Ave Cassandra

My friend Bob Pfohman, a Vietnam vet and all around brilliant guy, now and then says that someone has "shit in their own mess kit."

Meaning they'd fouled their own livelihood, their own good deal, or even their own survival. Kinda gross imagery, but vivid...

As in the health insurance industry becoming so grasping and greedy that they've now got a majority of Americans seeing clearly that health insurers have more in common with the Mafia than any kind of institution we'd want to subsidize.

Utah is the most Republican state in the union. It's not really the place to go to for liberal commentary. But here's the Utah Statesman's film reviewer going over the top 10 movies of 2007:

9. "Sicko": No, I didn't pick this documentary by Michael Moore to be on my top 10 list because I'm some "bleeding heart liberal." As a matter of fact, I detest politics and politicians (on both sides of the aisle) more every day. So, if you're like me and want to see what politicians have done to our healthcare system, this is the movie for you. Moore is a master of editing and making people feel what he wants them to feel, I know that. But you can't argue with the fact that the way our healthcare system is set up is ridiculous. Maybe, just maybe, socialized medicine would work here. That's right, I said it. Now I'm going to run and hide so I don't get stoned.

That from a writer so immersed in right-wing culture that he calls guaranteed healthcare "socialized medicine."

Does he also call the police and fire departments socialized protection, I wonder?

Heather Bennett, a daughter of Larry and Donna Smith, was in "SiCKO" along with her parents. It was her house in Denver that the couple were headed to at the film's beginning — Heather's husband on his way to Iraq to do "some plumbing," as her son explained. Heather describes herself as "the proud daughter of Larry and Donna Smith." She's right to be proud, because her parents have done this country proud by not shutting up, not resting, but instead relentlessly leading and speaking out. They've done that despite the uncomfortable label of "health care system victim" that catapulted them into what might seem to be a catbird's seat. In fact, both Donna and Larry are more akin to being transformed into canaries in the mine.

Those of us who have been hurt by the despicable U.S. healthcare system have a duty, as Christians, Jews, Muslims, atheists, Wiccans, mothers, friends, and most of all as human beings, to speak out. The private health insurance industry will hurt you too. And if that doesn't outrage you, like the bumpersticker says, you're not paying attention. Heather's family understands. Here's Heather's column.

What I have learned...

By Heather Bennett, proud daughter of Larry and Donna Smith

My parents are featured in the Michael Moore film, "SiCKO." I am one of their six children and I am the daughter who volunteered her home when they had no place to go. I offered my home out of love and understanding that this was what I could do for them at the time. I could not erase the years of financial burden placed on them by their health care woes, but I could offer a soft place to land. For them, the opportunity to tell their story in this movie has been uplifting, dignifying and — and admittedly difficult at times. What people do not know — what people cannot see - is the private struggle behind the scenes for them and for their adult children.

It bothers me that our family did not feel comfortable sitting down and having this conversation together. Perhaps it is too idealistic to think that families do that today. Do adult children know how their parents have planned for the future? Do parents talk about health care concerns and needs? Or are we so caught up in the “me” and in keeping everything private that we don’t stop to talk about it? What is the emotion behind this? Is it fear, embarrassment or shame?

When people ask me why my parents are in the film and why I think this is so important, I answer that my parents are an example of what a couple might have to go through even though they are both working and are fully covered under multiple insurance plans. What I have come to understand over the past few weeks is that the importance of this movie is even simpler than that. It is about having the conversation and then doing something about it.

Inability to have conversations is a big part of the problem in America today. We are so careful about what we say, how we say it, when we say it and to whom we say it that often we decide it is easier not to have the conversation at all. As Michael Moore asks in this film, “Who are we?” My answer is that we are lots of individuals or small family units that are pretty uncaring and unconcerned for those around us. I would argue that Moore’s statement about the “me not we” ideology has bled past our every day dealings with the outside world, straight into our family lives. I know that I myself have learned things about the struggles they have faced by watching them give interviews or reading my mom’s eloquent words posted on a blog or a newspaper article. I also know that I feel utterly unprepared to assist as my parents age.

We live in a different time. Gone are the days that families stayed close together, generation upon generation living in the same community - taking care of each other. In our family, discussions on health care issues, financial issues and independent living issues rarely take place. What is the source of the stubbornness that stops these conversations from happening? How can we regain that connectedness?

If you are the child of an aging parent, I urge you to sit down with your parent(s) and have this discussion. Talk to them about their health. Talk to them about their healthcare. Ask the tough questions. What will happen if there is a major illness? What will happen if that illness is so debilitating that assisted living is required? Would your parent be able to survive the financial drain that a health issue can cause?

Not only do these conversations need to happen within families, but we need to take those discussions and turn them into action. Start with your State Representative, your Congressional Representative and your Senator. Where do they stand on universal health care or a single-payer plan. Have they taken money from the health care lobby? If so, why? Pledge your support for a bill in Congress - HR 676. Challenge each of the Presidential Candidates for 2008 to really explain their health care plan. The voices that rise up from our families, to each state House to the halls of Washington should be filled with anger and outrage at a system that is failing so many. For every day that we do not take action, 50 more people will die.

I wish that I had asked these questions earlier. I wish that I had been engaged in discussions with my parents on an entirely different level. In America, we must get back to a focus on “we”. It starts with asking the questions and planning for the future. Parents must feel no shame or loss of dignity in telling their children what they might need to survive a major illness. Children need to be prepared before something happens.

I urge you to see this movie - parents and children together. Start the conversation and then take action. When you start the conversation, you may be surprised at what you learn. I know I have been.

The Progressive Democrats of America have a great story up on their website about last Sunday's rally for single-payer universal healthcare.

“We spend hundreds of billions of dollars on this war, so don’t ever tell me we don’t have the money!” Michael Moore told a cheering crowd on the steps of the Capitol building in Denver. His speech was the climax of a Health Care for All Colorado rally which began with Colorado PDA speakers Evi Klett and Steve Wangh and included Michael Huttner of Progress Now, Nathan Wilkes of Health Care for All Colorado and Donna Smith, who appears in Moore’s new film, SiCKO.

That story also quotes Colorado Democratic Party Vice Chair Dan Slater’s newsletter, where he told readers his position on single-payer universal healthcare:

I'm sold.

I'm sold in large part because I was lucky enough to snag tickets to the local premiere of SiCKO, Moore's new documentary about the health care system in America, last night. The movie makes sense, and it leaves you outraged at what has happened to America. I really, really, really encourage each of you to take time to see it. It smashes the right-wing talking points about universal health care into shards, and it does so with a wonderful sense of humor. One talking point we always hear is how expensive universal health care would be. A British member of Parliament really nailed it on the head in the movie:

"If we can find money to kill people, then surely we can find money to heal people."

The guy in the audience stood to declare that Lasik surgery shows that if the free market were just allowed to work, it would work in healthcare just like it does everywhere else. Lasik's costs just keep going down.

This is a cherished myth on the right. Because a one-time, walk-in surgery's costs have dropped, they'd like to believe that little Thomas Wilkes' $4,000-a-day factor for hemophilia would also drop. Eventually.

Suppose it did — suppose it dropped 20 percent a year, like Lasik surgery has. By 2009, perhaps Thomas' daily costs for that medication would just be $3,000 a day. Perhaps the Wilkes could afford that. Of course, that medication is just one part of their costs — all together Thomas' treatment costs about $1 million a year.

The fact is that the cost of catastrophic illness and injury under free market conditions would be beyond reach for most of us. We'd just have to hope we didn't get sick or hurt and know that we'd die if we got cancer or were hit by a bus — leaving our children orphaned.

We can't afford to be on our own when it comes to healthcare. We have to pool the risk, and be smart about funding preventive care.

I attended the Northern Colorado Business Journal's Health Care Summit today, mostly to hear "The Great Single-Payer Debate" between Dr. Cory Carroll, a single-payer universal healthcare advocate, and Republican State Senator Shawn Mitchell.

That debate was originally to have been between a Blue Ribbon Commissioner and Dr. Carroll. Weren't the commissioners supposed to keep an open mind about possible solutions?

There were also "healthcare heroes" awards, one of which went to Dr. Glenn Pearson, who was given the award for his work supporting Physicians for a National Health Plan. It is so refreshing that a business journal would recognize Dr. Pearson's work like that. I hope they're not penalized by insurance companies pulling advertising. It was a brave move.

Dr. Carroll, a Health Care for All Colorado supporter, gave a great presentation on why business should support single-payer universal healthcare.

He made the point that as long as there's the 1986 EMTALA law — that's the Emergency Medical Treatment and Active Labor Act — which requires hospitals to care for people in dire need of treatment, that the "free market" really can't work in healthcare. Hospitals would have to be able to turn away victims of car accidents, if they could not pay. Now while that may fit in with the Independence Institute's libertarian values, it's certainly not "What would Jesus do?"

"For a true free market system to succeed, those who cannot pay do not get care," Dr. Carroll said.

This is something those against single-payer universal healthcare play both ways. On the one hand, they complain that government intervention has distorted the market, and that's why it doesn't work. On the other hand, they say that we don't need single-payer, we just need to strengthen the safety net. But not government, I guess. Although anyone from the hospital associations or from charitable organizations will tell you that there's no way that charities can afford to replace the government safety net. Single-payer universal healthcare could, however.

Dr. Carroll included a David Letterman-style top ten reasons why business should support single-payer universal health care. I missed #2, but here are the rest of his reasons:

10. The single-payer system will reduce liability insurance and workers compensation costs for businesses.
9. Single-payer will eliminate the costs and headaches of running a health benefits program — no more annual negotiations with insurance companies.
8. Single-payer will eliminate complaints from employees about the company's health plan.
7. Single-payer will reduce incentives to hire part-time workers.
6. Single-payer will curb medical bankruptcies and free up money for spending on consumer items.
5. Single-payer will reduce the overall costs of covering employees.
4. Single-payer will eliminate retiree benefit costs.
3. Single-payer will reduce absenteeism because the workforce will be healthier.
2. Dunno.
1. Single-payer will allow health care costs to be controlled and predictable, eliminating a major source of business uncertainty and a barrier to planning.

Dr. Carroll also gave the audience a brief history lesson on universal healthcare, with dates that other countries adopted universal health care — the 1800s for Germany — and failed attempts in the U.S.: 1935 for FDR; 1948 for Truman; and 1994 for Clinton.

Sen. Mitchell was smart and funny. He offered the standard criticisms of single-payer universal healthcare — that the U.S. does best for breast cancer and that you might have to wait for a hip replacement in Canada — and managed to make it sound as though the U.S. system was always best and other countries' systems wracked with problems. His foundation seemed to be that yes, primary care was good in those countries, and you were probably happy with your care as long as you didn't need a specialist, but once you needed a specialist you'd be best off flying to the U.S. for care. Which isn't true at all.

All the same, he was personable and funny — and seemed open to learning more about single-payer. He seemed to think that those other countries were moving towards the U.S.'s system, which has no bearing in reality. The Canadian Supreme Court saying that auxiliary health insurance should be legal does not in any way equate to those countries moving more towards our system. People in the rest of the industrialized world mostly assume that Americans have universal healthcare too. Doesn't everyone? Those people who do know — and more will soon, because "SiCKO" will be a hit internationally — feel sorry for us.

Conservatives everywhere are in favor of cost-effective universal healthcare, which means single-payer universal healthcare or a slight modification of it. The U.S. right is the exception that proves the rule on this. What's more, the best of them, if they only had the facts in hand, would surely join their Tory brethren.

About 2,000 Coloradans came from as far as Pueblo to rally at the state capitol yesterday to show our Colorado politicians that we support Michael Moore's call for single-payer universal healthcare.

With Moore's latest film "Sicko," this movement now has a truly charismatic figure to draw attention to the outrageous injustice that passes for a healthcare system in the United States. For anyone scoffing that a self-depreciating and overweight guy from Flint, Mich., could be charismatic, go hear him speak. He's really very good. And even better, he's a brilliant documentary filmmaker.

How anyone could walk away from this film unmoved is beyond me. And while healthcare is its theme, Sicko approaches it in a systemic way — in particular how the slightly taxes that the French, British, Canadians pay is not resented in those countries because they see a tangible benefit to their lives from those taxes — healthcare, for starters.

He added it up for the audience after Sicko's special preview. In France, for instance, there's universal education through the university level — how much do American families spend on increasingly unaffordable higher education? He asked the audience what they were paying monthly in student loans and although one person answered $800, $200 a month was average. Add that to an average of $500 a month for healthcare, a similar amount for childcare and other services that famililes there get for free or for highly subsidized rates, and in fact we're the highest taxed people in the world. Except we call our taxes premiums and tuition, and thus can be persuaded that we're better off.

The crowd brought amazing signs. Most of the rallies I go to are for candidates, where the signs are all the same. No two signs were the same yesterday.

Michael Huttner of ProgressNow, Evi Klett of the Progressive Democrats of America, and I spoke to the crowd first, and then Nathan Wilkes spoke, warning the crowd that those of them who thought they had good healthcare coverage probably were mistaken. He had thought the same before getting the news that his son Thomas had been diagnosed with hemophilia. Health insurance companies have been trying to get rid of the Wilkes family ever since. Thomas, evidently is nothing more than collateral damage when it comes to maximizing shareholder profit. Nathan introduced Elinor Christiansen, MD, the president of Health Care for All Colorado.

Elinor spoke eloquently without notes: She's been fighting this battle a long time.

Next to the microphone was Donna Smith, one of Health Care for All Colorado's newest members. She emailed me her remarks, and I'll simply share them rather than try to condense:

Remarks by Donna Smith, Aurora, Colo.

DENVER -- My name is Donna Smith. Today I stand here as a member of a very exclusive club. I am one of only a few Americans featured in Michael Moore’s new movie, SiCKO. And I am part of an even more exclusive group of just eight Americans who traveled to Cuba with Michael to receive medical care.

Trust me, as much as I’ve grown to respect and enjoy Michael Moore and his crew, this club that isn’t one for which you want to qualify. Each of us in the film has lost much at the hands of the American private health care system. Some lost everything they owned after a lifetime of hard work – like we did; and some lost their lives.

The stories you will see on the screen during SiCKO represent tens of thousands of other American tragedies. As we stand here today, 50 Americans will die today without the necessary care they needed simply because they couldn’t afford it.

But you and I together are in another not-so-exclusive club with more than 250 million fellow Americans, we are the health insurance card-carrying club – we are Coloradoans, we are Americans – we are brothers and sisters, mothers and fathers, neighbors and friends at great risk due to the lack of universal health care.

Having health insurance no longer means having peace of mind. If you get sick and you are insured you may find yourself underinsured or worse – unable to get necessary care. You may have premiums rising so high that you can no longer afford both housing and health insurance. You may have deductibles and co-pays that effectively and efficiently squeeze you away from seeking care. You may have collectors pursuing medical debt hound you to the point of garnishment and humiliation – as we did. You may have an employer that no longer wants you covered by the group health insurance plan with rising premiums and huge deductibles. And you may not know these things until in the grip of a health care crisis with no options and no ability to dig out.

But our club is a powerful club too, my friends. We have what we need to change this broken health care system. We have voices to speak up, we have pens and computers with which to write and we have the ballot box in which we will send the clearest statement of our membership creed:

No Coloradoan, no American, should ever want again for basic health care. No American family should face financial ruin because someone gets sick. And certainly not one more American should die because he or she was denied treatment. Universal, single-payer health care is within our reach and it our duty and responsibility to push for it.

Though many of our elected officials will scatter like bugs when they are forced to take a stand on this issue or heaven forbid stand in unity with Michael Moore, it is up to you and me to hold them steady to the cause. They must fear our voices and the loss of our votes more than they fear the loss of health care lobby money for their campaigns or the threats of negative ads against them if they do not tow the private health care line.

It is no longer enough for our leaders to protect life only while it is in the womb. To be cared for when we are sick is a basic human need and a basic human right.

Forty years ago, in April of 1967, speaking at the Riverside Church in New York, Dr. Martin Luther King, Jr., said,” Of all the forms of injustice, inequality in health care is the most shocking and inhumane.”

Reach deep into your minds and hearts Colorado. Are we willing to be shocking and inhumane any longer?

Half measures will not do. Universal, free health care must become reality.

On the day I left Denver to meet up with the Michael Moore production crew in Miami, the front page of the Rocky Mountain News had a story about Anna Nicole Smith’s body and where it might end up. Page one, my friends. On page 14, there was a much smaller story about Nathan Wilkes and his family right here in Colorado. Though fully insured, they are living the same healthcare nightmare faced by so many of us today.

Earlier this week on a movie screen in the middle of Manhattan, my dignity and my voice began to return. No longer shamed by my inability to stay financially afloat in a sea of health care debt, I will not rest until every American has access to free, universal health care.

My husband Larry and I rode from Manhattan through Philadelphia and into Washington, D.C., on a bus dubbed the SiCKO bus with nurses from throughout the country led by the brave and dedicated nurses from the California Nurses Association. We had nurses with us from New Jersey, New York, Pennsylvania, Massachusetts, my home state of Illinois and of course from California. Everywhere we stopped, we were met with cheers and support for the nurses and their message: Universal health care now for all Americans.

And now I’d like to introduce to you the man who restored my dignity in SiCKO and who fights for justice in health care throughout this land. He is an Academy Award winning and Cannes Film Festival winning filmmaker, and an American patriot in the truest sense. He is also here to inspire us to keep up the fight right here in Colorado.

She then introduced her "SiCKO commander-in-chief," Michael Moore.

Sara Crocker of the Denver Post did a good job covering the story. She led with Moore telling the audience that we'll see single-payer universal care within our lifetimes (wait — we're hoping for 2008!) and she listed Moore's charge to politicians: "to take a four-part pledge: to support free, universal care; to eliminate private insurers; to regulate phamaceutical companies; and to refuse money from the health care industry. 'In fact, let's get the money out of politics all together,' he said."

Raj Chohan of CBS4Denver also did a good job, ending with this:

Critics of the movie say it fails to critically explore the potential downsides of a single payer system including delays in care because of what they call the rationing of service.

"I'd be willing to wait a couple of weeks," said Moore. "Statistics Canada, which is the governmental statistics office in Ottawa will tell you the following: there is a 4 week wait in Canada to see specialist. There's a 3 week wait for diagnostic testing. And there's a 4 week wait for elective surgery."

Moore's movie appears to make a compelling case for a single payer socialized system. And it underscores a real problem with health care in the United States.

Now there's some radical reporting: there is a real problem with healthcare in the U.S.

Fox got it wrong. Their reporter — or maybe his editor — repeated an earlier, erroneous story that Moore was here to support a nurses group. Fran Ricker, the new director of the Colorado Nurses Association, called me Sunday morning to apologize for having been out of town and out of the loop on the rally. She was wonderful, and did everything she could Sunday morning to get nurses to the rally.

In fact, Moore was in Colorado to promote "Sicko" and to do that while promoting single-payer universal healthcare. The Colorado Nurses Association does support single-payer universal healthcare, and we at Health Care for All Colorado are lucky to be working with them. They have clout — witness the fact that the Denver Post edited out the names of all the other sponsoring organizations for the rally.

Michael Huttner, executive director of ProgressNow in Denver, and Monica Griego, legislative liaison of the Colorado Consumer Health Initiative, were really the two who made this rally come off the way it did. I've never organized a rally, and was in full meltdown Friday afternoon — after Rehya Young, associate producer of the film, had called Thursday afternoon and suggested one.

Sure, I said. It was naive, but we could not say no. We had to try to make it happen. I emailed about a dozen organizations, asking them to help spread the word, but not ProgressNow. I won't make that mistake again. Huttner called to say that Monica had told him about the rally. He offered to email out tens of thousands of blasts about it; to send out the press release to his media list; and oh, we didn't have a good location? He'd make a call. It wasn't long before he'd arranged for a permit for the West Steps of the Capitol. I'd been told too bad — you need to apply 30 days in advance for a permit.

In addition to passing on the word to Michael Huttner, Monica Griego arranged for audio — pretty key when you're talking to 2,000 people. She was the first one there, with clipboards and volunteers to spread the word about healthcare.

So it was really the Colorado Nurses Association but also the Colorado Consumer Health Initiative, Health Care for All Colorado, ProgressNow, and the other co-sponsoring organizations: the Colorado Progressive Coalition, the Physicians for a National Health Plan, the Progressive Democrats, the Rocky Mountain Peace and Justice Center, and Boulder's Wellness Institute.

Not all these organizations are for single-payer universal healthcare. I hope that "Sicko" will change that. It's time to come on in. The water's great.

It's all Sicko all the time here.

This is the funny one — just a sentence on Think Progress about Moore inviting about 900 health insurance lobbyists to a "Sicko" screening. A dozen showed.

Too many comments to read, but they're entertaining — and insightful:

Anybody else remember then second Democratic debate on MSNBC? Dennis Kucinich answered a question about his plan for health care. He said his plan is single payer, eliminate the insurance companies and not-for-profit. The audience erupted in cheers. Perhaps the loudest cheering of the night.

Anticipating all this Chris Matthews started to interrupt Kucinich even before he finished his answer. I know Matthews makes a career out of interrupting people but it was clear he didn’t want Kucinch stealing Hillary’s and Barack’s thunder.

God forbid anyone say on television “not-for-profit healthcare”. I think that phrase has been added to George Carlin’s list of seven words you can’t say on t.v.

Comment by Larry

U.S. Senators and Representatives got a screening of "Sicko" yesterday on Capitol Hill. Kaiser Daily Report has a fairly dry account.

Kaiser should come over, away from the Dark Side. They belong with us, pushing for single-payer. They're as good an HMO as can be created in our crazed system — relentlessly nonprofit and with better outcomes at lower costs than anyone else. They've taken hit after hit from having to compete with the operations that don't care about patients, and they've had some people themselves who don't care. But in general, they're a decent outfit — astonishingly decent, when you consider how big they are, and how many opportunities that gives them to screw up.

Come on, Kaiser. Go see "Sicko" and come on board.

An editorial at Investor's Business Daily on Sicko and healthcare reform lays out a war strategy:

The Hillary Clinton-led forces that tried to socialize medicine in the U.S. 13 years ago are mobilizing for war. Stopping them requires knowing their strategy before the first shot is fired.

Michael Moore's new documentary, Sicko, which opens June 29, has been screened to the press, and it's powerful propaganda.

In it, America is a country where health insurers and hospitals kill people by denying coverage, make obscene profits charging outlandish sums for treatments and drugs, and even dump hapless, gown-clad patients who can't pay their bills on the doorsteps of other hospitals.

Meanwhile, Canada, Britain, France and even Cuba are portrayed as medical fairy wonderlands where doctors, hospitals and medicine are free or cost a pittance. Yet socialism doesn't prevent government-employed physicians from driving Audis or living in million-dollar homes.

Rep. John Conyers, the far-left Michigan Democrat, calls the Sicko release "one of the most important developments in the national debate on our health care crisis since the Clintons attempted to pass universal health care legislation in 1994."

Conyers and Rep. Dennis Kucinich, D-Ohio, are co-authors of legislation to have the government take over the health system and provide "enhanced Medicare for everyone." Sicko producers Harvey and Robert Weinstein have even hired ex-Clinton White House mudslinger Chris Lehane to use the movie as a flash point for organizing political rallies.

Like the bullet that slew Archduke Franz Ferdinand and sparked World War I, Sicko"may one day be looked back on as triggering the great health care war. The next president will likely end that conflict with the momentous decision of replacing our faulty employer-based health insurance system with a reform that empowers one of two interests: the government or patients.

No doubt about the sickness of a current U.S. system that "smothers competition," according to John Goodman, president of the National Center for Policy Analysis.

A Pennsylvania health care agency recently reported that the 60 hospitals performing heart-bypass surgery in that state showed little if any relationship between the price charged for the procedure — from less than $20,000 to nearly $100,000 — and quality of care or mortality rates.

Responding to the findings, Dr. Ronald Paulus, an executive with Geisinger Health System of central Pennsylvania, told the New York Times there's no current financial incentive in the present system for hospitals to provide care leading to better outcomes and lower payments.

Dr. David Gratzer, a Canadian physician, Manhattan Institute senior fellow and author of the new book "The Cure: How Capitalism Can Save Health Care," calls U.S. health care "an accidental system."

... "Federal subsidies enabled managed-care plans to attract customers by offering benefits that other insurers could not," said Regina Herzlinger, a Harvard Business School professor and author of the just-published "Who Killed Health Care?," which makes the case for a new consumer-driven health system.

Herzlinger added that "in its cruelest aspect," the Nixon-Kennedy HMO act "enabled physicians to be paid for not providing health care." The managed-care movement became, as she described it, "the worst kind of business — the kind that injures its customers."

... But is the answer socialism? Many Democrats think so. Chairing a health care panel in Poughkeepsie, N.Y., last month, freshman Rep. John Hall, D-N.Y., a supporter of government-provided single-payer universal coverage, dazzled the audience with a story of how his mother once fell on the steps of a restaurant in the Czech Republic and received a free operation and two free weeks in a hospital....

Herzlinger offers as a model for reform Switzerland's long-standing, market-based, consumer-driven health system. "Individuals in the Swiss system can safely and effectively buy insurance from a large number of competent firms," she said. Universal coverage is required and prices for consumers are not risk-adjusted.

"A sick 60-year-old man pays the same price for insurance as a healthy one," Herzlinger said.

In addition, the Swiss system directly subsidizes the poor. The overall result is that costs and inflation rates are 40% lower as a percentage of the economy than in the U.S....

Interesting. They like the Swiss system, the most expensive system other than our own.

The Swiss generally agree that their system needs major reform — but they've been assaulted by the same barrage of fear-based appeals to scare them off from single-payer that we have. But this is an interesting strategy on the part of the right — to promise a system like Switzerland's, which is indisputably better than ours. It's just not up to par with its neighbors in terms of equity or cost-effectiveness — and does not have better statistics on quality and outcomes.

The only problem with this strategy is that it's hard to imagine the insurance industry money really getting behind it. Switzerland's system depends on regulation that the insurance industry here would never agree to. There are far too many insurance CEO Marie Antoinettes who believe that the peasants can eat cake a while longer — at least until their own own golden parachute comes through.

Donna Smith, who describes herself as "one proud American appearing in Michael Moore’s newest film, Sicko," wrote up this story about the time of her 31st wedding anniversary earlier this month. She and her husband Larry lost their home after both becoming ill around the same time. They're scraping by these days, walking wounded with him, after three heart bypasses, arguing the need for him to go back to work and her arguing that he mustn't. Donna, a newspaper editor who understands how unlikely it is that she'll ever work in that capacity again since taking up the cause of healthcare justice, wrote this up last week. Sicko opens June 29. Go see it that first weekend.

A package arrived today at my home. It was a welcome sight. It came from a friend, a SiCKO soul mate, who knows what it is to go without medications so that others might have theirs and because there just isn’t enough cash to go around.

Over the past several weeks, I have been weaning myself off of one of my most important medications, my Advair. It is the asthma inhaler that helps my lungs stay open and free from asthma attacks. And I have taken it for almost four years.
Advair is expensive. But even as the doctors in Cuba, where we went with Michael Moore, were taking me off of five other medications, including the beta blocker they said no asthmatic should ever take, they all agreed, “Take your Advair. It is perfect for you. It makes you better.”

But the doctors in Cuba don’t understand. No matter how perfect a medicine or a treatment may be for an American with health issues, unless that American has the cash to pay for the needed item or care, their body will go without.

I first started on Advair four years ago after a debilitating obstructive asthma attack that landed me in the hospital for three days. The pulmonary doctor who saw me then thought I might be helped by the inhaler, and he was right. My lung function dramatically improved with the medicine and my need for the short-acting inhalers to stop acute asthma attacks dropped to almost nil.

It seemed that within a few short months, my lung status was changed from one I feared every time I was outdoors in the cold or near one of my asthma triggers or – heaven forbid – I caught a cold, to one of a nearly normal person. Advair was a miracle for me.

But it' s pricy. Even at the local mega-discount chain pharmacy, Advair in my strength can be $200 a month.

I have insurance, but that doesn’t solve the problem. That same pulmonologist that first prescribed my Advair quit seeing me because we declared bankruptcy in 2004, and his practice group wanted cash up front from me (and then they suggested I submit my own insurance claim). I was devastated since my insurance carrier had always paid handsomely for my care and the only amount this clinic in Rapid City, SD, lost was $200 that had to be listed in the bankruptcy action. So, I couldn’t see him anymore.
I waited until spring of 2007 in Havana, Cuba, to see a lung specialist again. I never got to see an allergist in South Dakota either. The only one my family doc would refer me to was in the same practice group with that “no-dirty-bankrupt-persons” sign on the door.

But over the years, I did manage to talk my way to a continued Advair prescription from whichever doctor I was seeing at the moment. I knew it was helping me, and I knew I had to take it.

Then the bottom fell out of our lives. Insurance premiums topped $600 monthly, and something had to give. Though I was deeply grateful to be participating in the Michael Moore project, that wasn’t going to fix the problems that made me perfect fodder for the film.

When I returned from Cuba, the Advair ran out. My new insurance has a deductible to meet, and it so happened that my Advair was the medication next up on the refill queue for us. My husband takes eight prescription medications for his coronary artery disease, peripheral artery disease, and other conditions. Though I had come off several meds in Cuba, I still needed four – including my expensive Advair.

One local doctor gave me a sample that lasted two weeks, and then offered a sample of a lesser drug. I took it. But as the days wore on, I could feel my lungs starting to tighten again. The pain I had lived without returned. Climbing stairs once again became more taxing; my sleep issues worsened. My asthma was back.

And the shame is all there too. How do I tell the world that I am still a failure – SiCKO “star” and all. I cannot even manage to spring loose $200 to meet my deductible and get my medicine.

The rent, the utilities, the food, the gas for me to get to work, the insurance, the loan payments… my husband’s medications… all must be paid. And my lungs will keep hurting, and all the ground I gained over the past four years will be lost for the lack of $200.

Ask for help, you say. Borrow the money, you say. Get another job. I did but it isn’t helping enough just yet. I’m sure it will if I work a little harder. Stop whining. Buck up, buck up… this is America where if you want it bad enough you can do it.

But how do you admit that no one close to you wants to hear any more health-related trauma? They’d rather buy you dinner or almost anything else than hear you need help to buy Advair.

Grown children might send you a Mother’s Day card, but do not want to help with a prescription. And it isn’t cruelty, it’s denial. Denial that the problem with health care really is as bad as it is in America and denial that your mother is a failure at solving it.

Folks want to hear about the potential fame and notoriety of a film part. What they cannot stand to face is the reality of the situation for me and for many Americans. Thousands and thousands of people will go to bed without their meds tonight.

Being a part of a film with so much potential did not adjust reality for me – not this part of the reality. It’s going to take work and compassion and intelligence to do that over time. Whether a new president will actually tackle the issue is by no means a given, and no one has yet explained to me in a way I can comprehend why the current Congress, including so many of these presidential candidates, cannot and will not act on behalf of the Americans like me who are sinking fast.

But then a package arrived today. My SiCKO sister, more a sister than she can know, sends me the Advair samples she can no longer take. This woman, this friend, stood at ground zero on 9/11. She was made sick by it… very, very sick. Her lungs hurt as mine do, but Advair doesn’t relieve her pain. So she gave it to me.

We also lack the political and moral will to care for her – and thousands of her fellow 9/11 workers. We make them beg for benefits and fight at hearings planned months into the distance. They were our heroes held up to the world yet now they apparently are our albatrosses. Dead weight. It is incomprehensible to me that one of our elected officials does not simply stand up and honor these people by demanding they be cared for compassionately and completely. No explanation suffices for the system failing my SiCKO sister.

The health care system that brought about this chain of events is making many of us sicker than we need to be, and it is costing us so very much.

I will spend, with my SiCKO sister, the next however-long-it-takes fighting for change. The health care system in this nation must change. And it should start today, not with the next presidential election. No, Senators Obama and Clinton – and all of the rest of you — not by the end of your first terms. That’s not good enough.

But for now, I cradle my gift given with only love and complete understanding for what I am going through. Tonight I will inhale my Advair, and a few weeks from now I will breathe easier again.

Donna Smith, who appears in Michael Moore's new film Sicko and who is very much a Christian, sent along these quotes from the end of a story in the Detroit News.

"This film comes from a spiritual place," Moore says, "so I wanted to go to the headquarters of the sisters who taught me in my early years. They had a profound impact on me."

The idea that it's about "the we, not the me," came from the nuns. "Instead of calling it 'socialized medicine,' it should be called 'Christianized medicine.'"

"This was one of the ground rules that was laid down by Jesus. He said, 'I'm going to ask you a bunch of questions when you get to the pearly gates. When I was hungry did you feed me? When I was homeless, did you give me shelter? When I was sick, did you take care of me? And if you didn't do these things, and you didn't do these for the least of my people, then I'm going to have to say that you can't come in the big house.'"

Michael, according to Maryknoll Father Charlie Dittmeier, is probably a Matthew 25 Christian — a verrry different species than a Matthew 28 Christian.

Here's the difference:

In Matthew 25:31-46, Jesus told his disciples that those who fed the hungry and gave water to the thirsty, those who clothed the naked and visited the sick or in prison will go to heaven. “I tell you the truth, whatever you did to one of the least of these brothers of mine, you did to me,” said Jesus.

Those who don't will go to hell: “Depart from me, you who are cursed,” he begins. “… I was a stranger, and you did not invite me in, I needed clothes, and you did not clothe me, I was sick and in prison and you did not look after me.”

Now Matthew 28: “Go, therefore, and make disciples of all nations, baptizing them in the name of the Father, and of the Son, and of the Holy Spirit, teaching them to observe all that I have commanded you.”

















I wrote last year in the Catholic Sentinel about what a difference that makes in real life:

PHNOM PENH, Cambodia — The middle-aged woman waiting for a connecting flight is an Evangelical Christian, proud of what her church is doing in Cambodia. There is an orphanage for 30 children and a school for more than 200. But most important, they were building churches so fast that she couldn’t keep track of them: A dozen just this year.

The Catholic Church, she said, doesn’t have much of a presence in Cambodia.

How about Catholic Relief Services, Caritas, the Jesuits, the Maryknollers, the PIME fathers and all the other Catholic NGOs and orders?

She shook her head. “All they do is help people,” she said. “They’re not really spreading the Good News.”

Bless that woman for giving me such a great lead.

That great photo, by the way, is from Rick D'Elia, who has recently emailed from Rwanda.

Sicko's even at Business Week — and with a positive review. Which is as it should be. Our healthcare system is bad for business.

"Anything—including a film—that can bring this issue into the public eye is good for the debate," says heart surgeon Dr. William Plested, president of the American Medical Assn. "So, I'm cheering on Michael Moore, even though I haven't seen the film."

Business Week has a nice trailer for the film there.

Can we reform the system? Or are the cynics right, and it's "unfeasible"? If that's the case, we're in the decline and fall of our democracy. Here's a comment from a recent Washington Post back and forth with Steven Pearlstein:

If you look at wealth inequality from an historical point of view, you will see that countries with a vast difference in the percent of wealth held by the upper 1 percent (say) as compared with the lower 90 percent (say) soon go down the tubes. The reason is that wealth translates into political power, and soon the country is making decisions that benefit the top 1 percent and not the country as a whole. This is discussed in detail in Kevin Phillips' "Wealth and Democracy." Since this is a feedback situation, it tends to happen and has at least started to happen several times in our history. The strength of America has been that just when the trend starts to enter the strong feedback stage, something has happened that redistributes the wealth. The rise of unions and FDR are two such examples. What we have to worry about is that the trend of wealth piling up in the top 1 percent or 0.1 percent is increasing and we see the country taking positions that benefit only the Rich. Two examples are taxing dividends and capital gains at a lower rate and the attempt to abolish the estate tax. I am sure you can come up with many more such examples.

Time to redistribute, wouldn't you say? Or are we too "free market" to save the country?

Donna Smith, a journalist faced with crippling healthcare costs despite being insured, was one of eight Americans who traveled with Michael Moore to Cuba in March for treatment there. Moore filmed the trip for his documentary Sicko, which opens later this month. Donna writes movingly about the experience at Huffington Post and at Healthcare Now.

At Moore's site, there's this introduction to Smith in an AP story about the recent New York screening of Sicko. "Donna Smith, in from Denver with her husband, Larry, was in tears when she spoke. The film opens with their painful story: Plagued with health problems, they were forced to sell their home and move into the storage room of their daughter's house because they couldn't cope with health costs, even though they were insured.

"'Health care is an embarrassment to our nation,' Donna told Moore. 'You give dignity to every American in this film.'"

At the heart of Donna's story is the psychic trauma that our healthcare system inflicts on people like her — people, she says, "who play by the rules" (she's always had health insurance) but are still victimized by our system. From the Healthcare Now piece:

As I walked to where I would stay in the hospital [in Cuba] for my evaluation, I felt something deeply painful beginning to surface. I felt my gut tighten and even a stab of pain in my chest as I flashed over all the incidents of the past 20 years when I struggled to get health care and when I was made to feel disgusting. My brain swirled with images of payment plans (some signed literally at surgical bedside), applications for community benefits, rising health insurance deductions, angry health providers dunning us for small balances not covered by insurance (though many had been paid thousands already), and countless other humiliations in spite of the fact that I had never allowed my family to go without health insurance...

Over the next few days, I began to absorb the healing power of this form of medicine. Just the knowledge that each human being is valuable, that each life is sacred and worthy, began to heal so much of the sickness of my spirit that also caused some of the sickness of my body. And so my journey into a new life was started. For perhaps the first time in my life, I felt that my Creator had given a glimpse of unconditional love and peace.

Donna is articulate and passionate about this issue — she knows first hand that our system is so unjust that it's fair to call it barbaric. It certainly has no relationship to the Christianity that Americans think of as guiding this country.

I always find myself admiring people like Donna for sticking with their faith despite the evidence arrayed against it — mostly evidence about how miserably most individual "Christians" and "Christian nations" fail to live up to their ideals. She's right there with Bill Moyers in terms of being a better example of what a Christian should be.

Donna's bout with cancer together with her husband's many medical problems forced the two to leave South Dakota, where she had edited a small daily newspaper. She's in suburban Denver now, still struggling with healthcare costs — although in better shape than she had been before Cuba.

I spoke with her tonight, and she says that she arrived in Cuba on nine medications, and left on only four — and feeling much better.

One of the meds she's still dependent on is an asthma inhaler costing $175 — each. Her insurance will pay for it — after she spends enough to cover her deductible. The Smiths' real worries, however, are regarding her husband, Larry, who was too ill to travel safely to Cuba. Donna said that her sense that it should have been Larry there getting treatment was the hard part of her trip to Cuba.

And Moore's fact-checkers. They were tough to take as well. Contrary to mainstream media's depiction of Moore being more interested in telling a good story than he is in sticking to the facts, Donna said that his staff was relentless when it came to insisting on documentation for everything that she and Larry told them about their story.

I'm sorry that the Smiths have had their lives turned upside down by the idiocies of our system. I'm thankful that she's taking this experience and speaking out to make the world a better place. "God gave us brains so we could use them," she told me tonight.

Hope so.

Tomorrow night's "Imagine Action" program, 6 - 7 p.m. on Fort Collin’s KRFC (88.9 FM or online here), will focus on health care reform. Guests will be Health Care for All Colorado and Physicians for a National Health Program member Dr. Cory Carroll, a local family practitioner and president of the Larimer County Medical Society; Rudy Deutschmann, president of the State Association of Health Underwriters; and HCAC board member Eliza Carney, who will discuss the 208 Commission and the political process around health care reform.

The call-in number is 970-221-5065.

In more international single-payer news, take a look at Salon’s feature article on Michael Moore’s new film Sicko. It will do your heart good.

Author Andrew O’Hehir writes that Sicko is

both a more finely calibrated film and one with more far-reaching consequences than any he's made before. Moore is trying to rouse Americans to action on an issue most of us agree about, at least superficially. You may know people who will still defend the Iraq war (although they're less and less eager to talk about it). But who do you know who will defend the current method of healthcare delivery, administered by insurance companies whose central task is to minimize cost and maximize shareholder return? Americans of many different political stripes would probably share Moore's conclusions at the press conference: ‘It's wrong and it's immoral. We have to take the profit motive out of healthcare. It's as simple as that.’

Sicko purposefully does not focus on the 50 million or so Americans who don't have health insurance, as scandalous as that is, but on the horror stories of middle-class working folks who believed they were adequately covered. There are so many of these they begin to blur into each other: the woman in Los Angeles whose baby was denied treatment at an emergency room outside her HMO network, and died as it was being transferred hours later; the woman in Kansas City whose husband was repeatedly denied various drugs his physician prescribed for kidney cancer, and who in the last stage of life was denied a bone-marrow transplant that could have saved his life; the woman who was told her brain tumor was not a life-threatening illness, and died; the woman who was told her cancer must have been a preexisting condition, and died.

If the Salon article whetted your appetite for more reviews, here’s one from The Guardian:

His question: what has happened to the idea of universal healthcare in the United States?

In four tidy acts, Michael Moore spells out the facts. Act one: 50 million Americans have no health cover, and 250 million who think they do, through costly health insurance schemes ($2,000 per person a year), are often denied treatment when they need it….

Act two: when did it all start going wrong, asks Moore. The answer: in August 1971. President Richard Nixon and his adviser Edgar Kaiser plot to break the system. "The less care they give, the more money they make," says Nixon, caught on tape….

Meanwhile astute national publicity campaigns have demonised the concept of universal healthcare by associating it with "socialised medicine", which in American English translates as "Soviet medicine" - the kind such oppressive regimes as Canada, Britain and France have adopted for their citizens….

Act three: Moore pays these regimes a visit….

Act four, the most powerful: Moore decides to test the US administration's claim that Guantánamo Bay prisoners get the best free healthcare in the world. He takes 9/11 volunteer rescue workers, whose health problems were not covered by the state because they weren't on its payroll when they ran to help, to Guantánamo Bay in Cuba….

And lastly, the news, also in The Guardian, that the U.S. government is trying to impound Moore's film – a claim that’s hard to dismiss considering everything else in our country’s recent past. “Now, according to movie mogul Harvey Weinstein, whose Weinstein Company is behind the film, the US government is attempting to impound the negative.”

The pretext would be Cuba. Moore had applied for permission to travel there but received no reply until this month, when “the treasury department notified Moore that it was investigating him for unlicensed travel to Cuba.

Watch a trailer for Sicko and more on Moore's website.