For those not familiar with the “Sicko”, it is a Michael Moore documentary about the miracles of modern medicine. For example (spoiler alert for the rest of this paragraph), early on we meet an 80-yr-old man who, thanks to modern medicine, is still able to work a full day, every day, cleaning up a store. Then we meet some people who’ve had fingers severed, then reattached! Then we meet a couple of grandparents, one of whom has had three heart attacks and the other has had a stroke and, get this, they’re still alive! (Sorry if I may have got a couple of those details off—was it 2 heart attacks or 3?—but those little details aren’t important—it is a Michael Moore movie after all.) You can’t watch the film without a renewed sense of wonder and gratitude for the miracles that modern medicine have bought us. Through most of civilization’s thousands of years few people have survived even one heart attack, or dismemberment, or stroke, or 80th birthday). Later on we learn that even in a place like godless Cuba, with an average income 1/13 that of the good ol’ USA, modern medicine is a marvel of life-saving technology. Same thing in France (France! Who woulda thought!). Everywhere, it seems, we have medical miracles happening every day--everywhere except England where dental care remains a problem.
- BTW, Mr. Moore. You did not need to taint an otherwise excellent documentary by belittling the people of other countries and exhibiting such rah rah “we’re number one” US patriotism. OK, so the English have bad teeth; so what! And the French talk funny; so what! OK, maybe those are just for comic effect, but to make the Canadians look so stupid by showing that one of them will cut off all their fingers, while one of us will only cut off two, is just mean and uncalled for!
Most people think the answer is easy: simply implement government-funded universal healthcare, as found in other first-world countries. Take England, for example: As Sicko points out, England was able to quickly switch to free social health care at the end of WWII. Their society had been devastated by years of war, depravation, missiles of mass destructions, and mayhem. Being in total disrepair, it was easy to start something anew. Here in the U.S., at this time, we haven’t recently suffered years of a real, hard-fought, devastating war. Just our bad luck, I guess.
We can’t so easily switch because we currently have a semi-working system composed of these components:
- Health insurance provided by employers, for well-to-do employees
- Health insurance provided by the government, for less affluent
- Emergency rooms that don’t turn away critically sick (critically sick because they couldn’t afford to get medical services before they were critical) and ultimately pass on the cost to those in the other two categories
- Morgues that accept any kind of riff-raff
To get to a point where we can switch to free healthcare, we have two options:
- Suffer some cataclysmic event that destroys society to the point where we can rebuild it anew
- Reform healthcare in such a way that nobody loses their job
It is time again to learn from the lessons of history. By 1933, the people of the United States realized they had erred in affirming the 18th amendment, prohibiting alcohol. It would seem like a simple thing to just repeal the 18th amendment and be done with it. But, no, after years of prohibition entire industries had emerged to employ a huge number of people based on the 18th amendment: smugglers at all levels to bring in contraband, law-enforcement at all levels to fight the smugglers, jailers, judges, speakeasy proprietors, hidden-flask makers, and on and on. Simply repealing prohibition via the 21st amendment would have put all those people out of work, and elected officials would have been in deep doo doo. So the politicians came up with a plan whereby they could make alcohol legal again, and yet all of those same people could keep their jobs: they made other things illegal in place of alcohol (marijuana, barbiturates, cocaine, eventually amphetamines and hallucinogens, and so on).
So, learning from history, the trick now to making healthcare free is to simultaneously come up with a way so that all of the people now involved in healthcare insurance can keep their jobs, or at least jobs nearly identical to what they are now doing.
- ... phew, everything so far has been easy. Simple, clear, logical, thinking. Now it gets hard… hmmm…. What to do… what to do...
First, Congress shall enact a single-payer, universal, everyone-is-free healthcare system, so that no patient will ever again need health insurance.
Simultaneously, Congress will enact a law stating that if any physician should ever cause any harm, whatsoever, to any patient (and “harm” shall be interpreted extremely loosely from here on) then that physician will be sued, disbarred (or however physicians get dissed), and sent to jail. The only out will be if the physician has purchased insurance before interacting with each and every patient.
“First, do no harm” (“primum nil nocere”) is a revered expression of every medical student. “First, do no harm” (FDNH) is hallowed Hippocratic advice. Now let’s make it THE LAW! Let’s make FDNH insurance necessary for any doctor before treating every patient, and on a per-treatment basis.
From minute 1 of the new laws passing, the same people who two minutes earlier had been involved in insurance for every patient to be allowed to see any doctor, will instead be involved in insurance so that every doctor is allowed to see any patient. At every level of the health-insurance chain, everyone will continue to do what they did before, except in reverse.
Yeah, that’s the ticket. Everyone gets free medical care. No one loses their job. We might even be able to employ more people with this scheme. It’s perfect, except maybe for a few physicians who will forget their FDNH insurance and end up in prison. But every prison cell needs someone they call “Doc.” All the classic prison movies have a character named “Doc,” and isn’t recreating classic films what this is all about?