We Hold These Truths and They're Not to Sell

Saw this at Crooked Timber.

Mr Moore’s enemy … is the complexity of it. He rejects subtleties. His goal is not to break through to those who do not agree with him but to drown out the doubts of those who do. Those who sit down to watch Sicko without a broad knowledge of the US healthcare system will leave the theatre with a shallower understanding of the crisis than the one they arrived with. One should face up to the fact that this is the way Americans increasingly choose to get their information on all sorts of issues, not just healthcare policy. The appetite for slanted ideological dramas grows. Mr Moore is not alone in satisfying it.

My comment in that thread:

People who get sick or who have a loved one who is sick in this country get a pretty good goddamn education right fast. Your mom gets cancer, you learn a LOT about that kind of cancer, and how the treatment of it is paid for, and after a few months you are as versed in this stuff as anyone.

This [paragraph] is condescending and disgusting. Americans KNOW the American healthcare system already, or else they will someday get it chapter and verse. Life and death questions do tend to hone the mind, you know. You have a disease in your family, you start spouting latinate terms in a matter of weeks. And you gird yourself for the inevitable insurance battles like you are goddamn Hector and you see the enemy ships landing.

The real issue is that Americans have too much freaking expertise about our system, because we learned it the hard way, and not enough time for, you know, caring for the sick and ridiculous stuff like that. That it’s so hard to make the system less inhumane is just really fucking shameful.

Pardon my language.

Essentially, what I meant was that the idea that Americans do NOT have an intimate knowledge of our healthcare system is absurd and obnoxious. We know the details of this system to a fucking fault, at the expense, in many cases, of knowing about anything else that makes life worth living.

YOU smell the fucking roses when you're not sure how you can afford a doctor to see to that cough your kid has, that cough that just sounds, bad....

I am quite serious when I say that the problem is that Americans know too much about our healthcare system, not that they do not know enough -- and that they have not as yet called for mass hangings.

 

Comments

[Auguste]

This is exactly why I won't see this movie: I can't afford to get my hopes up. It's not going change anything because shitbags like the FT genius and libertarians and middle Americans who are "fully insured" (which is to say, haven't gotten actually sick yet) are going to drag their feet and drag them until they're fucking bloody, at which point they'll pay a $50 copay on an 80% ER bill and say "well, sheeit, at least I only waited seven hours instead of eight!"

MOTHERFUCKERS, SAY IT TO MY FULLY-INSURED-AND-ABOUT-TO-GO-BANKRUPT-ANYWAY FACE!

Pardon my language.

[rachel]

He sounds like the kind of guy who'll learn how it works when he gets screwed over personally--and not a moment sooner.

[rea]

American ignorance is part of the problme but not ignorance of the American system--it's ignorance of the Canadian system, and the French, and the Cuban. People are still claiming that there is no viable alternative to our system.

And there are a lot of people (including, to some extent, myself) whose rice bowls depend on the present system . . .

[Molly Ivors]

But we're trained, in a family crisis, to think of this as a personal thing. We assume, when we're tussling with doctors and insurance companies, that it's just us going through it. What Moore is doing is placing our experiences in context.

This is what the feminist consciousness-raising groups of the seventies did: "You mean it happens to everyone?" Realizing that we share problems can lead to real work toward solutions, and that's the goal, ultimately.

[GWPDA]

We assume, when we're tussling with doctors and insurance companies, that it's just us going through it.

That would be because you're still very young. It reminds me of the horrified reaction of people I work with when they discover that their mothers and fathers are ill.... That only happens to other people, only old people get ill, my family can't die....

It's solipsism.

[dan mcenroe]

He rejects subtleties.

Nothing about the American health care system is subtle. It's not some elegant yet labyrinthine construction to be contemplated - it's a clumsy, over-engineered nightmare. To critique it with subtlety is to do it a courtesy it doesn't deserve.

[Phila]

This is exactly right. Propaganda really isn't very effective when it proposes to contradict people's actual experience.

We pay good money for insurance every month, and still had to lay out a $1000 co-pay for an MRI a couple months ago. That's the difference between swimming and sinking for a lot of people in this country.

It's not a complicated issue, and pompous mystification a la CT is the last fucking thing anyone needs.

[John Barry]

How can every other industrialized nation but us figure out a way to do this? Another system designed to cater to those with money at the expense of those without. The equation is very simple in this country, you receive the quality of health care your socioeconomic status affords you. Ask Molly about the transplant list her sister wasn't put on, because she had Medicaid.

[Spokane Moderate]

Thers,

Your comment, harsh language included, was exactly right. Last year, my brother was diagnosed with a rare and debilitating illness. He and his wife have been dealing with it as best they can, but there's no easy way to get through it. So they, especially his wife (because she's not in constant pain), study the disease and the health care "system." Because the illness is so rare, I doubt there are 50 people in the world more knowledgable about it than my sister-in-law. It helps that she's whip-smart and listens to everything she's told.

But, as impressed as I always am with her knowledge and determination, the truth is, she's not that different from thousands, perhaps millions, of other people around the country.

To suggest that the American people are ignorant of the U.S. health care non-system is absurd. We know it all too well, and I, for one, have had enough.

[Gabe]

My brother died of AIDS in 2001. One of the things that sticks with me was that during his last few years his briefcase, something from another life, was always close by and packed with his most crucial or latest medical/insurance/government paperwork. When he got that skeletal look the last couple of years was when it was strangest -- a skeleton with a briefcase.

His joke was always that if he went to hell at least he wouldn't have to carry that briefcase anymore.

[Phila]

His joke was always that if he went to hell at least he wouldn't have to carry that briefcase anymore.

I carried one of those when my mother was dying of a brain tumor, during which time she rang up $750,000 in medical bills.

Immediately after she died, I shocked my caseworker by calling her to ask how it affected certain aspects of my paperwork. She said she felt bad that I'd been jumping through hoops for so long that it was the first thing I thought of.

Almost everyone I know has similar stories.

[flory]

American ignorance is part of the problme but not ignorance of the American system--it's ignorance of the Canadian system, and the French, and the Cuban. People are still claiming that there is no viable alternative to our system.

This is exactly right. I know far, far too many people who work in the present system -- in the reimbursement and managed care and finance areas -- and only make a fucking living because our system is so screwed -- and know it -- who still maintain that our system is the best there is.

As for the idiot you link to, that's the kind of pretentious insiderism that got Hillary in trouble 15 years ago. Only the "experts" can design the reforms. And every fucking "expert" has to have their favorite pony included.

Go talk to your grandmother you wanker, she knows exactly what the system should look like. It's called Medicare, with an unfucked drug benefit, and higher lifetime maximum.

[refinnej]

Just got back from seeing Sicko. Good movie.

Anyway, what it did was confirm what I had been thinking the real problem is with health care in this country. Too many people are making too much money to be motivated to make the changes. Then there are the people who are just plain afraid, and the ones who think the MSM report truth and vote, if at all, according to sound bites.

I have no idea how to change this, but I do know that the smoking laws, etc got passed because someone put ethics above money, and they went after the lobbyists as well as Big Tobacco. I suspect that's going to be a big part of the solution here as well. The HMOs are doing what they do because they can, and that won't change until, well, they can't.

[Marky]

I made this comment on DK. Maybe it is something obvious to you, but I think it is helpful. My observation is that domestic discussions of US versus socialized health care usually devolve into the question of whether patients are satisfied with care. The uninsured are a subsidiary issue, IMO, because the bottom line feeling is that if these people were insured to get AMerican style care, they would get much better care than the dirty French.
And therein lies a problem, because it may be true that Americans are more satisfied with their care, but that is a USELESS measure of health care, one which takes primacy here only because of the reigning free market ideology. The proper way to look at health care is in terms of outcomes: overall mortality, longegity, infant mortality should come first. After that, you should discuss outcomes for heart disease, cancer, et.c, as well as the incidence of those diseases.
Patient satisfaction is something you should consider, but it isn't even correlated with quality of care! Another point is that the amount of treatment in many cases is inversely proportional to the health of the patient---e.g. in an area where there is a glut of urologists, men may get more prostate exams and surgeries, but be less healthy than men who get fewer.

Anyway, I think its very important to tackle the idea that patient satisfaction is how to measure quality of care.

[dday]

Those who go to the theater without a broad knowledge of primates and their evolutionary relationship to human beings will get nothing out of "Every Which Way But Loose." This is the way Americans increasingly choose to get their information about chimpanzees, through slanted ideological lenses.