DVD Review: Sicko

December 30, 2007

Michael Moore, the controversial film maker with a wonderful sense of the absurd is considered a propagandist by many in America. Like Charlie Chaplin who made us laugh as he made us understand the deep-rooted social problems of poverty, racism and exploitation, Moore's films have struck a similar chord of humor and social issues with me.

The film deals with the totally expensive and dysfunctional Management care- Health system of the US. The conclusion is simply Universal Healthcare for all. Let your tax dollars pay for Health for all. The Special Features section of the DVD has some wonderful interviews with various persons including Tony Benn of Britain and Marcia Angell of the US. They are infectious, for certain! More middle class families went bankrupt last year in the US owing to huge medical bills in spite of being insured.

Now, for you and me, who have been used to free medical care in India for decades, in those dirty government hospitals, it is not something new. For America, that has been told for over 35 years that Managed health care is the only way to good and affordable healthcare, this is equal to communist propaganda.

Moore points to the NHS of Britain, Canada and the public health system in France and communist Cuba, only to be slighted and called a propagandist in US popular media. What he fails to show his viewers is the direct link between drug companies and them funding the media in the US by paying gigantic advertising monies.

Moore shows the high cost of administration involved in Managed care that takes out medical care from the equation of insurance. So, basically, all the fools like me who are shelling out approximately $1000 per month on insurance for a family of 4 are paying for the CEOs and administrative staff (and the shareholders, we mustn't forget them) of all those wealthy insurance companies and if and when I do show up at the Doctor's Office I have to shell out more as co-payments and other charges that are not included in my plan.

That is pretty much the gist of this film. The sad part is that companies like Apollo Hospitals in Chennai and Hyderabad have made this model very successful in India. Managed Health care has sounded the death knell to true medical help in our country. In the past two years, I have heard personal stories from family members in India (mostly seniors with a small pension) who had to face a by-pass, cancer etc. having to shell out lakhs of Rupees after having paid for insurance. Not only were these procedures expensive, post-operative care was abysmal. Once money changes hands, you are thrown out like yesterday's garbage. If you don't have money, then you are thrown out right away!

Last month, medical students in Tamil Nadu protested against the center's idea of making all medical students do a compulsory stint of one academic year in the rural areas compulsory, as part of their MBBS degree. As much as I understand the plight of students from poor families who have mortgaged their families and fortunes to become a doctor, I am shocked at the mercenary attitude of this most noble profession.

In ancient India, the tradition of dakshina existed only for two professions- for Vidya and Vaidya. Both education and medicine were considered so precious that they could never put a price tag on them. Hence, the student (in the case of Vidya) and the patient (in the case of Vaidya) made a "token" offering or "dakshina". How can we truly evaluate the knowledge that we have gained from all our teachers? How can we put a value to our very lives and health when we go to a doctor?

It is unfortunate that in a country like the US, where public education is given importance, the services of a doctor is not included. In India, both have become a lost cause for some time now though we technically have free government schools and government hospitals. In the medical sector, we still find some amazingly committed doctors who are doing yeoman service in their communities and beyond. The number of charitable hospitals in India are mindblowing. From the Cancer Institute in Chennai to this doctor living in a shack in Hrishikesh (he was instrumental in stitching up my brother's toe in candlelight after a sudden accident), this country still has many practitioners of this noble art of healing the sick.

The last time I went to Safdarjung Hospital in New Delhi and Ram Manohar Lohia, New Delhi, I was amazed at the commitment and focus of these doctors and nurses. The ob-gyn from Safdarjung was sharing some funny stories about these rural women who come to her for deliveries and have no clue about even lying down in a hospital bed. When a woman was told to slide down further for the doctor to examine her (aur neeche aao), she promptly got up and lay down on the floor!! They are so used to a mat on the floor! The job of a doctor includes teaching people basic ideas of health, nutrition, hygiene and disease prevention.

I honestly don't care about the super rich who can afford any kind of care anywhere. I am interested in the majority of humans who need access to quality health care for the ailing and the ill. Universal healthcare is a must as is universal literacy.

Blokes aka Meenakshi enjoys writing along with being a mom, a school teacher, a musician and an Art of Living teacher (of meditation and breathing)
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December 30, 2007
12:49 PM

meenakshi... while I agree with much of what Moore has said in just about every movie he does, you should know that he *is* a propgandist. He spins everything to the extreme and he admits it.

That being said, yes there is a huge healthcare crisis in the US. And yes, drug companies and managed care companies are getting fat off the massive profits and denying people their rightful healthcare.

But you seem to not understand a lot of things about healthcare in general. First of all, the system in the UK and other places looks all bright and shiny till you dig under the surface. Go read, for example, about abysmal obstetric care in the UK, or the heinous wait to see a specialist. Socialized heathcare is also not all it is cracked up to be. In many countries it is failing miserably. Go to Italy and take a look there at healthcare.

And in India it is not just poor families who shell out lakhs.. the price of med school now for even a middle class family is skyrocketing, and making students do a compulsory extra year hadicaps them from paying back their loans even more. Do you know how much a doc makes first year out of school here in Bangalore. Well, ask my husband. It's about 9-15K a month. You try living on that in a city. Especially a city where brats just out of college are making a lakh a month and prices are rising by the second for everything. So do not be so quick to judge.

December 30, 2007
03:36 PM

Dear Small Squirrel,

I agree with all that you say. And I do not "judge" any system as ideal or perfect. On the contrary, I demand that medical care be a basic human right as education ought to be. It requires commitment from all stakeholders. And no, kids out of college (except for a select few from the top institutions) also start with Rs. 5000-Rs. 15,000 as starting salary in Bangalore. We too have a business in Bangalore and we know what we pay them.
If you delve deeper into some of these "big tag" salaries that some B-school grads get, trust me, you will find that kid to be a son or daughter of someone who got something passed for that company that hires him or her. Every kid out of B school or college does not get such astronomical sums.

My brother who lives in Delhi and has been a CA and financial advisor for over 15 years makes a six figure salary now- in the past 2 years. Before then it was in the low 5 figures.

Corruption of values has led all of us to this mess. Money is nothing but yet another form of energy exchange and when some of us have not come by it the hard way, we will tend to fritter it away with no care for self or our society.

December 30, 2007
08:06 PM

I think you need to look a bit harder into what some kids make in IT. In some businesses, yes, the salaries are still low. But you have to admit that the majority of companies in Bangalore are IT or IT-related, and they offer big bucks! That is basically a commonly known fact, one that I saw with my own eyes after working in a consultancy.

and yes, healthcare is a basic human right. and the US system is failing miserably. but greed and corporations go hand in hand, and believe me when I tell you that the average GP in the US is not making what you think, either. It's sad. They shell out massive sums and then scrape by (all while paying huge amounts for malpractise insurance)

December 31, 2007
01:24 AM

My husband is in IT!! And he is from B'lore! Right now IT combined with MBA is hot and there are kids from the IIT/ IIM combo who are getting paid tons. And I have 2 Docs practicing in the US and they tell me horror stories from their end! The problem in America is insurance (including liability, malpractice etc.) and Brand equity that demands a higher sum just 'coz its branded!! And that is getting rolled out globally in this modern economy.

Even now I find myself living within a budget as I do not buy branded products as a rule and buy least processed foods which are 1/3 to 1/4 the cost of pre-prepared food.

Don Nixdorf
January 3, 2008
08:26 PM

Meenakshi, excellant commentary on health care. The problems are the same regardless of country. Moore has shown the light on a problem in the US which is resonating in all countries including Canada. Moore can be foregiven on his assumption about Canada based on the few examples he had time for, his film was about the US. While some persons health care can be good the issue is how to improve outcomes and lower cost. Paying more for the same is a game. The "squandering of billions in Canada" is no less a problem than in the US. While individual costs may be high in the US, can you imagine Californian's taxes or the Governor allocating 42% of the State budget, and rising in each Canadian province, for public health care. Canada has wait lists so that private surgery centres are now necessary in addition to Canadians travelling to the US for care. Medical mistakes (iatrogenic) are higher per capita than in the US and are major contributors in US and Canada to cost and poor outcomes of care. Look closely, Canada may not be the antidote for US health care. As co author of Squandering Billions Health Care In Canada we disclose the problems and solutions common to health delivery today.

January 3, 2008
10:35 PM

Thank you Don. My concern as a human being is that there is no education on prevention in the post modern world. Our scientists, in their zeal to make wonder drugs made us forget the simple axiom of Prevention being better than a cure. Holistic traditions still alive in small pockets across the globe take care of most common ailments that impact the alimentary, respiratory and dermal systems. Serious issues like diebetes, cancer, heart diseases can be avoided by proper nutrition and exercise. Bring in pyschosomatic therapies like Yoga and meditation, hey, we can live healthier, happier and longer! And cheaper too!

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