SICKO Part Four

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Michael Moore’s SiCKO explores a seamy underside to the American health care system: the self-serving collusion between the US federal government and the immense powers within medical care.

The most recent of these has been the creation of Medicare Part D, in which the government agreed to spend your Medicare money on prescription drugs. Given the high costs of medications these days, this sounds nice, except the government also agreed to pay full retail price for everything.

The single congressman who pushed this bill through is now a million-dollar-a-year consultant to the pharmaceutical industry. Unsurprisingly, the industry has been enjoying record profits since Medicare D became law.

This collusion has been going on for more than 150 years. In the 19th century, the American Medical Association (AMA) convinced each state to create the concept of licensing physicians (namely, AMA members), immediately making it illegal for other healers like herbalists and homeopaths to practice. The AMA also determined the standards of education, convincing the government to shut down dozens of naturopathic, homeopathic, and eclectic medical colleges, even though at the time (19th century), there was absolutely no evidence that one form of healing was better than another.

As recently as ten years ago, if you were an acupuncturist, you could be arrested and tried as a felon in Illinois. Illinois still refuses to license naturopaths.

American doctors, whose politics generally run slightly to the right of Mussolini’s, historically would freeze in their tracks at the slightest hint of universal health care. The AMA labeled it “socialized medicine” and equated it to the red menace of Communism. Most physicians politically supported congressmen who voted against “government interference” and, to their perpetual shame, loudly protested the creation of both Medicaid (for the poor) and Medicare (for those over 65 and the disabled.)

So really, doctors didn’t mind one bit when Nixon signed into law a system that would place your health care into the hands of the insurance industry. They saw it as less government and more privatization. And now, as you will learn in SiCKO, it’s the big insurers who pay your congress people unspeakably large donations to keep this profitable system going just as is.

It didn’t take long, though, for physicians to realize there was something inherently dysfunctional in a system that made its profits by providing as little actual health care as possible. Within a few years, physicians found themselves pleading with faceless insurance company drones to get “authorization” to perform emergency surgery or prescribe much-needed drugs. Hospitalized patients were being micro-managed by nurses called “utilization reviewers.” These nurses, employed indirectly by insurance companies, scrutinized each admission, test, and procedure for ways to reduce costs.

Of course, physician never imagined what it would cost them: their incomes have been steadily eroding for the past 15 years and they’re so unhappy with this mess that 75% of them actively discourage their own children from entering medicine as a career. I realize I mentioned this statistic in a previous health tip. I wanted to say it again to underscore the thinking of today’s doctors.

In fact, a recent survey showed that only 3% of doctors really enjoyed their lives as physicians and would make no changes. Three percent!

Next (and last, I promise): can the system be fixed?

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