If you had any doubts about the assertion that American healthcare system is broken prior to watching Michael Moore’s latest film, ‘Sicko’, many of them will be dispelled after watching his latest movie, ‘Sicko’.

Rather than focus on the reported 50 millions Americans with un- or under-insured healthcare coverage, Moore instead spends a fair bit of his time examining the issues and delving into some of the horror stories ordinary middle class Americans face with their health care systems.

Stories of how a mother lost her child because the ambulance took her to a hospital that wasn’t a part of the HMO network. Or how a elderly couple are forced to sell their home and move into their adult child’s storage room because they ran out of money paying the co-pays and deductibles. Never mind the segment where Moore takes a group of 9-11 rescue workers to Cuba to be treated for their 9-11-related ailments because their health insurance wouldn’t cover them.

Is this film left wing propaganda? Well, let’s put it this way:

Does Moore present a completely one sided picture of the American healthcare systems? Yes.

Is Moore guilty of generalizing the perils of the US healthcare system to the few people he chooses to focus in on in the film? Yes.

Does Moore present the alternative health care systems in Canada, the UK, France and even Cuba in only their best light? Yep.

Does Moore deliberately try to elicit an strong emotional response through slick editing and narration? Yes – I guess Moore is an adept film maker.

Is Moore doing anything different than what the conservative (re: Republican) media have been doing for years to deposition foreign health care systems? Nope. Turnabout is fair play here.

In the same way that “An Inconvenient Truth” sought to package up existing information on climate change into a salient and compelling message, Moore seeks to do the same with the US healthcare system.

For managers and policy makers in the health care system, Moore does plainly bring to light a number of serious, though already known issues in the US health care system:

  1. In the US, the incentives that govern the behavior of the healthcare providers is misaligned to the objectives society is trying to address. Profit-driven insurance companies and HMO’s whose goal is to maximize earnings are driven either by raising insurance premiums to as much as the market can bear (reducing accessibility of healthcare for less well off folks) or reducing its unit costs by reducing payouts to policyholders, reducing quality of care. The result, as Moore’s film shows, is a system where:
    • promotions and raises of insurance company staff responsible for approving treatments are tied to percentage of people they turn down, irregardless of the impact, denial of treatment will have on its policyholders.
    • HMO’s that have special teams responsible for recouping payouts by whatever loophole they can dig up or evne in some cases, manufacture
    • Healthcare providers refusing to pay for costs of necessary tests to properly diagnose ailments for fear having to be saddled with the costs of treating serious conditions. hospitals dropping uninsured patients onto non-profit clinics – essentially free-riding on the non-profit system
    • Insurance companies cherry-picking the most desirable patients, but more importantly refusing coverage to unattractive (re – costly) potential clients. HMO’s who refused to pay for anti-biotics treatment for an infant girl because the mother took her to a hospital that wasn’t ‘in-network’.
  2. A “too-cozy” relationship between lawmakers, who are supposed to look out for the interests of its electorate, with the for-profit health providers. Witness Moore’s case in point in the movie – congressman Billy Tauzin, a major proponent of the 2003 prescription drug benefit who, upon the passage of the bill left his seat in Congress for a cushy $2m salary as president of the drug lobbying group – or the 14 other congressional aides who also left to work for the drug industry upon the pass drug benefit. To be fair, the issue of the cozy relationships between lawmakers, lobbyist and giant companies that back them is not limited to the healthcare industry but most all industries in the US.
  3. A healthcare system where insurance is tied to employers – where employees are unable to change jobs or retire because the overriding fear of losing healthcare coverage. This reduces the flexibility of the labor market and prevents employees from pursuing the best career opportunities where their skills will be most optimally utilized. Watch has Moore trots out the 79-year old janitor because Medicare doesn’t cover the all the costs of his prescription drugs.

Moore doesn’t offer up any concrete solutions in his movie. He does spend a fair bit of the movie juxtaposing the US system with supposedly superior systems in the Canada, UK, France, and even Cuba. To be fair, I think he does present these countries’ systems in their most flattering light and not at all critically addressing some of the problems each of the countries face.

Already critics of the movie have been quick to point out that:

  • The rest of the world essentially free-rides on Americans who bear the brunt of the helping drug makers recoup their enormous R&D costs for developing new drugs. Thus the exorbitant cost of drugs for Americans.
  • Non-essential health care treatments are rationed in places like Canada and the UK.
  • France suffers from the lowest economic growth rates in the world – an issue that recently came to forefront in the latest French elections.

This is all true but this is besides the point, or rather this is the point – Moore didn’t make his movie to provide a critical comparison of the health care systems in the world but rather to raise awareness for the significant issues he sees in the US system.

That this movie will inevitably generate a shitstorm of rebuttle, spin and argument from the health care industry and raise awareness for the issue in the American society in general, akin to the effect ‘An Inconvenient Truth’ did for global warming is the effect he was trying to accomplish.

In marketing, we have an saying that customer has to be aware and appreciate the problem before they are willing to invest time and money to solve it. Opening the eyes of public to these issues, letting them get greater air time and actually investing the effort to learn about the issues, that’s what ‘Sicko’ movie accomplishes.

In my next post, I’m going to try to take Micheal Moore up on his offer some thoughts on potential ways to address issues in the US healthcare system and perhaps the Canadian system along the way.

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