Sicko, Wacko

by Jim Davies

Exclusive to STR

July 2, 2007

It must have been Be Kind to Michael Moore Week.  

On Friday, a breathlessly waiting world was rewarded by the release of his latest movie, "Sicko," and in the run-up days he was given the rounds of the TV interview circuit. Larry King treated him as if he were some kind of expert in public policy--but then, King has an hour to fill every day, whether or not anyone interesting happens by. To his great shame, Jon Stewart, one of the more intelligent hosts on television, also afforded Moore ten full minutes on his Comedy Channel "The Daily Show" with nary a single tough question in sight or hearing.

The reviews were underwhelming--even the L.A. Times managed to contain its enthusiasm--and to my mind Kyle Smith in the NY Post had the neatest comment: "The silliness of Moore’s oeuvre is so self-evident that being able to spot it is not liberal or conservative . . . it’s a basic intelligence test, like the ability to match square peg with square hole."

"Sicko," so Moore explained, includes the story of a man who loses the ends of two fingers in an accident. Both severed ends could be re-attached, but first the insurance company has to approve the expense, and the clerk responsible will not pay for more than one. What a scandal, said Moore ; surgeons ought not to have to submit their judgments to bureaucrats on the end of a phone line, and if a man needs two fingers fixed, he should get two fingers fixed. In the story, the man--a romantic--picked his ring finger for repair, leaving his middle digit foreshortened forever.

Moore 's prescription is to emulate Canada : Every person should be provided with health insurance and no need should go unmet, free of all charge. His reasoning is that insurance companies are obligated to provide profits for shareholders, and that can only be done by limiting treatment to patients who need it, and clearly that's counter-productive, so nothing less than universal government-provided health insurance will do, QED.

And I say again: His interviewers treated this argument seriously, just as if Moore was an economist. About the only relief I saw was that Moore admitted that currently, it's "not politically feasible" to change to a single-payer, government health-care monopoly, for it seems the politicians sense that the great American public doesn't want one. If that is so, the public goes up several notches in my esteem.

The fantasy world Moore inhabits is one in which:

1. Medical services are provided free, by all who work in that industry. Doctors, nurses, administrators and all are so moved by pity for their patients that none of them will draw a salary. Banks, too, furnish capital for buildings and equipment without thought of interest or repayment, just for the greater good of humanity. All this, yet in some unspecified way--manna, perhaps, from heaven--all those parties live comfortably ever after.

2. Alternatively, those people are properly paid with money, but the funds grow on money trees in the gardens of D.C., lovingly tended by the manure-dumpers and shearers of Capitol Hill. Since the price to patients tends towards zero, their demand for health services will tend towards infinity; but money trees grow and reproduce fast, so there's never any problem.

3. Alternatively yet again, if the money trees should wither, the cost is loaded on to the backs of taxpayers, who willingly shoulder the extra burden. Unfortunately, that is less fantastic than #1 or #2--it could actually happen. The portion of GDP grabbed as tax has quintupled in the last century, yet complaints are not noticeably louder.

4. Final alternative: The extra cost arising from the extra demand resulting from the zero marginal price for health care is provided not by money (from either trees or taxpayers) but from the patients in the form of time. That is, the service they need is provided without money charge, but only after a long delay. This not only could actually happen, like #3, it probably would actually happen--because in other countries where such madcap schemes have been in operation for a few decades, that is exactly what does happen.  My cousin's husband in England is in daily abdominal pain yet must wait two or three more months for surgical relief. Any treatment that is not needed immediately and urgently is placed in a queue. During those months, some patients cease to be patient; that is, they die. That reduces the demand and enables the system to function. I feel confident that some patients would prefer to pay rather than die, but under a government monopoly, that choice is not available.  

There's one other way in which Michael Moore's illustration is far removed from reality: He objects to an insurance company's representative holding the life (or at least, two fingers) of the victim in his arbitrary control.  I can see his point, but two things are wrong with this: (a) normally, that's not the way insurance policies work. A policy states what treatment will be given and what will not be given; those clauses form parts of  a contract, which patient and insurer alike read and accept before it takes effect. There are exceptions when the condition arising is not precisely described in the contract, but normally that doesn't happen; Moore has therefore built his case upon a "straw man" or free-market abnormality--and one which, in a free society, would be cured easily if the contract provided that such anomalies be settled by arbitration of the Peoria Resolution Company. Then (b) you can call me a cynic, but I strongly suspect that in a government health-care monopoly, there would be in some dim cubicle in some gray government office a bureau-rat, whose job (supervised, perhaps, by a gray-faced David Spade lookalike) will be to say by telephone "No!" to some request for treatment. When he does, he will not be operating according to a contract, but according to the latest happenstance of the political wind. If voters were to decide that people careless enough to get their fingers cut short shall have them stay short, then regardless of the victim's wishes, short they will certainly stay; and the only recourse will be that of the clout factor. If he or his family happens to wield political influence, or to be generous with campaign contributions, strings may be pulled and the finger-ends, reattached.  

Your fingers, therefore, along with all other appendages, organs and maladies, would be wholly at the mercy of government. A prospect quite enough to make one ill.