Tue, Jul 03, 2007 - Page 16 News List

How well does 'SiCKO' stand up to the facts?

The movie presents a series of heart-rending anecdotes meant to illustrate systemic failures and foul-ups under the US' insurance industry - even if many of the major pieces of evidence have already been widely reported elsewhere

By Kevin Lamb  /  NY TIMES NEWS SERVICE, DAYTON, OHIO

Filmmaker Michael Moore is shown on the poster for his documentary, SiCKO, an indictment of health care in the US that taps into widespread public concern over the system, which does not work for millions of Americans.

PHOTOS: AP AND REUTERS

In making SiCKO, his new documentary about US health care, Michael Moore assumed the public knows it needs improvement but doesn't fully realize why. So he argues that the US' health care suffers badly in comparison to other countries - costing twice as much for results that are no better and often worse - and basically asks, "Don't we deserve better?"

"I really want to make a contribution to the national debate on this issue," Moore said. The movie's national release Friday was limited after it sold out in all 44 of its previews.

Moore's audience is likely receptive to his diagnosis, if not his prescription "to take the profit motive out of health care." In a CBS News/New York Times poll last year, 34 percent said the health care system should be completely rebuilt and 90 percent wanted at least fundamental change. In last month's Kaiser Family Foundation poll, health care was the top domestic priority for presidential candidates, second overall to Iraq.

SiCKO already has spun off Scrubs for SiCKO, with doctors' and nurses' groups advocating universal, single-payer health care (www.guaranteedhealthcare.org), and www.FreeMarketCure.com, with articles and short films favoring private-market solutions. YouTube, Oprah.com and other sites are soliciting tales of woe.

Moore has been rave-reviewed on foxnews.com, pirated on the Internet and warned of possible federal prosecution for taking Sept. 11 rescue workers to Cuba for medical care they couldn't afford at home.

Even many of his allies have bemoaned the Cuba trip for hurting their cause more than helping it. As always, Moore exaggerates, overly generalizes, ignores opposing viewpoints and raises doubts about how much he should be believed.

Several years of solid research on US health care can help viewers draw their own conclusions about Moore's contentions.

Do we really spend twice as much on health care as the rest of the developed world?

Not twice as much as everyone. But at a per-capita cost of US$6,102 in 2004, US health care more than doubled the expenditures in 19 of 29 other developed countries in Organization for Economic Cooperation and Development (OCED) data.

On the individual level, health insurance premiums rose by 58.5 percent, after inflation, from 2000 to 2006, while wages increased by just 1.7 percent.

That extra spending often doesn't even improve health, said Mark McClellan, who directed the Food and Drug Administration and then Medicare-Medicaid in 2002-07. "We know that much of the spending is going to treatments that are unnecessary or lead to medical errors, so we're not getting nearly as much value as we should."

But don't the high taxes in other countries cancel out the differences?

Those figures include both private and public (tax) expenditures. Americans even spend more tax dollars on health care than the other OCED countries, where taxes pay for universal coverage. We spend 10 percent more than high-taxing France and about US$10 for every US$7 in the OCED median.

Does the US health system really rank 37th in the world, as Moore says?

Only in a seven-year-old report by the World Health Organization. It ranked the US first in the health services it delivers, but below 50th for overspending and making those with low incomes pay so much.

OCED comparisons are more useful. The Commonwealth Fund regularly compares six countries - the US, Canada, the UK, Australia, New Zealand and Germany - and consistently ranks the US last overall.

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