'Sicko,' Health Care and SCHIP

Aug. 5, 2007 — -- Michael Moore's movie "Sicko" is deeply troubling. Critics have objected to its various stunts, its flip title and slight distortions, but its basic points are on target. The United States spends an enormous amount of money on health care, yet there are approximately 45 million people who are uninsured.

Included among them are illegal immigrants and some who could easily afford insurance. Perhaps more significantly, there are countless millions who have insurance but whose reasonable and justifiable claims are routinely denied.

No other developed country lacks universal coverage, and others that spend considerably less on health care, such as Britain, Canada and, particularly, France, achieve better results, including greater average longevity. Perhaps needless to say, the legitimate interest of insurance companies, HMOs and others in saving money is often at odds with providing needed care.

(Not unrelated to health care is vacation time, another area in which the United States differs from other developed countries. A report by the Center for Economic and Policy Research states that the United States "is the only advanced economy in the world that does not guarantee its workers paid vacation." Other industrialized countries offer their work forces a government guarantee of annual paid vacations. In Britain, it's 20 days of compensated leave, in Germany 24, and in France 30! The United States guarantees zero days, and even those Americans who do get paid vacations take an average of just 12 days.)

But how can health care in these other countries be "free" as "Sicko" and many experts claim? Well, it is and it isn't. People do pay more in taxes, but they don't pay for insurance premiums, associated and often inflated medical expenses, and the burdensome blizzard of insurance paperwork. Other approaches such as mandatory private insurance also play a role in some cases.

The bottom line is that universal coverage, done right with appropriate incentives, reasonable limitations, etc., can result in better and lower cost health care. Of course, this doesn't dictate that we emulate any existing system.