Sicko is Michael Moore's best film yet. It brought tears to my eyes and infuriated me at the same time. I saw it last night with my youngest daughter. Ah, let me think here, how am I going to give this an environmental twist? How about using our pathetic health care system as another example of how dysfunctional our political system has become, the same one we are counting on to protect our biosphere and us from peak oil and global warming?
The film documents how Hillary Clinton was beaten into submission when she tried to reform the system and how even she is now beholden to the industry. And who is to blame for this? Would it be the politicians, the lobbyists, or the ignorant, self-deluded American citizens who allow the lobbyists to buy the politicians because they are terrified of losing their jobs, everything they are paying off, and their health care to boot? All of which is covered in the film, by the way.
When Moore asked a retired member of the British Parliament how long they have had free health care for all citizens he was stunned by the reply. They have had it since the end of the Second World War. Imagine that; a country bombed flat and financially exhausted being able to afford universal health care. He explained that before the advent of democracy, only the wealthy could afford education and any semblance of health care. Once it was decided that everyone should have a free education, it wasn't much of a leap to realize that everyone should have free health care. The free market is an incredibly powerful force, but when a man without insurance has to choose which finger he wants reattached, the $60,000 one or the $12,000 one, you may have found a place where the profit motive does not belong. My brother lost his thumb to an accident two years ago. He was uninsured and no attempt was made to reattach it.
The analogy between our national education system and a national health care system is a pretty strong one. Our public school system is not what you would call perfect. The wealthy still put their children in private schools and those schools are better than the public ones because they are for-profit, free-market enterprises. I know this first-hand. Not only have my children attended both types of schools, but my wife also used to teach math in a private school. But, they are not that much better. In other words, the quality per unit-cost of a private school is actually much worse than a public school. A private high school in Seattle is presently costing about $18,000 a year. This is especially true for higher education, where it costs about $40,000 a year. An engineering degree from a state school holds its value against one from the very best private school.
I am also intimately familiar with our health care system, as any parent who has spent years dealing with a chronically ill child tends to become. I am also caring for my aging and impoverished mother. I know first-hand how incredibly inept our medical system is. I find it difficult to believe that national health care could be worse, and if it is, it sure can't be much worse. There are four health care lobbyists for every member of Congress. The AMA is one of the most powerful. Its main reason to exist is to trip up the free market by limiting the supply of physicians, thus guaranteeing the perverse wages they receive, and this is just one of the forces controlling our politicians.
When Moore asked a French citizen why his government is so responsive to its citizens' needs, he replied that it's because the government fears the people. The French will protest and strike to get what they need. He said that in the States, people fear the government. They fear losing their health care. Riiiight. Wait a minute, when was the last time you attended a protest?
Maybe it's time to go find one. Make it a family affair if you are too exhausted and strapped for time. May I suggest your local Critical Mass on the last Friday of every month? Improving biking infrastructure and safety not only fights global warming but it also prepares us for peak oil. It is refreshing to rub elbows with hundreds of energetic, naïve, idealistic young people -- something we need more of. I will let you know of other protests coming up you can participate in, from biofuels to bike trails.
My only concern about the film is that in its attempt to demonstrate that universal health care does not mean living in squalor, it goes a little overboard and will leave the more naïve with the impression that countries with universal health care are paradise. They aren't. They just have better health care. They still have their problems.
I want to conclude by attempting to explain why free markets work. I want to do this in a vain attempt to cut off at the knees the coming misinterpretation that socialism trumps a free market. First, no two economists will agree on an exact definition of socialism or a free market. The two terms are, in reality, an attempt to pick a point on a continuum. Picture a horizontal bar marked with units:
Communism-socialism-regulated free markets-unbridled capitalism
Picture also one of the major defining differences between them: taxation. As taxation goes up, you slide to the left of the chart. As taxation approaches 100 percent, where all wages are taken by the government and reallocated evenly via services to all citizens, you have communism and its attendant poverty and misery. In a system without taxation, where all power has concentrated into the hands of the wealthy (a description of much of human history), you have what looks an awful lot like unbridled capitalism, slavery, serfdom, poverty, and misery. You don't want to be at either end of that spectrum, especially when the system finally implodes.
Now to explain why something in the middle works better. To buy my explanation you have to first buy the theory of evolution and the existence of a genetically bounded human nature. This automatically eliminates about half of the American public. By trial and error, via various modern social experiments with communism, we have discovered how human beings respond when a government attempts to force all people to have the same status. When competition is squelched, innovation and efficiency are also squelched. We are social primates. We need hierarchies to function properly as a group. History has also taught us what happens when the disparity between the wealthy and the poor becomes too great.
I call this a status gradient. Picture a chart with a line that slopes down from the upper left corner. The vertical line on the left shows increasing status (closely correlated with wealth) and the horizontal line shows the number of people at that level of status. You don't want a "flat line," but you also don't want the slope to get too steep. I once read a book called the Status Syndrome. I can't recommend it because it was one of the driest books I've ever read. It described a detailed study of the health of the bureaucrats of White Hall (the employees of Britain's government bureaucracy). The author controlled for everything you can imagine -- age, sex, wealth, diet, exercise -- and the only thing he could find to explain health discrepancies was status. His recommendation at the end of the book was to keep the status gradient (my term) from becoming too extreme. He also conceded that that there is probably a limit to how flat you can let the slope (my term again) get before things unravel.
You can stop reading here, assuming you have managed to get this far. My last analogy for free markets, and government's role in them, is for the mechanically inclined out there. This analogy comes from my observations as a child of the governors that controlled the massively powerful engines that drove my father's bulldozers. A governor is a small device used to control how much air and fuel is allowed into an engine. It consists of a set of weights on levers. The faster the engine turns, the greater the centripetal force on the weights. This force causes them to close the air intake slightly, thus slowing the engine, which in turn causes the weights to drop, exerting less force, and causing the intake to open again.
Think of this massively powerful engine that can do huge amounts of work as the free market. Think of this small governor that sits on top of it as, well the government. Now picture a massive governor sitting on top of a small engine. The engine uses most of its energy trying to spin the dead weights, which in turn are slow to respond to input. That's communism. Now picture an engine where someone unbolts the governor and runs off with it while the engine is running. The engine will rev to it maximum PRM until something breaks or it uses up all its resources (fuel). That is unbridled capitalism. What you want instead of these two extremes is a well-designed, functional governor that responds quickly and efficiently to the needs of the engine without drawing too much power from that engine. Throttle an engine too much, and it will stall.
I am old enough to remember the horror stories of my parents growing up in a stalled economy (the Great Depression). I also have first-hand experience of what it is like to be at the bottom of the employment hierarchy during a series of deep recessions. You don't want to stall an economy any more than you want to stall a bulldozer engine. It takes a tremendous amount of energy and effort to restart them, and no progress can be made until you do.
Climate Citizen: Mary Stuart Masterson
Happy birthday, EMA Awards ... and you other groups, too
Comments
View as Flat
JMG Posted 5:18 pm
20 Aug 2007
That's nonsense -- they aren't better because they are for-profit. They're "better" only insofar as it's easy to be "better" when you cream off the students who need the least actual teaching, particularly in early childhood.
In the US, parents select private primary and secondary schools in the same way that they select universities: they send their kids to the same schools that others of the same status send theirs. Rich kids go to schools that attract rich kids, and benefit thereby. They have massive amounts more resources.
IF private schools are "better," it is only to the extent that they exclude the most difficult to teach, starting by excluding those who can't pony up the tuition, which automatically screens out a huge number of children who have no books in the home, whose parents read little (if at all), who struggle with asthma because they have a lot of cockroaches in their homes (in Lansing, MI, school asthma rates correspond closely to the reduced-price lunch percentage of the schools), etc.
Save the world: Reduce greenhouse gas emissions 5% annually.
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Pangolin Posted 6:32 pm
20 Aug 2007
US trained MD's are capable of doing 2 things 1) writing a prescription and b) surgery. When faced with a patient whose problem resides in exposure to molds, allergins, dusts, lead, mercury, volatiles or heavy metals they will most likely attempt to treat for depression. Patients then have to deal with mind-altering drugs in addition to their original illness.
Because there is no chance of increasing their kickback from surgeons or big pharma physicians will generally refuse to consider environmental illness as a cause of complaint. The patient is then likely to get pushed out to the street as their finances fail due to illness.
In a socialized medical system it becomes obvious very quickly that it is easier and cheaper to house and feed people minimally than to treat them for exposure and malnutrition. It likewise becomes obvious that overwork is a losing proposition economically as it leads to increased economic costs for medical care.
In the US the profits from pollution, overwork of employees, unsafe working conditions, unsafe housing and polluted food are retained by corporations. Meanwhile the resulting costs in health care, policing, housing and loss of productivity are borne by the public sector and individuals. The government has no incentive to correct the situation because the legislatures are bribed into quiescence.
Eventually the environmental damage will crash the economy as it did in the Eastern Bloc. Maybe then we can get pound some sense into our government. Check your stock market ticker.
Put the Carbon Back
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Colin Wright Posted 7:26 pm
20 Aug 2007
Let me muddy the waters a little on your clear exposition on government intervention in the economy. Instead of just a unidimensional scale from State Communism to free market libertarianism ("political freedom"), how about we add another perpendicular axis of "economic democracy"? Then we can account for a richer variety of economies (such as Yugoslavia or Venezuela).
This creates more space for the kind of political/economic system I would advocate for -- economic democracy, political freedom.
Of course, in the current system, I understand that only the government can protect us from the predations of the free market with regulation and safety nets. But as far as possible, I want the government to create the political space for new economic forms to emerge (cooperatives, democratic workplaces, etc.) that more respect our evolution as group participators.
In other words, for me, both corporations and government bureaucracies can stifle individual resourcefulness. On the other hand, free market entrepreneurs direct thier creativity in a way that leads to increasing inequality (and usually end up selling out to corporations for personal greed, anyway). I would like to see a system whereby people are able to use their talents to help save the earth through "social entrepreneurship" and new non-profit models. I don't think the wild pursuit of profit is appropriate anymore (if it ever has been).
Anyway, I'm sure there are other ways too of looking at the economy. I bring this up here since authors like Bill McKibben have written that happiness ought to be a more important goal than continued economic growth and BAU.
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MikeB Posted 9:21 pm
20 Aug 2007
Actually what I think you were trying to say is that you want something in the middle, but it got lost somewhere. Free markets are seldom perfect, which is something every economics student learns about as soon as they open a newspaper, but they can be useful.
Healthcare is simply too important to be left to the market (some would say the same of sub-prime mortgages after this week..), and has none of the price signals that work in a free market. Are you sick is not the same as can you pay. Only the most fanatical free-marketeer would argue that bird flu should be left to the free market to deal with, for instance.
The NHS and other such systems work on the premise that while the free market is great at getting you a cheap DVD player, there are seldom great profits to be made in ICU's and the like. Universal healthcare is simply insurance for everyone - it spreads the risk, allows long-term planning and allocates (hopefully) resources where they will be the most effective, rather than the most profitable.
The reason the NHS was set up just after the war was not despite the shortages and damge caused by the war, it was in part because of it. The old system (which closely resembled the situation in the US in many ways) simply did not work, and there had been radical changes during the war in terms of healthcare organisation, diet and the whole idea of state control. The Beveridge report simply said what many had been thinking already.
The 'retired member of the British Parliament' is actually Tony Wedgewood Benn, a long-time hate figure for the British right, and a former Lord (the Wedgewood part comes from the pottery dynasty). Now he's something of a national treasure. Times change...but we still love the NHS, whatever its failings.
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Jon Rynn Posted 10:21 pm
20 Aug 2007
BioD, the governor analogy was actually a good one. If you ever wanted to dig into political sociological classics, I would recommend "The Great Transformation" by Karl Polanyi, written in 1944, in which he basically argues that a too-free market in the 19th century led to its own near self-destruction, requiring some sort of regulation (he went on to be a founder of the study of premodern economies).
One way that Sicko has an environmental twist is that it shows what happens when an industry (in ouor case, the insurance companies, pharma, ama) get their claws into the society and won't get them out, and that in other societies they have managed to prevent the claws from getting in or taken them out; and I think we will have the same problems (are having the same problems) with our coal and car companies, utilities, etc. when it comes to shifting to a more sustainable society (not to mention the resources going into the mother of all claws, the military).
One quibble I have with you is that generally its not taxation so much that is a part of government intervention, it's how much of the economy is controlled, and to what degree. The USSR actually did not take everything in taxes and did not control the whole economy (they didn't decide who bought what, for instance), and the poverty was to a large degree caused by the huge percentage of the national income devoted to the military. Swedes pay a lot in taxes, mostly going to social welfare costs; the intervention there is more of a consensual meeting among government, labor, and business, then any central planning. The US during World War II may have actually had more central planning than the USSR. I trust we will have many more discussions of the appropriate level of government intervention into the economy, in which sectors (e.g. energy) for what period of time (e.g. rebuilding the grid) and in which ways (e.g. carbon taxes vs. public investment vs. cap-and-trade).
Thanks for the post!
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amazingdrx Posted 11:03 pm
20 Aug 2007
Why? Because it will help get a democratic majority in congress and a democratic executive branch.
That will only last for 2 years though. So we need to sneak a plugin renewable energy plan in along with national healthcare.
The only way to do this is to inflitrate key positions in the upcoming campaigns. Push healthcare hard to do this, have meetings/parties with Sicko showings and discussions. Only a tiny fraction of voters care about environmental issues, we need to ride the healthcare issue.
Infiltrate from the grass roots, even though many of us hold humanity responsible for this eco mess, we need to champion helathcare that will benefit humans.
kind of ironic, eyyh? hehehey.
I already have a bootleg copy of Sicko. But Moore said it's ok if you don't make money off of it.
http://amazngdrx.blogharbor.com/blog
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justlou Posted 11:55 pm
20 Aug 2007
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spaceshaper Posted 12:49 am
21 Aug 2007
I agree with Colin that the sliding scale is too one-dimensional, which is a common but unacceptably limited condition in our excessively bi-polar culture. The governor (automatic regulator) analogy is a useful one but somewhat misapplied. The extreme free marketeers would indeed prefer to operate without a designed-in regulator, believing that somehow the machine will either grow its own or function fine without one. But command economies also disdain the automatic regulator, preferring instead direct human control of the machine by central committee or dictator: Stalin's, Mao's or Saddam's hand on the air intake valve. Economic failures in communist systems have not been due to oversize governors (presumably this means massive bureaucracies, in which the free-market US is actually a world leader) but to hubris, corruption, and disdain for the iron law of unintended consequences - characteristics apparently shared by the present US administration.
The oversize, resource-guzzling governor is in fact a very odd image: it's extremely uncommon to find in the world of mechanical design an automatic regulator that consumes any significant fraction of the power of the engine which it controls. There is no reason to think that properly designed automatic economic regulators should be any different, whatever the political system. Democracy and its sister value accountability I believe are key to designing such controls.
The true meaning of life is to plant trees, under whose shade you do not expect to sit.
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Delay And Deny Posted 1:15 am
21 Aug 2007
http://you-read-it-here-first.com/viewtopic.php?t=792& ...
Last month I saw the movie Sicko. Like all of Michael Moore's films, it's at its best in the small parts of life...detailing people's individual experiences. As a film, it's really enjoyable watching his adventures such as taking people to Cuba. As long as you don't try to attach "meaning" to it, it's funny, and touching...like an "A" version of a David Letterman prank.
...
John Bailo
Sutext:
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billsierra Posted 1:24 am
21 Aug 2007
Free markets are only tangentially involved in schools. Here in the Chicago area, the best schools (according to state tests) are public, typically located in wealthy suburbs where strict economic segregation keeps poor folk and ordinary middle class people out. As a result the public schools of rich suburbs such as Winnetka, IL are attended by sons and daughters of the upper upper middle class and the lower upper class. Of course, that kind of economic segregation only occurs in a totally free market economy.
In the city of Chicago there are two top high schools that score among the top ten on state tests. One is public, one private. Both are very selective in admission policy. So their student bodies resemble those in the rich suburbs.
So I say, good schools and bad schools are all about class, and yes that is related to free markets. Question is, is that kind class segregation what we want in education?
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Biodiversivist Posted 2:22 am
21 Aug 2007
As pointed out to me more than once, my scale is grossly oversimplified and correspondingly inaccurate. I've been told this in the past but I continue to use it because it is so simple to understand and works to make the point. A chart that accurately explains how various governments and economies interacted through time would be too complex to understand, assuming I could even build one. I should post a qualifier saying as much anytime I use it.
Jon
"The US during World War II may have actually had more central planning than the USSR."
That is a good point. Certainly Britain did also. They even rationed food for several years after the war. I have given a little thought to that. The British were relieved when the government finally stopped rationing as were the citizens of the United States. The ability to grit our teeth and follow orders for a few years to fend off an evil murderous foe is a primary human genetic propensity that has been honed by tens of thousands of years by inter-group warfare. Those goosebumps you get when you hear the national anthem are your genes getting ready to grab you by your nose and lead you off. Read "Constant Battles" by LeBlanc. Think of it as a fist fight or sprint that can't be maintained for very long.
In fact, that is how the Soviet Union continued to control and eventually exhaust its populace. They managed to keep them thinking they were on a war footing (with ever decreasing success) for decades. I have been told by people who lived through it that in the end, the government had become the butt of every joke told (in private).
Thanks MikeB for the British perspective
Keep in mind that our system actually is not a free market one, but something in between. What would our system look like for example, if the AMA were to stop restricting the supply of physicians? Competition for your business would spring up. The best doctors would have more business, the worst would have to go find another career or starve. Offices with long waits, surly staff and arrogant doctors would be shunned. The AMA uses the excuse that they are simply picking the best of the best. That's bullshit. There are millions of people out there who would make wonderful physicians. I personally know way too many doctors and they are not the best of the best of the best. It isn't rocket science. They are lottery winners. You have to have good grades and a willingness to gamble several years in pre-med to play the lottery. Having a physician parent and/or attending a private college appears to up your odds.
Then there is the insurance industry employing tens of thousands of people, very much like a government bureaucracy would do, making it look and act very much like a government bureaucracy.
JMG,
You are partially right. But picture public schools with only 12 kids per class room. Picture public schools where every kid has their own laptop, gets assignments off the internet, are encouraged to email the teacher with questions any time of the day or night. Pleasing the customer (parents) is the goal of eveyone because those parents are buttering their bread.
You should see the math homework my 7th grade daughter just completed for review before returning to (private) school this year. It would curl your hair. In comparison, her public school teacher in fifth grade could not do fractions, did not know how many zeros were in a billion and came down on my daugter like a load of bricks until she cried for correcting her.
Not all public schools are created equal. Many people buy homes in districts known to have good public schools. This way you can still afford a McMansion, and give your kid a decent education : )
Everybody seems to have left a pearl in the comments but I'm running out of time here, can't get to them all. We have to fix our health care system. We have fix our government.
In the end, it all comes down to biodiversity. Poison Darts--Protecting the biodiversity of our world
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Lena812 Posted 2:49 am
21 Aug 2007
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JMG Posted 4:43 am
21 Aug 2007
Medicare has the lowest admin overhead costs by an order of magnitude. Social Security insurance is similarly administered with low overhead.
The relentless propaganda from the faceless corporate insurance bureaucrats is self-serving BS. A single-payer health care plan would not result in a horde of government insurance bureaucrats.
Save the world: Reduce greenhouse gas emissions 5% annually.
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Coyote369 Posted 5:06 am
21 Aug 2007
In other words, let's encourage the enviro movement to be co-opted even more by the socialist Left while alienating conservatives who might be sympathetic to environmental protection. No thanks. If that had been the strategy in the 1960s and '70s, we'd never have the ESA, the EPA, NEPA, the Wilderness Act, the Clean Air Act, the Clean Water Act, etc., etc., etc. Your suggestion is a recipe for marginalization and inefficacy. While we wait ten or twenty years for health care reform (it most certainly ain't gonna take two years), enviro issues will be on the back burner. Hell, you even suggest enviros start focusing on health care, which would obviously take energy away from enviro protection efforts. WTF?
As for Sicko, it was nothing but socialist agitprop. If you actually listen to Moore's comments on the film, he intended to make a paean to socialism as an "indictment of our System." And that's what he did---it's not an accident that he visited Marx's grave and interviewed Che Guevara's daughter about the evils of America. The first half was actually OK, but the second half was nothing but lies and half truths only tangentially related to health care, typical of Moore's style. It puts forth an extremist agenda that will only set back any serious attempts to make much needed reforms in our health care system.
And unless you're a watermelon who thinks a dictatorship of the proletariat will usher in an enviro-utopia, Sicko has nothing to do with environmental protection. On the contrary, centralized socialist governance and environmental protection have clearly proven to be incompatible.
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justlou Posted 5:44 am
21 Aug 2007
I am assuming you don't really mean you think you are going to have everyone else pay for your health care.
And Coyote, you pretty well nailed it. Moore is definitely a propagandist who has some valid points but fails on a lot of interpretation. No doubt that he is just as polarizing as someone like Rushbaugh. He'd be a little more believable on health care if he followed the example of Mike Huckabee.
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Biodiversivist Posted 6:44 am
21 Aug 2007
In the end, it all comes down to biodiversity. Poison Darts--Protecting the biodiversity of our world
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randino Posted 9:15 am
21 Aug 2007
The conservatives and the GOP which they control, are to the environment what the KKK is to African Americans. They hate environmentalism. They hate environmentalists. It is kinda hard to make a deal with people who wish you did not exist, and that your issues have no validity.
By default, the left broadly defined and in practical terms the Democratic Party, is the only game in town for greens.
Randy Cunningham
Randy Cunningham
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justlou Posted 9:45 am
21 Aug 2007
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JMG Posted 10:54 am
21 Aug 2007
http://grist.org/feature/2007/07/06/candidates/
Save the world: Reduce greenhouse gas emissions 5% annually.
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randino Posted 11:35 am
21 Aug 2007
Yeah, I am rough on the Republicans. They deserve it. Are there some that are not raving earth haters. Yes, a few. Very few and those that exist are utterly powerless before the majority that are utter and complete whores for polluters and corporations. This is not my problem. It is the GOP's problem. It is a problem because the GOP for a generation has not been a conservative party. It has been a reactionary party. It has gone out of its way to dismantle every notable environmental reform passed since the start of the 20th century. It has loaded the bureaucracies of the Forest Service, the Interior Department and any other agency you can think of with people who frankly don't think those agencies should exist. It has utterly corrupted the scientific agencies of the government, putting at their heads, two bit hacks whose prime qualification is ideological fanatacism.
I think saying that the Dems and the Republicans are the same, just because they both know sin, does not pass the laugh test. It is sort of like equating someone with a personality disorder, with someone who has just butchered their family with a chain saw, because both persons are mentally ill.
Republicans who do not want to be tarred with my brush, should get off their asses and bring their party into the 21rst century, where the environment is going to be one of the top issues. They are going to have to dump their Taliban wing, and the corporate bag men. That ain't gonna happen soon.
Randy Cunningham
Randy Cunningham
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