On July 4th I walked with my sister through the park by the Willamette river to Eugene's Valley River Center mall to see Michael Moore's new film "Sicko." Arriving at Regal Cinemas early, we were subjected to two right-wing propaganda ads against marijuana and for the National Guard. Both made me angry. I wondered if the theater owner had decided to stick it to us lefties.
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 make 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 must be simple enough for most people to understand.