Murray Tucker: ‘Sicko’ creates dialogue | SteamboatToday.com

Murray Tucker: ‘Sicko’ creates dialogue

Murray Tucker

— “Sicko,” Michael Moore’s latest exploration into policy-directed documentaries, raises the level of awareness of the bureaucratically encumbered American health care system.

Moore provides snippets of other health care systems, but does not go into the finer points, those facts that are necessary for crucial policy making.

Moore uses France’s health care system as an example of what can be done. In 2000, the World Health Organization rated the French system the best in the industrialized world. (The U.S. ranked 37th of 191, just ahead of Cuba).

The French system is not totally publicly funded. Individual responsibility for paying for care increases with income. Individuals use private insurance, similar to Blue Cross and Blue Shield, to supplement public contributions. If a person falls below an income ceiling, stays more than 30 days in a hospital or has a chronic or debilitating illness, financial exposure is minimal. The equivalent situation for an American is often bankruptcy.

Almost all French providers accept the fee schedule set by government. Patients are responsible to pay providers directly, receiving reimbursement in about 10 days.

Based on studies between 1997 and 2000, the French have more resources per person than the U.S. Per 1,000 people, France has 3.3 physicians and 4.0 acute hospital beds; in the U.S., those numbers are 2.8 and 3.0, respectively. The only place the U.S. far exceeds the French is in nonphysician personnel: 1.9 in France, 5.7 in the U.S. Personnel who handle administration and billing account for the difference.

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The French have twice as many office visits per capita, longer hospital stays, use more pharmaceuticals, but only half as many expensive MRIs as Americans.

Tax revenues fund 75 percent of the French health care program. Over half comes from a tax on employers and about 35 percent is from general revenues. Additional amounts come from taxes on automobiles, liquor, cigarettes and pharmaceutical companies and a 5 percent tax on earnings.

Why are we troubled about our health care system? After all, 83 percent of Americans have some form of third party coverage, yet only 40 percent are “fairly satisfied.” Are we more critical than the French, two-thirds of whom give this rating to their system?

Why does “Sicko” have such an impact?

When you see workers from Sept. 11 that cannot get services, when you see a woman dying on an ER floor, bleeding to death after waiting three hours for help, when you see a child in an expensive, publicly funded ER waiting hours when he should be seeing a pediatrician in his office, are you a bleeding heart for saying, “Can’t something be done about this mess?”

I submit that the U.S. system is balkanized and more bureaucratic than the French, the country that created bureaucracy. Our private insurers (there are about 1,300 of them) determine whom they will pay and how much based on contracts that change annually.

In the U.S., if you have the ability to pay, you can receive first class health care. But, a significant portion of our population (between 16 and 30 percent) is locked out and must resort to inferior, often more costly services, or none at all.

In 2006, more than 16 percent of our GNP went for health care; the French laid out less than 10 percent. While the French government funds 75 percent of services, the U.S. funds 50 percent. Yet, on a per-capita basis, we are spending more public funds than the French.

Looking at systems like France, I can see the possibility of providing access to first class care to everyone with the financial resources we now use, maybe even less. Thanks to Michael Moore, our dialogue will begin.

Murray Tucker

Steamboat Springs