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Huckabee vs. Moore:

"Frankly, Michael Moore is an example of why the health care system costs so much in this country. He clearly is one of the reasons that we have a very expensive system. I know that from my own personal experience," said Huckabee, who lost more than 110 pounds and became an avid runner after he was diagnosed with diabetes.

"I know how much more my health care cost when I didn't take care of myself than when I do take care of myself, not only in terms of doctor visits but regular diseases, illnesses, chronic things that come up, monthly prescription bills," Huckabee said. "All of those things have gone dramatically down since I've taken care of myself and worked to live a healthier lifestyle."

No comment could be obtained from Moore, but Meghan O'Hara, producer of "Sicko," questioned Huckabee's motives in criticizing Moore.

"Looks like Mike Huckabee is auditioning for some insurance company dough, since he's raised just about no money and sparked zero interest since jumping into the race," O'Hara said in a response provided by Moore's production office. "I wonder what the good governor would say to the French, who drink more, smoke more, eat more cheese and still live longer than us despite paying less for health care?"

Advantage: Huckabee. Feel free to correct this non-expert in the comments, but from what I read the real experts find very little correlation between the various health care systems used in the Western world and longevity, and attribute the (relatively small) differences in longevity to lifestyle factors, with obesity being the primary disproportionate "health sin" in the U.S.

Anecdotally, I know Israelis have great longevity, despite, from what I can tell, is a relatively poor (and very unequal, because the wealthy use private insurance) health care system, and despite a high percentage of ultra-Orthodox and Arabs with very large families living in general poverty and ignorance.

If Moore's "people" have any evidence that the French's longevity is due to their health care system and is despite an overall worse lifestyle profile than Americans', I'd love to see it. (Indeed, drinking more is likely correlated with better health if more people drink, but there are fewer alcoholics. And cheese, per se, isn't harmful, and has some dairy-related health benefits.)

Moreover, O'Hara's retort is not directly on point, since Huckabee raised the issue of health care costs, not longevity. Smokers, some have argued, actually save the system money by dying young of a signature disease. The morbidly obese tend to have lots of chronic health problems, like diabetes.

The American health care system can use all sorts of improvements, but I doubt anything on the table, much less Moore's favored single-payer system, will improve Americans' health more than it would be improved if we cut the rate of gross obesity by 2/3. My esteem for Mr. Moore would rise significantly (from an admittedly low base), if his next film encouraged Americans to take more responsibility for their health, and he led by example. And I say all this as someone who could stand to lose a few.

Constitutional Crisis (mail):
nonsense on both sides. love love.
7.12.2007 3:05pm
Kieran (mail) (www):
In short, "Michael Moore is fat." Look, there are goals like improving public health, or reducing obesity which is one thing; and then there are goals like getting more or less the same average standard of care more cheaply, to more people, and with less waiting and time-wasting (with every insured patient his own medical secretary) than the present system. The two are quite separable.
7.12.2007 3:06pm
Kieran (mail) (www):
with every insured patient his own medical secretary

In the present system, I mean. The deadweight productivity loss to the economy of people wasting time during work hours arguing with insurance companies over the phone is surely enormous.
7.12.2007 3:08pm
DavidBernstein (mail):
Kieran, agreed, but you're making an argument O'Hara didn't make. If he had responded, "Moore's weight has nothing to do with whether whatever health care he or anyone else needs can be delivered more efficiently and at less cost," I'd be with you 100%.
7.12.2007 3:11pm
Dave Griffith (mail):
If Moore's "people" have any evidence that the French's longevity is due to their health care system and is despite an overall worse lifestyle profile than Americans', I'd love to see it.

The percentage of people smoking in France is much higher. That fact alone almost certainly makes their hypothetical "lifestyle profile" much worse. The fact that they drive much less probably negates that to some extent. Accidents are the fifth leading cause of death overall, and the largest in most younger age groups, with automobile accidents dominating this number.


The American health care system can use all sorts of improvements, but I doubt anything on the table, much less Moore's favored single-payer system, will improve Americans' health more than it would be improved if we cut the rate of gross obesity by 2/3.


Reducing smoking or automobile use would be much more effective than that, but your point is still valid.
7.12.2007 3:13pm
DavidBernstein (mail):
Typo: "she had responded"
7.12.2007 3:14pm
DavidBernstein (mail):
Interesting point on the autos, not only do they cause lots of injuries, Americans tend to walk a lot less than in other countries.
7.12.2007 3:15pm
tsotha:
Dave,

I doubt that is true. From what I've read obesity is much more dangerous to your health than smoking.
7.12.2007 3:20pm
anon252 (mail):
Michael Moore isn't just fat, he's HUGE. In a proper socialized system, on the one hand he would get free medical care. But he would also be put on a restricted diet, and have mandatory stomach surgery if that failed. No motorcyclist should be forced to wear a helmet until Michael Moore is forced to go on a diet.
7.12.2007 3:21pm
scote (mail):

The American health care system can use all sorts of improvements, but I doubt anything on the table, much less Moore's favored single-payer system, will improve Americans' health more than it would be improved if we cut the rate of gross obesity by 2/3. My esteem for Mr. Moore would rise significantly (from an admittedly low base), if his next film encouraged Americans to take more responsibility for their health, and he led by example. And I say all this as someone who could stand to lose a few.

Well, actually Moore has lost weight. The fact that you don't give him credit for that suggests that you really didn't research the subject much before making a snap judgement.

Second, you make an assertion about obesity vs/ healthcare improvements entirely based on your gut feeling--or in this case your feeling about Moore's gut. This isn't the Department of Homeland Security, so perhaps a gut feeling should be backed up by some stats if you want to make a strong case.

Moore claims that 17,000 people die each year because they are uninsured. Will your suggestion save more than 17,000 lives per year?

We should be careful with the assumptions, too. Neither really skinny nor really fat people live the longest: however, the people who live the longest, on average, are actually overweight.
7.12.2007 3:26pm
Elliot123 (mail):
Kieran,

Increasing the number of people who live a healthy lifestyle decreases their demand on the system and releases health care resources to others in need. This would increase the average standard of care and decrease waiting. I'm not sure what the cost effect would be, but there is a case to be made that it would be a downward pressure on prices.
7.12.2007 3:27pm
dk35 (mail):
I agree that Moore's producer's response was a non-answer, but I fail to see how Huckabee has the advantage. After all, Huckabee seems to have started the fight, and his criticism of Moore was equally as misguided.

As far as I understand it, Moore's general point in his movie is not that we spend too much money on health care, but rather that the money we do spend is going to far too great a degree into the hands of private insurance companies who then, out of some combination of greed and ineptitude, don't use the money for the purposes to which the public would like it to be used. So, I just don't see how Huckabee's comment have any relevancy to the discussion.

So, I guess you can argue that the entire exchange was a waste of time. But, I don't see what about Huckabee's statement possibly gives him any "advantage" over Moore.
7.12.2007 3:27pm
Dave Griffith (mail):
From what I've read obesity is much more dangerous to your health than smoking.

The CDC disagrees. They estimate smoking-related morbidity in the US at 440,000 per year, versus obesity-related morbidity at 365,000 per year.
7.12.2007 3:29pm
DavidBernstein (mail):
Moore may have lost weight, but I saw him on t.v. recently, and he's undoubtedly jeopardizing his health at his weight.

And this piece claims that if we take "the lowest" estimate,26K people die a year because of obesity.

But putting aside mortality, obesity is strongly correlated with all sorts of chronic health problems.
7.12.2007 3:32pm
theobromophile (www):

No motorcyclist should be forced to wear a helmet until Michael Moore is forced to go on a diet.


::Snorts laughing::



If Moore's "people" have any evidence that the French's longevity is due to their health care system and is despite an overall worse lifestyle profile than Americans', I'd love to see it. (Indeed, drinking more is likely correlated with better health if more people drink, but there are fewer alcoholics. And cheese, per se, isn't harmful, and has some dairy-related health benefits.)


Moore, from what I understand (not having seen the movie) did not establish a causal connection - only a correlation - between longevity and socialised health care.

Should the penultimate sentence include something about wine? Never heard anything about, say, the health benefits of tequila.

If I remember correctly, cheese can level out blood sugar (anecdotally, I've noticed this) and, although calorie-dense, actually helps people lose weight (presumably because someone who eats cheese is quickly sated?).
7.12.2007 3:36pm
Orielbean (mail):
Huckabee's response is actually a stock response in the healthcare industry. I work in benefits and one of the programs that we encourage our employer-group clients to enroll into is a weight-management or WebMD type of program that has participants tracking important data from month to month. It is the engagement that is a problem - people feel too stressed or busy to engage in worrying about their health, which snowballs and gets worse.

Huckabee says "Blame the patient for getting sick / being fat / having health problems" (that can be congenital).

Huckabee is offering a sparse panacea that is uttered from the insurance company's mouth. The companies have no interest in changing the status quo - they think the current system works great. So they offer these low-value plans or programs that do nothing at all on a grand scale.

The real problem isn't that Huckabee was more motivated to get healthy vs Moore (who HAS lost weight)- the problem is that he raises the red herring to distract people from the current problematic paradigm. Those weight loss programs are designed to reduce the premium paid by employers to the insurance company, yet they rarely work and are being abandoned for the future.

I look at the dollars every day, and there is nothing that can be done with the current system to keep it solvent, other than breeding disease-free worker clones that pay premiums to keep real people premiums down to a reasonable cost.

Why can't we do BOTH things suggested by Huckabee and Moore? Walk more AND fix the broken system? Does this big wide world always have to reduce to "He won, so the other guy lost?" Even DB's comment does this. Moore doesn't tell people to get fat, he wants to raise awareness of the broken system. Huckabee can't be bothered and would rather make the ad hominem attack, as it is easy to hate Moore.
7.12.2007 3:40pm
frankcross (mail):
I think that longevity is a poor measure of health care, but not mainly because of obesity (which has more of an end of life effect).

America's lower lifespan is probably due to a relatively high rate of violence and accidents (as in autos), plus infant mortality. All of those often hit early in life and have a disproportionate effect on the averages.
7.12.2007 3:43pm
Cornellian (mail):
And cheese, per se, isn't harmful, and has some dairy-related health benefits.

Cheese is awesome, especially extra-old, razor sharp Cheddar.
7.12.2007 3:47pm
Thorley Winston (mail) (www):
Michael Moore isn't just fat, he's HUGE. In a proper socialized system, on the one hand he would get free medical care. But he would also be put on a restricted diet, and have mandatory stomach surgery if that failed.


What if we just wired his jaw shut?
7.12.2007 3:48pm
theobromophile (www):

Huckabee says "Blame the patient for getting sick / being fat / having health problems" (that can be congenital).


So Americans are more genetically prone to obesity than are the French???

Americans are more obese than in generations past and are more obese than people in other industrialised nations, with whom we share a common genetic heritage. That, to me, suggests that there is a lifestyle component.
7.12.2007 3:53pm
Crust (mail):
Huckabee's picked a losing angle by arguing from cost and citing lifestyle as the reason (or even the primary reason) that "the health care system costs so much in this country". The huge discrepancy in per capita cost between the US and France or Britain (roughly a factor of 2) is just too large to plausibly attribute to lifestyle differences.
7.12.2007 3:53pm
anon252 (mail):
Huckabee clearly said "one of the reasons," not THE reason. Another reason is that we don't ration care for elderly patients with terminal illnesses.
7.12.2007 3:56pm
John Kaiser (mail) (www):
"Smokers, some have argued, actually save the system money by dying young of a signature disease. The morbidly obese tend to have lots of chronic health problems, like diabetes."

Excellent point. I am glad to have finally gained control over my weight problem.
7.12.2007 3:58pm
glangston (mail):
I sincerely doubt the claim of Moore's producer, O'hara.French Study

They called it the French Paradox, and it really wasn't.

Moore's films are a trip through urban legends.
7.12.2007 4:03pm
Jam:
And think of all the fuel that could be saved if more people would lose weight.

Save the healthcare system,
Save the environment.
Lose weight.
7.12.2007 4:04pm
paul lukasiak (mail):
Huckabee managed to demonstrate that reformed fat people are only marginally less annoying than reformed smokers.

And I think you missed O'Hara's point --- Hackabee was blaming the high cost of health care using Moore as an example because he's overweight -- i.e. an unhealthly lifestyle choice. O'Hara demonstrated that "unhealthy lifestyle choices" have nothing to do with whether or not a country can provide good health care at far lower prices despite the "unhealthy lifestyle choices". And that is completely on point.

Finally, it should be noted that there are lots of healthy fat people in the USA, and while being overweight increases the risk of various diseases, they are no guarantee of them. The SOLE reason that Huckabee lost weight is because he was diagnosed with diabetes --- he didn't wake up one morning and decide to go on a diet, he was told that if he didn't lose weight, he was gonna die.

In other words, Mike Huckabee is no less to blame for health care costs than Michael Moore is --- the only difference is that Michael Moore hasn't been told by his doctor (as far as I know) that he has a specific, life-threatening condition that absolutely requires him to lose weight, and live a more healthy lifestyle.
7.12.2007 4:09pm
DCraig:
the idea that, as of today, smoking is less of a strain on the healthcare system than obesity is laughable.
7.12.2007 4:09pm
r78:
EDITOR: Deleted for invective
7.12.2007 4:09pm
Hoosier:
I don't understand the claim that Huchabee's point is irrelevant or off-point.

Moore is not just criticizing the system the US now has. He's pushing for a change. To make his specific plan workable, won't /average/ health care expenses have to decrease? And won't any guranteed health care system itself have greater health and longevity if more people are like Huckabee, and fewer like Moore?
7.12.2007 4:11pm
rarango (mail):
Look at the top ten causes of death and it becomes obvious that most are linked to behavior. Stop smoking, lose weight, exercise, drink in moderation, get annual physicals and recommended screenings, wear seatbelts and helmets if driving bikes. None of that except for physicals and screenings require much in the way of health care dollars.
7.12.2007 4:11pm
r78:
Here is one link demonstrating that obesity causes few deaths than being underweight:
http://www.medicalnewstoday.com/medicalnews.php?newsid=23210
<blockquote>
Obesity is responsible for 112,000 deaths annually in the United States, and overweight people might live longer than people classified having a normal weight, according to a... CDC and National Cancer Institute study published Wednesday in the Journal of the American Medical Association, the Wall Street Journal reports. Researchers led by CDC senior epidemiologist Katherine Flegal analyzed data from several major federal health studies conducted between 1976 and 2000 (McKay, Wall Street Journal, 4/20). Data was controlled for factors such as smoking, age, race and alcohol consumption using a complex analytical method based on a popular method for predicting cancer rates. Weight groups were based on body-mass index calculations. According to the study, obesity and extreme obesity cause about 112,000 deaths per year, but being overweight was found to prevent about 86,000 deaths annually. Based on those figures, the net U.S. death toll from excess weight is 26,000 per year. By contrast, researchers found that being underweight results in 34,000 deaths per year (Kolata, New York Times, 4/20). Flegal noted that there might have been a large number of frail elderly people in the normal-weight category, which might have affected the findings (Wahlberg, Atlanta Journal-Constitution, 4/20). The new study does not offer a reason why being slightly overweight correlated with a reduced risk of death. Study co-author David Williamson of CDC said that most people are over age 70 when they die, and some excess weight appears to have a protective effect in old age. However, Williamson also noted that the reasons behind the "paradox" are theoretical at this point, saying, "It's raw conjecture" (New York Times, 4/20).
</blockquote>

But I know that these mere facts will not pose any impdiment whatsoever to Mr. Bernstein's opinions.
7.12.2007 4:17pm
Avatar (mail):
I'll be blunt here - not really a fair attack on Moore. To his credit (and that ain't something I extend to him often), he was asked this question on Larry King's show just after the movie came out, and he admitted that the criticism was totally valid, and that he'd noticed the same thing and was working on losing weight. (Along those lines, he honestly looked a little thinner too.)

It's perfectly possible to contest Moore's actual arguments without bringing this sort of thing into it. Not only that, it's much more palatable...
7.12.2007 4:22pm
Felix Sulla:

Advantage: Huckabee
Bologna. The only way this statement could possibly make sense is if Huckabee and Moore were playing Tennis.

Smokers, some have argued, actually save the system money by dying young of a signature disease. The morbidly obese tend to have lots of chronic health problems, like diabetes.
Yeah, I've heard that argument too...mainly from smokers attempting to justify their habit. (Of which I once counted myself, incidentally.) Is there any actual scientific or at least statistically-based evidence to bolster this? My guess: this is the urban legend.
7.12.2007 4:24pm
DavidBernstein (mail):
Data from one dubious reanalysis of epidemiological data showing correlations is not a "fact," and the study doesn't even address the issue of chronic illness.
7.12.2007 4:24pm
Hoosier:
O'Hara demonstrated that "unhealthy lifestyle choices" have nothing to do with whether or not a country can provide good health care at far lower prices despite the "unhealthy lifestyle choices". And that is completely on point.

She didn't "demonstrate" that.
7.12.2007 4:24pm
uh clem (mail):
Yawn. Another "Michael Moore is Fat" thread.

That's the best ya'all can do?
7.12.2007 4:28pm
Porkchop:
Moore: "The healthcare system in the United States is broken."

Huckabee: "You're fat, and I'm not, anymore. It's all your fault."

What did I miss?
7.12.2007 4:38pm
TJIT (mail):
r78 says

Here is one link demonstrating that obesity causes few deaths than being underweight:
Might want to pass on that bit of info to the nanny statists who are busy passing a myriad of regulations and programs to reduce obesity.

I would not be surprised to see in twenty years trans fats will be back in the healthy column and the nanny statists will be hectoring us to put on more weight.
7.12.2007 4:42pm
FC:
A filmmaker, a politician and a bunch of law-talking guys opining about physiology and epidemiology.

Priceless.
7.12.2007 4:47pm
Hoosier:
I've been Moore. I've been Huckabee. I am sticking with Huckabee. Being in shape /does/ save me a large amount of money on medical bills. Even with life-threatening illnesses off the table, I don't go to PT for my knees anymore. Nor do I need back surgery any longer.

If medical care is going to become a common goos, then Americans are going to need to take a more communitarian approach to health. And this does mean lifestyle changes. Regardless of how heavy Mr. Moore is.
7.12.2007 4:48pm
paul lukasiak (mail):
She didn't "demonstrate" that.

I believe that by saying "I wonder what the good governor would say to the French, who drink more, smoke more, eat more cheese and still live longer than us despite paying less for health care?" she is demonstrating exactly what I claim she demonstrated.... that a country can provide health care to all of its citizens and spend far less per capita even those its citizens make notoriously bad "life style choices".

Fat people aren't the problem with health care costs, insurance companies (including malpractice insurance companies) and a health care system that is completely unintegrated and often operates "for profit" are the reasons.

(and at some point, can someone explain to be why supposedly non-profit hospitals spend so much money on marketing?)
7.12.2007 4:49pm
Bpbatista (mail):
scote:

17,000 die because they lack insurance -- what is the source for that statistic? Additionally, how many would die because of wait times and/or sub-standard care in a socialized system that Moore wants?
7.12.2007 4:53pm
Dan Weber:

And cheese, per se, isn't harmful,


I disagree: I ate a pound of it yesterday morning and I *still* can't go to the bathroom!
7.12.2007 4:54pm
r78:

Data from one dubious reanalysis of epidemiological data showing correlations is not a "fact," and the study doesn't even address the issue of chronic illness.



Hmmm - if a lawyer like yourself without any medical training or knowledge were to try to climb up on the witness stand and start opining about "facts" contrary to a those contained in a peer-reviewed JAMA article, no doubt you would jump on your Daubert pogo-stick and start hopping all over the place.

So, please, if you are going to mention the word "fact" you might want to start out by admitting that you haven't produced any at all.
7.12.2007 5:01pm
ElizabethN (mail):
Actually, David, quite a few studies have shown that obesity has a protective effect, especially in the elderly. This blog does a pretty good job of reporting on such studies, if you leaf through the archives a bit.
7.12.2007 5:06pm
JosephSlater (mail):
First, a serious, nom-partisan question about the French and smoking. I used to believe that the French smoked considerably more than Americans do, based on anectodal observations walking around cities. Then somebody showed me a study -- and obviously I can't remember where/what/which -- that indicated that in fact, the percentage of French people that smoke was pretty much the same as the percentage of Americans that smoke. It only appeared that the French smoked more because (at least until recently), smoking was permitted in more places, and smoking was more common among the professional and upper classes (whereas in the U.S., smoking is increasing concentrated in the lower economic classes, albeit of course not exclusively).

So, does anyone have any links to reliable information about that?
7.12.2007 5:11pm
Dave Griffith (mail):
The blog software won't let me post the link, but the American Cancer Society has a good atlas of smoking statistics you might look at.

Bottom line is the about 25% of the French smoke, compared with 20% of Americans.
7.12.2007 5:22pm
rarango (mail):
Paul Lusiak: even though the hospitals may be 501C3s, and ar such nonprofits--they still require at a minimum to break even in terms of revenues versus expenses. (in the nonprofit world, it isnt profit; it's excess of revenues over expenses)
7.12.2007 5:24pm
JosephSlater (mail):
Thanks, Dave Griffith, I'll check it out.

And for the record, the reason my last post begins, "First," but there's never a "second" is because I realized my second point wasn't very good, and then didn't edit. In case anyone really wanted to know.
7.12.2007 5:25pm
whackjobbbb:
Huckabee says:


"I know how much more my health care cost when I didn't take care of myself than when I do take care of myself, not only in terms of doctor visits but regular diseases, illnesses, chronic things that come up, monthly prescription bills," Huckabee said. "All of those things have gone dramatically down since I've taken care of myself and worked to live a healthier lifestyle."


This may be anecdotal evidence, but intuitively we know that this is likely true across the board. Put down the fork, and you save money on health care costs. What's so hard to understand here?

Plus, as others mentioned, if we lost weight, then our planes/buses/cars wouldn't be hauling around millions of tons of extra mass all day long. And I figure we're likely hauling around at LEAST 1,000,000 extra tons... 300M people, each carrying 20 pounds over... cut it to only 1/3 of that number and you're STILL at 1M tons... which is about as much weight as ALL of our Nimitz class nuclear powered aircraft carriers, to put this in perspective. (Moore is equivalent to a fleet attack submarine, all by himself).

And if we lost that extra mass, we wouldn't be hauling around all the extra FOOD we put into all that extra mass. And we wouldn't be forced to environmentally handle all of the byproducts of all that extra food that we put into all that extra mass (packaging, human waste, etc.).

From a systems engineering perspective, this is a conservation of mass issue, even before we get to the ongoing medical costs that Huckabee mentions.

And if you remove all those ongoing medical costs, right up to the point that you die (by Phillip Morris' cancer sticks, or perhaps suddenly and violently by an illegal assault weapon, or in one of Detroit's evil deathtraps, or in evil Cheney's next 9/11 plot), then the absence of those medical costs represents a true savings to society, no? Especially because the more expensive costs of our medical system occur at the end of life, the last 6 months or so, do they not, and we'd have avoided those?

I'd have more respect for Moore and others if they made that distinction in health care costs, re ongoing and end of life, but they appear to be more focussed on the evil insurance industry... and don't want to address the rationing that would likely occur if we decided to deal with the end of life thing. (I understand prostate cancer patients are allowed to die in Europe, as they let the clock run out before treatment starts, but perhaps this is just urban legend.)

I saw Moore on tv last night, and he looked as fat as ever to me. Let's watch and see if he outlives Huckabee, but I'd definitely put Moore higher up in your death pool, from the looks of things.
7.12.2007 5:33pm
frankcross (mail):

I believe that by saying "I wonder what the good governor would say to the French, who drink more, smoke more, eat more cheese and still live longer than us despite paying less for health care?" she is demonstrating exactly what I claim she demonstrated.... that a country can provide health care to all of its citizens and spend far less per capita even those its citizens make notoriously bad "life style choices".


This is just not a good argument. It isolates a few lifestyle choices but doesn't attempt to measure overall lifestyle factors. For example, I noted violent deaths of the young as an explanation for the lower US lifespan. To analyze the lifestyle effect you would need to look at more than just drinking, smoking, and cheese. Especially since moderate drinking is associated with longer lifespans.

Bear in mind that the WHO study used by Moore suggesting that the US is #37 also found that in terms of patient care the US was #1.
7.12.2007 5:45pm
MDJD2B (mail):
(and at some point, can someone explain to be why supposedly non-profit hospitals spend so much money on marketing?)

I assume this is a real inquiry, and not snarkiness.

The short answer is that "non-profit" is a tax status, not a statement of whether money is coming in faster than it is going out.

Non-profit hospitals have no stockholders, and their surplus must be retained and used for capital or operating expenses. this can include increased salaries for their officers, though. Furthermore, their governing body is an unpaid board of trustees. The trustees are ultimately responsible for the medical quality and financial health of the hospital. Losses often are made up by philanthopic contributions. Trustees tend not like to make philanthropic contributions to cover poor performance by the paid administrators they employ.

Thus, the officers of the hosptial will be fired if they show a loss, and will keep their jobs and get raises if they show a surplus.

If marketing puts buns in beds, then hospital administrators will market.
7.12.2007 5:52pm
Eli Rabett (www):
You know, making up facts is such a great game, you can prove anything you want.

Here are two markers of health care, life expectancy

Sweden (80.4) Canada (80.1) France (79.6) Israel (79.3) US (77.7) Cuba (77.2)

Infant deaths per 1000 live births
Sweden (3) France (4) Canada (5) US (6) Cuba (6) Israel (7)


Sweden France Canada Israel and Cuba have universal health care. Sweden, France, and Canada have single payer systems. Israels system became universal in 1995.

Per capita GNP is (PPP basis 2005)

US ($43444) Canada ($35494) Sweden ($34409) France (30693) Israel ($30464) Cuba ($4000)

Who gets the least bang for their buck?
7.12.2007 5:52pm
whackjobbbb:
Yeah, those numbers are likely skewed, if you're comparing countries. Tough to compare.

For example, I believe our infant morality rate is always higher, but we work hard to keep preemies alive and count 'em in the death toll too I believe, and in Europe I understand that they just throw 'em out with the medical waste and don't bother with high itensity efforts to keep 'em alive, so the numbers are skewed (again, that may be urban legend, and I hope some of you med types can jump in here).
7.12.2007 5:52pm
MDJD2B (mail):
(and at some point, can someone explain to be why supposedly non-profit hospitals spend so much money on marketing?)

I assume this is a real inquiry, and not snarkiness.

The short answer is that "non-profit" is a tax status, not a statement of whether money is coming in faster than it is going out.

Non-profit hospitals have no stockholders, and their surplus must be retained and used for capital or operating expenses. this can include increased salaries for their officers, though. Furthermore, their governing body is an unpaid board of trustees. The trustees are ultimately responsible for the medical quality and financial health of the hospital. Losses often are made up by philanthopic contributions. Trustees tend not like to make philanthropic contributions to cover poor performance by the paid administrators they employ.

Thus, the officers of the hosptial will be fired if they show a loss, and will keep their jobs and get raises if they show a surplus.

If marketing puts buns in beds, then hospital administrators will market.
7.12.2007 5:52pm
rarango (mail):
As an epidemiologist and biostatistician, I would submit that looking at aggregate figures such as life expectancy and make inferences from those about health care or lifestyle doesnt provide much information. In general, it is much more useful to disaggregate the data and look at rates per 100,000 per condition to make accurate transnational comparisons.
7.12.2007 5:55pm
rarango (mail):
Eli--please please please not with the infant mortality statistics. That figure has been debunked so long and so often I dont even know why you bring it up. The US is probably the only country that stringently follows WHO guidelines for reporting live births--As Whackjobb says, our infant mortality figures tend to be lower because of premature births. We are, as far as I know, one of the few countries that even report a 24 week old fetus as a live birth.
7.12.2007 6:00pm
Elliot123 (mail):
It might be easier to look at the health and longevity stats of diferent populations in the US. Race, national origin, cultural identification, income, geograpical distribution, etc.

And I suppose we could also look at the weight of people in the same US system. We don't need the French to understand the dynamics of an overweight population.
7.12.2007 6:01pm
rarango (mail):
Elliot123 is on it. Thats precisely the right approach to take from an epi standpoing. For those interested, google "Relative Risk" which is the most useful biostatistic for comparing groups. It is the biostatistical equivalent of a chi square or crosstabs.
7.12.2007 6:11pm
paul lukasiak (mail):
I wonder what the reaction would have been if Huckabee had used Newt Gingrich instead of Michael Moore in his example?
7.12.2007 6:30pm
Mikeyes (mail):
There are very few health insurance companies out there any more if you define them as typical indemnity companies. Most private health insurance is self pay (by the company) monitored or administered by organizations whose primary purpose is to save money and earn a bonus for themselves. Hence the paperwork often serves as a brake on the use of medical care. Companies choose their outside administrators based on bottom line considerations and it is not unusual for a company to change systems (and as a result employee choices such as personal physician, etc) every three years or at every union contract negotiation. The money being spent belongs to the companies, not the adminstrators.

Health care is a benefit of the employed, at least some of them, unless you are one of the many people on public health insurance, which probably makes up the bulk of all the money spent on health in this country. (I am sorry for the lack of statistics or cites, I am too lazy to look it up right now.) This means that a lot of money is spent and it comes primarily from two sources: the tax payer and business. Hence these two entities are the one with the most interest in reform.

My experience has been that the primary rise in costs of medical care comes from three sources: the cost of research, health related companies trying to cash in on all the money floating around, and administrative costs. The latter skyrocketed when the Reagan administration rescinded the rule that all insurance forms had to conform with the Medicare forms. I remember when I first started practicing medicine I had one secretary who spent very little time filling out forms because there was only one and it was a page long. Once that rule changed, there were >100 forms, one of them 19 pages long (CHAMPUS, a governmment provider), and a plethora of restrictions. There was no uniformity with the exception that it was a lot harder to get paid for your services or to even provide them. The ensuing war of wills between the insurer and the insured (with the providers in the middle) brought on all sorts of clever solutions, but also added perhaps 25% to the cost of medical care. I know in my office we have quadrupled our benefits staff just to keep up.

I blame that one simple change in the law for that cost increase. (I may be wrong, probably am, but there was an historical rise in the amount of paperwork and administrative crap as soon as the rule was changed.)

Rapid medical advances in care and equipment results in expensive equipment being changed out (in order to decrease the chance of a suit if something goes wrong and for purposes of staying competitive) before they are amortized. Drug complanies keep looking for the drug that will be number one so they can make a huge profit. Otherwise they lose market share and the stock goes down. They don't look for the greatest good (nor should they.)

Last of all, 15% (or so) of the GNP is a HUGE amount of money and people will do anything to cash in, just ask anyone who has worked for HCA when the company sold all of their money losing hospitals to the company pension fund in order to line the pockets of certain former senators from Tennessee. Fraud and sharp practices abound, much of it legal and typical of American business standards (this is not a criticism of American business practices, that may come later.) This leads to short sighted ideas about health care policy and decisions at the level where it counts: in the legislation and at the company level. No one is looking at long term consequesences and most likely in our "system" it would not make a difference anyway.

As a result of short term goals, the party of the rich, the party of small government and less spending made a decision to pander for the votes of the elderly. The result: an entitlement program that makes LBJ look like Herbert Hoover that will never go away and will eventually cost more money than the war in Iraq. (OK, hyperbole.)

There are no simple answers. Every "solution" from either side of the aisle has led to more complexity. (For example, it is illegal for a physician to give away services without filling out a ton of paperwork to comply with various federal laws and it is illegal to not charge someone if they have certain government insurance just to save administrative costs - which usually exceed the money the government pays you.)

I am so pessimistic that I don't think that any of the solutions offered will work.
7.12.2007 6:32pm
dwlawson (www):
I think the reason our health care costs so much is due to a couple of factors:
1. Outrageous torts
2. Over reliance on patented drugs as cure-alls.
7.12.2007 7:13pm
robertemmet (mail):

Interesting point on the autos, not only do they cause lots of injuries, Americans tend to walk a lot less than in other countries

I'm not a statistics expert (just took what I needed to to get a degree), but I know some of the folks who post here know all about capital Sigmas and stuff, so:
It strikes me that a death at 16-25 where the heavy concentration of auto related deaths occur affects the old bell curve a lot more than one at 65. So have any studies ever been made of how long folks live in a country excluding deaths from accidents?
And that reminds me, while I'm on the keyboard. These longevity figures talk about averages. We talking mean, mode, or median here? Makes a difference IIRC if the old bell curve is skewed.
7.12.2007 7:29pm
frankcross (mail):
Many of us are unaware of the evidence debunking international infant mortality statistics. Could you favor us with a source?
7.12.2007 7:30pm
Q the Enchanter (mail) (www):
"Advantage: Huckabee."

On the narrow point? Sure: Obesity, like any other health condition, increases health care costs. Duh.

But as a substantive criticism of "Fatso" (i.e., assuming we are not to take Huckabee's remarks as an otherwise unmotivated ad hominem obesum)? No way: That there are health returns from nonsmoking, nondrinking and nonbinging is completely consistent with the premises of "Fatso."
7.12.2007 7:30pm
r78:

I think the reason our health care costs so much is due to a couple of factors:
1. Outrageous torts


And this is why doctors love to practice in California where pain and suffering damages are capped at $250K and that is why insurance premiums are so very cheap in California.

Not.
7.12.2007 8:18pm
whit:
"Americans are more obese than in generations past and are more obese than people in other industrialised nations, with whom we share a common genetic heritage. That, to me, suggests that there is a lifestyle component"

yes. and the CDC agrees that over 60% of chronic disease is lifestyle/diet related.

as i said in another thread, NOWHERE can this be seen more blatantly than in the fact that for the first time in recorded history - the poor are the fattest. in the US, obesity is among the largest (no pun intended) health problems among poor people. they also tend to smoke cigarettes more.

hmmm.

what's the connection?

people who make bad and self-destructive choices (stuffing their faces and/or smoking) tend to have far more health problems and cause far more of a burden on the healthcare system.

yes, there is a very small %age of people who are obese through no fault of their own.

i am not a lawyer. i do compete as a weight-classed athlete, and i have personally trained dozens of women and men (many from stages of obesity into stages of fitness).

i'm not a fan of our healthcare system, but i find it ironic that the statist ninnies who want to socialize everything (including healthcare) tend to completely ignore the fact that individuals can and do make decisions that radically affect their health, their need for healthcare, etc. iow, stop stuffing your fat face and stop smoking.
7.12.2007 8:22pm
wooga:
"Universal health care" is not going to reduce health care costs. It's just going to change who gets my checks: Uncle Sam or Blue Cross. As a productive member of society, I'm still going to be the one paying out the nose.

Personally, I'd prefer the US method of low taxes over the Euro method of subsidies via high taxes. Outside of the university system, the single laziest segment of the workforce are government employees. I want to keep my healthcare as far away from those people as possible.
7.12.2007 10:40pm
Houston Lawyer:
I have also read that US infant mortality statistics cannot be compared to any other country's because we count any infant born with a heartbeat to be alive. Other countries use a standard that starts very late in gestation.

How many of you have ever been told by your doctor to gain 20 pounds? I think it is indisputable that obesity has all sorts of negative health effects.

If we adopt socialized medicine, the nanny staters will have every incentive to interfere with decisions that lead to bad health results. I don't believe that anyone who suffers a head injury while riding a motorcycle without a helmet should be treated at public expense. Why should we treat the health problems of a 400 lb person?
7.13.2007 12:12am
Eli Rabett (www):
Very convenient, I suppose the life expectancies are also some figment of imagination. Face it you don't like the outcomes so rather than fixing the situation you try and explain it away. If you are right, how about putting up the comparative miscarriage rates.
7.13.2007 12:50am
Jay Myers:
dk35:

As far as I understand it, Moore's general point in his movie is not that we spend too much money on health care, but rather that the money we do spend is going to far too great a degree into the hands of private insurance companies who then, out of some combination of greed and ineptitude, don't use the money for the purposes to which the public would like it to be used. So, I just don't see how Huckabee's comment have any relevancy to the discussion.

If that's the problem, that private insurance is a bad deal because private insurers take too much profit, then don't buy insurance and pay the bills yourself. Under our current system nobody is being forced to get health insurance. If we go to a socialized system as Moore wants then you will be forced to pay regardless of how healthy you are or how little you use the health care system. Besides, do you really think a government bureaucracy ("You're doing a heck of a job, Brownie.") will be any more efficient?
7.13.2007 1:04am
Thorley Winston (mail) (www):
Very convenient, I suppose the life expectancies are also some figment of imagination.


No but much like infant mortality rates, the causes of life expectancy are pretty complex and varied. Things like ethnicity, immigration, lifestyle choices (e.g. diet, exercise, obesity, etc.), etc. none of which have anything to do with the quality of health care available can shorten or lengthen your country's reported average life expectancy. It's a little bit like spending money on public education, once you get beyond a basic level of literacy and numeracy, spending more diminishes the returns in those areas but you might spend more because you want things other than just making sure everyone can read, write, and perform basic match. In the United States we've decided that we like to have the latest and greatest technology so we lead in R&D and generally have more of the latest technology per capita that most countries (except Japan IIRC). We're generally more productive in how we use to treat disease (except diabetes IIRC) but that doesn't necessarily translate into a great difference in life expectancy. And as others have pointed out, people are willing to spend more on heroic measures to extend life in the final days and to save the most vulnerable at the beginning.

So no, simply throwing out the numbers about life expectancy and infant morality may be an easy to remember factoid but it doesn't really say anything about our health care system.
7.13.2007 1:40am
Thorley Winston (mail) (www):
If we go to a socialized system as Moore wants then you will be forced to pay regardless of how healthy you are or how little you use the health care system. Besides, do you really think a government bureaucracy ("You're doing a heck of a job, Brownie.") will be any more efficient?


Probably not. Although if it's anything like Medicare, most of its administrative functions will be paid for by the budgets of other federal programs or departments so its apologists can say "wow, they're only spending 3% of their budget on overhead."
7.13.2007 1:44am
SFBurke (mail):
I saw a report that indicated that much of French longevity is due to extremely long-lived women. Essentially in the couple of decades after World War II, very few French women smoked (it was not in fashion), as a result they have lived a very long time and have skewed the life expectancy stats. I haven't looked into this deeply but it does suggest a couple of things: 1) life expectancy can be affected by many factor other than the quality of the health care system and 2) demographic and cultural factors vary widely between countries and can have a profound effect.
7.13.2007 2:01am
Christopher Cooke (mail):
I agree that the French probably live longer than we do because of their diet and lifestyle. Everyone is forgetting one important reason why Americans are fatter than the French: it is all of the corn syrup in our food, courtesy of ADM (Bob Dole's biggest supporter). Combine this with our two or three car lifestyle, reliance on machines versus physical labor, and you have the start of an explanation. I also think the French lead less stressful lives than we do---6 weeks vacation, 1 to 2 hour lunches, and 35 hour work weeks.

There was a study of Mexicans who immigrated to the US. The study found that they gained weight within a few years. Why? In Mexico, they walked more (no car) and they ate better, or at least less fatty foods (corn tortillas versus flour here, in the US). I think France, for example, a typical family might have one car, and spends more time walking to markets, the subway, etc than the average family in the US (even apart from the less stressful lives they seem to lead).

As for the Huckabee criticism of Moore's movie, it is bogus. Yes, Moore is fat. But, that doesn't begin to defend the crazy way we spend money in our health care system.
7.13.2007 2:11am
abw (www):
For those asking about infant mortality, wiki links sources.

For solutions to health care: Free market. Give the individual control.

For those complaining about "Moore is fat" jokes, at this point isn't it really unfair to ask us to take him seriously?
7.13.2007 3:54am
paul lukasiak (mail):
"If that's the problem, that private insurance is a bad deal because private insurers take too much profit, then don't buy insurance and pay the bills yourself. Under our current system nobody is being forced to get health insurance."

I guess you've never actually looked at a hospital bill. I recently went for a very simple test, and was shocked to see that the test was billed at $1500. But the insurance company only paid $600, I had a $30 co-pay....and the rest was "written off" in some fashion. In other words, the hospital would charge someone without insurance $1500 for a test that it only gets $630 for if the person is insured.

In other words, hospitals are in cahoots with the insurance companies to ensure that buying health care "a la carte" poses a far greater risk to individuals than it should.
7.13.2007 8:35am
some physicist:
Regarding Israeli longevity, keep in mind that every single israel goes through boot camp. That's certainly good for your health.

It also explains why Israel has a higher proportion of hotties than other countries.
7.13.2007 8:50am
rarango (mail):
"Very convenient, I suppose the life expectancies are also some figment of imagination. Face it you don't like the outcomes so rather than fixing the situation you try and explain it away. If you are right, how about putting up the comparative miscarriage rates."

And comparative miscarriage rates tell us precisely what about the health care system, Eli? A measure of a health care system's effectiveness with respect to pregnancy is the start time and frequency of prenatal care. The earlier prenatal care starts, the better the chance for a good birth outcome. You are speaking like a lay person who has absolutely no understanding at all of epidemiology. As it turns out, Eli, life has a bad outcome. The health care system does little to prolong life expectancy. Life expectancy is much more correlated to lifestyle, diet, and a host of other risk factors.

For those who prefer using aggregate statistics such as life expectancy or infant mortality, please make sure you compare apples to apples (or appropriate population groups). Aggregate statistics as I said above are relatively useless for making conclusions. One big issue with respect to US is its diverse population compared to the more homogeneous European populations. Try comparing hispanics who live in the US with hispanics who live in, say, Mexico to see the relative outcomes. Or blacks in the US versus blacks in the UK or Canada.

As far as sources, I recommend googling "infant mortality statistics." Or read the footnotes on the CDC site for an explanation of the data. For infant mortality, look at the World Health Organization guidelines for reporting that specify a live birth as any sign of life, movement, gasping, or heartbeat. The takes the point of live birth down to about 22 weeks. The Swiss, for example, don't count a live birth as a neonate less than 30 cms. Since low birth weight increases the relative risk for a neonate, compare birthweights among simmilar population groups across different countries for a real measure of prenatal care. Thats the way epidemiology works.
7.13.2007 9:42am
rarango (mail):
Paul Lusiak: Here is a reasonably good explanation of what you saw on your hospital bill. The 1500.00 charge is based on what are called usual and customary rates. This article won't completely answer your question, but in many areas, medicare charges are the elephant in the room that drive U and C rates.
7.13.2007 10:50am
Tom952 (mail):
The practice where providers charge uninsureds more than insurance companies are required to pay is a major problem. Recently, I viewed a hospital bill for a non-complicated heart stent implacement for $130,000, which is what an uninsured/self insured person would be required to pay. The insurance company settled the bill for $36,000.

At no cost to the taxpayers, congress could greatly help the uninsured by allowing them to purchase medical services for the same price that Medicare would pay.
7.13.2007 11:19am
whit:
"If we adopt socialized medicine, the nanny staters will have every incentive to interfere with decisions that lead to bad health results. I don't believe that anyone who suffers a head injury while riding a motorcycle without a helmet should be treated at public expense. Why should we treat the health problems of a 400 lb person?"

the problem is - socialized medicine or not, the people who can't (or won't) pay DO get treated at everybody else's expense

i've sent hundreds of people to the ER via ambulance in my job. it's well known that the no insurance crowd is never going to pay the bill. the nurses, etc. know this. we all know this.

heck, if i was some homeless or poor guy and i got admitted to the ER i'd give a fake name. it's not like you are going to get in trouble for it.

the other problem is that people w/o insurance and/or irresponsible people (in a non-socialized system) will use ER's like a "normal" person uses a general practitioner. this is very expensive, inefficient, and ties up ER's that should be treating the real emergencies. and/or they wait till something minor and easily treatable becomes terribly serious and then go to the ER cause that is their only option

those are just realities and they cost us big bux. add in the costs associated with irresponsible choices (obesity, smoking) and its even worse.
7.13.2007 12:19pm
calmom:
Rarango is exactly right. The most useful comparison of the heath care systems of Europe versus that of the United States isn't longevity (which incorporates lifestyle differences) but what the patients life expectancy is likely to be with a certain disease, breast cancer for example, if treated in Europe versus the U. S.

I say a study out of the American Cancer Society comparing many different forms of cancer; prostate, breast, ovarian, lymphoma, colon and others.

You are more likely to live and live longer if you are treated for one of these cancers in the United States than in any of the European countries.
7.13.2007 12:44pm
Thorley Winston (mail) (www):
Rarango is exactly right. The most useful comparison of the heath care systems of Europe versus that of the United States isn't longevity (which incorporates lifestyle differences) but what the patients life expectancy is likely to be with a certain disease, breast cancer for example, if treated in Europe versus the U. S.


Tyler Cowen had a great piece comparing the productivity of the United States, United Kingdom, and Germany in the treatment of diabetes, cholelithiasis (gallstones), breast cancer, and lung cancer. The US was more productive in all except for diabetes.
7.13.2007 12:56pm
Xanthippas (mail) (www):
This all seems like a very high-falutin' way to talk about Moore being a fat ass. It just doesn't seem relevant to the debate to me.
7.13.2007 12:57pm
rarango (mail):
Calmom--thanks. And I think the crucial point is this: When we look at the results you summarize so nicely, our health care system IS more expense--but we are getting a whole lot more "bang for our buck" from it than the critics who cite life expectancy and infant mortality and other bogus stats insist. Anyone who would prefer to be sick in Europe versus the US hasnt looked at the performance of systems.
7.13.2007 1:04pm
Thorley Winston (mail) (www):
Try comparing hispanics who live in the US with hispanics who live in, say, Mexico to see the relative outcomes. Or blacks in the US versus blacks in the UK or Canada.


I think we may need to break it down even further. In the United States we probably have a greater percentage of both our overall and Hispanic population who spent much of their lives (or in the case of pregnant women, much of their time of pregnancy) in countries like Mexico where they would have been using or only had access to Mexico's health care and prenatal care resources. I suspect that their life expectancy and infant mortality rates are probably worse than those of native-born Hispanics (or Hispanics whose mothers spent the majority of their pregnancy within the United States).

While I'm generally one of those who thinks that legal immigration is a good thing, we do need to realizes that the United States by having a more liberalized immigration policy than . .. well pretty much every other industrialized nation in the world including Canada and those in Western Europe where we accept more refugees and people who come from poorer nations (my own Twin Cities has one of the largest Somali communities in the country) is that we're going to have a lot of people who spent a great deal of their lives living in poor conditions which affect their life expectancy even after coming here.
7.13.2007 1:11pm
rarango (mail):
Thorley: your point is well taken--I actually participated in a study of birthweight outcomes comparing first generation Mexican women with Anglo women. As it turned out, prenatal care was less important than basic diet. Counterintuitively, first generation Mexican women had higher birthweight babies than did Anglo women. It appeared that the key variable was diet; first generation mexican women at a more traditional "rice and beans" diet versus their anglo counterparts. Care to guess what happened to second generation Mexican-american women as they became acculturated into anglo lifestyle? :(
7.13.2007 1:18pm
Dick King:
Statistics are funny things.

If you look at the numbers, and assume that the typical person who dies in an automotive accident is about 30 and therefore loses 50 years of life, you can see that our auto accident rate [presumably proportional to our large rate of care usage] is costing us almost a full year of life expectancy as compared to a hypothetical country that was otherwise similar to the US but has half the car usage [with no reduction of skill among those who actually drive in that other country].

On another note, one fact that probably increases our infant mortality rate is that late-term Mexican women have a huge incentive to sneak across the border, perhaps quite legally on a tourist visa, to have their babies. The baby is born a US citizen [and, probably, a Mexican citizen as well although I'm not sure about this]. This is constitutional, and unlikely to change no matter what the gang in DC chooses to do about "immigration reform". I have no handle on how often this happens, but it's likely to unfairly affect our infant mortality rates because infant mortality is partially a result of poor prenatal care.

-dk
7.13.2007 1:44pm
Bpbatista (mail):
Let the market decide: When the posters on this site get sick, do they go to France or Cuba for care? I highly doubt it. When Michael Moore gets sick does he go to France or Cuba to get care? I highly doubt it. When wealthy foreigners get sick do they go to France or Cuba to get care? No, they come to the U.S. (just ask King Fahd and King Hussein). In other words, people vote with their feet -- and they are voting overwhelmingly for the U.S. health care system. Game. Set. Match.
7.13.2007 2:57pm
Aleks:
Re: Another reason is that we don't ration care for elderly patients with terminal illnesses.

Of course we do! How many 70 years with leukemia or other blood tissue cancers are given bone marrow transplants? Pretty much none, since the procedure has a very low margin of success (and very high mortality) at that age. "Rationing" may be a bad wotd, but in the medical world rationing (AKA triage), based on sound medical criteria, is a rational way to allocate scarce resources.

Re: Additionally, how many would die because of wait times and/or sub-standard care in a socialized system that Moore wants?

How many people die today in the US because of such factors when they are covered by existing public programs (Medicare and Medicaid). I think we could asnwer your question by extrapolating from that stastitic.

Re: Sweden, France, and Canada have single payer systems.

Actually, France does not. Private insurance exists in France, but is very strictlty regulated in the manner of a public utility, and it functions much in the manner of a Medigap policy in the US.
7.13.2007 6:09pm
TJIT (mail):
Aleks said

Re: Another reason is that we don't ration care for elderly patients with terminal illnesses.

Of course we do! How many 70 years with leukemia or other blood tissue cancers are given bone marrow transplants? Pretty much none, since the procedure has a very low margin of success (and very high mortality) at that age.
There is a vast difference between a medical decision based on probable outcomes and quality of life issues versus a government fiat on the amount of money that will be spent.

We spend significant amounts of money putting elderly patients in ICU units and providing them days to weeks of highly expensive, invasive, and painful treatment.

Educating people on how painful this is to the patients and the futility of the effort might make more people willing to forgo extraordinary medical procedures at the end of life and replace this with simple palliative care.

A win for the patient, the family, and society.
7.14.2007 1:43am
MDJD2B (mail):
When Michael Moore gets sick does he go to France or Cuba to get care? I highly doubt it. When wealthy foreigners get sick do they go to France or Cuba to get care?

Yasser Arafat went to France for medical care.
7.14.2007 12:03pm
Jay Myers:
MDJD2B (mail):

When Michael Moore gets sick does he go to
France or Cuba to get care? I highly doubt
it. When wealthy foreigners get sick do they
go to France or Cuba to get care?


Yasser Arafat went to France for medical care.

He also died. Seriously, I doubt he could have gotten a visa to come here for medical treatment and he probably was too afraid of an assassination attempt to try. That's a decision based on politics and not quality of care.
7.15.2007 7:04pm