This is the Bush Administration solution, of course. The White House wants Americans to use insurance only for major medical bills, pay high-deductibles, and rely on savings accounts for more routine health services. Supposedly, this scheme will make Americans more prudent users of health care. It's all part of the idyllic Republican vision of the "ownership society," an Orwellian term for the further dismantling of employer-based coverage. In fact, insurers are now in overdrive to sell cheap, high-deductible health plans to what they call the "young immortals" market: the healthy, uninsured young people who are not likely to file claims.
Sometimes the obfuscation involves what their promoters like to present as delightfully innovative business solutions. Take former America Online CEO Steve Case, whose new career as a healthcare investment executive is inspired by images of the dollar signs lurking in walk-in "mini" clinics at Wal-Mart stores. Case gives speeches in which he speaks of a future health system that creates incentives for healthy living by offering "bonus points" redeemable for "awards" from movie chains and airlines. And profits for Case, no doubt.
Other times the miasma involves just deluded ideology. Like that of Republican Presidential candidate Rudy Giuliani, who proclaims "market-based" solutions as the only acceptable avenue for health system reform. No word yet whether Gulianni plans to abolish Medicare should he be elected. Or Star Parker, president of the Coalition for Urban Renewal and Education, who wants us to believe that the "power of individual choice" and the "creativity of the marketplace" would better replace the supposed burdens of Medicare. Parker calls Moore's vision of guaranteed health care "pornographic."
Then there is the esteemed committee of health policy experts from Harvard University's Program for Health System Improvement, who propose a 20-year plan for health reform in three stages and write things like: "Our national government should contribute to and stimulate local innovation by creating a competitive process, in which appropriate, interested localities can bid to receive matching federal seed money to initiate their innovation. The anchor corporations, local health plans, local philanthropic organizations, research universities, and others will match the seed money and provide specific business plans that present detailed information about how each entity will fulfill its roll in the proposal. Federal and state governments will provide regulatory relief if appropriate and will help to evaluate whether the plan can fulfill its stated goals."
Accordingly, the Harvard panel's bold vision for decades of experimental system tweaking proclaims the possibility of reducing the number of uninsured from 45 million to 30 million over 10 years. Please note that this reduction will occur during stage two of their plan.
Executive profiteering. Uninsured millions. Rising premiums for policies that increasingly offer fewer benefits. Is Moore wrong for declaring this reality immoral? Is he such a radical for arguing that insurance companies should have zero role in health care? Actually, the answer to the latter question is yes. The leading Democratic candidates for the party's presidential nomination, John Edwards, Hilary Clinton, and Barack Obama, all seek to set the health reform bar low enough that the insurance companies responsible for the current broken system remain a part of the system. But should we really expect different from politicians who say they're opposed to the Administration's war in Iraq, then reject an immediate pullout and repeatedly vote the money necessary to continue that war?
The virtue of SiCKO is that it frames the issue of health care in larger, more principled terms. After years of ideological assault on the very idea that society and government should provide more than bare-bones social services, Moore's movie resurrects a nobler vision of society. SiCKO challenges us to think of ourselves not as individual consumers, or health care "customers," but as citizens with rights and common human aspirations and needs.
In this sense, SiCKO speaks to that "radical revolution in values" the Rev. Martin Luther King, Jr. once said this nation must undergo if it is ever to become a land of real justice. Not to take anything away from Moore, but the splash the film is making partly reflects the simply vacuous state of our political-media culture; so rarely is a mass American audience exposed to ideas that suggest the possibility of far-reaching social change. Consequently, the movie is proving to be an empowering experience for many audiences, from the impromptu post-film discussions in lobbies to union nurses setting up single-payer information tables.
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