Sicko and Morning Joe

I went to go see Michael Moore's new movie, Sicko, this weeeknd. Now, I fully admit he Moore is a total lightning rod, but as someone who had worked in the legal field in health care, I was particularly interested in what he was going to say.

I was not disappointed. Go see the movie.

Seriously.

And, when you want to do something when it's over, go to Moore's website and sign the petition to expand Medicare to all Americans.

Seriously.

Medicare has 1% administrative expenses (over head and SALARIES), while private insurance companies, even not-for-profit ones, have 30% or more in administrative expenses (much of which is salaries). Medicare is the most efficient health care payment system in the United States.

And as Moore implies, there's no reason that when we're spending more on healthcare than any other country (15% of our Gross National Product) on healthcare, that we should have the 37th healthcare system in the world (particularly when we already pay for one of the most efficient ones).

But what has disapponted me most is seeing the mainstream reaction to the film. Basically, there's a general acknowledgement that there's a problem with healthcare, but then, there's no actually discussion of the issue or the merits of any particular solution, whether it be a full universal system (such as what I advocated above), a basic universal system with supplemental insurance provided by employers or other sources, the present system with ERISA amended to require health insurance companies to be liable for their decisions (you want to see them start paying...make them liable for when they don't), or something else. That's the discussion that I hoped this movie would inspire.

Apparently, I'm truly naive. Because that's not the response I've seen.

Instead, the prototypical example that I've seen has been what was on "Morning Joe" on MSNBC this morning.

Here's what I learned:

1) Michael Moore is fat.

2) People are generally obese, which is their fault, and they need to change their eating habits and that (impliedly) will fix the problem.

3) Joe Scarborough has a personal trainer and that's why he's not fat, so people should be like him and exercise more.

My retorts:

1) Ad hominem argument - Whether Moore is fat or not neither harms nor buttresses Moore's argument that the health care system in the United States is woefully inadequate.

2) Where to start? First of all, obesity is not the obese person's problem...it's everyone's problem. The whole point of Sicko is that we're all in this together. So, if there's an American obesity problem, it's a problem for all of us, whether we're personally obese or not. If 30% of us are fat, it just means we're all going to sink together quicker. We're all going to have higher premiums, less opportunities to see our doctors, more Medicare/Medicaid/Private Insurance expenses. Ridiculing people who are doesn't get any of us anywhere quicker.

Second, a number of expensive health problems have nothing to do with obesity, but rather have to do with the profiteering of the private insurance system. I don't think pre-approval of ambulance services is something that is affected by whether you're obese or not, nor do I believe that obese people are more likely to get most forms of cancer. While obesity may help reduce the incidents of Type II Diabetes, heart attack and stroke, other severe debilitating illnesses, accidents, and the simple effects of age are not necessarily helped by reduced weight.

Third, why are 30% of Americans obese? Certainly, there are a number of factors, but let me suggest that part of the reason is that we do not teach good eating and exercise habits. I imagine most adults, frankly, don't know them, having been raised in a society that constantly advertises fast food, where we are told we need to work more to get ahead...essentially, working ourselves to death. Should we teach those values to our children? That would be a good place to start. So what have we been teaching children about health and physical fitness? Well, we certainly haven't been teaching them anything about it at school. We've decided that accountability for teachers is the priority there, so we've instituted school "grades" and "tests" to determine which schools are teaching better than others. However, those tests are in academic subjects (which, you know I value), but not about physical fitness. So schools, which are constantly faced with reduced state education funds are forced to make tough choices and, if you're an administrator being graded on how your students perform academically, but not physically, when you have to choose between cutting gym and an academic program, which are you going to pick? I'm guessing gym.

By the way, do you know what the top state expense in almost every (if not every) state (and certainly in my home state of Florida) is? Healthcare. Specifically, Medicaid - the joint state-federal program to provide healthcare to the poor. A universal basic system of healthcare would take this expense out of state budgets entirely. Then we could actually dedicate state tax dollars to education, like we should...including teaching nutrition, physical fitness, and other areas, reducing obesity and other lifestyle health-related problems (heck, then we might even pay teachers a living wage!!!).

3) I guess, being a member of Congress and now being a television personality makes it unlikely that former Representative Scarborough is going to run out of time to go to the gym and still have time to spend with his family. Also, I imagine his salary makes it much easier for him to hire a personal trainer at at least $50/session. Give me his salary and I'll hire a personal trainer too. In fact, if everyone in the U.S. had his salary and hours, then he'd be right...of course, there would be a lot of demand for personal trainers. --- Seriously though, this proves my point with #2. If Scarborough needs a personal trainer, then it means that he a) lacks motivation to do it himself or b) doesn't know what he's doing at the gym and needs someone to teach him. If the former is the case, he has nothing to complain about other people's lack of motivation. If the latter is the case, then he's an example of how we have failed to teach basic physical education as a result of the same policies that he advocated in Congress...teaching for a test.

Well, that's my take for now. Ideas anyone?