Over the past couple weeks our friend Mark at the Lean Blog has been tackling a subject I’ve astutely avoided… Michael Moore’s latest rant, Sicko. His two main posts on the subject are here and here. I’ll comment a bit on his posts in a minute, but first I’d like to quote an interesting tidbit of his statistical analysis.
Michael Moore keeps screaming that 18,000 Americans without insurance die each year. That’s awful, don’t get me wrong. If you take the number as approximately 47,000,000 Americans who don’t have insurance, that’s a "death rate" of 0.000383.
The U.S. population, per Google, is approximately 301,000,000. That gives us 254,000,000 WITH insurance. If you believe the oft-cited Institute of Medicine numbers, 98,000 Americans die each year because of preventable medical mistakes. Also a tragedy. That’s a rate of 0.000386. Basically the same rates.
Hmmm… kinda makes you think. Of course there are reasons and nuances, but the bottom line is that the analysis of statistics should always be questioned, especially when they come from an… uh… slightly biased perspective.
Mark knows a lot about lean healthcare, and correctly analyzes the movie and current healthcare situation.
One thing that was powerfully reinforced to me during the Global Lean Healthcare Summit that I just attended is that we have to separate our world’s healthcare problems into a few categories:
- Problems with access to care
- Problems with delivery of care
“Sicko” appears to focus solely on the first problem.
With a large number of uninsured, the U.S. does have a problem with access to care. Or perhaps cost effective access to care, as many of those without insurance do actually access care via very expensive emergency rooms.
The first problem, the lack of access to care – and Moore focuses less on the uninsured than on those with insurance who get systemically screwed by the insurers and HMO’s. Moore than beats the audience over the head with his simplistic view that socialized, government-run systems are better (and practically Utopian).
From what I’ve read, “Sicko” largely ignores (or completely ignores) the problem of waiting times for people who DO, in theory, have coverage in socialized medicine countries like Canada and the U.K. You have coverage and can get routine or elective care, but the waiting times might still be outrageous. Is waiting two years for a hip replacement surgery any better for your quality of life (when you’re 85) than NOT being able to get the surgery?
Anyone who has dealt with the current Social Security or Medicare bureaucracy knows the nirvana that socialized medicine would become.
Those of you that watched CNN (not Fox!) last night saw how their medical correspondent Sanjay Gupta systematically discounted many of Moore’s statistics, or in most cases lack of the full story. As Mark eloquently put it,
Ironically enough, Moore complained that he would probably be edited and parts of the interview would be left on the cutting room floor to make him look bad. I guess he’s familiar with the method…
Probably the one I liked best was how Moore points to France as the perfect model of socialized medicine. In his movie you hear about the wonders of a system that charges less for sicker patients, short waiting times, and the like. What you don’t hear is that their system is running rapidly increasing deficits, and to close them France is looking at privatizing and capitating many aspects by implementing the U.S. HMO model. As Gupta puts it,
Americans do pay more, but the United States also ranks highest in patient satisfaction. And Americans have shorter wait times than everyone but Germans when seeking non-emergency elective procedures like hip replacement, cataract surgery or knee repair. That’s not something you’ll see in Sicko.
In business, and especially politics, look for all the statistics. Sometimes they might tell an inconvenient truth… about inconvenient truths.