It's simple, the difference is a single letter, it is "Me" versus "We" - and Michael makes it very clear. He can have you laughing and crying about it all within the space of about two hours - or however long Sicko plays.

That kind of simplicity is why I like my idea for talking about it - talking about the goal of perfect health for everybody. What kind of a system would it take to get there? Nevermind the fact that we'll never make it, go for it anyway. How could we do worse?

If you've been paying attention, you already know the answer.

When we are all dead what country's citizenship did it matter that we belonged to ? According to the movie 'SICKO" that would be any country that takes good medical care of its living citizens, but that would not be here in the USA. It could be any socialized medical country like: The Vatican, China, Palestine, Germany, Israel, Ireland, England, Cuba, Russia, Canada, Mexico, France, etc. etc.. The biggest point of Michael Moore's movie is that if you socialize only one thing around the world and here in the USA, just one thing, it should be the public health system. The only thing different I would have changed in the Sicko movie was the ending where instead of Michael Moore taking his laundry up the Capitol steps to see if the government will start paying government employees to do his laundry like they do in France, well, maybe that was a pretty good ending. But another good ending may have been seeing Americans give back the USA to the Indians because our health care system leaves most Americans as bad off as the day the pilgrims first arrived and then show Americans returning back to their respectful socialized medical countries where they'll get top notch medical treatment instead of the 1600s type still going on today.

Then if you want a real surprise watching Sicko Michael Moore donates $12,000.00 dollars to the guy who has the largest Anti-Michael Moore website against Moore movies going on because this same guy's wife has now taken ill and cannot afford to be a giant Michael Moore hater anymore and pay for his wife's new medical bills; so Moore donates anonymously the money to keep going his biggest critic on the web...class act right? That's the way you do it.

Don't worry - I won't see sicko. I have no stomach for socialism. Government health care would put every health care worker into slavery, and every potential patient at risk.

Robert you are right. It is "Me" versus "We". I opt for me and my family every time. I mind my own business, not yours.

Your options include moving to Canada. Get going.

Have a nice day - Kitty C.

Wow, Kitty. I'm happy that people like you exist. It keeps me motivated to stay involved and active.

Because of you, I fight for socialized medicine...because of you, I fight against the injustices of Wal-Mart...because of you, I try to do everything that I can for my brothers and sisters while STILL managing to look out for me and mine.

Why does it have to be an either/or proposition, Kitty? Is your world really THAT black and white?

Sorry...I fed the troll...

So I'll donate progressive or socialist today as well.

Thanks for the reminder...

Actually I doubt the stomach is the most useful organ for dealing with any kind of economic system - most do a lot better with their heads.

As to being against all the socialist systems we've got going, I don't see a lot of folks out there trying to get rid of our socialistic road system, schools, mail delivery, defence,...

All these anti-socialism folks are mainly incompetent given their track record of getting rid of these things. Good thing for the rest of us.

Back when I was about 5, I needed my tonsils removed. Because we had just moved here from Australia, we were still "sort of" covered by Queen Elizabeth's health care in Canada. Although I had to share a room, sit on a row of toilets in public to get a urine sample, and wake up in a recovery row of beds, the operation was a complete success - and free to my parents earning minimum wage in the US.

If I believed in Jehovah, I could console myself with the conviction that Milton Friedman is roasting in the hottest hole in Hell. That he could, with the collusion of politicians like Ronald Reagan and George III, move this country from a culture that acknowledged the importance of the social compact to a nightmare of Darwinian individualism in only a few decades still stuns me.

Mencken is credited with saying that "You'll never go broke underestimating the intelligence of the American people." Neither will you by pandering to their basest anti-social impulses (is that feeding the troll?).

I seriously hope Sicko generates some rage, a LOT of rage, enough that we rise up and do something about the issue. And that with that rising, we begin to mitigate the compulsive profit motive by ascending to the humane imperative.

Thanks for the post and the warning... I'll keep my blood pressure pills handy.

I'm not so sure how many folks "buy massive cars so that we make sure to crush others in a car accident" - I'm bet more buy massive cars so they won't be crushed in an accident.

My point being, it might not work well to set others up. Michael discusses this in the movie. The main preventing factor is fear - the folks most effected by this are afraid, and often don't even vote. I liked the original idea, the one that makes the case this is an issue of morallity.

And of course, once that provokes folks to look at it, then I like the focus on perfect health for all.

I wasn't going to chime in until I read this last post by Kitty C. I have three questions for her.

1.Have you or any of your family members ever suffered from a chronic or terminal illness ? 2. Have you or any of your family members been financially destroyed by by the current health care system ? 3. What kind of monster are you ?

Madam socialism has nothing to do with something that is moral and just. You sound like an very uninformed parrot, or lemming for the GOP; perchance a lobbiest for the insurance industry?

Putting political idealogical rhetoric before anyones life is an abhorable action.

Granted I may not possess the education in economics that you do. I do know the difference between socialism (a system or theory of social organization in which the producers possess both political power and the means of production and distribution) and the government model insurance companies abide by, (a government by a single person or group of people who are in no way held responsible to the general population.) Your smart look that one up.

Robert is correct in saying "me or we", however you seem ever the humanitarian and add "me; and my family". When truth known is it's all 'me', you know you would not sacrifice yourself for anyone if it came down to the choice.

When people make statements, then add modifiers like "and my family" they think people will look at them as a martyr, rather than the predator that they are.

They intentionally leave out the most important closing to these statements "me and my family: as long as i don't have to sacrifice or suffer".

My experience as a sociologist (not to be confused with socialist). Having often seen statements like this come from the mouth of people whom view them self as morally superior, usually church going (not all but most), whom often forget the one tenant that separates us from animals, the reason society has survived over the past few millions of years with it's faults, failures, rises and falls. That is, the fact you are your brothers keeper.

I hope you or your family will never see the day where you must chose between seeking medical assistance or chance dying, or one illness away from poverty.

This happens everyday outside the bubble in which you, and people of your mindset live madam. It elates me to know that over millions of years people of this same mindset have been and always will be a minority, and that gives me inspiration and hope. Knowing that compassion always wins, over narcissism and greed.

And I am my brothers keeper, And I will fight his fights; And speak the words for beast and bird Till the world shall set things right. - Ella Wheeler Wilcox

Just my two cents. Rick.

Canada and France do not have Socialized medicine. They have single payer medicine. Meaning, the government is the insurance company.

"Socialized medicine" the likes of which, Conservative, anti-moral, anti-Christians like to scare us with is when the government runs the hospitals and the doctors and pays the salaries of both directly. This is similiar to Britian.

When Conservatives use "Socialism" to denouce what should be a RIGHT as opposed to a PREVILEDGE, they are in fact voting AGAINST democracy. Let's get that straight here.

Also, Moore's move is NOT about the uninsured. He states that quite clearly... trolls take note, or stop your foot twice for yes, once for no. This movie is about the rest of us.

This is a MORAL issue and one that the Conservatives are on totally the wrong side of. Next to Iraq, Healthcare will decide the next election. That is why a Democrat will win the next election because Conservatives are so far behind the times here.

It's all well and good to take care of "me and my family," but what happens when you can't take care of them? You have to turn to people outside your family. But if your attitude has always been "me and mine," who out there do you expect to step in to make a personal sacrifice on your behalf? We're all better off with a system that combines the sort of personal responsibility that conservatives value with the societal responsibility that liberals recognize is so vital, where we understand that we all need each other once in awhile, and where we readily reach out to help those in need knowing that if we need it someday, they will be there for us, too. No system of charity can be as reliable in this regard as the government.

Interestingly, conservatives readily recognize the capacity for government corruption to destroy social service programs, but want to bury their heads in the sand when the culture of corruption is infecting the GOP. Rather than kill universal health care, these people ought to be raging against corruption and doing everything in their power to clean it out of our political system. Of course, that would be seeking a solution, and they're far more interested in complaining.

I have a friend who works exclusively on this issue, and who has convinced me that this is an issue that will have to be dealt with sooner rather than later, as employers begin to cut off health insurance programs because of their inability to pay for them.

But I'm not convinced that a government sponsored program that will provide coverage to everyone will work well either. Here are some of the questions I have, which I hope that someone can answer, as I think I represent the typical "average Joe" who votes and doesn't know a whole lot about this issue:

1. Will a person who is currently insured be able to get the same quality of coverage as they currently receive? I don't think talking about where America ranks amongst the list of developed nations answers this question, as I assume that that list considers both insureds and those without coverage. Unless insureds believe that they will receive similar quality care that they currently receive, I don't think any program can be sold. I just don't believe that the moral argument of insuring everyone will trump the fear of poor care to those who are currently insured.

2. I like the focus on prevention, but am reminded of the old adage about leading a horse to water. Can we really get people to voluntarily stop smoking, stop eating cheeseburgers, start exercising daily, start eating vegetables, reducing their stress etc.? And if we can't, won't there be an almost irresistible urge to regulate these behaviors, especially as the cost of the program rise?

3. Will rationing make the wait times intolerable? A form of the first question. My family and I have Kaiser coverage. The wait times are tolerable (except for their dental coverage), the care is acceptable, and their pharmacy plan is great. Can we expect to see similar coverage under a single payer plan?

4. What about specialized coverage? I have yet to have a relative go bankrupt by a medical emergency, due to the fact that all of my relatives have always had medical coverage, either through work or because they've paid for it, so I have a harder time seeing through the eyes of someone who has been bankrupted due to a lack of coverage. On the other hand, I have had relatives that are alive today only because of the very specialized and expensive treatment that they've received in this country, that I don't believe they would have received anywhere else. Will that care be available, either through the system or through some type of supplemental insurance available to those who can pay?

5. Can we afford to insure everyone? I'm guessing that the answer to this is yes, but again, in order to make the program affordable, won't we have to ration treatment, such that many treatments available today through private insurance are not available under a government sponsored plan? Should we provide coverage to anyone in this country, or only to citizens? Do we raise taxes to pay for the program, or do we cut other government programs to pay for it?

6. Who will pay the physicians/nurses? If we allow supplemental coverage, isn't it likely that the private sector will pay more than can be earned through a government sponsored program, thus attracting the best and brightest MD's and lowering the quality of care to the majority?

What are the answers to these questions?

I'd like to do something as well, but I'm just not sure that the single payer answer is any better for the average working citizen than the current situation. When the average working citizen loses health coverage, however, that's when changes will come about. Until then, I just don't know.

-Columbia Kid,

I would strongly recommend seeing Sicko. It is well thought out and explores many of the questions that you pose.

If you think about the question of rationing and wait times long enough, it should occur to you that you already realize that so many people have no health care at all that to cover everyone might result in wait times and rationing. That fact ought to be very shocking and unacceptable. We really do have a cultural problem when we're so concerned about having quick access to health care ourselves that we are willing to tolerate the fact that many others don't have any health care at all.

The health care situation will be scary whether or not we move toward a single payer system. We don't have enough health care providers and caregivers even now, let alone: - if we succeed in covering more people, thus increasing the demand for services, and - when the rapidly aging population creates the same effect all by itself.

We need a different paradigm for recruiting, educating and training more providers, as well as one for directing research toward and incentivizing discoveries of new drugs. We need a quantum leap in improving the information technology used by medical providers, while protecting privacy rights (no small matter). And we need to help consumers do a better job of managing their own care, to the extent possible, through better information.

Don't worry - I won't see sicko. I have no stomach for socialism. Government health care would put every health care worker into slavery, and every potential patient at risk.

The first modern national health program was introduced in Germany by one of Europe's most conservative leaders - Otto von Bismarck. Winston Churchill, a strong Conservative, also supported a national health system for Britain. Both recognized if their nations were to be strong militarily and economically they would need to have healthy citizens. It was true then of Europe and is true now in every nation. So this use of "socialism" as a derogatory term in the context of health care is meretricious nonsense.

Peter J. Drucker, who was regarded as the father of modern management in the 20th Century and no socialist, once said that there were three entities required in a nation: enterprises, government and non-profit organizations. The trick is to decide which function belongs in which category. Clearly, the insurance companies, hospitals and the AMA (enterprises) have failed in the delivery of health care to the nation so it is time to reassign that responsibility to another entity. Americans are not sufficiently charitable as Kitty and her ilk suggest to sustain health care for all through a non-profit organization, so that leaves government to do the job which it could do for just a fraction of what we spend on weapons of mass destruction and using them in misguided pursuits of empire. As Britain and other European nations have demonstrated, if people want to go the private insurance route then that option is available to them. In the meantime, most of the rest of the Europeans choose their national health services.

Consider this, Kitty and think-a-likes. You have a neighbor whose kid becomes ill with some contagious or infectious disease but can't afford to take that kid to the doctor for a cure. Instead, the kid socializes and spreads the disease to your kids. Now what?

Yeah, we could decide to spend just as much on trying to gain perfect health for everyone as we spend on killing people - or getting ready to kill them.

Who else has as many military bases around the world as we?

How funny. Right as you are talking about the concept of "We" a right-winger posts a whole editorial expounding on the evils of the liberal word "we":

“We” is the Democrats’ and liberals’ killer word. They mean that “we” are our brothers’ keeper, whether we like it or not. “We” must sacrifice our lives, our work, our hard-earned money to pay for any looters who want to take our money, courtesy of government-elected thieves.

“We” is an attempt to make you forget the word “I,” as in “I” earned my money and “you” don’t have a right to take it from me.

The Democrat-looter Presidential candidates all claimed the right to tax us to death to pay for uninsured people’s health care (including Mexican illegal aliens), unemployed peoples’ training, tenured-teachers unearned pay raises, congenitally-incompetent public schools’ unending failure, government workers who get rich on these programs, and every other whining special-interest group who demands government hand-outs at your expense.

Let’s be clear on one thing. You are NOT your brother’s keeper, and no government you elect has the right to force you to be. “Compassion” enforced at the end of a government gun (taxes) is naked compulsion. Every program that looting liberals promote with their “we” forces you to be your brother’s keeper, whether you like it or not. In effect, Democrats tell you, “your money or your life.”

There is only one way to fight the Democrats’ vicious moral notion that “we” are our brother’s keeper. Like a prayer, keep repeating the words that you have the God-given right to keep every cent you earn. Your property is not someone else’s “resource” to spend as they please. Liberal looters who spout their “we” think your hard-earned money is theirs for the taking. They think of you as an expendable sacrificial animal. They think that your duty is to work for the money, but they have the right to spend it.

To fight the liberal looters, keep repeating like a prayer, “My money and property are mine—I earned it. No politician I elect has the right to steal my money to give away to others.” It’s as simple as that.

What a great run-down on the thought process of the "Me" generation.

Another perspective on Sicko:

Reason Magazine

You can talk all want about health care as a "moral" issue, but moral indignation alone isn't enough to revamp our broken and inequitable delivery of health care. We also need to muster the political will to pay the higher taxes necessary to fund national health care.

I'm willing to contribute to a tax-based government program, but I wonder how many of the other progressive readers of this site will step up when the debate comes down to higher taxes, as it surely must.

The way I figure it, we, insured and uninsured alike, will all be better off without the co-pays and deductibles and high administrative overheads that accompany all the for -profit plans that we now rely on. An efficient single-payer system is worth the cost in our tax dollars.

You can talk all want about health care as a "moral" issue, but moral indignation alone isn't enough to revamp our broken and inequitable delivery of health care. We also need to muster the political will to pay the higher taxes necessary to fund national health care.

I'm willing to contribute to a tax-based government program, but I wonder how many of the other progressive readers of this site will step up when the debate comes down to higher taxes, as it surely must.

The way I figure it, we, insured and uninsured alike, will all be better off without the co-pays and deductibles and high administrative overheads that accompany all the for -profit plans that we now rely on. An efficient single-payer system is worth the cost in our tax dollars.

I have no idea how that double post happened. Sorry.

We also need to muster the political will to pay the higher taxes necessary to fund national health care.

Not so. We need to elect politicians who will represent the people and not the military-industrial complex and the health-pharmaceutical industries. If we cut out the monstrous waste on unnecessary and illegal military ventures we could pay less in taxes and still fund a national health care system. If politicians quit stacking the deck in favor of Big Pharma and other parasites in the current health care system prescriptions and other services would cost less.

We also need to muster the political will to pay the higher taxes necessary to fund national health care.

Our very own, now croaked in Ways & Means, Senate Bill 27,

http://www.leg.state.or.us/07reg/measpdf/sb0001.dir/sb0027.a.pdf

"For the purposes of the benefit design process, the Oregon Better Health Design Board shall assume that the resources available to the Oregon Better Health Trust Fund will be the total of the following funds currently being spent on health care each year in Oregon:

(a) Medicare funds under Title XVIII of the Social Security Act, based on the national average for reimbursement rates;

(b) Medicaid funds under Title XIX of the Social Security Act used to fund the Oregon Health Plan, other medical services and administration;

(c) General Fund moneys that would otherwise be spent in the Medicaid program; and

(d) The value of state and federal tax expenditures for employer-sponsored health insurance coverage."

We spend more for less perfect health in this country.

Wow-this is too good to pass up. I will respond personally to RickF who asked me three questions:

1. Yes-members of my immediate and extended family have suffered from a terminal illness. Cancer for one.
2. No we have not been financially destroyed by the current health care system. My Blue Cross PPO insurance was a financial life saver during those dark illness times. It does cost me $650/mo, plus deductibles.
3. What kind of stupid question is that?

Heres my two cents. The rest of your comments appears to be rather paranoid, as if you were afraid of the values I expressed. You do not know me as a person, you do not know my life experiences, you do not know my education level. Why would you appears so hostile and bitter?

Thanks BlueOregon for letting a country gal express views to the city folk.

Hate to break this to all of you, but in order to get good medical care, Canadians are suing to get private medical insurance:

http://www.cbc.ca/news/background/healthcare/

In the USA, we have the best medicine available in the world. Unfortunately, only the rich can afford it. However, anyone can go to emergency and get treatment whether they can afford it or not.

I just don't think making everyone's medical care equally bad or poorly meted out is the solution.

I have neither the time nor inclination at that moment to read all of the comments, so mine is directed only at Jeff's post:

Thank you. Such a bait of a title though! I said the same thing recently -- for the first time publicly -- it is a moral issue. The problem is that there are people who realize that now, and people who will have to witness the collapse of a great deal of our infrastructure to realize it.

I'm glad that Moore made the point that education, police, and fire are services we accept. Yet the thought of health care is somehow a red, commie, socialist idea that will somehow undermine all that is America. Yeah, sure -- if your America is about Capitalism profiting off the ailments of your friends, family, and neighbors.

Thank you, Jeff.

Good thread, Jeff. You cite three reasons why Republicans have been able to kill health care reform (although the contrarian in me would point out that Democrats controlled Congress during Clinton's failed attempt at health reform): 1) restriction of choice, 2) too expensive, and 3) government provided healthcare is immoral. I think you're right that we can win on #3. Most Americans actually believe in a "socialist" approach to health care. . .that's exactly what private insurance is. (Yes, there is a lot wrong with private insurance in America, but at its heart insurance it's a very lefty, community-oriented concept where everyone puts money into the pot and it's doled out only to those who need it.)

But I don't think it's the moral/philosophical issue that's keeping us from serious health care reform. After all, Americans are very happy with Medicare, which is one big single-payer, government run system for 99% of those over 65 years old. Similarly, Medicaid is a decentralized single-payer system. Together, these two programs cover something like 60-70 million people -- or about one out of every 4 or 5 Americans.

What keeps us from serious health care reform are issues #1 and #2, restriction of choice and cost. Columbia County Kid had a great post up above where he/she posted six really good questions -- questions that single-payer can't easily answer. The reason comprehensive health reform has failed time after time is because the devil is in the details, and when people move beyond the slogans and bumper-stickers and try to develop reform plans, they get stuck. For instance, one claim of single-payer is that we would save billions by cutting out the middle-men and lowering administrative costs. This point is academically true but totally unachievable. "Getting rid of the middle-men" means laying off more than 1 million people who work in the insurance/billing/health administration field. It would be catastrophic to our economy (and immoral to boot) to make such a switch without dealing with the fallout -- which is very expensive, thus eliminating the savings (at least in the short term).

What's often left out of the debate over what to do with the 43 million uninsured is what will happen to the more than 200 million with insurance? The only health reform that will succeed is one that benefits those 200 million -- and that's not going to be cheaper than our current system. I've often felt that single-payer makes the best sense on paper, but is not really achievable given the complexities of our current system.

Oh, and I can't wait to see Sicko.

I hate being called "selfish" by liberals/socialists. I'll put up my charitable contribution and kind actions up against anyone here and I know I'll come out on top more often than not.

I am a giving person, but giving should be done of one's own free will, not mandated by the government.

Secondly, the entire world, including countries with socialized medicine benefit from the US health care system. I know you guys all hate anyone who makes a single dollar from working, but pharma companies profits entice them to spend more on R&D. Without the profits made here, do you really think medical advances will be made as fast?

Finally, government by its nature is inefficient and slow to act. Death rates from breast cancer in the USA have fallen in the past 10 years while they've stayed the same in socialized Europe. More people die from breast cancer in Europe than in the USA. Why? Because European governments, who control their health care systems, have not approved new medicines that have proven to work.

What makes the USA so great is freedom. We've got the freedom to succeed or to fail. Some people may be afraid to work or to compete, but based on the immigration numbers of the USA compared to the rest of the world, I'd say the American Dream is alive and well. For those of you who don't have the American spirit, I suggest (as someone else did above), you move to Canada or another country with socialized medicine. We'll be sure to welcome you back if you ever need complex medical care.

Buh-bye.

It seems a peculiar trait on the part of many who post here to go on at length about the method of financing a health care system, without describing how (or if) it will secure perfect health for all.

JLI writes: Without the profits made here, do you really think medical advances will be made as fast?

No, they won't. But let me ask you this: When people in America are dying from treatable diseases because they can't get the medical care they need, is it better to spend another $1 billion looking for the next great cure, or spend it curing people using existing medical technology? Very few people should be dying from prostate or colon cancer as both have very low mortality rates when caught early. Yet thousands die from these diseases because they don't have the medical coverage that allows them to get screened. No one should die from run-of-the-mill tuberculosis, yet people in inner-cities are dying from it because they don't have coverage for the six months of antibiotics needed to cure it. That lack of coverage then contributes to the creation of drug-resistant TB, which threatens the health of everyone.

As for the profit motive being the driver of the next great cure, did you know that drug companies don't spend much at all on primary R&D. Most of the big medical discoveries that you read about happen in publicly-funded NIH labs. These discoveries are then shared with the private sector -- for free -- and they spend about $30 billion a year doing secondary R&D that turns the broad knowledge into a practical application. But if the taxpayers funded the initial discovery, why do we then allow drug companies to patent the results of that discovery and make billions off the resulting drugs? Why do the taxpayers have to pay for the research, and then pay again in order to use that research?

Finally, government by its nature is inefficient and slow to act.

Yup, when it comes to killing folks, you can't beat the private sector - ever see The Origin of AIDS?

Hmmm, that is,

The Origin of AIDS

Dunno why that didn't work, so...

http://www.aidsorigins.com/content/view/203/28/

In the USA, we have the best medicine available in the world. Unfortunately, only the rich can afford it. However, anyone can go to emergency and get treatment whether they can afford it or not.

I know a young woman without health insurance who endured her problem until she was forced to seek help at an emergency room. The people there didn't do much to help her, but she still got a $1,200 bill that she can ill afford.

1. Will a person who is currently insured be able to get the same quality of coverage as they currently receive?

Under the current system there's no guarentees. The situation changes as one changes employment circumstances, health circumstances, ages, etc. One can become too ill or disabled to continue in the same job, and have their life dramatically change - even go bankrupt - under the current system.

2. [Paraphrase] With an emphasis on prevention, won't we get into a system of regulating behaviors?

No, behaviors have consequences, and that will never change. A different health care system may provide different consequences for particular behaviors, but if it is well designed, it will be well thought out.

3. Will rationing make the wait times intolerable?

Under the current rationing folks often wait until it is very expensive to impossible to change their health to better. Under a better designed system folks could be healthier, their health costs less, and part of the reason for this is because they would receive attention when they need it and when it will do them the most good.

4. What about specialized coverage?

Specialists are needed, and that will never change. Under a better designed system than the current system specialists might be more plentiful, and happier with their work.

5. Can we afford to insure everyone?

Obviously not under the current system - millions are not covered. A better designed system can provide better health to everybody.

6. Who will pay the physicians/nurses?

Currently they are paid by a variety of methods - in some cases by locally grown produce. Under a better designed system their method of payment might be more uniform.

Insurance companies and Pharma companies aren't going away; there would be layoffs, but the companies wouldn't cease to exist. The medical jobs would become public.

One of the arguments in favor of single payer is that most of those jobs would go away. When people compare the 20% overhead in private insurance to the 2% overhead in Medicare, they then use the difference to extrapolate how much the country could save if everyone was in a single-payer system. Those billions and billions of dollars could instead be used to cover the uninsured.

The difference in overhead, however, is mostly people. The people who process claims, review claims, code claims, coordinate claims, make payments, issue refunds, work in medical billing "clearinghouses", etc. Medicare's overhead is so low because every doctor or hospital who treats a Medicare patient agrees to be paid according to the Medicare fee schedule, so much of the administrative hassle is gone.

In and of itself, that's not a reason to stay with an inefficient system. But the savings argument from single-payer advocates leaves out the fact that the transition will be extraordinarily expensive. Not to mention the political hurdle since we can guarantee all those losing their jobs will oppose the change.

A friend of mine who lives in France made this observation a couple years ago: "Americans don't have universal health care because they just don't think they deserve it."

Americans don't have universal health care because they just don't think they deserve it.

Only the sick don't deserve health care.

There's a bit of survival of the fittest going on here, I suspect. If you did every thing right, and had health care, then you deserve it. But if you're a wimp and a weakling, then you don't deserve it - and should be leaving this planet soon.

The "Me" versus the "We" Michael Moore noticed. Plus the inability to conceptualize the transition.

What the heck, I'll chime in (if in fact I really haven't been banned by the BO Overlords).

I have seen every Michael Moore film and will see Sicko eventually. What can I say, I think he's a talented filmmaker and always good for a laugh or two, even though I disagree with his political bent more often than not. Go into it with an open mind with your cynicism cranked to the max and it's all good.

On health care, I too admit our current system has much room for improvement, but it is not the complete disaster the socialists try to paint it. Face it, we in the U.S.A. have the best care in the world from a product standpoint. Name one country that has higher-end health care. On the flipside, those who cannot afford the price of admission are left out in the cold, until they really get sick and hit the emergency room. That's not right and it winds us costing us far more in the long run. Even this classic liberal (though most here would probably choose to define me as a hate-filled, racist, ultra-right-wing conservative- whatever floats your boat) believes that we should not deny emergency assistance to anyone (see the good Samaritan you godless progressives), yet all are not entitled to state of the art health care simply because they have the ability to consume oxygen. Health care is not a fundamental right, it's a product and a damned expensive one. Though I have to admit I'd agree with Moore on some point, we couldn't be farther apart when it comes to fully socialized medicine.

My "gun nut" chums almost put the pariah tag on me for enjoying Bowling For Columbine, but it did not change my pro Second Amendment views. My progressive buddies will not like my take on Sicko, but so be it. All I have to say is this: Ron Paul

Don't worry, my conservative friends don't like it any more than my progressive ones. Tells me I'm in the right zone. Peace.

On the flipside, those who cannot afford the price of admission are left out in the cold, until they really get sick and hit the emergency room.

Most of Michael Moore's movie, "Sicko", is about the insured, and how they get left out in the cold - story, after story, after story. And you have plenty of confidence he could make a thousand hour movie, and still have plenty of stories left.

Story, after story, after story.

I have yet to be left out in the cold. All but one job I ever had provided health insurance, and the one that did not I picked up a Blue Cross plan myself. In my worst, most dire unemployed straits when I carried no health insurance and had good cause to go to the emergency room, I was quite impressed with the care I received as well as the dreaded bill. Providence St. Vincents Hospital is tops in my book. They had a sliding scale and were most generous about making payment arrangements. They reduced the bill and required as little as $10 per month. I'm grateful for the level of care I received and will pay them off well before their minimum requirements. Goes back to what I said earlier. I feel like I got first rate care from top professionals. There was no nightmare story- I absolutely had to go to the emergency room, got right in and they took care of me. Had it wound up costing me thousands of dollars, I would have been grateful.

On another note, my mother recently suffered a stroke down in So. Cal and they discoverd some heart issues after she was given a clean bill of health by her regular doctor just a week prior. She has a good pension and is no on Medicare due to her age, so they're not shy about giving her proper treatment. For that I am also thankful, and it appears she's making a good recovery with better care than she'd probably receive in her small town Oregon hospital. Long story short, Im a firm believer that we have the best health care in the world while recognizing that not everybody is entitled to that level of care. That bumps us down several notches. We don't just give it away.

Let's face it. In America to be poor is a sin. You are poor because you are morally depraved and you and your offspring deserve to not survive.If you were righteous, God would bless you, if you are not blessed, then you are not righteous. That's how that works. I've heard that straight from the lips of Sean Hannity, a good moral Christian, right wing but representative of how America thinks. It's also true that our national religion is to look out for number one. We are responsible for no one except ourselves and maybe our immediate family. Period... That's why we don't have a national health care plan. Even Hillary is saying she really can't offer universal health care in a first term, maybe a second term. We have a sick soul, folks.

Puritanical soul. Work hard, and you will be blessed. All goes back to that Puritanical work ethic. A very Republican outlook, too.

I have yet to be left out in the cold.

Michael Moore's Sicko made it seem like once was enough.

Not to mention the political hurdle since we can guarantee all those losing their jobs will oppose the change.

I think this hits the nail on the head. The United States has the most expensive health care in the world but does not come close to providing the best results. There are a lot of people making money from that system. They are going to oppose any change that reduces costs since it means they will make less money. And without reducing costs, there is no way to pay for universal coverage.

If we really want universal coverage we need to figure out how it will allow drug companies, doctors, hospitals and insurance companies to make more money, not less.

All goes back to that Puritanical work ethic. A very Republican outlook, too.

I beg to differ. Republicans today are society's freeloaders. They pass costs on to other people while reaping benefits to themselves.

OK, you guys convinced me. This country needs socialized medicine. I no longer feel people should work to pay their way through life. It's just wrong we live in a society that values hard work. We should be more like France, where it is practically illegal to fire someone, health care is on the government, and people actually like soccer. Pay no mind to the double digit unemployment and the economy that's in the toilet.

So let's get socialized health care. Uncle Sam is a great doctor. How about you put it on the ballot and see what the rest of the country thinks? HAHAHAHAHAHA

So let's get socialized health care.

The approach taken by the Archimedes Movement (I'm trying this link thing again), is to design the health care system we want to replace the miserable one we have now, then figure out how to pay for it after.

A socialized approach might work, since it's the way we pay for roads, schools, etc. - but why worry about that before we figure out what we want?

So how would you design a system to secure perfect health for everyone?

"From a product standpoint, our system is shite."

It may be as good as anywhere else in the world, but if you cannot receive help when you're sick, it doesn't matter whether the care is the best or worst. That was one of the points of Michael's movie, folks who figured they were covered, found out they weren't, at the worst possible time - when they needed to be covered. Folks don't get sick just to test the health care system - but that seems to be the most common state they're in when they find out it's "shite!"

Amazing how right-wingers conflate universal coverage to mean not valuing work. The program "Foreign Exchange" on PBS last night pointed out how there are better worker productivity rates than the U.S. in a number of Northern European countries where they have three times the vacation time, and universal health care, etc. despite the American workers long hours and miserable state of benefits. It's also amazing how "socialism", the "bad" word gets used so freely to diss anything that involves universal health coverage. Well, Canadians have 80 plus % satisfaction with their system where everyone is covered. What they have might be called socialized health insurance at best, but not socialized or socialist medicine. It's even more amazing the that the pro-life right seems to say it's fine to let people sicken and die who can't pay, especially if they are brown skinned undocumented immigrants. And the folks who seem to dislike Darwin so much are such proponents of policies of social Darwinism when it comes to having a safety net for communities. They seem to have forgotten their much touted biblical values and the story of the rich man and Lazarus. And let us not forget "the least of these." (Matt. 25:45) More and more of us seem to be falling into that category of "the least of these."

Could someone explain to me why I have a moral obligation to provide health care to any and everyone, yet they have no moral obligation to behave in ways that limit their own health risk, thus driving my costs up?

Many of you folks berate practically anyone that will stand still for it for not providing health care to the entire country, but why aren't you out there demanding that people drink less, smoke less, abstain from drugs and promiscuity, eat healthy and exercise? 80% of all health problems are behavior-related. Access to free health care is a nice pipe dream, but it isn't a cure.

Some will say that smoking, drinking, eating, getting high and getting laid are all personal choices and are none of my business. I agree. But don't expect me to write a check to cover your complete lack of self-control or bad choices.

But don't expect me to write a check to cover your complete lack of self-control or bad choices.

You already are, so are all the other tax paying folks.

Could someone explain to me why I have a moral obligation to provide health care to any and everyone, yet they have no moral obligation to behave in ways that limit their own health risk, thus driving my costs up?

And, as the article here points out, is the core of the indictment of not only the American health insurance system but of America itself.

There are countless ways in which I believe I have a moral obligation to help pay for services that make our larger society a better place for everybody, even when those contributes go to cover costs that were created by someone else's choices.

Let's start with the easy example. Education. As a gay man without any children, I pay taxes to help cover the cost of education for people who feel they have an entitlement to pop out as many children as they want. They never ask if their reproductive choices impose too much cost on people who weren't asked about how many kids to have. My taxes help pay for someone else's choices. Why don't I make a huge deal about it? First, because I have an expectation that we're all in this together and that while I may be paying for education that my family will never use, the benefits of an educated society make my life better even if only indirectly. Second, while I may not use those education dollars, I benefit from other taxes that other pay.

That's not socialism. That's social responsibility. And for one am fed up with conservatives who have no issue dipping their faces into the public trough for the things they want, need, and from which they personally draw benefit but throw tantrums when they're asked to contribute in likewise manner to help their neighbors and the larger society from which they benefit.

As for the people who think that issues with any other country's single-payer health insurance is cause enough to rejected it, let me point out what should be the obvious. Any system that has such complexity as a health insurance system is going to have areas for improvement. That's no excuse for making the perfect the enemy of the good. Geez, single-payer isn't perfect so it's not worth considering?

And even so, I'd gladly take a health care system that ensures all the citizens and makes sure everybody can get the care they NEED when they need it over a system that makes sure the well off get their boob jobs, botox, and boner pills on demand while people go without care, wither in poor health and suffering, and then die.

The measure of a society is not how well the best of us are doing but how well the least well off are doing. And by that measure, we're a pretty poor society. It's time to do something about it.

The parts of the human body work together to ensure the survival and wellbeing of the whole. Why shouldn't we?

Of course, there is a situation in which a minority of cells within the body exploit the whole for maximum benefit even if that threatens the life of the whole...that's called a cancer. And we cut that out.

That's not socialism.

Actually it is socialism, any of various economic and political theories advocating collective or governmental ownership and administration of the means of production and distribution of goods - I think you could add delivery of services to that list - given your description of schools.

The example I like best is our roads, where there are lots of vehicles that wear our roads more than mine, and return to their owners much more money per mile than I get from mine.

But again, I see no sense in arguing how we're going to pay for a health care system we haven't even described - there's no evidence offered here how we are going to secure perfect health for everybody.

Our current system has a heavy dose of socialism in its method of payment, taxing all for payment. Even the employer based system has a heavy dose of public moneys involved.

Could someone explain to me why I have a moral obligation to provide health care to any and everyone, yet they have no moral obligation to behave in ways that limit their own health risk, thus driving my costs up?

This is the kind of muddled thinking that forms part of the anti-tax, anti-government brigade. The author can relax. HE will not have to pay for everyone. A national health system will be like many other government services. Those of us that can afford it will chip in enough to make it work, and if we compare the national systems of other developed countries with ours and follow their examples, then we can come up with a better system for a hell of a lot less money. If we eliminated the waste by the department of war (aka the grossly mis-named department of defense) the savings there would pay for a large percentage of a national health system. Read Dwight Eisenhower's Farewell Speech and think about it.

While a national health system might provide care to people who brought their illnesses upon themselves, this would only apply to a minority. No system is perfect or ever will be, but it would be a blessing to the nine or ten million children without health insurance and their parents.

Personally, after reading some of the comments above, I would like to see two systems: One along the lines of France and Britain and another continuing the one we have that costs more while providing less and helps the insurance companies make their fortunes by dumping people they can't make money off. Then let the people choose.

Personally, after reading some of the comments above, I would like to see two systems: One along the lines of France and Britain and another continuing the one we have that costs more while providing less and helps the insurance companies make their fortunes by dumping people they can't make money off. Then let the people choose.

That's a bit like the Edwards plan - a system including something like what's available to Congress and a "Medicare for all" offering. Edwards claims this would include a mechanism preventing the first system cherry picking the well, leaving the ill to chose the the second.

any of various economic and political theories advocating collective or governmental ownership and administration of the means of production and distribution of goods

Kudos for being syntactically correct while missing the point I was making in the bargain.

The people who argue most passionately against single-payer insurance do so by waving the red flag of socialism about. It's a baiting tactic that gets them what they want while missing the real point. The entire basis of our system of taxation is that we each contribute part of the benefits we receive from our system so that we invest in order to "provide the common defense" and "promote the general welfare".

The whole point of insurance is to distribute risk across a large pool so that the weight is minimized on average. It's socially responsible to want to contribute to a system of health insurance that maximizes distribution of risk for the benefit of making sure everybody is covered.

As Moore and others point out, we as a society and as taxpayers do exactly this all the time. We do it with roads. Education. National defense. While it may be semantically correct to call this socialism, the real point is that if you benefit from the wealthiest and most powerful civilization in human history then you have a moral obligation to give back to that system to ensure that everybody can benefit from it also.

After 3,000 Americans died in 9/11, we found the political will and the financing to spend billions of dollars and many more thousands of lives to sacrifice in response. But the same people who think this expense is noble and defensible will say that we just can't afford to spend a fraction of that amount to react to the equivalent of SIX 9/11s in deaths due to lack of health insurance every year.

That's not just hypocritical. That's immoral.

the real point is that if you benefit from the wealthiest and most powerful civilization in human history then you have a moral obligation to give back to that system to ensure that everybody can benefit from it also.

Currently there's a significant difference between the health benefits from this civilization in terms of what's possible compared to what's realized.

There may even be a majority will toward changing that difference - perhaps all the way to none at all.

How are we going to reduce or obliterate that difference, what's the best way? Finally how are we going to pay for the way we chose to do this?

You already are, so are all the other tax paying folks.

Which is really everyone, directly or indirectly.

The moral and ideological arguments are all very entertaining, but I think they are basically irrelevant. Lets be clear - what most single payer systems will do are take money out of the pockets of insurance agents, insurance companies, actuaries, drug companies and medical care providers. They use that money to expand medical care to everyone at no additional cost to the rest of us. Opposition to that idea, or support of it, has nothing to do with any ideology or morality. It has to do with whether you are paying the bill or not.

The other reality is that we have system of universal health care - its called the emergency room. And hospitals provide billions of dollars in uncompensated service to people who end up using the emergency room as their primary care provider. That extremely expensive medical care is paid for by everyone else who uses that facility.

Finally, there are a huge number of children that go without medical care because their parents are either uninsured or have extremely high co-payments that cause them to avoid using the insurance they have. Aside from the question of whether we have a moral obligation to those kids, there are some pretty expensive side effects that come from some young children not getting medical care that we end up paying for over and over again as they grow up.

They use that money to expand medical care to everyone at no additional cost to the rest of us.

There's another way to save tons of health care dollars. Design a health care system to secure perfect health for everyone.

Healthy people do not need to go to doctors, stay in hospitals, take drugs, etc. If everyone were healthy it would bankrupt the health care industry.

Naturally such a goal would be impossible to attain, but we don't even know how impossible right now. It would be easy to measure how well a health care system designed to secure perfect health was doing. Furthermore such information might be useful to the design process.

Such a health care system would cost much less than the one we have now.

Crying through “Sicko”

Reviews of “Sicko” have not done justice to its huge emotional impact. This is a four handkerchief movie, and unfortunately I only took two. I was either crying or laughing through most of it. Moore is a master at making you feel what he wants you to feel, and deftly inserting leftist ideas into the American mind. You come out of the theater smiling. It’s only later that the outrage at his intended target sets in.

Moore made the political decision to touch briefly on the plight of the uninsured, my main concern, and spend most of the movie on the struggles of the insured with their HMOs. I’ve been studying the health insurance issue for years, and I had no idea. I knew that there had been fights in the 1990s between HMOs and the insured over coverage, but I thought all that had been settled.

Nope. The HMOs are still at it, using all sorts of sneaky strategies to deny coverage. They will simply refuse to insure anyone with a long list of pre-existing conditions, although Moore doesn’t mention that if you’re an employee these exclusions don’t apply after a certain waiting period. It used to be six months, as I recall.

But that doesn’t settle it. The insurance company can still deny coverage later on the basis that you didn’t declare some very minor illness when you filled out your application, or that you didn’t know about an illness that a reasonable person would have known about.

They can also refuse to cover a treatment your doctor recommends if they consider it ineffective or “experimental,” even it’s commonly used.

In other words, anything to avoid paying up. How it is possible to maintain this system I don’t know, except that the American middle class is so indifferent to politics and terminally passive. I think too that most people don’t know what their insurance covers until they have to use it for a serious illness, and then it’s too late. And of course you have to take whatever your employer gives you.

Moore points out that there is a fundamental conflict in privatized, for-profit medical insurance: the HMOs makes a profit by denying care. He contrasts that with the single-payer, government run health care systems in other civilized countries. Because we have to pay the high administrative costs of insurance companies, including their profits and the high salaries of their CEOs, the U.S. spends much more per person on health care than other countries, with much poorer measured results in terms of life expectancy, infant mortality, etc. We are not getting our money’s worth from our rickety, patchwork health care system.

Many of us are hoping that “Sicko” will start a serious debate about medical insurance in this country, pushing us towards a single-payer, universal health care solution. The issue is being felt in national and state politics, but so far the politicians have offered us what my parents would have called Rube Goldberg contraptions, complicated public-private hybrids that keep the insurance companies in the loop. (Goldberg was a cartoonist who drew complex, absurd machines.)

The Oregon legislature just passed SB 329, the “Healthy Oregon Act.” Insofar as I can even understand it, the legislation would set up a voluntary medical insurance purchasing pool for people who are uninsured or on Medicaid, about 30 percent of the population. A lot of the details about benefits, financing, etc. are still vague. An appointed board is supposed to come up with a plan to present to the legislature in 2008, and it wouldn’t go into effect until 2010.

What we really need is a nationalized single payer plan. We won’t get it without a strong political push. Health care activists need to understand that whatever proposal they come up with needs to be simple enough for most people to understand.

You come out of the theater smiling.

I've helped with a leafletting campaign in Corvallis. It's great talking with folks after they come out of the showing of Sicko - perhaps it's preaching to the choir, but most respond exactly the same. So did I.

What's needed is a statewide discussion resulting in a Health Care Transformation. The way I see doing that is to discuss how we are going to have a health care system that works towards perfect health for everyone.

Progress towards that goal is measurable. It can be stratified, and we can begin to have a common understanding where it's easy, and where it's hard to get there. We've already got some intuitive ideas about this, like it's easier to have perfect health if you're young, than it is if you're old. But the point is that we have access to information that allows all of us to have a grasp of the problem.

Then reaching perfect health for everyone becomes a common goal - the "we" wins out over the "me."

I find it amazing how republicans are still living in the past, communism is still evil, but trading with china is godsend to the economy, but how dare you smoke a cuban cigar.

All of these severely askew right wing rhetoic spewing misinformed souls lack the compassion of a common parasite. Their argument always boils down to the same thing, "they'll raise our taxes".

These are the same people whom always have a hand out for tax breaks. Meanwhile firefighters, police and EMS services are cut, because after all they're social services who needs them, as good republicans they pay their way. It's the same people who grasp their chest in horror and complain why the ambulance is taking so long to arrive, because the local station was shut down because lack of funding, to take them to the hospital so they can live another day to be their same, sad, horrible little selves, so they may cheer on their corrupted political party, and bask in the glow that they're successful upper middle class contributors to society, the chronically ill, impoverished and working poor should just die.

These are the same people who are fighting them there at a cost of $442,264,725,185 and growing every day so we don't have to fight them here. They're always the victim of the big bad government because they pay their taxes, and the government owes them because it works like a banking system, invest and withdrawal (provided a republican administration can hijack the country again).

Just like Joe: Joe gets up at 6:00am to prepare his morning coffee. He fills his pot full of good clean drinking water because some liberal fought for minimum water quality standards. He takes his daily medication with his first swallow of coffee. His medications are safe to take because some liberal fought to insure their safety and work as advertised.

All but $10.00 of his medications are paid for by his employers medical plan because some liberal union workers fought their employers for paid medical insurance, now Joe gets it too. He prepares his morning breakfast, bacon and eggs this day. Joe’s bacon is safe to eat because some liberal fought for laws to regulate the meat packing industry. Joe gets up at 6:00am to prepare his morning coffee. He fills his pot full of good clean drinking water because some liberal fought for minimum water quality standards. He takes his daily medication with his first swallow of coffee. His medications are safe to take because some liberal fought to insure their safety and work as advertised.

All but $10.00 of his medications are paid for by his employers medical plan because some liberal union workers fought their employers for paid medical insurance, now Joe gets it too. He prepares his morning breakfast, bacon and eggs this day. Joe’s bacon is safe to eat because some liberal fought for laws to regulate the meat packing industry.

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Joe takes his morning shower reaching for his shampoo; His bottle is properly labeled with every ingredient and the amount of its contents because some liberal fought for his right to know what he was putting on his body and how much it contained. Joe dresses, walks outside and takes a deep breath. The air he breathes is clean because some tree hugging liberal fought for laws to stop industries from polluting our air. He walks to the subway station for his government subsidized ride to work; it saves him considerable money in parking and transportation fees. You see, some liberal fought for affordable public transportation, which gives everyone the opportunity to be a contributor.

Joe begins his work day; he has a good job with excellent pay, medicals benefits, retirement, paid holidays and vacation because some liberal union members fought and died for these working standards. Joe’s employer pays these standards because Joe’s employer doesn’t want his employees to call the union. If Joe is hurt on the job or becomes unemployed he’ll get a worker compensation or unemployment check because some liberal didn’t think he should loose his home because of his temporary misfortune.

Its noon time, Joe needs to make a Bank Deposit so he can pay some bills. Joe’s deposit is federally insured by the FSLIC because some liberal wanted to protect Joe’s money from unscrupulous bankers who ruined the banking system before the depression.

Joe has to pay his Fannie Mae underwritten Mortgage and his below market federal student loan because some stupid liberal decided that Joe and the government would be better off if he was educated and earned more money over his life-time.

Joe is home from work, he plans to visit his father this evening at his farm home in the country. He gets in his car for the drive to dads; his car is among the safest in the world because some liberal fought for car safety standards. He arrives at his boyhood home. He was the third generation to live in the house financed by Farmers Home Administration because bankers didn’t want to make rural loans. The house didn’t have electric until some big government liberal stuck his nose where it didn’t belong and demanded rural electrification. (Those rural Republican’s would still be sitting in the dark)

He is happy to see his dad who is now retired. His dad lives on Social Security and his union pension because some liberal made sure he could take care of himself so Joe wouldn’t have to. After his visit with dad he gets back in his car for the ride home. He turns on a radio talk show, the host’s keeps saying that liberals are bad and conservatives are good. (He doesn’t tell Joe that his beloved Republicans have fought against every protection and benefit Joe enjoys throughout his day) Joe agrees, “We don’t need those big government liberals ruining our lives; after all, I’m a self made man who believes everyone should take care of themselves, just like I have”.

The Democrats are the party that says government will make you smarter, taller, richer, and remove the crabgrass on your lawn. The Republicans are the party that says government doesn't work and then get elected and prove it.

P.J. O'ROURKE

All but $10.00 of his medications are paid for by his employers medical plan because some liberal union workers fought their employers for paid medical insurance, now Joe gets it too.

Actually this is not exactly true.

Back in the day (some details are going to be left out of this tale - okay lots) some folks in this area wanted area wide retirement. Didn't matter who you worked for in this area, all kicked into the retirement fund.

This scared the pants off employers - workers could move between jobs and not lose an important benefit - so one of them said okay, I'll offer you a company retirement plan. And to sweeten the pot - I'll throw in health care.

What was the worker's leader to do? Talk folks into turning down that deal?

Then the employer's went to the gov and said, give us a tax break for the money we spend on our employees - and the gov did that for them, 'cause everyone knows, these are all good guys. That tax break is public money.