"Up to one-third of our health care dollars are squandered on ineffective, sometimes unwanted, often unproven procedures," Wennberg told Maggie Mahar in her recent book, Money-Driven Medicine: The Real Reason Health Care Costs So Much.
Don't other countries have long waiting lists and rationing?
Yes, most other countries have longer waits to see specialists and have elective surgery. On the other hand, patients elsewhere are more apt to see doctors promptly when they're sick.
Cost tends to be the main US rationing tool. In the six-country study, sicker Americans were most likely to forgo medicine, doctor visits, tests and medical treatments because of cost. Most of the 51 percent who skipped at least one in 2005 had insurance.
Moore praises Canada, but aren't they always coming here for better health care?
Anecdotes aside, a 2002 Health Affairs study found "barely detectable" numbers of Canadians going to US border cities for treatment. In a 1996 Canadian survey, only 20 of 18,000 respondents crossed the border specifically for care.
Research comparing their quality favors Canada just slightly, Open Medicine reported in April. Even so, "Nobody in the US seriously proposes recreating the British or Canadian systems here," wrote The New Republic's Jonathan Cohn, author of Sick: The Untold Story of America's Health Care Crisis - And the People Who Pay the Price.
Do insurance companies really cancel sick people's policies?
California officials recently fined Blue Cross of California US$1 million for just that, and is investigating other companies.
It found violations in each of 90 randomly selected cancellations, of about 1,000 a year. But California insurers can't cancel policies without proving intent to deceive, which Money magazine said is not true of Ohio.
Is it true that in Canada, France and Great Britain, "Anyone can go to the hospital, can go to a doctor and never have to worry about paying a bill," as Moore says?
No. Even in the socialized UK, there are some out-of-pocket expenses, but Americans have more than most.
Americans spent US$5 out of pocket for every US$3 spent in OCED's median country in 2004. In 2005, 34 percent of sicker US adults spent at least $1,000 out of pocket, more than twice the percentage anywhere else in the six-country study.
The insured family selling all its possessions to pay medical bills in SiCKO is also extreme but plausible. "Medical debt is surprisingly common," Access Project officials wrote last year in Health Affairs, "affecting about 29 million nonelderly Americans, with and without health insurance." That's roughly one in six, and medical bills sent 44 percent of them through all or most of their savings.
As Cohn wrote in his review, "SiCKO got a lot of the little things wrong. But it got most of the big things right."
On the Net: www.michaelmoore.com.
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