Sicko: Beyond the 'Health Care Horror Stories'

Last weekend in a sneak preview I watched Michael Moore's new documentary, "Sicko." I was prepared to see a bunch of nightmare stories about people getting cut off insurance and people suffering and even dying because of bad decisions profit-driven corporate insurers made, and that is what I saw. I was ready for Moore to use these stories to make a call for universal health care, and this is what he does, and he does a fabulous job.

Moore has reached out to YouTube, Oprah and other outlets to spur Americans to air their own "horror stories" to raise awareness of the unethical actions of insurers acting for profit. But these outlets aren't going to capture a big part of the story of "universal" health care.

What matters so much about a universal system is not just that it covers huge costs of life-saving treatments; what matters most is that it levels the playing field and gives basic care to everyone. This is why other countries call it "universal," not "single-payer." And basic care includes not just dramatic or expensive treatments that look great on Oprah; it also includes preventive care and treatment for mundane problems that can and do happen to everyone-the stuff that maybe doesn't give good film, but which is truly "universal."

Here's what a universal health care system means to me: It means anywhere you go-any hospital, any doctor-you can get care for your baby when he starts to spit up uncontrollably. That's what happened when we moved to London when our son was three months old. My husband was teaching a semester abroad; I was a new mother; Jonathan developed gastric reflux. I knew the NHS would treat him and pay for the treatment. What I didn't know about was their attitude toward treating us. The field is level: British doctors don't look down on patients who can't pay, because British doctors never raise the issue of money.

Taking money out of the health-care equation also removes anxiety from health care. You get to feel that you deserve the care, not because you can or cannot pay, but because you're a human being living in society, and in society human beings take care of each other. It's no coincidence that the words "hospital" and "hospitality" share the same Old French linguistic root, meaning to receive travelers and strangers with liberality and goodwill. The idea and the impetus has been around for centuries.

If I were going to tell Oprah a story, it would be this (it's not a horror story, but it further exemplifies "universal" health care): Two days before we flew back to the States, my London doctor gave me an IUD. This relieved a nagging problem I hadn't a clue how to solve. My American midwife had urged me to choose a birth-control method before I left. My insurer would cover any hormonal or surgical method, but at 33 I wasn't ready for sterility, and estrogen was no-go because it aggravates my migraines and mood-swings. I needed an effective, low-cost reversible birth-control method; research says that is the IUD. But my health-plan wasn't interested in this medical problem; they just wouldn't pay. My best option would cost $500.

This scenario is neither Oprah-sexy nor YouTube-worthy. But preventing unwanted pregnancy is an ongoing, recurrent problem that causes a great deal of conflict and stress for women. Which is why, the day the British GP inserted my IUD, I walked out of her office on light feet: the system had solved my problem. For the next nine years, if I chose, I would not have to give one thought or one dollar to birth control. My gratitude felt boundless.

Moore says his film is about the 250 million Americans with health insurance. Mostly, it was about insured Americans who have faced terrible health problems and unethical, even lethal decisions from their insurers. There are many more Americans who face a multitude of daily, commonplace hassles-co-pay and premium increases, medication formulary changes, prior authorization requirements, time limits on doctor visits, and on and on. As Moore says, the World Health Organization rates the U.S. as having the 38th best health care system in the world, just above Slovenia. We live with substandard health care every day because of the tenuousness of insurance coverage in this country. How safe and strong and healthy can our society be, if so many people are so fearful about a need as basic as health care?

"First of all," one blogger wrote about "Sicko," "there is no right to health care. None!" Corporate insurers and the politicians they lobby have nearly succeded in completely erasing from American consciousness the belief that health care is a social right. A study published in the Journal of the American Medical Association shows the leading causes of death in our society-the use of tobacco, alcohol and illegal drugs; diet and activity habits; and firearms, sexual behavior, and motor vehicles-are all factors amenable to preventive and public health interventions. Preventing the illnesses these factors cause is far less expensive in the long run than treating those problems in full bloom. And as far as the taxes required to fund a universal system, the polls are clear: a May CNN poll found 64 percent of Americans want to pay higher taxes to get a government-run national health insurance program; New York Times/CBS and NBC/Wall Street Journal polls came up with similar numbers.

If you watch "Sicko" and you want to be part of the dialogue but have no horror story to file with YouTube or Oprah, write or film your ordinary story anyway. These outlets need to know the entire spectrum of problems. Health care is about basic care for regular folks: the dramatic, life-and-death stories aren't the beginning and end of the universal health-care debate.

Jennifer Matesa is a freelance writer with a focus on families, birthing and health care. Her first book, Navel-Gazing: The Days and Nights of a Mother in the Making, won a community-service award from Lamaze.

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