children and their Eligibility for Medicaid and SCHIP
  • A new benefit platform for life security
  • FDA Reform
  • Cost shifting in California hospitals: What is the effect on private payers?

COMPETITION: A PRESCRIPTION FOR HEALTH CARE TRANSFORMATION
Authors: Senator Tom Coburn, M.D., Joseph Antos, Ph.D., and Grace-Marie Turner
Source: The Heritage Foundation, 06/13/07

Senator Tom Coburn, the Senate’s only physician, described the comprehensive health reform proposal he has developed at a recent forum hosted by The Heritage Foundation, which also featured commentary from the Galen Institute’s Grace-Marie Turner and AEI’s Joe Antos. Under Coburn’s Universal Health Care Choice and Access Act, the current tax exclusion for job-based health insurance would be redirected to consumers as a tax rebate of $2,000 for individuals/$5,000 for families to buy their own health insurance. The plan would also provide new mechanisms and incentives for Medicare beneficiaries and Medicaid recipients to obtain private health insurance. Joe Antos of AEI thinks ?the Senator’s proposal is very daring?[but] there isn’t enough focus in the proposal on slowing the growth of health spending.? Galen’s Grace-Marie Turner praised Coburn’s ?comprehensive vision of free-market health reform? and focused on his reform plans for Medicaid that incorporate the Turner-Helms proposal for Medicaid Advantage.
Full text: www.heritage.org

MAXING OUT ON DEBT HYSTERIA
Authors: Aparna Mathur and Tom Miller
Source: The American, 06/20/07

Media reports and academic studies would have us believe that ?Americans [are] being crushed under the onslaught of rising credit card debt and sky-rocketing medical expenses,? but that is simply not the case, write Aparna Mathur and Tom Miller of the American Enterprise Institute. The studies that say nearly half of all bankruptcy filings are caused by medical debt contain flawed data, write the authors. Miller and Mathur cite data from the Survey of Consumer Finances (SCF) that show medical debt was around 6.1% of all debt in 1989 and 6% in 2004. “Although one-time spikes in medical costs due to accidents or even long-term illnesses are likely to place a heavy strain on household finances, the average debtor today has not seen a huge rise in medical debts, even compared to the late 1980s,? conclude Miller and Mathur. ?Anecdotal snapshots based on few restricted and ultimately unconvincing samples deplete our understanding of complex issues by overdrawing their thin reserves of evidence.?
Full text: www.american.com

TRIM3 SIMULATIONS OF FULL-YEAR UNINSURED CHILDREN AND THEIR ELIGIBILITY FOR MEDICAID AND SCHIP
Authors: Kenneth Finegold and Linda Giannarelli
Source: The Urban Institute, 06/07

The Urban Institute finds that the number of uninsured children is about half the number cited by the Census Bureau’s Current Population Survey (CPS). The Urban study finds that around ?4.9 million children were uninsured for the entire calendar year? in 2003 and 2004 versus the 8.8 million cited in the Census Bureau survey. The Urban model is based upon state-specific rules regarding eligibility for Medicaid and SCHIP. It shows that about 257,000 of these 4.9 million children were eligible for Medicaid at some point during the time period, and an additional 794,000 were eligible for SCHIP under current eligibility rules. Almost half (2.2 million) of the uninsured children were ineligible because their family incomes were too high to qualify, and about one-fourth (1.1 million) were undocumented or temporary immigrants who would not qualify.
Full text: aspe.hhs.gov

A fact sheet from the Department of Health and Human Services says funds should be targeted to uninsured children in families under 200% of poverty when Congress considers reauthorization of the State Children’s Health Insurance Program, not expanded by $50 billion.
Full text: www.hhs.gov

A NEW BENEFIT PLATFORM FOR LIFE SECURITY
Source: The ERISA Industry Committee, 06/13/07

An association that represents the nation’s largest employers is calling for a much more flexible, portable system of employee benefits. A “New Benefit Platform for Life Security? is a comprehensive plan for medical, retirement and other life security benefits released by the ERISA Industry Committee (ERIC). ERIC’s plan, which results from two years of work, envisions ?a new structure for providing benefits through independent Benefit Administrators who would compete with each other? based upon quality, use of IT, plan design, and cost. ?Since benefits would be separately administered, employees could move to new job opportunities while their benefits stay with the Benefit Administrator, allowing their new employers to make contributions.? This is an important new study that uses a defined contribution model for portable health and retirement benefits that would engage more individual responsibility and flexibility in benefits.
Full text: www.eric.org

FDA REFORM

In an appropriately titled article for The Wall Street Journal, ?Uncle Sam, M.D.,? AEI’s Scott Gottlieb strongly criticizes current congressional proposals to manage prescription drug risk. He said proposals now under consideration would put the Food and Drug Administration ?squarely in the role of regulating medical decisions.? The legislation, attached to the Prescription Drug User Fee Act, would give the agency ?unprecedented new authority? to ?restrict the doctors who can prescribe drugs, and even which patients can purchase them.? He said the experiment would ultimately end in failure, but not without creating ?a lot of obstacles and uncertainty?along the way.?

Peter Pitts of the Center for Medicine in the Public Interest (CMPI) argues that the real FDA reform that is needed is to allow ?science not politics? to govern the agency’s work. ?Currently, 50 percent of drugs that undergo large-scale late stage trials turn out to be too unsafe or not effective enough for marketing,? Pitts says. ?That is not a sustainable model for the 21st century.? The FDA approved 18 new drugs last year, down from 36 in 2004. ?A healthy and sustainable vision would include appropriate support of cooperative agreements, partnerships, [and] targeted infrastructure,? he concludes.

In a New York Times commentary, Henry Miller of the Hoover Institution criticizes states for attempting to legalize the use of medical marijuana, saying that, ?if marijuana has therapeutic potential, it should be required to pass muster with the F.D.A. like any other medicine.?
Full text (Gottlieb): www.aei.org
Full text (Pitts): www.cmpi.org
Full text (Miller): www.nytimes.com

COST SHIFTING IN CALIFORNIA HOSPITALS: WHAT IS THE EFFECT ON PRIVATE PAYERS?
Author: Daniel P. Kessler
Source: California Foundation for Commerce & Education, 06/06/07

Government underpayments to hospitals through Medicare and Medicaid in California are ?a substantial factor in driving up private health care costs,? according to a study released this month by the California Foundation for Commerce and Education. Stanford University’s Daniel Kessler, the author of the study, found that these underpayments by public insurance programs contribute to a 10.8% increase in private health insurance costs. ?The message to state and federal policy makers is clear: The most effective way to reduce private health care premiums is to increase public insurance program reimbursements,? according to Foundation President Loren Kaye. The study also found minimal cost shifting to the uninsured of 1.4%.
Full text: www.cfcepolicy.org

UPCOMING EVENTS:

Insider’s Look at Washington Politics
The Fund for American Studies Professors Seminar
June 20 – 22, 2007
Washington, DC
Grace-Marie Turner will participate in a panel discussion of the health care system and prospective legislative changes on Friday, June 22, at 12:30 p.m. For additional details and registration information, go to: www.tfas.org.

Grace-Marie Turner appearing on CNBC?s Power Lunch
CNBC Television Broadcast
Friday, June 22, 2007, 12:00 p.m. ? 2:00 p.m.

Grace-Marie Turner will participate in a segment discussing Michael Moore?s film SiCKO. For additional details, go to: www.cnbc.com.

The Massachusetts Health Plan: A Progress Report
Cato Institute Capitol Hill Briefing
Thursday, June 28, 2007, 8:30 a.m. (Breakfast Included)
Washington, DC
For additional details and registration information, go to: www.cato.org.

Republican Women’s Club Meeting
National Federation of Republican Women Event
Thursday, June 28, 2007, 7:00 p.m. – 8:45 p.m.
Alexandria, VA
Grace-Marie Turner will speak about health care policy during this local chapter meeting. For additional details and registration information, go to: www.nfrw.org.

Medical Malpractice Insurance Studies
American Enterprise Institute Event
Friday, June 29, 2007, 9:00 a.m. – 12:15 p.m.
Washington, DC
For additional details and registration information, go to: www.aei.org.

Health Policy Matters is a weekly newsletter containing summaries of timely and informative studies and articles on free-market health reform. It features research and writings by participants in the Health Policy Consensus Group, articles of interest from the health policy world, and announcements of coming events. Health Policy Matters is published by the Galen Institute, a not-for-profit public policy organization specializing in information and education on health policy. For more information about the newsletter and our organization, please visit our website at www.galen.org.

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