Roger Ebert savages "John Q." for general dumbness

February 18, 2002 11:31 AM

Roger Ebert savages "John Q." for general dumbness yet agrees with the message: we should have socialized health care. Steve MacLaughlin, however, details how the film greatly misrepresents medical and health care reality just to make its point -- and he fears that Joe Popcorn is going to absorb it as political education. Given that the film is set in the present day, rather than some fictional dystopian future, is this artistic license or irresponsible oversight? Perhaps libelous propaganda?
posted by Tubes (73 comments total)

Warning: The McLaughlin article contains huge SPOILERS.
posted by jpoulos at 11:42 AM on February 18, 2002

Not having seen the film, I only offer this for what it's worth: The maker of the film (Nick Cassavetes) has a child with a debilitating disease (heart failure) and so he has had to go through a lot of insurance company rigamarole. It *is* a fictional film, and I can only imagine how gutwrenching it was to tackle a subject to close to home.
posted by macadamiaranch at 11:49 AM on February 18, 2002

Stephen Hunter, of the Washington Post, says: In, let's say, Israel, if a man goes to a busy emergency room, pulls a gun, takes the place over and demands policy changes or he'll start killing hostages, what would you call him?

Why, I believe the answer is: a terrorist.

But if the same thing happened in the United States, according to the grotesquely inverted moral compass of "John Q.," here's what we'd call the man: a hero.

That pretty much sums up why I won't be going to see this film. Plus, nothing is more annoying than films whose political view's are so aggressive that anyone who disagrees is, ipso facto, some sort of troglodyte baby killer. Cradle Will Rock, I'm looking at you.
posted by haqspan at 11:53 AM on February 18, 2002

Spoilers? Get real! Like we wouldn't have been able to predict all of that based on the 30-second trailers. What is there to spoil? It's a transparent, vacuous plot. And, more importantly, its a bad argument for a good cause.
posted by yesster at 11:55 AM on February 18, 2002

haqspan--Cradle Will Rock was a film about a theatrical troupe in the 30s (a *bad* film I might add). I think you meant The Hand That Rocks The Cradle (another *bad* movie).
posted by macadamiaranch at 11:59 AM on February 18, 2002

I haven't seen the film, but I heard on NPR that the script was written in 1993, when the message about health care reform may have been more timely. I think the "terrorist" sentiment is understandable, but based on when the movie was written, not necessarily hypocritical.
posted by uftheory at 12:00 PM on February 18, 2002

I don't think that Ebert needs to worry about "Joe Popcorn" getting the wrong idea about health care from this film because, quite frankly, I don't think nobody is going to see it. Based on the reactions I've observed from local audiences watching the trailer for this, it's going to tank massively at the box office. Any film maker who seriously believes that the public is going to take a sympathetic view of hostage taking given the current national mood is fooling themselves.
posted by MrBaliHai at 12:03 PM on February 18, 2002

Do you think Nick Cassavetes actually watched any of his father's films?
posted by thebigpoop at 12:03 PM on February 18, 2002

Given that celebrity drunks like Mickey Mantle (who didn't deserve a new liver) can seemingly get organ transplants with the snap of their fingers, while others are left to wait in vain and eventually die, I'm not in line to be sympathetic to the health care industry.

Anyone that thinks that money and status is not a factor in getting a transplant is seriously deluding themselves, regardless of propoganda. If you've got enough bucks and fame, they'll find you a new organ.
posted by mark13 at 12:05 PM on February 18, 2002

MrBaliHai: John Q made $20 million as the #1 movie in the country this weekend...
posted by owillis at 12:09 PM on February 18, 2002

owillis: I'm amazed. All I can say is it must be playing better on the coasts than it is here in Flyover Land.
posted by MrBaliHai at 12:14 PM on February 18, 2002

Good burn, owillis.
posted by uftheory at 12:16 PM on February 18, 2002

Anyone that thinks that money and status is not a factor in getting a transplant is seriously deluding themselves, regardless of propoganda. If you've got enough bucks and fame, they'll find you a new organ.

Are you saying that everyone should be entitled to a new organ or that some people shouldn't be entitled to one just because they can afford it? In general, I'm as big a supporter of socialized medicine as anyone, but even within that framework, cost considerations are essential. You simply can't spend half a million dollars on everyone who could benefit from a transplant because you'll run out of money. I'm sure that's terribly difficult for parents to accept, but resources are limited, and for the cost of a single transplant, you can likely immunize thousands of children and save many more lives.

There are plenty of places where our current medical system lets too many people down. I'm not sure transplants is one of those places.
posted by anapestic at 12:17 PM on February 18, 2002

uftheory: are you keeping score or something?
posted by MrBaliHai at 12:23 PM on February 18, 2002

Stephen Hunter, of the Washington Post, says: In, let's say, Israel, if a man goes to a busy emergency room, pulls a gun, takes the place over and demands policy changes or he'll start killing hostages, what would you call him?

Why, I believe the answer is: a terrorist.

If the the hypothetical Israeli gunman had a child in the hospital dying as a result of the policies of the current health system, I think most people, while not approving his actions, would probably not classify so quickly.

But if the same thing happened in the United States, according to the grotesquely inverted moral compass of "John Q.," here's what we'd call the man: a hero.

Uh, yeah, it's called a movie. And from what I've read about it, the treatment of Denzel's character in the film is a bit more nuanced than Hunter admits. But why is Hunter surprised that a Hollywood movie would make short, simple work of a complicated issue?
posted by Ty Webb at 12:26 PM on February 18, 2002

MrBaliHai -- modus operandi: anecdotal evidence.
owillis -- MO: empirical data.

score: 1 - 0, owillis.
posted by uftheory at 12:26 PM on February 18, 2002

Odd that Ebert didn't mention the socialized medicene bit in the tv show review I saw last night. Even more odd that he pays a one sentence lip service to national health care and Tubes used it as a major point in posting it.

Ebert was blasting this movie last night based on its horribly stereotyped characterization of the current status of healthcare in the US. He resoundingly gave the film a terrible review and said it had no merit. I don't think anyone who believe anything but stereotypes will think it is believeable.
posted by mathowie at 12:40 PM on February 18, 2002

owillis, I wanted to go to the movies yesterday. Looking through what new movies were playing at the local theatre and a 17 movie megaplex a little further away, the best choice was seeing LOTR a third time or watching John Q. I stayed home and cleaned around the apartment instead. (And no, Crossroads wasn't playing at either of them.) Good movie, or the best of some bad choices?
posted by bragadocchio at 12:51 PM on February 18, 2002

So, what you're saying is, Denzel Washington is in a bad movie?
No, that can't be right.
posted by dong_resin at 12:58 PM on February 18, 2002

Actually, macadamiaranch, I think haqspan did mean Cradle Will Rock. As far as I know, The Hand That Rocks the Cradle didn't evince any political opinions -- however, the notoriously political hand of Tim Robbins was all over the former film. I think the "baby-killer" comment threw you off.
posted by Big Fat Tycoon at 1:06 PM on February 18, 2002

macadamiaranch: Hey, I liked Cradle Will Rock. C'mon, how often do you get to see Marxist vaudeville portrayed in a positive light?
posted by ook at 1:10 PM on February 18, 2002

Then again, I liked Bulworth, too, so I guess I have a soft spot for aggressively political films that everybody else thinks stink. Guess I'll have to go see John Q. now.

Nah.
posted by ook at 1:13 PM on February 18, 2002

score: 1 - 0, owillis.

Whatever floats your little gloat boat, I guess.

If I'm going to be proved wrong, I certainly don't mind being called out by Oliver. However, I don't think that one weekend of big box office necessarily makes it a hit yet. Let's wait a couple of weeks and see if this movie's got any legs beyond the Denzel Oscar Bounce. I still don't think that this film is going to play in Peoria. If I'm wrong, it wouldn't be the first time.
posted by MrBaliHai at 1:16 PM on February 18, 2002

bragadocchio: I'm not saying whether it's good or not (I haven't seen it yet), just providing data that said a few million (say 2, based on $9 admission) went to go see it. Not really an accounting of taste as I see it, hell more people went to see LOTR...
posted by owillis at 1:19 PM on February 18, 2002

How does any cause justify taking hostages and threatening people's lives? No matter how much I might agree with someone's cause, they lose my sympathy when they threaten innocent people.

In the context of this movie, for example, most of the people in the ER would not have any influence on policy, so he's threating and traumatizing people who didn't have anything to do with the situation he's protesting. And taking hostages at least implicitly means he will kill people if he doesn't get what he wants; why is his son's life worth more than the lives of the hostages?
posted by kirkaracha at 1:20 PM on February 18, 2002

Big Fat Tycoon-- Mayhap it was the baby-killer part that threw me off upon looking back! Apologies all around for jumping the IMDB gun there.
ook--no offense to you. It wasn't the Marxism--it was the heavily over used Soft FX filters and over...dramatic...ACTING! which grossed me out. (For what it's worth, I thought it needed more Bill Murray too.)
In the case of John Q. (again, I haven't seen it) I can't stand movies about sick children. It's an already helpless situation that you know is going to be milked for more melodrama. So a sick kid mixed with hostages? Ugh, I can hear my heartstrings being manipulated already, so I'll not be seeing it.
posted by macadamiaranch at 1:24 PM on February 18, 2002

Matt: Maybe I should have lead with the MacLaughlin link, since my angle was mainly about the apparent use of an entertainment film to make a political statement using a straw-man argument. I just used the Ebert comment to illustrate the overall message of the film.
(The thread hasn't exactly gone as expected...)
posted by Tubes at 1:26 PM on February 18, 2002

i still love how ebert considers himself a holier-than-thou critic when he's the man responsible for penning three of my favorite russ meyer films.

so let me get this straight, ebert can write some of the best trash cinema thru the seventies and still keep a straight face while critiquing some of the best trash cinema of today... well more power to him.
posted by boogah at 1:28 PM on February 18, 2002

Some info on the Canadian Healthcare System (namely, how the media mis-portrays it).
posted by five fresh fish at 1:31 PM on February 18, 2002

owillis, good point. I expect a lot of viewers for the movie regardless of its subject, with the oscar buzz going around for Denzel. dong_resin might be right about Mr. Washington's acting abilities. I think the worst movie I've seen him in was The Mighty Quinn, and I enjoyed that one. I didn't expect the temperment of his last character in Training Day, but it was a really strong role. Oscar worthy? I think I would have to rewatch a couple of movies to make that decision.

I agree with Ebert about the Dog Day Afternoon assessment. That's exactly what was going through my mind when viewing the preview for John Q.
posted by bragadocchio at 1:40 PM on February 18, 2002

Interestingly, in a recent TV piece on "John Q." (I cannot remember where it was) they interviewed health care lobbyists, who were setting up things like "community dialogues" and taking out advertisements in Variety and other entertainment papers to counter the message that they felt the movie gave, that HMOs are injurious and without compassion.
posted by ltracey at 1:41 PM on February 18, 2002

As someone who has had a (kidney) transplant, let me note that while the system has its inequities, giving famous people an advantage is not one of them. Mickey Mantle got a liver because it was his turn, not because of who he was. The matching process is extremely complicated, and just by virtue of where they live and their antigens some people can get an organ in days while others wait decades. Money doesn't play that big a role either, but it does provide an advantage for those who can afford to pick up and move to states with shorter waiting times. I was able to get my transplant years sooner than I would have because I got on a list outside of my state which was much shorter than the list in my state.

As far as socialized health care, well, it's pretty clear that capitalism and the health care industry aren't exactly compatible. I don't know that the solution is government health care, but the solution isn't layers of insurance bureaucracy either. And "insurance" clearly isn't appropriate for people like me whose health costs are guaranteed to exceed any premiums I pay.

Rationing health care sounds great to people in the abstract, but when it's practiced in specific cases communities protest. This kind of schizo behavior makes it impossible to figure out exactly how to handle health care costs. We have to choose to ration at some level. When a $200,000 treatment has a .01% chance of saving someone, do we go ahead and use it? The Clinton health plan has more or less been put into place but with private companies and not the government at the helm.. Frankly, I'd rather have the government making the kinds of decisions that need to be made.
posted by spira at 1:45 PM on February 18, 2002

Sorry, but we decided that giving a sizeable chunk of the GDP to the US Government was not the way to treat this problem.

I felt that way during Clinton's attempt to socialize medicine, and I still feel that way. And, my views are backed up by every single Canadian I talk to. Every one, without fail. In fact, a couple of them even told me that the US healthcare system was one of the primary factors for moving here, one of them so he had a chance of getting a heart operation for his mother. No, I don't have signed affidavits so I can't actually prove any of that...

Now, that's not the same as saying "there isn't a problem." I don't claim that. In fact, it doesn't make a lot of sense for people without insurance to wait until they have a life-threatening infection before they visit the E.R. (as one example). It would cost far less - in both the long-term and short-term views - to treat the infection early than wait until it is very serious.

So, aside from giving the socialists yet another chunk of our economy (and creating yet another class of people who are certain to vote for said socialists), how do we solve this problem? How do I make sure that my sister's children have decent healthcare coverage (other than her brother paying for private insurance, that is...)? I don't mind - I love her and my nephew - but there are an awful lot of folks out there that aren't related to me. :)
posted by hadashi at 2:09 PM on February 18, 2002

I don't ever want to see the movie (the trailer made it look awful), but if it's getting the American public to think about the inadequacies of our employment-based health care system, I'm all for it. Consciousness-raising is an important part of encouraging a movement.

44 million people in the US without health insurance, and most of the them work. The insurance companies spent millions of their clients' dollars to defeat the Clinton health insurance plan. Makes me sick.

We need a single-payer national health program. Plain and simple.

I might be a little biased, working with these guys and Quentin Young, but really, health care should be a right. How can we argue that we're civilized if we can't provide for people when they're ill?

“Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” - Martin Luther King, Jr.
posted by gramcracker at 2:16 PM on February 18, 2002

1. Doctors do not make medical care decisions based on a patient’s ability to pay. In fact, it’s illegal to deny emergency care even if someone can’t pay for it. The whole “hypocritical oath” scene was out of bounds.

err, doctors and hospitals can and do refuse to treat people based on their ability to pay. Emergency rooms can't refuse to treat you, but ERs will only give you enough treatment to stabilize your condition, and they'll still bill you for the services afterwards. They just aren't allowed to ask you whether you can pay before they admit you. Also, some hospitals do voluntarily provide charity care to the very poor, but no hospital is going to give you a free heart transplant no matter how poor you are.

Of course, you might be able to get one through the state Medicaid program (depending upon how generous it is), but you would first have to quit your job and get rid of all your assets.
posted by boltman at 2:19 PM on February 18, 2002

"...it's pretty clear that capitalism and the health care industry aren't exactly compatible."

Bull. They ARE compatible. It is the government's intrusion into the healthcare industry, notably the introduction of Medicare/Medicaid in the mid-60s, that has triggered an explosion in costs. Once the government started paying the bills, no one was "incentivized" to lower prices or costs. See here and here.
posted by davidmsc at 2:27 PM on February 18, 2002

if joe popcorn acquires his functional knowledge and worldview from motion picture shows then he deserves be taken off life support.
posted by quonsar at 2:29 PM on February 18, 2002

Ok, it's the heartless insensitive physician commenting: There is a widely held perception that physicians are somehow hamstrung by a health plan's decision to pay or not. They are not. Physicians are morally, ethically and legally bound to provide the best medical judgment. Period. Gag clauses have been roundly defeated so physicians can and should say, "You need this expensive test because of these medical issues but your insurance doesn't cover it. You as a patient have a decision to make." I would gleefully incur debt to save my family and no insurance policy forbids me paying for my own care.

That said, there is no incompatability between health care and capitalism. Insurance is about covering expenses that you don't want or might be able to afford yourself. Why should insurance pay for annual check-ups or immunizations? Does car insurance pay for oil changes? It's the American consumer that is incompatable with healthcare and often capitalism itself.
posted by shagoth at 2:50 PM on February 18, 2002

Good point, shagoth, which raises an interesting issue: why is "healthcare" insurance treated differently than any other kind, and so often tied to employment? It should be just like car insurance. After all, when you switch jobs, you don't have to worry about the "portability" of your car insurance, or switch carriers.
posted by davidmsc at 2:57 PM on February 18, 2002

here's three reasons why capitalism and health care don't mix:

1. supply and demand. by the very nature of the work that they do, doctors and other health care providers control both the supply and demand for their services. Doctors tell people what health care services they need to buy and then the very same doctors supply those services. As nice as this situation is for doctors, this is not condusive to a functioning market. A functioning market requires that consumers have good information and in health care that is usually just not feasible, unless we want to send everyone to medical school for a few years.

2. employer-based insurnace. most of us get our insurance through our jobs. we don't pay for it, or we don't pay for enough of it to matter when it comes time to make decisions about costly health care treatment options. so of course we are going to demand the best health care money can buy -- it's not our money that's buying it!

3. compassion. to have a truly market-based health care system, we'd have to be willing to let people die because they couldn't afford to pay for health care. it wouldn't just be poor people either that we'd have to let die, it would also be chronically ill people and the elderly, whose health care costs are higher than their incomes. davidmsc might be willing to sacrifice these folks to the almighty invisible hand, but I don't think he speaks for the rest of us.

all the other industrialized countries on earth provide health care to all of their citizens and spend a small percentage of GDP doing it. A single-payor system is far more efficient because of the massive economies of scale and allows for an intelligent allocation of scarce resources. When will the U.S. get with the program?
posted by boltman at 3:10 PM on February 18, 2002

Again, healthcare insurance isn't really insurance at all, so it certainly can't be treated like other insurance.

As far as the rising costs in the health care industry, it's purely the result of the greater ability to treat diseases, mostly with drugs. 40 years ago, drugs were a minor part of medical costs; now they are probably the biggest single factor.

The object of modern medicine is to keep everybody alive and healthy. A system based on supply and demand is simply not set up to achieve that goal. Should transplants go only to the highest bidders?
posted by gspira at 3:18 PM on February 18, 2002

I felt that way during Clinton's attempt to socialize medicine, and I still feel that way. And, my views are backed up by every single Canadian I talk to. Every one, without fail.

I wonder how many poor/lower class canadians you've talked to? I know you are just relaying ancedotes, but I'd be careful about drawing conclusions from it.

It seems pretty clear there are two extremes:
1. A completely deregulated health care industry, you can't pay, you go into debt, or you die (this last bit, um, would be the distinction from other kinds of insurance, for those of you who are asking that question).

2. A heavily regulated health care industry, with gaurenteed health care. This, of course, comes with the costs of beauracracy, takes incentive away from health care companies, and means higher taxes.

Frankly, I find some of the inimations that #1 above would work a bit naive (maybe intentionally so). Corporations (rightly so) are motivated by profit, and profit only, so it'd be pretty stupid for them to go out of their way to help people who can't pay. If you're response is that the poor who die or suffer because of this are not a concern, I guess we've found the crux of where we disagree. I strongly believe there needs to be some kind of minimal gaurenteed health care, despite the costs in taxes, beauracratic inefficiencies, and abuse of the system. Better that than the alternative.
posted by malphigian at 3:25 PM on February 18, 2002

davidmsc: Medicare and Medicaid increased costs mainly because more money was flushed into the system, while no cost controls were imposed in connection with it. You can't honestly look at what other countries have done, or what Hawaii has done at home, (employer mandate, prevention stressed, etc.) and say with a straight face that government intervention results in higher prices every time. It's how the government intervenes, as much as whether it does. People don't live as long here for all we pay regardless. Wake up.
posted by raysmj at 3:41 PM on February 18, 2002

And, yeah, prices rose as a result of Medicare/Medicaid, but there are other factors involved there. More companies started paying health benefits in a then-unprecedented boom era, technology was developed, etc. (Sheesh. Most people in the Deep South, where I live, were just being introduced to serious modern medicine, really, even if plenty of advances took place here.) Prices really exploded in the 1980s, and they exploded worldwide. Where's your convenient government target for that?
posted by raysmj at 3:48 PM on February 18, 2002

why is "healthcare" insurance treated differently than any other kind, and so often tied to employment? It should be just like car insurance.

The only reason it's so often tied to employment is because it's a benefit most employers offer to full-time staffers in order to entice them to work there. They don't have to offer you health insurance if they don't want to, and you don't have to get a full-time job in order to get health insurance. Plenty of companies sell health coverage to individuals. You'll generally have to pass a physical, and of course you'll have to pay the entire monthly premium yourself (most businesses split the cost with the employee), but if that's the way you want to go, you can.
posted by aaron at 4:10 PM on February 18, 2002

Okay, okay, if you want to get down to semantics, yes, health care and capitalism are compatible. Providing health services can occur in a capitalist society, and those that can afford them can use them. Supply. Demand. Ad nauseum.

But can you really say that health care services are merely a matter of payment? There's a priceless value on life, and just because you can't put a dollar value on someone's life doesn't mean they don't count. Do some people in this discussion also support Philip Morris' report on the cost-effectiveness of smoking? Other countries can do it. Do you really think the US is special?

Medicare spends 2-3% on administrative costs; HMOs spend, on average, 9.5%. (Or more.)
posted by gramcracker at 5:06 PM on February 18, 2002

There's a priceless value on life, and just because you can't put a dollar value on someone's life doesn't mean they don't count.

This is wrong. There are not infinite dollars available to spend on health care. The choice as to who gets treatment and who does not must be made. Pretending otherwise merely increases your chances of making the wrong choice.
posted by jaek at 5:17 PM on February 18, 2002

A clarification: you don't have to make that decision based on the individual patient's ability to pay. Sometimes that is the best way to do things (laser eye surgery), sometimes it's not (childhood immunizations). Sometimes it's unclear. But saying that human life is priceless is among the worst kinds of sticking-one's-head-in-the-sand out there.
posted by jaek at 5:43 PM on February 18, 2002

Jaek, I never said there's an infinite amount of money that could be spent on healthcare. Yes, there are limited resources. You misinterpreted my statement. Life is precious. Life is valuable. Those are moral arguments I'm making, not economic ones. No, it doesn't appear to be the case that every person can have every medical procedure they need.

You can ration health care based on the procedure's ability to save life (as is done in... Norway, I believe?), based on certain core values decided upon by the community (as is done in Oregon's health program), by age, by ability to pay, by any number of criteria.

No, not everyone can receive every procedure. But I believe that everyone should receive some basic level of care, no matter their ability to pay. (And emergency rooms are expensive. Give people access to a doctor before they get sick enough to go to the emergency room, and you'll save money in the long-run. Prevention.)
posted by gramcracker at 5:57 PM on February 18, 2002

hadashi said: felt that way during Clinton's attempt to socialize medicine, and I still feel that way. And, my views are backed up by every single Canadian I talk to. Every one, without fail. In fact, a couple of them even told me that the US healthcare system was one of the primary factors for moving here, one of them so he had a chance of getting a heart operation for his mother. No, I don't have signed affidavits so I can't actually prove any of that...


If you cannot see what the selection bias is when you are talking to Canadian expats then you should certainly continue to beleive that Canadians are unhappy with universal health care. However, you might want to steer clear of wondering why we still have it if we despise it so much and why no politician has the courage to openly attack it. It could cause unpleasant dissonance if you were to come to the conclusion that not only is it popular but it is considered politically untouchable.
posted by srboisvert at 6:01 PM on February 18, 2002

Hadashi: well, let me be the first Canadian to tell you that I *NEVER* want to see an American-style healthcare system in Canada.

By no means is our Canadian system perfect, but it is leagues ahead of your system.

Please refer to a link I posted earlier in this thread. I suspect much of your knowledge of the Canadian system is based on media misinformation.
posted by five fresh fish at 6:48 PM on February 18, 2002

i'm surprised no one has brought up the horrible acting done by the kid.. i was actually embarassed for him, whenever he started doing his whole flexing thing. and the ending? oo, that made me cringe.
posted by lotsofno at 7:10 PM on February 18, 2002

By no means is our Canadian system perfect, but it is leagues ahead of your system.


I still don't understand why some Canadians would come to the U.S. for their healthcare needs when the Canadian system is "leagues ahead" of the system in the U.S.
posted by gyc at 7:46 PM on February 18, 2002

mark13,

Let me be the first to suggest that Mickey Mantle has done more to bring joy and happiness to society than a random poster to a blog (such as you) ever will.

Your desire to have denied him a liver transplant has a lot to do with your ignorance of his disease and some achievement jealousy to boot.
posted by Real9 at 8:14 PM on February 18, 2002

why don't the writers/research people do their job? they should have asked a nurse (like me) to look after the technical details--yet another reason I won't see a medical movie. Glad I saw the MacLaughlin link.

I also agree with gyc--have seen many Canadians cross the border when they are ill.
posted by RunsWithBandageScissors at 8:29 PM on February 18, 2002

I still remember when a visit to the doctor involved the patient and the doctor, and at the end of the visit the patient payed a reasonable fee for the services. Doctors didn't become exaggeratedly wealthy, and the profession had respect and satisfaction in it.
Then came the insurance companies, first providing a seemingly wider reach of health services. Doctors began to charge exorbitant fees and the patients didn't care because it didn't come directly out of their pockets.
To deal with the paperwork, doctors offices became large bureaucracies, and the situation reached a point when an individual could not get medical care without insurance, because it would have been too expensive.
Right now the insurance business decides what doctors may or may not do, what services patients may or may not get. It has become an overblown bureaucracy, wherein healthcare is not an issue, profits are. There are still doctors out there with integrity, but more and more of them tow the line, working for the insurance companies and not for the sick.
What is sometimes also forgotten is that the insurance companies get payed by the insurers, and when they are withholding services or medication they are, in fact, breaking a contract.
posted by semmi at 8:40 PM on February 18, 2002

gyc: Weird, eh? I hear some Canadians even prefer American beer.
posted by ODiV at 8:40 PM on February 18, 2002

As spira said Mickey Mantle waited in line. Walter Payton died on that line rich, famous, and much-loved.
posted by john at 9:00 PM on February 18, 2002

the free medical coverage available to the poorest of the poor in the US is leagues ahead of where it was even 30 years ago. The reason is Capatilism.
posted by Mick at 9:10 PM on February 18, 2002

I still remember when a visit to the doctor involved the patient and the doctor, and at the end of the visit the patient payed a reasonable fee for the services. Doctors didn't become exaggeratedly wealthy, and the profession had respect and satisfaction in it.

You pay more for medical care these days, but you get more too. If you don't want to see specialists, have advanced procedures, or take non-generic drugs, you can probably get medical care for not much more (in then-year dollars, of course) than you did then.

What is sometimes also forgotten is that the insurance companies get payed by the insurers, and when they are withholding services or medication they are, in fact, breaking a contract.

If this were actually the case, they'd be getting their asses handed to them in court. Health insurance policies don't say that the insurance company will cover any and all treatments - you pay more to get more coverage, just like anything else.
posted by jaek at 9:15 PM on February 18, 2002

the free medical coverage available to the poorest of the poor in the US is leagues ahead of where it was even 30 years ago. The reason is Capatilism.

err, no. charity care is available because of non-profit hospitals and insurers and because of surplusage resulting from the imperfections in the health care market. The more competative (i.e. capitalistic) the market for health care becomes, the less surplus there is left over to give to the poor. In a pure market, hospitals that provided charity care would be put out of business by their more "efficient" competitors.
posted by boltman at 9:49 PM on February 18, 2002

I'm currently unemployed, and I'm getting just as good health care right now as I ever did when I had a job and insurance. And with the exception of the 12% of the funding of the clinic I go to that comes from federal grants (yes, I asked), every bit it is from private sources: capitalism. The clinic, while nonprofit, is privately run. Everyone there, from the secretaries to the doctors is donating their time. The clinic has its own pharmacy, where every prescription is only $2 (and free if you don't even have that), because the Evil Drug Multinationals provide all the medication for free. By signing up there, you get a pseudo-insurance card that allows you full access to either one of the two local PRIVATE hospitals for any sorts of medical services you might need there. (So far I've had blood work and a sleep study done there, ~$1500 worth of services, absolutely free.) In fact, in one or two minor ways, it's even better; the pharmacy fills your prescriptions in as little as two minutes, not two hours like when you go to a commercial pharmacy. And the doctor is often willing to spend more time talking to you about your concerns, because he's there to give back to the community, not make cash. (And no, socialized medicine wouldn't solve either of those; the lines would be worse at the pharmacy because EVERYONE would be there, and the doctors would still be *ahem* "encouraged" to spend no more than X minutes per patient in order to keep costs down for the government.)

I'll admit I have no idea how good that clinic card would be if I suddenly found out I needed an organ transplant. But it's equally true that insurance companies and socialized health programs take long hard looks at all such requests themselves.

But in the end, most "uninsured" Americans have some sort of access to most, if not all, of the health care they need.

As for the Canadians' view of their health care system, I think it's a combination of pride - it makes them feel morally superior to have socialized medicine that "covers everyone", even if only mediocrely, unlike those Neanderthal Americans that let their uninsured citizens die in the street - and a bit of the old "the devil you know vs. the devil you don't" conundrum. For all its flaws, at least it's there, and too many people are scared to consider changing it. Besides, to even consider changing it would again be considered a blow to national pride.

In a pure market, hospitals that provided charity care would be put out of business by their more "efficient" competitors.

Luckily, the United States is not a pure laissez-faire capitalistic society, so there's no worry here. We're not Hong Kong. We have regulations. But we're still capitalists.
posted by aaron at 10:00 PM on February 18, 2002

As for the Canadians' view of their health care system, I think it's a combination of pride - it makes them feel morally superior to have socialized medicine that "covers everyone", even if only mediocrely

Really? They live longer than Americans do, on average.
posted by raysmj at 10:05 PM on February 18, 2002

RunsWithBandageScissors : I thought you lived in Florida. Did you once live near the border? Still work there on occasion, what? Not a hostile question. Just asking.
posted by raysmj at 10:12 PM on February 18, 2002

Aaron pointed out something very important there: capitalist healthcare does not somehow rule out charity services. There is no rule for capitalism that says you can't give back to the community, just that you're not forced to. I am an optimist, I admit, but I think that if we would get rid of the stigma against charity healthcare in the U.S. most of the current problems could be solved easily.
posted by Nothing at 11:20 PM on February 18, 2002

Really? They live longer than Americans do, on average.

Since "life expectancy" statistics encompass everything from climate to pollution to eating and drinking habits and everything else under the sun, they're not much of an argument for or against any one of those things, including health care. American and Canadian cultural differences alone could explain the differences. (Even Canada itself argues it's largely a matter of environmental quality (see 4th graf).

It doesn't help matters that you can pull up about 30 different sets of life expectancy rankings on Google, none of which agree with each other. Or that almost all of the studies were doing for blatantly political purposes of one sort or another.
posted by aaron at 12:45 AM on February 19, 2002

Aaron: But what else do you have to go on? (My info comes from a text with info provided by the governments of each nation, which happens to be at another locale at the moment.) How can you say that Canada's health care is mediocre? What other stats do you have to go on? Are you in favor of cleaning up the environment here, by any means necessary? Should we care at all, or just hope charity comes along and takes care of everything at some point?

In any case, I've *never* had access to practically free or dirt cheap pharmaceuticals and can say with some certainty here that most people couldn't imagine that. (Sheesh. One place I lived was the Miss. Delta. You think charities were all over that place, going all out to help the 25 percent or more living below the poverty level there? Think again.) The idea that charity could take care of everything is more utopian than thinking that any universal health care system - and Canada's is far from the only, or even the best, model in this department- would solve all our problems forever.

Our health care system can be a train wreck, depending on where you live and what options you have in your health plan. (OK, it's a train wreck for being so inconsistent, alone.) I can't believe, really, that when I go to the doc I have to ask what the stats are they're collecting about me. Y'know, blood pressure, all that. They never, ever say. You're not given any incentive to go back for regular check-ups. It's never been any different, under any health plan. I would think that encouraging the above for all the population would cut costs dramatically in less than a decade.
posted by raysmj at 7:57 AM on February 19, 2002

And with the exception of the 12% of the funding of the clinic I go to that comes from federal grants.

With 12 percent federal funding of enough near-free clinics to serve all of America's uninsured, you're easily talking a multi-trillion dollar program, one that would make Medicare/Medicaid look smallish by comparison. Good luck getting that policy through the D.C. maze, especially given a near-certain deficit and debt to pay down.
posted by raysmj at 8:17 AM on February 19, 2002

[crosspost from plastic:]

i like the idea of state health care. national health care seems too unwieldy to me. washington sort of has one.

military health care seems pretty great, too btw.
posted by kliuless at 8:41 AM on February 19, 2002

really, health care should be a right

You do have a right to (some) health care in the USA. The tough question is how much health care everyone should have a right to. Some people think it should be more than the current obligation of hospital ERs to stabilize someone in an emergency. Most people realize we don't have enough money to draw the line so that everyone who could use a transplant gets one. But where between those extremes do we draw the line?
posted by straight at 1:36 PM on February 19, 2002

Private, social, I don't care what happens, as long as it is voluntary. I have no interest in being drafted into a health scheme, and remind you all that there is nothing stopping you from forming your own system with your own money.
posted by thirteen at 6:08 PM on February 19, 2002

raysmg--no hostility taken. yes I live in Florida. doesn't mean I have always worked here or have always lived here. and I've worked with a lot of Canadian nurses that come to the U.S. because of the way they treat their nurses, too!
posted by RunsWithBandageScissors at 8:40 PM on February 19, 2002

Yes, we routinely tie nurses to trellises and let patients suffering hangnails whip them. After that, we force the old people to pour vinegar in the cuts, and pay small, cancer-striken children to rub salt in afterward.

Instead of listening to someone from Florida who has obviously limited his dataset to the disaffected who've flown the country, please read Canada's Burning!, an expose on the media lies regarding Canadian healthcare.
posted by five fresh fish at 9:33 AM on February 20, 2002