Controversial Michael Moore Flick 'Sicko' Will Compare U.S. Health Care with Cuba's

[HM2VikingRN]

Health care advances in Cuba

According to the Associated Press as cited in the Post article, "Cuba has made recent advancements in biotechnology and exports its treatments to 40 countries around the world, raking in an estimated $100 million a year. ... In 2004, the U.S. government granted an exception to its economic embargo against Cuba and allowed a California drug company to test three cancer vaccines developed in Havana."

http://alternet.org/envirohealth/50911/?page=1

[ZASHAGALKA, RN]

Since we are singing paens of praises to Rudy Care I think that we should really look behind the numbers: (source American Prospect at http://www.prospect.org/cs/articles?article=a_man_with_a_nonplan )

Failure of the press aside, let's examine this "vision." What Giuliani offered is this: A tax exclusion of up to $15,000 for families, and $7,500 for individuals, to help pay for health care. What Giuliani is relying on is people reading those numbers -- $15,000 and $7,500 -- without noticing that they don't denote the amount of money he's offering them, but the amount of money he's not taxing them on. And when we plug it into my magical Rudy Translation Machine (constructed with the help of friendly neighborhood economist, Dean Baker), we can watch how $15,000 can easily become … zero.

Let's stipulate a family of four -- a mom, a dad, and two children. The type of family Republicans like. And let's say your household income is $30,000 a year. Giuliani's tax exclusion will save you … nothing. Your income isn't taxable anyway. Bring it up to $40,000 … and it's still nothing. Your child tax credits are crossing out your taxable income. Indeed, according to the Center for Budget and Policy Priorities, 55 percent of the uninsured don't earn enough money to have any taxable income. This proposal -- unless changed from a straight exclusion to a refundable tax credit -- will do literally nothing for them.

Don't get me wrong, some families will save a few bucks. If you make $50,000, Giuliani's exclusion will save you $1,220. And if you make $70,000, you'll get a whopping $2,250. And the higher up the income ladder you go, the more our hypothetical family unit will save. Meanwhile, here's the kicker: According to the Kaiser Family Foundation, in 2006, premiums for family coverage amounted to, on average, $11,480. Giuliani's giveaway barely makes a dent.

So under Rudy Care-once corporate employers drop their group plans-families will in effect see compensation cuts of 8000-12000 dollars per year. I think I'll pass on this plan as yet one more attack on the living standards of the middle class.

Except that, this example forgets a few key things.

1. The truly poor are already covered, through medicaid. In fact, the current SCHIP proposal aims to cover everybody through age 25 and incomes as high as 84,000. Your tax dollars, subsidizing the care of high five figure incomes. The 'uninsured' that aren't purposely uninsured (because they're 20 and invincible) tend to be people in the income 'gap' between poor and middle class.

2. EMTALA insures emergency treatment for everybody.

3. Your model did not take into account the positive benefits of a change towards making the system truly free market: first party payors vs. third party payors. The result of such a system would bring prices down, WAY down. The price of healthcare is so high largely because those that pay for it don't care what it cost. When cost is brought into play, much more rational decisions are made. That brings down costs. Your doctor can charge 200 bucks for an office visit because insurance pays for it. But, there is a growing field of docs that take cash only for visits, and their visits are much more like 50 dollars. It's like any new tech gadget, the more people that begin to use it, the less the price becomes, because of competition and sufficient demand. As more people begin to discriminate what things costs, the costs will come down.

The chief problem with the current system is that price isn't a consideration, for far too many users; there is no rational check on demand. Moving to restricted, socialized care is a continuation of the same problem. That's WHY such care always becomes restricted care, with waiting lists and denials of service: you simply MUST make supply and demand balance. It is an economic law immutable by legislative fiat.

So, you quote what the cost of insurance is NOW (and drastically inflate that price, to boot. 11,480/yr for premiums alone? That's almost 1,000/month. I suspect that very few people insured through their works pay 1,000/month in premiums). Then, you apply that fantastically inflated number to a plan that would radically change what the cost of insurance would be under that plan. Nice trick, but it is nothing more than playing with numbers.

4. When it comes right down to it, we have a fantastic healthcare system. 86% of Americans are covered with insurance (either private or gov't sponsored) and the remaining 14% are covered for emergencies, under Federal law. The gap is in other than EMTALA care for the working class.

Rudy's plan does help there.

First, let me point out the doubletalk of decrying that tax cuts can't help if you already pay no taxes, and then compare that to claims by the same groups that the rich don't pay their fair share of taxes. The top 50% of wage earners in this nation pay 96% of all income taxes. I'd say that is at least a "fair share". When it suits you, you point out the tax inequities of the rich, and here, when it suits you, you point out that the poor and working class don't pay any taxes, in any case. hmmmmm.

However, there ARE other ways to engage in tax cuts.

1. You point out one: tax credits. In fact, the EITC was the brainchild of one of your anti-heroes, Milton Friedman. Friedman suggested giving tax credits (ie CASH) as the ONLY form of welfare asst. Whatever we are spending in the various programs, eliminate those programs and figure out what cash benefit that should lead to, and then give it as a tax credit.

2. You could give a tax cut on PAYROLL taxes, SSN, FUCA and Medicare. Those taxes affect everybody. I would suggest paying for those cuts by means testing those programs. Rudy doesn't go that far. Unlike Rudy, I suffer from the luxury of not running for office.

3. Healthcare Savings Accounts.HSA shield money before all taxes, including payroll, are considered.

Finally, understand the import of what I said in the earlier posts: the system is prohibitively expensive precisely to prohibit you from staking out on your own. Once choice is returned to the system, the house of cards will collapse and routine care would become affordable, even for the working class. THAT is the key.

If you want the working class to be able to afford routine care, it has to be affordable. Rudy's idea attacks the system that is designed NOT to be affordable. Once under attack, whether you can directly take advantage of the tax cuts made available or not, the plummeting cost of care actually valued to market forces will place that care within the reach of far more people.

Tax cuts are an interim step to overthrow the current third party payor system. Once under attack, the benefits of returning to a free market for healthcare will benefit EVERYONE.

~faith,

Timothy.

[Spidey's mom, ADN, BSN, RN]

Except that, this example forgets a few key things.

1. The truly poor are already covered, through medicaid. In fact, the current SCHIP proposal aims to cover everybody through age 25 and incomes as high as 84,000. Your tax dollars, subsidizing the care of high five figure incomes. The 'uninsured' that aren't purposely uninsured (because they're 20 and invincible) tend to be people in the income 'gap' between poor and middle class.

~faith,

Timothy.

I read this and was so frustrated . . . .

steph

[ZASHAGALKA, RN]

I read this and was so frustrated . . . .

steph

But, it's FOR THE CHILDREN!

~faith,

Timothy.

[Spidey's mom, ADN, BSN, RN]

But, it's FOR THE CHILDREN!

~faith,

Timothy.

Oh, please Timmy . . . . . ..;)

(nice to see you btw - say hi to your dear wife). :balloons:

steph

[ZASHAGALKA, RN]

http://www.signonsandiego.com/uniontrib/20070805/news_mz1e5mair.html

"In creating "Sicko," Moore must have overlooked some of the major news stories about the NHS from recent years. Stories such as one from the BBC stating that in September 2006 more than 6,000 patients in eastern England had to wait more than 20 weeks to begin treatment already prescribed by their doctors. Or a BBC story, also from 2006, noting that over 40,000 patients in Wales had to wait more than six months between being referred for, and actually having, an outpatient appointment. Or the recent London Times story regarding an admission, by Britain's Department of Health, that some patients will have to wait more than a year for treatment, and that 52 percent of hospital inpatients are currently waiting more than 18 weeks to receive treatment."

"Ultimately, we can have the debate about whether it is better to have a health system that prioritizes something basic, and quite poor, for everyone, or something good for the vast majority. But Moore is wrong to pretend that socialized medicine delivers real quality of care over and above what we see in America today. And he is wrong to portray Britain's National Health Service as an entity where quality of care, as opposed to budgets, always comes first."

~faith,

Timothy.

[HM2VikingRN, RN]

SCHIP gives states matching federal funds to provide health coverage to children in families whose income is modestly above Medicaid limits, typically up to 200 percent of the poverty line (or roughly $34,000 for a family of three) but sometimes a little higher. About 4 million children receive health coverage through SCHIP each month. Some states also use SCHIP funds to cover a limited number of low-income adults, such as parents or pregnant women.

http://www.cbpp.org/pubs/health.htm

This eligibility rule for SCHIP is hardly up to 84,000/year. The poverty guideline for a family of 4 is $19350 (see http://aspe.hhs.gov/poverty/05poverty.shtml ) So at 200% of poverty that is only $38,700/year. Hardly a true middle class income. The states that have used SCHIP up to 300% of poverty as I understand it are free to impose sliding scale premium schedules.

Assuring access to insurance for low income families is good public policy. See http://www.cbpp.org/10-20-06health.htm for an explanation about how expansion of SCHIP increases family health overall as well as family income from work.

[BBFRN, BSN, PhD]

What's so wrong with insuring coverage for children? I'm not understanding the smug attitude regarding this.

[bigreddog1934]

here in illinois we are working with the national nurses organizing committee to build a movement for universal health care. this effort is across states and has the involvment of thousands of nurses. if we think about it, the hmo's and the rest of the health care industry is not going to just part with all their income for no reason. its going to take a battle.

there are over 200,000 nurses just on allnurses alone. that is some real power. couldnt we start a thread that addresses what we are doing to fight for national health care? move from the dabate to the real action?

[Spidey's mom, ADN, BSN, RN]

here in illinois we are working with the national nurses organizing committee to build a movement for universal health care. this effort is across states and has the involvment of thousands of nurses. if we think about it, the hmo's and the rest of the health care industry is not going to just part with all their income for no reason. its going to take a battle.

there are over 200,000 nurses just on allnurses alone. that is some real power. couldnt we start a thread that addresses what we are doing to fight for national health care? move from the dabate to the real action?

Nurses are not a monolith - we all don't agree that universal healthcare is the answer.

steph

[ZASHAGALKA, RN]

What's so wrong with insuring coverage for children? I'm not understanding the smug attitude regarding this.

Because, it's 'for the children' is disingenuous. It's a lie. A smug lie, at that.

The purpose of expanding this legislation into the upper middle class and well into adulthood is to use it as a vehicle for gov't restricted, socialized care. Claiming it's 'for the children' when the current proposals are targeted far away from children is a lie to sell socialized insurance to the public because the topic cannot prevail on its own merits.

When I'm lied to, I reserve the right to cage my responses smugly:

http://www.heritage.org/Research/HealthCare/wm1577.cfm

"If Congress decides to go down the road toward SCHIP expansion, it means that more Americans will be dependent on government for their health care; taxpayers will be burdened by higher levels of government spending and increased taxation; and more Americans will lose their private health care coverage because of the "crowd-out" that accompanies government expansion."

~faith,

Timothy.

[HM2VikingRN, RN]

a california study found that a family of four with income of 200 percent of the poverty line that had individual-market coverage would have to spend 34 percent of its income on health care.[10] in 2007, this would amount to about $14,000, far more than any tax benefit a family at this income level would receive from any tax deduction or credit that has been proposed.

http://www.cbpp.org/7-31-07health3.htm

in contrast to these 34 percent and 30 percent “crowd-out” rates, a study by m.i.t. health economist jonathan gruber — the economist whose work on schip crowd-out the administration frequently cites — found that 77 percent of the benefits under the health tax deductions and credits the administration proposed last year would go to people who already had insurance. gruber also found that despite costing $12 billon a year, the administration’s tax subsidy proposals would produce no net reduction in the number of americans who are uninsured, because they would induce a number of employers to drop, or not to offer, coverage.

http://www.cbpp.org/7-31-07health3.htm

the data doesn't agree with your assertions about crowd out....

[piscesguy]

Goodness, I'm glad to see there is plenty of emotion on this subject. I think that shows genuine concern for patients.

Yes, I'm glad we are in agreement. As I said in my post, improvements are needed in our current system and it has areas that are broken but I (and I would guess many others) believe the current Canadian and European systems are not good models.

I also don't think its healthy to kowtow to Michael Moore who many would classify as a communist promoter and sympathizer.

I think we can all agree that we deserve better healthcare, but how does going to a movie and feeding Micheal Moore more money have to do with that?

I can feel one way about healthcare reform, and still find Micheal Moore not credible all at the same time.

But, why do we, as nurses, need to see a movie about this when we see it everyday in real life? I'm not giving MM a dollar for anything, and I certainly would cringe at the thought that he's somehow "standing up" for us. The only thing he stands up for is the mightly dollar--and he's getting none of mine..

How can you be so emotional about a movie you refuse to see? See it and then talk about how you feel, otherwise it's not fair to others who want to talk about the issues in the movie, and maybe spare the rest of us YOUR propaganda about how "healthy" it is to associate with "communists"....PLEASE!