Fisking Moore’s Fisk
Michael Moore has responded to CNN. I hate to put in two long posts in one day, but it’s a perfect example of his methods. He doesn’t lie, per se. But he deceives and obfuscates with the skill of trained propagandist.
Here’s a fisking. I’ve stripped out his reference and websites to save some space. You can go to the link above if you want to see where he’s getting his facts from. And you should. Because where he’s getting his facts from is half the problem.
DR. SANJAY GUPTA, CNN: “(Moore says) the United States slipped to number 37 in the world’s health care systems. It’s true. ... Moore brings a group of patients, including 9/11 workers, to Cuba and marvels at their free treatment and quality of care. But hold on - that WHO list puts Cuba’s health care system even lower than the United States, coming in at #39.”
THE TRUTH: “But hold on?” ‘SiCKO’ clearly shows the WHO list, with the United States at number #37, and Cuba at #39. Right up on the screen in big five-foot letters. It’s even in the trailer! CNN should have its reporter see his eye doctor. The movie isn’t hiding from this fact. Just the opposite: CNN hid the facts on Cuba But ‘SiCKO’ has the facts right up front.
So it’s shown on screen, but not mentioned in blazing great letters. And not shouted at the top of their lungs.
The fact that the healthcare system in an impoverished nation crippled by our decades-old blockade (including medical supplies and drugs) ranks so closely to ours is more an indictment of the American system than the Cuban system. Although Cuba ranks lower overall than the United States, it still has a lower infant mortality rate and longer life span. (see below) And unlike the United States, Cuba offers healthcare to absolutely everyone. In an independent Gallup poll conducted in Cuba, “a near unanimous 96 percent of respondents say that health care in Cuba is accessible to everyone.”
As I noted in a previous post, you can’t just take the WHO rankings and not know what they mean. Cuba is only ranked as high as it is because the medicine is “fair” - i.e., it’s equally crappy. Hell, I’d agree their crappy care is “accessible to everyone”. But in the same WHO report Cuba ranks 115th in responsiveness and 33rd in overall health (we’re 22nd). It’s comparitively high ranking is because it is 118th in spending. It’s always cheap to die. And a totalitarian system will always keep gun violence and over-eating down. It also keeps the AIDS rate down by jailing anyone who tests positive.
CNN: “Moore asserts that the American health care system spends $7,000 per person on health. Cuba spends $25 dollars per person. Not true. But not too far off. The United States spends $6,096 per person, versus $229 per person in Cuba.”
THE TRUTH: According to our own government – the Department of Health and Human Services’ National Health Expenditures Projections – the United States will spend $7,092 per capita on health in 2006 and $7,498 in 2007. As for Cuba – Dr. Gupta and CNN need to watch ‘SiCKO’ first before commenting on it. ‘SiCKO’ says Cuba spends $251 per person on health care, not $25, as Gupta reports.
Gupta admitted his error on $25—see, Michael, that’s what responsible people do.
And the BBC reports that Cuba’s per capita health expenditure is… $251! This is confirmed by the United Nations Human Development Report, 2006. Yup, Cuba spends $251 per person on health care. As Gupta points out, the World Health Organization does calculate Cuba’s per capita health expenditure at $229 per person. We chose to use the UN numbers, a minor difference - and $229 is a lot closer to $251 than $25.
Gupta is quoting numbers from the same report—he is comparing apples to apples. Michael Moore is mixing sources to deliberately make the US look as bad as possible. Mike, you can’t just pick the highest number you can find for the US and the lowest you can find for Cuba. According to the 2000 WHO report which everyone loves, the numbers are $131 and $4187, respectively. According to the UNHDR you cite above for the $251 figure, America spends $5,711. But that apparently wasn’t bad enough, so your scrambled around until you could find a bigger number.
Besides, Michael, do you think your movies would be better if you were paid a 20th of what you currently are?
CNN: In fact, Americans live just a little bit longer than Cubans on average.
THE TRUTH: Just the opposite. The 2006 United Nations Human Development Report’s human development index states the life expectancy in the United States is 77.5 years. It is 77.6 years in Cuba.
Again, you have to take into account the source. Gupta was using a different source. Notice Michael switches again to the resource that shows the worst case for the US. According to the 2000 WHO report that Mike uses when it suits him, Cuba’s life expectancy was 73.5 and 77.4 for men and women, respectively. It was 73.8 and 79.7 in the United States. Not bad for what Moore himself would call the violentist place on Earth.
Where is Michael getting his figure from? An obscure publication having mostly to do with development and public health. They get their numbers from an obscure 2005 United Nations conference. Much as I criticize the WHO report, I’ll take their numbers.
CNN: The United States ranks highest in patient satisfaction.
THE TRUTH: True, but even when the WHO took patient satisfaction into account in its comprehensive review of the world’s health systems, we still came in at #37.
More dissembling. Gupta acknowledged we rank 37th. And I noted below, we rank 37th because our healthcare system isn’t socialized.
Patients may be satisfied in America, but not everyone gets to be a patient. 47 million are uninsured and are rarely patients - until it’s too late. In the rest of the Western world, everyone and anyone can be a patient because everyone is covered. (And don’t face exclusions for pre-existing conditions, co-pays, deductibles, and costly monthly premiums). It’s not that other countries are unhappy with their health care – for example, “70 to 80 percent of Canadians find their waiting times acceptable.”
The health care wonks have backed off their claim that “no one gets healthcare” since people like me have pointed out that it’s illegal to turn away patients. But Moore is deceptive when he says our numbers are inflated by leaving out 47 millions people—who are patients, by the way—because the #1 ranking comes from a household survey, not a patient survey.
CNN: Americans have shorter wait times than everyone but Germans when seeking non-emergency elective procedures, like hip replacement, cataract surgery, or knee repair.
THE TRUTH: This isn’t the whole truth. CNN pulled out a statistic about elective procedures.
Um, which part of “non-emergency elective procedures” did you not understand, Mike?
Of the six countries surveyed in that study (United States, Canada, New Zealand, UK, Germany, Australia) only Canada had longer waiting times than America for sick adults waiting to schedule a doctor’s appointment for a medical problem. 81% of patients in New Zealand got a same or next-day appointment for a non-routine visit, 71% in Britain, 69% in Germany, 66% in Australia, 47% in the U.S., and 36% in Canada.
When we’re talking about wait times, we’re not talking about whether it takes one days or one week to get an appointment with your PCP (another artifact of our unhealthy nation is doctors being swamped). We’re talking about getting surgery in a week against getting it in a year. And no one would question that it’s easy to see a doctor in a socialized system. We’re questioning the difficult of getting complex expensive treatment.
But do you want to fix this? Remove the laws that limit the number of doctors our nation can graduate or give visas to. Wait times in Texas are plunging because our malpractice reform is bringing them in. Loosen the restrictions on nurse practitioners to allow them to act as cheaper PCPs. In other words, get the government to stop doing certain things.
“Gerard Anderson, a Johns Hopkins health policy professor who has spent his career examining the world’s healthcare, said there are delays, but not as many as conservatives state. In Canada, the United Kingdom and France, ‘three percent of hospital discharges had delays in treatment,’ Anderson told The Miami Herald. ‘That’s a relatively small number, and they’re all elective surgeries, such as hip and knee replacement.’
“Three percent of hospital discharges had delays in treatment”. That phrase should trigger alarm bells in the left side of your brain. If people die on the waiting list or in the hospital, they don’t get counted. If people are just getting their knee prodded, that counts as a non-delay. The proper figure is what percentage of serious health ailments have to wait months for treatment. And as we’ll see below, it’s quite high.
One way America is able to achieve decent waiting times is that it leaves 47 million people out of the health care system entirely, unlike any other Western country. When you remove 47 million people from the line, your wait should be shorter.
Notice that Mike contradicts himself here. He says that our wait times are only good for elective surgeries but then says we’ve left 47 million people out. But would those 47 million people be getting prompt elective surgeries under a socialized system? What the hell is he arguing—that if we socialize medicine and bring elective surgeries to 47 million people, our wait times will get worse? That’s what we’re saying!
And there are even more Americans who keep themselves out of the system because of cost - in the United States, 24 percent of the population did not get medical care due to cost. That number is 5 percent in Canada, and 3 percent in the UK.
24 percent of Americans don’t get healthcare because of cost? That sounds a bit high, considering that only 16% are uninsured and 50% are on the government’s dime. And did they not get care or did they merely delay it or forgo certain treatments? That’s not necessarily a bad thing. If people were more aware of the cost of medicine, they might forgo unnecessary doctor visits and tests—as I did when I was uninsured. I’ve also delayed buying a television, buying a car and seeing movies because of cost. And of course people in socialized medical systems are not hindered by costs—they’re not paying the bills!
One more thing. The survey Mike cites on people delaying care because of costs? It also shows that only 5% of Americans wait more than four months for care—against 27% in Canada, 38% in the UK, 23% in Australia and 26% in New Zealand. And notably, all five systems have gotten worse between 1988 and 2001 due to aging populations. But he’ll leave that tidbit out. He’ll quote a Johns Hopkins researcher on healthcare delays, but quote this report on costs. Again, he’s mixing sources to make America look as bad as possible.
CNN: (PAUL KECKLEY-Deloitte Health Care Analyst): “The concept that care is free in France, in Canada, in Cuba - and it’s not. Those citizens pay for health services out of taxes. As a proportion of their household income, it’s a significant number … (GUPTA): It’s true that the French pay higher taxes, and so does nearly every country ahead of the United States on that list.”
THE TRUTH: ‘SiCKO’ never claims that health care is provided absolutely for free in other countries, without tax contributions from citizens. Former MP Tony Benn reads from the NHS founding pamphlet, which explicitly states that “this is not a charity. You are paying for it mainly as taxpayers.” ‘SiCKO’ also acknowledges that the French are “drowning in taxes.”
OK, I’ve now got to see the movie soon. Does he really claim this? Anyone?
Comparatively, many Americans are drowning in insurance premiums, deductibles, co-pays and medical debt and the resulting threat of bankruptcy – half of all bankruptcies in the United States are triggered by medical bills.
Socializing our medical system will not magically make it more efficient—as I’ve shown, Medicare’s overhead is more like 20-30% than 1-3%. The high-paid insurance execs will be replaced by high-paid government hacks. Note that by Moore’s own argument, taxes will have to rise to equal our current expenditures.
The only way to cut costs is by rationing or stiffing the providers. Stiffing the doctors is a popular meme. And maybe you want to go to a doctor who is being paid as much as a gas station attendant. But I don’t.
CNN: “But even higher taxes don’t guarantee the coverage everyone wants … (KECKLEY): 15 to 20 percent of the population will purchase services outside the system of care run by the government.”
THE TRUTH: It’s not clear what country Keckley is referring to. In the United Kingdom, only 11.5 percent of the population has supplementary insurance, but it doesn’t take the place of NHS insurance. Nobody in France buys insurance that replaces government insurance either, although a substantial amount buys some form of complimentary insurance.
Again, missing the point. Keckley didn’t say that they were replacing socialized medicine. He said they are supplementing it. And there is a range of values for various nations. Moore disputes the 15-20 percent range with a figure from a single country. Also, keep in mind, Moore wants private insurance to be illegal.
CNN: “But no matter how much Moore fudged the facts, and he did fudge some facts…”
This is libel. There is not a single fact that is “fudged” in the film. No one has proven a single fact in the film wrong. We expect CNN to correct their mistakes on the air and to apologize to their viewers.
Pot. Kettle. And as we’re documenting on this website, you can fudge the facts plenty without getting any “facts” wrong. Just mix up your statistical sources, leave out critical information and imply things that aren’t true. It’s the sneaky lies of a child—“Gee, I can’t tell you who broke that vase!”
I’ll tell you what, Mike. I’ll join your call for CNN to apologize (although they already did apologize for the $25 mistake). When you apologize to the NRA for implying they were part of the Klan. Or apologize to Charleton Heston’s spirit for editing his quotes together to make him look bad. Or apologize about the war plaque. Or saying the Columbine factory made nukes. Or of the hundreds of people you have unfairly maligned, quoted out of context. Or apologizing for your distortion of the Mychelle Williams situation. Or…
Comments
lso, keep in mind, Moore wants private insurance to be illegal.
well then he should stop referring to australia, since private healthcare is one of the reasons our public system is still putting along.
something like 30% of the population
Michael Moore, the master of ad hoc arguments when he is backed into a corner.
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Also note: That if treatment falls within the governmentally proscribed wait time, then there was no delay in treatment.