I agree totally. I am frightened by the health care system. My dad had a successful surgery but died of hospital infections.

I recently went to my doctor to get the process going to fix my shoulder problem. I have severe pain and tingling in my right shoulder. I found out that I have arthritis in my neck. The doctor suggested therapy and chiropractic care as options, but gave me Vicodin for the pain. I will not take Vicodin. I am trying exercises to remedy the situation and went to a massage therapist who deals in healing therapies. The therapist wasn't covered by insurance, however. He helped, but I have a ways to go. I still haven't taken a Vicodin for pain.

Dr. Hyman,

Wow, a disappointing simplistic view of Moore's movie. You accept the major point of Moore's movie - that millions of people need access healthcare. You critique his solution - single payer - and but then don't offer anything more than "we need to do better."

But just the notion that everyone should have access to healthcare is a big deal, and one that many with interests in the current system don't accept. And those who are against changing the system will grab onto this kind of critique and use to not have change.

It's easy to attack Canada, but my Mom goes to them for her prescription drugs, because she saves 300/month. And, as it turns out, other countries that have a single payer system and spend less per capita than we do, have better healthcare - the US spends the most, but doesn't have the best. Canada spends far less than we do, that's why the doctors don't make as much, not because of single payer. But the results they get compared to what they pay should embarrass us.

I get your broader point - that preventive care is where it's at (of course I agree) and that you fear that "someone will lose" if we go to single payer. But right now millions and millions of people are losing. Insurance companies are doing great. Pharmaceutical companies are doing wonderfully. Businesses that don't provide healthcare to their employees are doing great. Do they need to keep "winning" in your formulation in order to have a successful new system?

I don't understand why you're going after Michael Moore so hard. From the tone of your blog it seems like you're expecting him to come up with a 'perfect' solution to the health care crisis in the US. First and foremost Michael Moore is not a doctor - but he is doing what US doctors are not doing; and that is, creating an awareness of an alternative to the medical and financial crisis many Americans face today.
You say the Canadian health care system is not all it's cracked up to be. Of course it's not perfect; but rest assured, as a Canadian (who has lived in the US) I do know that I will be able to get medical help when I need it. As a matter of fact, if it weren't for the Canadian medicare system, I would probably not be writing this reply today. Having free access to a physician and hospital when I need it, is something uninsured Americans do not have. Add to that - the insurance companies have a 'peak financial limit' for their clients - that means if your claim runs out - you will just have to die!! That in my opinion is criminal and they should be prosecuted. It is a given, that people will at one time or another need medical help; particularly the aged. I have heard too many horror stories of American losing their retirement incomes, homes and even their lives - because they cannot afford the astronomical medical fees and prescription drug costs in the US.
Don't misunderstand me here. I am not being anti-American - I'm just trying to correct your skewed representation of the Canadian medical system. On that note, yes we are losing many of our doctors to the US - it is certain doctors in the US make much more than they do in Canada. But on the other hand; we do know that the doctors who remain here .... are not just in it for the money. Yes, we have our flaws; but given the choice of no medical care - or being thrown out of a hospital - or being denied life saving surgery - or life saving medications - because I can't afford it; then give me the flawed Canadian system any day.

Yes you are right in stressing the importance of nutrition and lifestyle etc... Of course you are. But I believe that was not the issue concerning Michael Moore's movie Sicko.
I believe he is trying to demonstrate that every human being should have access to medical care when they need it. I'm curious to know why you did not mention France's health care system, that is recognized as one that works exceptionally well. Of course the populations (French, British, Canadian etc..) pay taxes that contribute directly to their health care system; and perhaps they are not perfect - but when compared with the terror or being aged and sick with little or no insurance in the US... there's no contest.

I believe the solution is right before your eyes. Offer Universal health care... and then get to work on educating the public - re: the benefits of nutrition and lifestyle.

And I think you owe Michael Moore an apology. You are busy shooting the messenger - instead of respecting the message.

I wonder if this will be shown?

Didi Miesen

Thank you

Moore made a movie with a solution for what he sees as a problem.

I think you wanted him to make your movie. He made his. Maybe you should make yours.

Thank you for your comments on Sicko. I have not seen it yet but I applaud Michael Moore for reinforcing the need for the debate which has also been highlighted by the democratic candidates for 2008. I appreciate your attempt to provide guidance, but I would like to see you reach out to Michael Moore and together create a coalition to draft ideas for improving our healthcare system. Clearly the problems are systematic and bigger than anyone person or organization. We need our best minds working together to improve healthcare which impacts not only our health but our competitiveness in the world.

I wish more people within the healthcare system would think like Dr. Hyman or voice their opinion louder if they share the same views. Unfortunately, until BiG Pharmacy and BiG Insurance companies are "fixed" our country will be stuck in the hampster wheel. In my belief, they are responsible for the monster of a healthcare system our country enjoys today. The only hope for change is by the consumers of healthcare and the providers themselves. Until the majority says enough is enough we will continue to have more of the same. Moore's film provides an initial step and a fresh approach at least for a vehicle of social change. Perhaps he will provide another look in a different film about how money does the talking in Big PHarm and Big Insurance, and how it trickles down (or in some cases doesn't "trickle" at all) until the consumer is drowning in its paradigm of red tape and monetary kick-backs. Dr. Hyman has an interesting point that it must be a "win/Win" situation before change can occur. However, clearly the American people are not winning and there are few within the healthcare system that are willing to point it out to us. If it remains easy and lucrative for doctors to dole out the drugs instead of finding the root of an illness, under Pavlov's theory, they will continue to do so and perpetuate disease. Perhaps medical schools should include a course on seeing the big picture along with a lecture on business ethics.
We have all become lazy. Doctors do what is easy and the patient accepts it because, after all, the patient doesn't have a medical degree. Surely what the doctor says is correct?! The American people must wake up and take a stand loudly and clearly. We deserve better and we, as a society, are most capable. However as long as the majority remain uninformed and seemingly disinterested our pitiful healthcare system is doomed. I say kudos to Michael Moore for at least bringing the issue of healthcare to mainstream media, for it is there the people will get the message, maybe even a wake up call.

I have not seen Sicko yet, but feel Michael Moore has brought this problem out in the open and we are at least talking about it. It starts at home teaching people how to eat, what to eat, in order to keep yourself and your family healthy. I put it this way, you take care of your car good oil, gas, maintenance. Maintenance to the body is the same. Its a machine also and needs good fuel to function. I am 60 years young and learned this lesson late in life but I learned it.

What a nasty hit piece (that completely misstates and oversimplifies Moore's movie). I'm extremely disappointed reading your comments, and you've just lost me as a reader/subscriber.

Excellent article!!!!!!

I totally agree.

I agree with your comments that more comes into play; being healthy comes through a number of factors: healthy eating, exercising, etc. However, your comments on the Canadian system are just outright wrong and you come off sounding like an agent of the HMOs.

I'm absolutely appalled that you make sweeping comments about the state of the Canadian system by saying that you are Canadian yourself.

Seriously, how about some numbers? How much did that "poor" doctor you worked with make a year? $200k? Yep, it's hard to live on $200k+ a year. The yearly Lamborgini purchase must really put a damper on things.

Why do doctors move to the US? They move to the US for the typical reasons: 1) atmosphere (climate, larger urban area, etc), 2) family, or 3) money.

Canadian doctor's aren't paid poorly. Let's see some actual numbers instead of giving the typical US media slant on our system and we'll see what you're comparing.

Your conclusions are correct. A few years ago, when I first heard that Moore was doing this movie, I published a challenge to him saying that if he was making a movie about the problems in the health care system, he needed to expose issues such as the ones you discussed (especially the problems associated with factory food). I never heard from him. Neither a publicly nor privately funded health care system will improve our health care. In an ideal world, doctors should be rewarded for having healthy patients, not sick. Kudos to you for exposing the same problems I found in the movie. Keep up the great work!
Pam Killeen, a fellow Canadian and co-author of the NY Times bestselling book, The Great Bird Flu Hoax, with Dr. Mercola.

Dr. Hyman,

I have not seen "Sicko" yet but I have been ill for the past 8 months (Valley Fever), and I know how frustrating and sad our health care system can be. I would like to see more emphasis on "wellness care" and less on treatment (kind-of) of disease. I would like to see the Government stay out of health care, however, as well as the insurance companies. How dare they say how we can be treated, by who or when. Universal Healthcare, a.k.a. Canada, doesn't work. There is a two year waiting period there for surgery.

I hope we can go back to the old way - competition, free choice, an Insurance industry that does NOT interfere with treatment, and a complete revamping of our legal system that allows so many frivolous lawsuits against doctors. The cost of malpractice insurance for them is outrageous.

We would probably improve our health-care system quite a bit if we got rid of all the lawyers, judges and politicians who profit from "punishing" them if they don't comply with "the rules".

One last thing - wouldn't our health care system improve a lot if we didn't have to wait so many years for the FDA to approve a new medicine, and for politics and religion to stay out of our science and discoveries being implemented?

I enjoy your newsletter - thank you.

Honey

P.S. Does anyone really believe that the same Government that can't protect our borders can direct and regulate our health-care?

Don't just criticze Michael Moore....send him your response and hope that it will educate him. He is at least drawing attention to the problem and can reach a much wider audience with your proposals for reform.

I did see Sicko. And yes, it overstates the glories of universal public health. But
You say:
" We have to make it profitable to help patients get healthy, and have business MAKE money by providing preventive care and lifestyle programs that create health."
I agree. But How? The devil is in the details. I'd love to hear a basic plan.
At least Moore addressed the fact that the Insurance companies and Big Pharma -with the help of some doctors- are knowingly committing people to death.
The major move in this century of American- subsidized business- 'greed is good, more greed is better' is a big mountain to move.
What are 'you' doing about it?
The newsletter is great and a good drop in the bucket, so thank you for that.
Sincerely
FBC

I have not seen the docu/movie "Sicko" but I wholeheartedly agree with your assessment of our health care system.....corporations and physicians make their money from keeping us sick. Wellness, preventative medicine, alternative therapies, natural medicines are not encouraged and in some cases the government is trying to prevent citizens from participating in these highly effective treatments.

How sad that the healthiest foods (i.e organic) are the most expensive..how can the average American pay for healthy food....Hamburger helper costs less then buying organic fruits and veggies...which would you choose when you are making minimun wage and trying to raise a family?

I have read both of your books....most recently "The Ultrasimple Diet"....and again wholeheartedly agree with all you have to say...and you even provide healthy food as part of the diet that can be purchased online....but I and many people cannot afford your prices....again I guess health is only for the rich...the rest of use I guess will have to wallow in our fat.

I appreciate your medical insight into the Michael Moore "expose". As a citizen who is cognizant of my responsibility to myself in keeping my body healthy, it is good to know that his whole premise is full of holes and doesn't address the real issue. In ancient times, Eastern philosophy was that doctors were paid to maintain you healthy. Our society has it all backwards!! Thank you for your viewpoints and concrete comments.

i think michael moore is a self promoting idiot who has a particular simplistic view that doesn't take into account true "facts" but pushes the simple solution to complex problems.. i pity the poor people who think he is a genius. he is simply a manipulative self important soulless being. in "bowling for columbine", for instance, there are numerous blogs disputing his presentation of gun facts. he finally had to admit he quoted people out of context, distorted the facts, etc. yet certain people still think he is a genius and a true documentarian. nothing can be further from the truth,

Dear Dr. Hyman,

I think describing SiCKO as "flat out wrong" is very excessively harsh, especially since I don't think that your opinion is all that far off from the core issues presented in Michael Moore's film.

Were you expecting ONE man (i.e. Mr. Moore) to come up with THE solution to health care? If so, you missed the point of the movie entirely - which was to get people focused on the issues and come up with an AMERICAN solution to the problem, taking the best of these other systems and working out the details to fit OUR needs.

I agree with you totally that QUALITY is a MAJOR issue that needs to be addressed as well, and you even used an example from the British system taken directly from SiCKO. So, why do you say that point was not addressed in the film?

You also mention profitability; this is the wrong focus on health care, the main focus of which should be HEALTH and CARE. Profitability should not supersede BASIC CARE for all Americans.

Mr. Moore has mentioned to others that he feels a single payer system should be regulated "like a utility." Utilities ARE profitable, but they are not the insane profits now made by insurance companies denying care to Americans and pharmaceutical industries pushing drugs that are marginally needed and marginally safe while ignoring "unprofitable" illnesses and allowing many to die due to their own greed for greater profitability.

No one suggested that quality should be ignored in health care, just the opposite, as your example from SiCKO showed. However, before a healing of the sick system can be achieved, it first has to be removed from the jaws of the predators that are inflicting the wounds in the first place, and then brought to a safe place where treatment can be administered and healing can take place.

It is this first step that Mr. Moore is advocating in SiCKO, and he is strongly suggesting that the rest of us get involved in getting this process started. Other details can be tweaked when the system is safely out of reach of the predatory influence.

However, I think you will also have to realize that your perspective from Lenox (a fairly wealthy area) is a lot different from the experience of those in, say, Springfield, where some may be choosing between buying food, OR paying the rent, OR health care, and cannot afford many (or any) expensive health products to increase the "quality" of their lives. BASIC care first.

Also, forcing people to BUY insurance by law (as was just passed in Massachusetts) does not address the problem either, for the same reason, above. People will still be forced to choose between basic needs, and many will be forced to default on their insurance "premiums." How can the legislators NOT see that? And what will they do? Deny them health care? That is NO improvement and is symptomatic of the way wealthy people see the poor. They just DO NOT understand.

I would really like to see the two of you, i.e. you and Mr. Moore, get together and have a discussion of the issues some REAL solutions, as you suggest. It appears you have something in common and something more to say and I would like to hear it.

Sincerely, Emily Daniels

i think michael moore is a self promoting idiot who has a particular simplistic view that doesn't take into account true "facts" but pushes the simple solution to complex problems.. i pity the poor people who think he is a genius. he is simply a manipulative self important soulless being. in "bowling for columbine", for instance, there are numerous blogs disputing his presentation of gun facts. he finally had to admit he quoted people out of context, distorted the facts, etc. yet certain people still think he is a genius and a true documentarian. nothing can be further from the truth,

I think the only effective solution to our healthcare woes, when it comes to 'encouraging' better care for patients, is to simply eliminate all protections which currently shield health care providers from being held FULLY accountable for any DAMAGES they inflict on their patients.

In nearly any other case, anyone who causes THIS level of damage to another human being, would be facing serious penalties, even possible jail time. I see no reason why it should be any different, in the case of doctors. They should have to compensate fully, face potential jail time for serious cases of wrongdoing and/or neglect, and they should lose their license to practice medicine as well, in the case of the latter, without exceptions.

As it stands now, most doctors in the US are allowed to go on committing abuses and inflicting damage on their patients, with little or no accountability, for decades! This is just not right, and it gives them the sense that they can pretty much get away with ANYTHING. We've even had instances in this country, where doctors have participated in secret gov't experiments, which maimed and killed many people, or instances where some medical professionals knowingly cooperated with the gov't in 'covering up' illnesses and conditions caused by exposure to clandestine bio-weapons experiments! (see the history of 'The Syphilus Experiments' and former 'Clandestine Radiation Experiments', which were once clandestinely performed on unsuspecting American citizens. While some would assume this could never happen again, I would NEVER assume the same sort of things couldn't happen again, and might even be happening, at this very moment, considering how little accountability was demanded, when the above instances became public knowledge. In fact, all of the doctors who participated in these 'experiments', continued to practice medicine, even after these matters were brought to court, and very little in 'equitable compensation' was offered to their victims, because the gov't continued to shield them from accountability, in exchange for their 'cooperation'.) This is one more circumstance which has given many medical professionals the sense that they are 'above the law', and need not subscribe to any ethical or moral limits in their practice. (since some of the unethical and immoral acts they have been committing, have been fully sanctioned, by our own gov't!) It is very dangerous to give anyone this kind of 'power' over our lives, and I think it's wholly unacceptable.

This last issue also points to a general problem with our gov't, which clearly does not have the level of dedication to preserving and protecting the health of it's own citizens, that it should! And this fact is manifested, at many levels of our society, not just in the one example cited above. Another example would be the way our gov't continues to turn a blind eye to the tobacco industry, continuing to allow the manufacture and sale of a product which has been proven, beyond a shadow of a doubt, to be a complete danger to public health - because for them, the bottom line is the MONEY this product generates, which they are, to some extent, benefiting from, in the form of tax revenue which is flowing into government coffers, from the proceeds of this business. This indicates that the 'priorities' of our nation are far askew, when our own gov't places more value on the dollar bill, than on the health and safety of the citizens it has sworn to protect. In fact, one might even say this a violation of the oath of office they swore to, when they took office, and it could perhaps even be viewed as a form of TREASON against American citizens!

Obviously, the above circumstances point to a problem that is far larger than just the health care system. There seems to be a general breakdown of moral and ethical practices (which are conducive to the health and well being of American citizens) ACROSS THE BOARD, AT ALL LEVELS OF OUR SOCIETY.

This is also the basic problem that is causing protections related to our food supply, to break down. Similar to the situation with the doctors, all those who produce and market unhealthy products to American consumers, should likewise be held fully accountable, facing the possibility of having to pay equitable compensation, spending some real time in jail, and being deprived of their right to continue doing business in the food industry, if they are shown to have abused that right, to the point where the health of Americans has been adversely effected.

There is no good reason why anyone in America should be ALLOWED to market products which cause damage to the health of other human beings. Yet this is what is often happening, and we need to fully face the realities of the situation, and realize and accept that it is often being done, with full knowledge that the products they are marketing, pose a health risk to the public.

It's not going to stop, if we simply ask them 'nicely' to stop doing it.It's not going to stop, until people KNOW they will be held fully accountable for their actions. Not while there's money involved, and I don't think that issue is something that can be changed. People are going to continue those activities which are most profitable for them, and they're not going to cease doing so, until the PENALTIES are severe enough, that it is no longer 'worth it', to them... If they make a million dollars, but have to spend 10 years in jail, and compensate that amount, or more, for their actions, then I think they will quickly reconsider how they go about doing things....

Also, I don't think it would hurt to put some 'caps' on how much doctors are allowed to charge for their services. No way do I believe that the procedures they are performing, actually cost anywhere near as much as they are charging. They are currently enjoying some outrageously large profit margins, I suspect...

I'm not saying that doctors don't have a right to expect to make a good living, for the invaluable services they sometimes perform, but I do think it is somewhat immoral and unethical to expect to 'get rich' from providing necessary health care to fellow citizens, which seems to be how things are now.

The medical profession is not like other 'jobs', there is a moral and ethical responsibility which SHOULD be inherent in this profession, since they are holding people's very lives and health, in their hands. So this is not a profession which should EVER be viewed simply as a cozy way to 'make lots of money'. The public good should be the top priority. I think reasonable and realistic caps on prices they charge for services, could go a long way towards addressing this problem.

Michael Moore has brought the problems of the health care system to the forefront the way Al Gore has opened society's eyes to global warming. Of course you are right about fixing the real causes of poor health in Americans. But this is a totally separate issue from what "Sicko" was about. This movie was about not having choices. Remember, health care isn't always just about poor nutrition. Sometimes people get hit by a bus and need surgery. And they have a basic human right to get it. This is the point Moore was making. He is the first to agree that major renovation is needed to get Americans to eat healthier and stem the problems before they begin. In fact, he has said that his own movie inspired him to eat healthier and he's lost 30 pounds. I'm sure, people who just don't like Michael Moore won't listen to the message -- the same way they put their heads in the sand about global warming because it was Al Gore who made the documentary. That's a childish and close-minded attitude and will only further block any hope of all of us working together to solve these two life-threatening issues.

Dr. Hyman:

I don't like Mr. Moore because I don' like his politics, however, as several of your commentors have suggested, Moore could be well served through some education in natural medicine.

Perhaps he could make a movie, without going to Cuba, that would hit up hard on improved medicine through proper nutrition including supplements. I know that the movie made a few years ago on treating microbes and poor nutrition and lack of general care as portrayed in "Osmosis Jones", and I believe another similar film were excellent about bringing this type of message to adults but more especially to children.

To our good health,

M.C.R.

Amen, brother!

I am a Canadian living in Canada, and while I agree that the North American medical system is antiquated in its approach, it is still better for the masses than no health care at all. My perfect world is functional medicine practiced by medical professionals in a multi-tiered hierarchy to optimize the efficiency of the process - but in the meantime, I need to know that I can go in for risky surgery at a moments notice rather than stay home and die from a medical problem that could have been resolved.

Perhaps the solution is to maintain the emergency/hospital system with only minor quality improvement initiatives and re-vamp the entire general practice industry.

Either way, at least we're talking about it.

I totally agree with your comments. I have not viewed Sicko as I fell Michael Moore never gets it right.

Anyway, I have worked alongside the Health Care system foir over 30 years. I am a manager in the Diagnostic Imaging industry., Our systems are only there to help diagnose disease. So more money is made if you are sick with heart disease or some other illness than if you had been treated and tiaught on to stay healthy.

For many years I have asked Dr. why we don't do more for prevention so we don't need so much cure. Always a shrug of the shoulders.

There are slow advance coming from software and programs that help patients manage their own healthcare and educate themselves on their conditions. The health payers (insurance companies) are the only ones with financial incentives to reduce the cost through better health, BUT they still focus on reducing care engagements rather that focus mostly on the true health of their insureds.

I saw the movie and I was disappointed too. And for the same reason., Doctors should not be paid if they can't make the patient well. I found my own wellness to fibromyalgia through a doctor (MD) who was selling glyconutrients and after 32 years of pain and suffering my pain was gone and I felt like a new person. Just recently I tested it to make sure that I had to keep taking it. I went off it completely for a week and a half. This morning I felt almost as bad as I had for the previous 32 years. I will not go off it again. I am on SS so I do my shopping at Thrift Shops and am very frugal with the money I do have. The only thing that ever gets charged on a credit card is the glyconutrients that come once a month and any repairs that my car might need. My husband and I saw first hand the medical system in Germany. My husband was head doctor of a dispensary in the town where we were stationed. He was always complaining about all the time that the German locals that worked in the dispensary had off when they were sick and how much vacation time they were allowed under their system. He did not realize that it was much better than our system. These people were given time to recover and vacation time to get away from the stress that causes so many of the illnesses that we Americans get. They were great workers at the dispensary and they stayed healthy thanks to the way their medical system worked. My husband worked from sun up to sun down and I suffered from his stress. I was the one who got sick and I divorced him as I knew if I stayed around him I would just get worse. He was not all bad but he could not see the forest for the trees.
Jan Newhouse

The Health Care "industry" is connected with the other industry's such as the drug industry, medical industry, food industry, hospital industry and media industry. None of these "industry's" have any real intention of curing your illnesses as they would lose MONEY. The best way to stop their money machine is to stop paying for health care insurance like I did about 20 years ago. Spend your money on real health by getting some books on natural healing and buy organic foods and locally grown free range meats, eggs, raw milk, raw butter,etc.
If enough people stopped paying for health insurance doctors, drug companys, etc. would have to lower the cost that they charge. I was told by our family doctor many years ago to stay away from doctors and hospitals and I would live to be 120 years old.

First of all, thank you Dr. Hyman for your impassioned comments. I am glad there are physicians that are concerned about how people stay healthy. I hope your numbers are growing.

Physicians are typically (correct me if I am wrong) schooled very well in preventive medicine - health promotion, and nutrition.

Educating providers would be one step that is necessary. There are mid-level providers who seem to do a better overall job of this -
the PAs and nurse practitioners, and nurse-midwives.

I saw Michael's movie and absolutely applaud his efforts. He showed real people talking about their health care systems in Canada and France. He didn't put words into their mouths.

This is a starting place. Not the entire solution. If you waited for all the "players" to agree and wait for the win-win scenario, well... when H.... freezes over is all I have to say about that.

This is probably not going to be a play nice stituation. Change is painful.

I am a health professional who sees that the allopathic approach is really not in everyone's interest. I agree this health care system has terrible flaws in providing quality health care.

If you are a consumer of health care, please be your own best advocate and become educated about your options. I believe the majority of MDs give the best care they can under the circumstances they work in.

What the insurance industry demands from them is certainly an underpinning of how they deliver care. That's why it's critical to change that piece.

First of all, thank you Dr. Hyman for your impassioned comments. I am glad there are physicians that are concerned about how people stay healthy. I hope your numbers are growing.

Physicians are typically (correct me if I am wrong) schooled very well in preventive medicine - health promotion, and nutrition.

Educating providers would be one step that is necessary. There are mid-level providers who seem to do a better overall job of this -
the PAs and nurse practitioners, and nurse-midwives.

I saw Michael's movie and absolutely applaud his efforts. He showed real people talking about their health care systems in Canada and France. He didn't put words into their mouths.

This is a starting place. Not the entire solution. If you waited for all the "players" to agree and wait for the win-win scenario, well... when H.... freezes over is all I have to say about that.

This is probably not going to be a play nice stituation. Change is painful.

I am a health professional who sees that the allopathic approach is really not in everyone's interest. I agree this health care system has terrible flaws in providing quality health care.

If you are a consumer of health care, please be your own best advocate and become educated about your options. I believe the majority of MDs give the best care they can under the circumstances they work in.

What the insurance industry demands from them is certainly an underpinning of how they deliver care. That's why it's critical to change that piece.

With all due respect, as I have the highest admiration for you and the important work you are doing, I really wish you modified your position with respect to "Sicko". Unlike you, I did not see the "take away" message of the film as suggesting that the USA should model any one particular country's universal health care system in how they "deliver" health care. Moore was not trying to say that in the film. The bigger message, elegantly presented throughout in various ways, is that we have to decide if we are a ME society or a WE society. I would suggest that Moore if he wanted to, or some other film maker could, make a sequel to the film and present everything that is wrong with how we deliver healthcare - a huge subject. Moore gave us a look at what happens when the wealthiest country on the planet creates a for-profit health care system. Now we need a good look at just how this affects all of us. For instance, I just learned about a form of healing light therapy that has been approved and practiced widely in Europe for the last 20 years called bioptron light therapy. Yet in this country it has only been approved for cosmetic use to treat acne, wrinkles and scars. When you see the list of ailments they treat, you understand why, as Big Pharma rules here and a goverment for and by the people does not! Everyone - go see "Sicko" ASAP!! I would have preferred to see you support this film, urge your readers to see it AND think about how a universal single payer healthcare system could work in this country when we alter the profit motives.

Dr. Hyman,

Your blog was wonderful, thank you. But like many of those who have already posted, I wish you hadn't titled it as you did. And for those of you who have posted before me who hadn't even seen the movie and yet denigrated it, you are not in a position to weigh in on this matter. Go see the movie, and then criticize it.

I did the documentary and, while Moore isn't able to do everything in 2 hours, he accomplished quite a lot! He DID address incentives, which is the same as your claim. But he does not have your expertise as an insider. I also believe strongly that he was trying, as best as he could, to NOT alienate doctors. He was addressing the system itself, and my guess it was aimed mostly at the government. He has since spoken during interviews about how much respect he has for the medical profession (the men and women themselves).

I, like others, who have posted, would love to see the two of you work together. You have important insight into the problem that MM doesn't have. But he has the ability to reach millions of people (which you do too, but not to the extent that he does). And so think of what a powerful team you would make!! You are both on the same team. His main concern was ACCESS. He rightly pointed out that we now have a 2-tiered system: the haves and the have-nots. Moore has ALWAYS been about justice for poor people. And so he came at the problem through a different door. Your concern is QUALITY. Work together!

The best way for that to happen is by adopting a more collegial attitude. So, now that I have outlined that, let me say that I am thrilled with both you and Michael Moore. Thank you both for talking about these issues, and working to change a very broken system. I, for one, feel blessed that I have read your books, and have adopted the UM lifestyle. My life has changed in ways that are amazing and I am so thankful and grateful for all of your efforts. But to solve this huge problem we need all of you, the Hyman team and the Moore team, to work together.

Hi I also just watched sicko and am a canadian. Is a government paid system the only answer to health care problems absolutely not, but it does make it available to everyone. The one basic premise in Canada is your life is not more valuable if you make more money. Everyone is intitled to health care regardless of your earnings. This is a basic right that should be in all countries. So I do agree alot of work needs to be done to improve things, but I also strongly believe all should have equal access to it. Early detection often saves lives people will go to doctors for annual check ups if it is free. Also after having a serious illness or accident makes it alot easier to recover if your not worried about paying bills and focus on getting better. Healthcare should be a right not a privledge.

sad that you would deprive yourself of so much life-enriching, health-enhancing information and storm out of this community because your ego got the best of you.

Take a look at some of the comments from others who probably share your point of view but have chosen to make a contribution to the debate rather than identifying with negative emotions. Your loss...

Hi there,
I like your comments "BUT" I feel that we need to get rid of most Health insurance since many people abuse it. I saw how it was abused at Bethlehen Steel when I worked there years ago. Some workers would go to the medical clinic for every little thing. One time I smacked my shin very hard on an obsticle in my path while I was operating a crane. My boss ordered me to go get it taken care of at the medical clinic and every day all week long I had to go there to get a large amount of bandage put on it instead of a small patch. On friday I told the nurse that I would take it off right after work and by monday it would be healed up because air could get at it and no vasolene would be on it. This was many yeas ago BUT was a BIG waste of money even then. I dropped my health insurace about 20 years ago because I was paying over $800.00 per year with a $5,000.00 deductable and "never" used it!!! Instead I learned how to stay healthy through healthy ways of eating, etc.
There was no health insurance back before 1950 and you had doctors charging $2.00 for a visit and that was even for house calls. If there was no health insurance today you wouldn't see people going for every test out there because they would have to PAY FOR IT. I have a friend that does this all the time because he wants to get his moneys worth for what he pays in insurance.
I learned back in the 60s when I was at Temple University and lived in Phi Roe Sigma medical frat. house because it was cheap that the interns there only got 8 hours on neutrition. They said that due to all the money the "drug industry" provided for their education they learned mostly about drugs and cutting people up. The interns would come to me for advice on vitamins they could take to stay healthy. I was shocked by this and that was how I learned about the drug industry.
I think a better health insurance plan would be to have a hefty deductable included in the plan to stop people from abusing it. More people would finally take responsibility for their own health and stop eating all the "junk foods" etc.
Rod Stoeckel

I agree 100% with your assessment, and would like to add that we, the people, are
also at fault. Our lives are so busy and
stressful that we don't have time to think
about our health, learn how to stay healthy, or take the time to do those things that are healthy. Instead we buy into the quick fix:
quick foods, quick drugs, the quick solution.
We take ourselves and our kids to the doctors
for a quick fix because we don't want to deal with it. Added to this are the doctors who prescribe the "quick fix" and the drug
companies that promote it. We all need to
turn our thinking around. Perhaps educating
parents and children in school would be helpful.

Tell that to the person who has cancer or is genetically disposed to heart failure. Maybe you could go to hospitals and let the pedestrian who was hit by a drunk driver know that its their fault.

Or god forbid that people become OLD.

No wonder Americans are so sue-happy. I always thought it was because people were greedy; I never imagined that it was because people are trying to finance themselves back to health.

I haven't seen "Sicko" yet. I do agree with you, Dr. It's not a quick fix and one payor for all healthcare is a big mistake! Who would that payor be? Most likely the Federal government. There are many things they currently run that I do not think they are doing a very good job with, so to trust them with the entire healthcare industry is very scary to me.
I do however, think that if there were a way to get rid of heath insurance all together, the quality of care would get better. -Or at least have the room to get better. If the insurances weren't there to put so many rules (ridiculous ones at that) and raise premiums because they allow outragous lawsuits to pay out outragous sums, the cost of healthcare would go down drastically. I also think people should be responsible for their own healthcare -including the payments of it! If a doctor is ordering a procedure on you and you don't think it's neccessary, why on earth would you not say so!!??

I agree with you 100%. My husband was almost near death to finally find out after 3 years that he has celiac disease. The doctors performed every test posssible etc. to find out what was wrong with him and even though he had every symtom of celiac disease they never tested for it! He is recovering, but it ook a lot out of him.
We were at a business seminar a few months back and there was a great speaker there named Barry Asmus who is an ecomomist. He was right on about what he said about our healthcare system. His solution is to let people pay for health care they buy by establishing health savings accounts(HSAs). In a nutshell people would pay for their everyday medical expenses and we would only have insuance for catastophic medical cost. More like the dental industry works. The whole idea is to make the system competitive. There is not enough time to explain his ideas here, but you can check them out in chapter Thirteen of his book "Bulls Don't Blush".

I agree with you 100%. My husband was almost near death to finally find out after 3 years that he has celiac disease. The doctors performed every test posssible etc. to find out what was wrong with him and even though he had every symtom of celiac disease they never tested for it! He is recovering, but it ook a lot out of him.
We were at a business seminar a few months back and there was a great speaker there named Barry Asmus who is an ecomomist. He was right on about what he said about our healthcare system. His solution is to let people pay for health care they buy by establishing health savings accounts(HSAs). In a nutshell people would pay for their everyday medical expenses and we would only have insuance for catastophic medical cost. More like the dental industry works. The whole idea is to make the system competitive. There is not enough time to explain his ideas here, but you can check them out in chapter Thirteen of his book "Bulls Don't Blush, Bears Don't Die."

Our health care system is such a huge problem it's hard to know where to start when searching for solutions to fixing it. I think first that the FDA's power needs to be severely curtailed. They are a big source of corruption and corruption of power in our country (for an explanation of this comment - see Kevin Trudeau's books). They are actually trying to put all manufacturers of supplements and nutrional products out of business! Second, I think our whole health care system needs to focus on preventative health and educating the public on that topic. Third, I agree that doctor's should be paid a bonus for keeping people healthy (as oppposed to writing prescriptions for drugs that make them more and more sick while supposedly alleviating their symptoms). Fourth, the food industry needs to be more closely scrutinized by the public - they should not be allowed to put additives in food that are not on the label, etc. Fifth, people should get a tax credit for keeping themselves healthy, or at least trying their best to in spite of our toxic environment.Sixth, organic food producers should receive a tax incentive, so that the consumer doesn't have to pay so much more for their products.

I think you are overlooking one important point, one which I DO think Mr. Moore attempted to bring out in his movie: The health care industry's profit motive will change dramatically once their industry becomes "socialized."

Today our health care system PROFITS from administering more costly procedures. We need to create a system that doesn't benefit from such actions but rather controls loss by keeping people healthier.

The whole point behind Canada and France's health care solutions is that they took profit motive away from the greedy corporations. Once their systems were standardized it became less costly to keep people healthy than to keep them sick. That's one of the major points of the movie!

You make reference to how our system today is broken because there is more PROFIT derived from $6000 toe amputations vs $60 diet counseling. Think about how that will turn around when the COST to society is $60 vs $6000! We won't have to come up with a way to solve that problem - like a heavy keel, the industry will self rite.

When the health care industry stops thinking about profits and earnings and starts thinking about the most efficient way to manage patient well-being then we will be on the way toward a better system. The only way that can happen is if we take commercial interests out of the prognosis.

Michael Moore is an ass and I would never see one of his movies even if I were paid for it. But I completely agree with you about the real healthcare problem in this country, Dr. Hyman.

Great points and I agree. You ask, "What ideas do you have for fixing our healthcare system?" One could come up with a list of “should do”s. But as ordinary citizens, saying what we SHOULD do has little or nothing to do with what are country WILL do. If we can't see that this is a political issue, our eyes are closed. A broken healthcare system is really just a symptom of a broken governmental system. Healthcare is like many other societal issues: The long term welfare of the people needs to be balanced with the affects on the economy. But the scales are tipped heavily on the side of the economy. Money talks and our legislators of BOTH parties listen. Our legislators are not working for US, the people - they're working for corporate America and special interest groups. They are mired in a “good ole boy” system in which the rich respond to pressure from the rich (money talks LOUDLY) to keep them rich or make them richer. It’s going to take a revolution: The ammunition of the corporations is money – the ammunition of the people is the vote. But the changes that are needed to fix healthcare (and government in general) will never happen as long as the people are apathetic. The lobbyists make effective use of their money while the people waste their votes – either by not voting at all, or by voting for incumbents simply because they “recognize their names”. And we the people need to quit believing that replacing the party in power with the other party is going to get the system fixed. Of course, there are some good people in congress, but if every single senator and representative were replaced today by conscientious citizens who wanted to fix the system, that would open the gates to tremendous progress. The rich and powerful love two-party politics. Two party politics has polarized the people so much that we no longer have a voice at all. We the people, in order to take our government back, need to stop voting by party and elect representatives who will stop playing partisan political games and return to debate in which the goal is to solve the nation’s problems in the most effective way for the nation as a whole; who will reform the system; who will reform campaign financing so that you don’t have to be rich to be elected; who will reform healthcare and other broken systems in way that is mindful of the long term economy, but not enslaved to the short term economy. We’re far from ready for this revolution. We’re too content. And so, despite recognizing that the healthcare system is broken and despite knowing things we SHOULD do to fix it, it will only get worse – until one day we open our windows and shout out, “I’m mad as hell, and I’m not going to take it any more!”

If only other people and doctors saw thins as you do. As a Canadian I think "Sicko" is a determent to the cause. Thanks for your wise observations.

Hi Dr. Hyman,

Where did you find these figures:

"If our healthcare system is responsible for more than 700,000 deaths a year from medical errors, hospital infections, bed sores, surgical errors, drug reactions, and more, which lead to an extra $250 billion in costs, do we want more people to be exposed to this type of care?"

Two days ago I spent 4 hours at the Loyola University Medical Center researching Adverse Drug Reactions and Adverse Drug Events. The most common study cited placed the iatrogenic (doctor/medical care caused) death rate at 106,000 for drug related deaths in the hospital.

This is almost exactly 10x the rate of death from illegal drugs.

Your $250 billion cost is probably understated. If I remember correctly, that's the cost from drug reactions alone.

Thanks for any information.

Burton Kent

I think we are focusing on a tree in this case instead of the forest. In all industries in this country I feel it is a "race to the bottom". Pressure to cost cut, maximive profit at the expense of quality in ALL areas is what is causing our world to become more dangerous and frustrating. I work in a multibillion dollar company that cheats their customers, disreguards their needs, frustrates them to make a penny extra. I have watched my job evolve from helping people to being robot who's primary concern is an arbitrary number that I must target with a proverbial gun to my head. When I meet this number, it is lowered again. It is the tyranny of numbers that is destroying AMERICA! Doctors aren't respected because they too have been caught up in this race to the bottom, no time to work on their knowledge and skills, no time to talk to the patients to even get a grip on the symptoms...they become robotic and hear a buzz word fed by pharmacutical reps and spit out a prescription and say NEXT!
The pressure to "feed the greed" is at the expense of safety and quality!!! Look at the recent scandals with Chinese food proessing and additives...and this is due ONLY to the agribusiness and food manufacturers trying to "cut costs" to save a buck. I take a lot of "natural" suppliments and now I find CHINA is the main supplier of these additives...which makes me wonder...what am I swallowing?...Something is going to have to change but I feel powerless against this machine we call American Business.
Suz

My dear good Doctor:

I'm sorry that you spent your good money to see anything Michael Moore has to say about any subject! But, I also understand your need to do so. It's important to know what will not work to get to what will.

In my opinion, you're on the right track with your orientation toward good "holistic" medical practices.

Never, in a million years, knowing what I know about Hollyweird in general and most of the goofs who live out there would I waste a single penny of my hard-earned money to support anything that (the obese) Mikey Moore would have to say about any subject. I KNOW beyond a doubt there are many better qualified people to speak to those subjects of interest to me.

The most important thought you wrote was:

Promoting and treating sickness should not
generate more profit. Creating health should.

There is a lot of truth on both sides. A single payer plan would eliminate the insurance companies and save a lot of money. I'm on Medicare, which appears to be perfect. If we can afford the Iraq war, we can afford to put everyone on a Medicare program!

Good idea, but if you do get a disease you end up in the emergency room as a charity patient and your stay is paid for by our taxes!

Greg,

You’re dead on.

All these well-meaning folks on this thread clearly see the need for change but I wonder if any of them are taking action that will initiate that change. The founders of this country put in place a system that allows the common folk to direct their fate through representation. We all have federal, state, county, and municipal representatives who would like to remain in office and who, in order to accomplish that, must satisfy their constituents. Sadly, from what I can tell, we common folk have lost touch with that system. We’re so busy trying to get from one day to the next, there’s no time left to become active in a cause, whether it’s health care or another of the plethora of issues plaguing our nation. We can complain about these things till hell freezes over but until we put down our remotes and inundate those in political office with letters, emails, and phone calls, our country will continue in its downward spiral.

So America, don’t blame the medical professionals, the food industry, the insurance companies, or even the politicians. We have no one to blame but ourselves. I guess when we’ve had enough, we’ll do something about it. Apparently, we haven’t had enough yet.

If anyone reading this has interest in taking an active role, the contact information for all of your representatives can be found at www.govengine.com.

No offense Dr. Hyman - but you should stick to being a doctor and leave the movie critiques to the entertainment professionals...thanks!

I applaud Mike Moore for making healthcare the topic of his movie. I agree with your perspective, but Mike shouldn't be faulted for missing it. You've only just begun getting your message out. It hasn't reached him yet. (Have you seen how heavy he is?!)

Mike has fired an initial salvo. I'm glad to see you in the foray that he's created.

Yes, I saw SICKO. I liked it and I also appreciate with your comments today. The problem with our sick healthcare system is massive and Michael Moore only focused on one of the worst problems -- accessibility/cost. Another part of the problem is what you addressed -- the kind of systemic and radical changes that must be made to the healthcare system. One question: what did you think about the segment on healthcare in Cuba? I think it would be wonderful to know more about that system and what kinds of methods are used there. It's amazing that Cuba has the highest doctor to patient ratio in the world. To receive medical care one only had to give name and age. I wish it was that simple and free here.

Thank you for your comments. Yes, it is an inflammatory title, but sometimes it takes that to get people's attention.

I DID see the movie and loved it. I think it causes people to think about our broken system. I don't think it was Michael Moore's goal or result to produce "the answer". At least there is lots of dialogue happening, and maybe more people are seeing the health (care) crisis as a crisis now.

I want to thank you for your blog and your advice. I am a person who has been obese for 25 years, and during the last year I have lost 120 pounds, and have 50 to go. I have dramatically changed my own health - through your help, a weight loss specialist in Beverly Hills and a functional medicine doctor that I met thru one of your blogs. NO surgery, no pills.

I want others to be helped as I have. I have had to pay out of my pocket, even though I have health insurance with Blue Cross of CA. Obesity (other than surgery) is not covered! So part of Michael Moore's answers are relative to me.

Keep writing! And I'm going to be working on some ideas for fixing the system. One is to pass a CHANGED FARM BILL in this session of Congress. I'm talking to my Congressman about that. (Lower the subsidies for corn and soy.)

Pam,
I agree with you. I have lived in countries with national health care systens, Japan, New Zealand. Health care was not a question. When I got sick they took care of me. Here in America things are different. I currently work in public education. Close to 60% of all student in our system do not have medical coverage. Healthy start, and other health care organizationa try to provide. But we need more Doctors who believe in prevention of illness than treating illness. In January I was diagnosed with cancer. We caught it early enough to prevent radiation and chemo. My doctor was great. Kaiser medical has been my program of choice. Preventative medicine all they way. I applaud Dr., Hyman for his insights and encourage more responses.

I have seen the movie Sicko, and I agree with it 100%. I have lived both with insurance (which currently takes nearly $150 out of an already small paycheck each month), and without insurance-which happens to be the primary focus of the broken system that the movie shows.
For my $150 per month insurance, I get virtually no benefit as far as preventative services go-try claiming any type of wellness tests or medications and unfortunately people in my system are turned down. And I'm talking of the same issues that you mention in your blog-weight reduction and smoking cessation being the two that most immediately come to mind. I have gone without medications and played "medication roulette" due to the cost.
Not having insurance is infinately worse. I have a 35% disability to one leg due to substandard care for a leg injury i recieved in 2001. I was covered by workman's comp for that one and received the lousiest care imaginable. I had an injury similar to the first last year and paid through my private insurance-I'm back to 100%. With this injury, and because I had access to private insurance, I was able to receive proper care and aftercare for my injury. And I wasn't made to feel like some sort of scumbag/cheat for using it.
To say that Canadian doctors that you know move here to practice doesn't surprise me-they can get on the gravy train here, make big money for providing services, and not have to worry about dealing with patients they'd rather not have to deal with.
We need to take for profit insurance companies out of the equation-that would allow people to receive proper wellness care that many simply do not bother getting now because the expense is too great. With one system that treats everyone equally, doctors would be freed from the mindnumbing and confusing paperwork that EACH insurance company requires them to complete on each visit. This would free them up to do the job they should be doing-helping the people that come to them. Good nutrition and lifestyle choices need to be taught life long. Freed from the necessity to measure things by what an insurance company will/will not pay for helps the doctors as well as the patient. The cost-benefit of that is pretty high too.

Dear Dr.

Your comments re: doctors in Canada is way outta line. My brother in law is a
family medicine practitioner in Canada. He has a huge beautiful home...six kids...three of which he has put thru med school and the other three seem to want what you infer is a tough life. Sure he sees 50 patients a day but he loves it. They have several cars and besides the big house in a better city district (high end) they have a cottage as well. Money has never been a problem; plenty to go round. they live great lives and feel fully satisfied with their lives. Our medical system works great...Michael was right; as canadians we are very proud of our healthcare system and it is the cornerstone of the pride we have in our democracy north of the 49th. Sure some still go to the US to make the "bigger bucks"
but invariably return to canada to have their families. Kudos to Moore for an excellent expose! Go for it America; its great and it works and there's nothing PINKO about it! FYI I am a newly retired teacher of 35 years with 3 degrees

Dear Dr.

Your comments re: doctors in Canada is way outta line. My brother in law is a
family medicine practitioner in Canada. He has a huge beautiful home...six kids...three of which he has put thru med school and the other three seem to want what you infer is a tough life. Sure he sees 50 patients a day but he loves it. They have several cars and besides the big house in a better city district (high end) they have a cottage as well. Money has never been a problem; plenty to go round. they live great lives and feel fully satisfied with their lifestyle. Our medical system here in Alberta works great and edmonton has the best coronary care unit in the country!...Michael was right; as Canadians we are very proud of our healthcare system and it is the cornerstone of the pride we have in our democracy here north of the 49th parallel. Sure some grads still go to the US to make the "bigger bucks"
but invariably they return to Canada to have their families. Kudos to Moore for an excellent expose! Go for it America; its great and it works and there's nothing PINKO about it! FYI I am a newly retired teacher of 35 years with 3 degrees so I been around the block, so to speak! God bless!

Dr. Hyman,
I have been reading your newsletter for a while now. I love your approach. I trust your opinion so, as you are a physician yourself. This last article brought me to tears. All of it is a true eye opener, however, when I read about closing the hospital diabetic program becasue they weren't profiting from amputations any longer, the tears came to my eyes.
You are a true hero my friend, for bringing these things to light.

Thank you so much,
Steve

P.S. If a single person or a parent did to a child what the government and the corporations are doing to our school children, they would be arrested and prosecuted for child abuse.

Dr. Hyman,

I agree with those who believe that you were quite harsh with your critique of a film that you, as a medical professional, expected much more from than we mere mortals (like Michael Moore) can make--or (like me) will watch. In fact, I was so taken aback by your initial comments against a filmmaker who was just trying to get the common man to think and perhaps take action, that I almost did not read the rest of your article...which I wholeheartedly agree with! I thought Moore's main point was that we do not have to do the exact same thing other countries do, but we certainly need to do something because, in comparison, our system is shameful in so many ways. I hope that all these differing opinions, from yours looking at the industries who stand to lose from our health and preventative measures, to those who spew venom about Michael Moore and Hollyweird (which happened to produce Ronald Reagan), do not cause us again to derail from the main problem--our health care system stinks.

I feel your title for this blog is very misleading. Moore was attempting to expose the the way our system denies coverage and the consequenes to the people in this country. You say you don't like the answer that Moore gave, yet you have no solution. I believe the important thing is to get coverage for every citizen in this country first. It is embarassing to see what this great country has done to its healthcare. Take the profit out of healthcare. I remember back in the 60's when the churches ran the hospitals.
Then the way we treat people's health needs to change. Like you and Mercola I agree that our system only treats the symptons and not the underlying cause. Shining the light on drug, food, FDA, Congressional lobbyists is a start to changing the system. I have already wrote my congressman and told him we have to change to a preventive system of healthcare. We all have to put pressure on the profit driven drug and food companies, as well as Congress to change things. Moore has brought this whole mess we call a healthcare system to the forefront, and for at least that you should thank him.
Larry

Rod
What if you got in a car accident and were in ICU for two weeks. The cost would probably be over 100 grand. How would you pay for that?

I guess Dr. Mark Hyman and I saw (through our different perceptual screens) different parts of the same movie. I missed the entire opening, arriving 15 or 20 minutes late, but Mark seems to have missed most of the good parts that I saw. I came away thinking the best part of the movie was about incentives in the medical business: how some physicians in other countries get paid a decent income by keeping their patients healthy, not by prescribing drugs or by surgery. I did not notice anything saying that universal coverage was the only important thing to consider. I came away thinking that this was a very important movie for all the reasons that Dr. Mark Hyman says are important. In any case, I agree with what is important, but think the movie was very worthwhile.

I do not Michael Moore was flat out wrong at all. I say Sicko and was incredibly moved and now terribly angry. The way we live in America seems just ridiculous to the way of living in some other countries, like France. Please remember when Michael sat around the table with many Americans who now live in France. They mentioned the 6 months paid leave for women & men (i believe) after giving birth, the minimum 5 weeks vacation, the 35 hour work week, the unlimited sick days, the 24 hour doctor house calls, the nanny's that will come to your house...what does all this lead too??? Citizens that are less stressed...human beings that are allowed to focus on their families and not made to feel unproductive because they care about their children, or taking care of themselves and their families. How about the young man that had to go back to France to get cancer treatment? After intense, yet successful chemo, his doctor asked how much time he would need before returning to work. He said 3 months, so that's what he got, at full pay. Imagine the luxury (notice how I called it a luxury, becuase that's the environment we live in here), of having enough time to regain your strength and overall health before returning to work. What would that do to the rates of recurring cancer or other health problems??? I think it would make a dramatic difference, but that is not a luxury that we have in America. America does not seem to look highly on taking care of yourself. Focusing on your own health seems to make you look selfish in this country. I truly think this simple issue and the stress that it causes on our physical, mental, emotional and spiritual health lead to much of our problems. Not to mention the food issues that Dr. Hyman has already focused on.

I also think that a single payer system would stop the focus on profit and providing unnecessary procedures and medications. A single payer system would save money by not doing these things and by actually making people healthier. Now it could also save money by just not providing care that people need, but as a country we would need to fight against that and hopefully doctors would fight against that too. There would be no insurance companies whose only focus increasing profits and shareholder value. How about the doctor in Sicko who earned a bonus for getting patients to quit smoking and decrease reliance on medications?? What if the system could be like that or better??

Michael Moore doesn't have all the answers and I don't think he tried to say that he did. He called MUCH NEEDED ATTENTION to a huge problem in our Country and for that I am thankful. Thankful that someone has the guts, money and talent to put such a documentary together. And whether anyone agrees with him or not, we certainly are talking about it now...and that is a step on the path to change.

Dr. Mark,
Thanks for writing, but don't delude yourself into thinking that anything
that comes out of M. Moore's mouth even remotely resembles thuth or even
something intelligent for that matter. I lived in Flint and Thank God I do
not now! His writing has made him a laughing stock and a blithering idiot!
George

I'm really disappointed in the title and overall tone of this blog. I agree with what you are saying about the quality of our health care system, but that was not the POINT of Michael Moore's movie. The point is, many Americans really believe that we have the best system and that socializing the healthcare system would be a health disaster and is some insidious communist plot against the American Way. They need to understand what is really happening and what could happen to them with profit-driven healthcare.

He makes the point powerfully that far from having the best care here in America, we have a deeply flawed system. That the tiny island of Cuba with it's limited resources cared for USA's 911 heros better than the USA is a shocking punch to the gut, isn't it? What treatment makes people healthiest or live longer is not the central message there. HMOs were created with the express purpose of creating greater profits - specifcally and consciously by providing less care. He shows how vulnerable we ALL are - even if we pay big money every month for health insurance - to being denied necessary medical treatment, watching loved ones die who might have been saved if we lived in another country and/or being completely irrepairably bankrupted. I don't wish to downplay the importance of quality care - but honestly, that is frightening and deserves our attention too.

The lack of quality care regardless of access is another important subject, but NOT the subject of Moore's movie.

Of course the system - what Kaiser and Richard Nixon put in place - the policies and proceedures of insurance companies - the lobbies and laws that enforce this mess - are all undermining the quality of care as well, eliminating any incentive for preventative care, and at times knowingly killing people (and you can't get much lower in quality than that.)

Sure, there's a lot more to say. There are serious problems with the quality of our healthcare even if we have access to it. The quality of medical school education and lack of nutritional understanding among doctors is appalling. The role of our compromised food, our stressful and sedentary lifestyle, deteriorating labor rights and lack of liesure time (or sick time) - sickness in the USA is a huge and complex subject which involves our political sytem, our economy and every major industry.

But why couldn't you have said something like "Sicko - Only Part of the Sick Picture" You could have added valuably to the dialogue without denigrading Mr. Moore's contribution to the discussion. Why attack someone who sticks his neck out to show the disaster our health system has become and adds so valuably to our understanding? Who at least exposes our prediicament of being 45th on the list of countries mortality rates (a fact you point out that was in the movie?) I mean, Michael Moore is not talking about what to do to be healthier (a topic of vital importance no doubt), nor does he pretend to know about that. He is talking about political and systematic coruption, a bamboozeled and victimized populace and what stands in the way of developing all the necessary changes that you are talking about. And that is pretty important too, don't you think?

It's always easy to criticize, and maybe you attacked because it makes a nice grabby headline. I just hope your comments don't result in someone not seeing the movie or appreciating it's intended message.

Stevo
You really should see the movie before you form an opinion about it, doesn't that sound fair enough? btw - if you think Morre has anything at all to do with Hollywood, you really are confused.

The incentive problem you mention goes beyond the clinic and the hospital - it infects the most basic of medical research. For example, it is much more profitable to find a new cancer drug that will increase someone's lifespan by a couple of months (quality of life for those couple of months is largely ignored, which is its own rant) than to take the risk of finding something that will put the cancer into remission. The FDA doesn't help matters much, by categorizing slight variations of cancers in such a way that these "add a few months" drugs are Fast Tracked (a system originally designed to get things like AIDS treatments to market ASAP back before we had any way of controlling it). I say this as someone who worked in biotech as a biologist - I got sick to my stomach looking at the data from our clinical trials and translating that into real-life terms while watching people cheer over getting Fast-Tracked and realizing that these sorts of results are considered not merely acceptable but really good. I'm beginning to think the system is rotten all through. . .

Even though I see your point and would agree with you about many things, I still think your proposed solution is way off base. While reminding us not to idealize Canadian health care, you turn right around and idealize British health care - which leaves a whole, whole lot to be desired. Spend some time talking to British Lyme patients or CFS patients, who basically have to beg for any real treatment at all. Or, ask about the physicians who are persecuted for being medico-politically incorrect. It's an ugly picture.

And I don't think the profit picture improves by rewarding physicians for treating non-illnesses. As nice as it is to have a physician who is wellness-oriented (I have one!), what you propose means...what, exactly to the ill? Do we go begging for care here as they do in England? Basically, I think you're inviting the wrong incentive entirely.

And I certainly wouldn't quote the government on wellness. The CDC recently broke with longstanding tradition and turned the Center for Chronic Diseases over to a psychologist, of all things! And that's the same group that came up with the bogus obesity figures. What effect do you expect that move will have on the chronically ill, really?

You might like to check out Congressmen Ron Paul and Tom Coburn. Both are physicians. I certainly don't agree with them about every point, either. But one great idea is to disconnect health care from employment altogether. How healthy is it for people to keep jobs they hate just for the insurance - or to leave the employer in charge of their health care when the employer is often the very source of injury or illness? (Trust me on this one - it's a bad, bad thing.)

And certainly, don't give it over to government! We aren't exactly short on incompetence and dysfunction in that area. Instead, let people buy whatever they like. Make THAT possible, and the open market will force both Big Insurance and the medical profession to deliver. How American is that? Some people love their HMO's (don't ask me why!) Some people want a holistic practice. Some people need a specialist more than a PCP. Some people want to see you and no one else. Don't dictate direction to people - that never works. We aren't points on a trend chart, or an exercise in epidemiology. Empower and educate instead, and I think we'll all benefit.

I've been ill lately and have seen...oh, maybe about 15 doctors in the last year. Out of those 15 doctors I can honestly say that about 2 (I felt) actually cared about me. I think(some, if not most)U.S. doctors will disagree with this movie, and why?? $$$$$$ what else. If we were to go to Universal Health care, doctors would not have as much control as they do now and probably would lose that big house and BMW parked in their garage. I have an HMO and now I know why I get treated the way I do. My HMO allowed me a "second opinion" but that was it, I wasn't allowed anymore visits with this second opinion doctor???? What was the point??? You know something is wrong when you call the doctor to make an appointment and they ask that question..DO YOU HAVE A PPO OR AN HMO? It's like discrimination, they might as well ask you, are you rich or poor??? I guess I should just be glad or privileged that I have insurance at all. Sorry if I pissed off any doctors, but I think some of you need a better bedside manner, WE ARE PEOPLE, NOT JUST A NUMBER...YA KNOW!!

I think you missed the reason Mr. Moore put the Canadian Health care system in the movie . It wasn't because their system is superior to ours but rather a woman of 22 was denied treatment by her insurance company because "she was to young" to have overy cancer. She lives close to the border and in order to receive care she crossed over .
The basis of the movie was that the insurance companies and drug companies are the reason our system is broke.Hospitals and doctors are being strong armed by both systems to keep costs down and are being rewarded for doing so. Perhaps you should watch the movie again and try to pay attention this time.
I for one have no insurance ! Nor do I want any. I don't trust doctors, insurance companies or drug companies.

Dear Dr. Hyman,
I do not think you have any real experience with being uninsured in this country. Health care isn't just for people who are sick, but also for those who are injured. I am one of those many uninsured Americans Mr.Moore highlighted in his film. I live near his hometown of Flint Michigan in a community devastated by GM. I am a college grad with 15 years of work experience and I am stuck working for a temp agency where I work full-time with no benefits. I am afraid to ride my bike for fear of injury. I could not go to the hospital when I recently lacertated my leg. I live in constant fear of becoming ill or injured because I have no way to pay for care. I rely on borderline-quack remedies and preventative care strategies to keep me healthy. It is true that this health care system needs reforms but let me tell you and the affluent clients at your private health spa; you don't have a clue what millions of people experience every day. Your clients not only can afford health insurance but can also pay for care (in your office) that is not covered by their insurance company. You say that Mr. Moore's movie is a distraction from the real problem which is that our system is antiquated and dangerous. You are telling me that it is better to have no health care at all than have at least access to basic care? Tell me Doctor, when my child wakes in the night with a fever, when I cut my leg open, CAN I CALL YOU? Do the working poor educated deserve to recieve your services? Perhaps if I just take some more supplements and eat an organic carrot it will prevent me from falling off my bike. You ask why medical professionals come to the US? Money. You yourself say that health has to be profitable to fix the problem. News flash: It already is profitable, just the way it is and that is why it is a broken system. That's why docters like you move to the US; why make $100K a year when you can pull down $500K here with a private practice? Why not double that with a book promising to remedy all of what ails us? You are part of the problem, not the solution. A fair and just society cares more for its eldery, its poor, its wounded and ill than it cares for your vacation home. If profit is the underlying factor by which we align our "values, needs, and interests" than our health care system will continue to flourish as it is; broken, second-rate, and totally unavailable to people like me. And take me off your mailing list.
Sincerely,
Nikki
Lansing MI.

AMEN !!

I agree with you that Health Care systems like Canada are missing the boat when they don't look for natural solutions to healing people that often work better and are cheaper. I don't agree that Doctors in Canada are poor. They are among the very highest paid professionals in this country. Doctors here do see a lot of patients in a day, but is that any different than in your country? Doctors from Canada who move to the U.S. often return back to Canada because of problems they experience getting payment for services from either patients or the insurance companies (who apparently will even reject pre-approved payments). It's rare for a Doctor in Canada to go to the U.S. for the money and there has been an influx the other way - U.S. Doctors moving to Canada for the freedom to do research and practice without limitations.

Even though I did not see Sicko, I completely agree with Dr. Hyman analysis of the fundamental issues of our healthcare system. I would refer everyone to a excellent recent article in JAMA written by Michael Porter, a long-standing and famous business writer associated with Harvard, entitled "How Physicians can change the future of healthcare" Journal of the American Medical Association (JAMA) March 14 2007. His main theme is that as long as everyone is focused on cost reduction and cost shifting, nothing will change as each interested party will fight to shift costs to the other parties. The focus should be on improving health and health care value for patients. And in that effort, his view is that physicians must take the lead.
As a current medical student with a 20 years of business experience, this approach makes total sense to me.

Firstly I am a layman without medical training. I did however have a mother who lived to nearly 100 yrs. From my upbringing she developed in me a keen sense of the true value of preventive health. By daily examples of her drinking many glasses of water, walking every day, cooking simple delicious meals varied in healthful methods not requiring a PHD. and little or no alcohol consumption the health of our family required minimal Doctor/dental intervention. I have raised my three children in a similar fashion and they to have benefited as well. For a number of years I have been lecturing, appearing on tv and radio and generally attempting to make people aware as to what is really important in life and teaching tried and true methods of prevention. We are both aware that without our health there can be little accomplished in our lives. Thus far I have attempted in vain to penetrate the failing school systems barrier of ignorance or genuine concern for students health. When administrators compromise students by refusing to remove Vending Machines because the monetary rewards benefiting a club or some other inane reasoning we know we are in trouble. One of my vehicles that has been helpful is a company---Greens Plus--that initially sponsored my competitive Race Walking has helped my work providing a stipend with the understanding that I not sell product but, merely attest to the fact that my performances were truly enhanced. Michael Moores physical appearance is a true testament to one who must have a firm grip on health and fitness as do so many Doctors who are morbidly obese. As a great fan of your work and refreshing candor I am pleased to submit a few thoughts. I am soon to be 73 and we recently celebrated our 50th wedding anniversary and are both in exceptional health.

When you're right, you're right. He's right!

I have catastrophic coverage and avoid going to the doctor because of the huge bills. Having something available that doesn't cost $200 to have someone look at the poison ivy on my arm would be helpful. The writer is totally correct about the lack of any kind of adequate health care for a great many people in this country who are "in between" - we don't qualify for "free" healthcare and we can barely afford basic healthcare. But the doctor is also correct. Just making "stick-a-finger-in-the-dike-with-a-drug" healthcare more affordable and available doesn't fix the current problem that our healthcare system is broken. It is focused on income and not curing people inexpensively. When did the war on cancer begin? So long ago that I can't remember. Was it Nixon? And where are we now? Anyone who actually cures people of cancer threatens the livelyhood of thousands of people. The Chinese had the system right. The doctors got paid when people were well and not when they were sick.

The problem with our Sickness Treatment System (read Health Care System) is so obvious to people like you, but not to the vast majority of people. If the Medicare & Medicaid system could only implement an experimental Program to demonstrate that true Health Care is far less expensive and by the way improves the Quality of life for those who are in the program, then this approach would get a lot of attention. I have no idea of how to make this happen.

David, Thank you for your excellent comments.
Dr. Hyman, Thank you for addressing these issues!!!
In analyzing the logic of your statements about Canada's system, our concern is that politicians and others will use your viewpoint as yet another excuse to avoid a single-payer system.
Just because there are less greed or high-dollar income incentives to doctors to work in a single-payer system, let us not rule it out! Many are suffering in our USA because they cannot get basic healthcare. My brother worked in the ER in Phoenix where thousands of immigrants get free ER care for colds, while as you know, many Americans cannot get seen. My brother-in-law was a caring podiatrist but could not stay "in business" because of the many who are not paying their bills, and the rising costs of his malpractice insurance. He is now doing research.
I can agree that our healthcare system and what doctors are taught should be much different, but this is separate from access to healthcare and how we pay for it, which is what Moore's film is mainly addressing.

Your statement is excellent:
"Until it is profitable for everyone to help create health rather than disease, we will not thrive."

There are many simple, safe, inexpensive, natural alternatives!

Just one example, that my brother showed me: I am sitting at this computer on a 2-2/2 foot diameter excercise ball that is encouraging my back to be in proper position, and keeping my body moving gently rather than creating hemmorroids or muscle knots. He has one at his high-dollar office job! Good idea.

Dear Dr. Hyman:

I read your review of "Sicko" with some dismay since you took the position that the film was "flat wrong". I strongly disagree with that characterization.

I did not see the film being "laser focused" on the replacement of our current system with a single payer system, although certainly that was a significant point of the movie. I also saw the things that you did like the British system that puts the payment incentives in the right places (i.e. the focus of the health system should be on maintaining health rather than curing disease). The film's discussion about the health of Cubans -- whose system does focus on preventative care -- made the very point that you made in your blog, as well as demonstrating how the health of a population can be made to be better than ours even with the expenditure of much less that 1/10th the amount of money per person.

I certainly agree with you that there are many other things that need to be addressed to really solve the wellness problem in this country, and the food and drug supply are certainly two areas where we need to stop pretending that we don't know the things that we do know (e.g. that subsidizing the growing of corn to produce high fructose corn syrup which in turn causes obesity and diabetes is simply insane). But I cannot agree that "Sicko" is "flat wrong". That sentiment denies any value to the film, and I believe that your own words acknowledge that there were portions of the film that were right on target even in your view of the situation.

I applaud you for continuing the discussion, but to give the opposition an easy sound bite by saying that "Sicko is flat wrong" is to do a disservice to all of us who want to see the health of all Americans improved.

Sincerely,

Greg Hill

I have not seen Sicko yet because I suspected it was headed in the wrong direction.

I think the most important change our country could make, and needs to make, is to require health class every single year, starting in 1st grade, all the way through 12th, and actually cover everything a person should know.

For example, in 1st grade it would be body parts, knowing the names and purposes.

2nd grade - Exercise, and what parts of the body are used in different forms of exercise

3rd grade - What you eat, and how the body digests the food, and what foods do what for the body

4th grade - what combinations of food and exercise work for you

5th grade - sex education

6th grade - sickness and disease, and how they infect the body, and what foods help prevent what

7th grade - cell structure, organ structure, purposes for their structure

8th grade - what role aging plays in our body, how every part of our body ages, and what can be done to slow that process

freshmen - effective eating in-depth

softmore - effective exercise in-depth

junior - sex education in-depth

senior - putting everything you know into use - cooking in class, exercising in class, having class dicussions

I think the education is the key. If everyone knew about all of this, then the medical system would collapse on it's own anyway, and so would the food industry.

I really like this remark. I would love to see Dr. Mark Hyman make a movie. However, systems that are close to perfect *can* be developed. The country as a whole has trucks loads of data, truck loads of money, and truck loads of great ideas. Even though each person might not. If a board of people was elected, one person at a time, let's say five from each state, and each of those people were to present one problem, and one solution for the entire country to vote on, then truely amazing solotions would be reached. Unfortunately, the goverment isn't "for the people" anymore. I'm not sure it ever was.

Dr. Hyman,
I appreciate much of what you've written and I believe that the fundamental problem with our current healthcare system is that medical science is woefully outdated....it's based on old science (Newtonian physics) while most of the rest of current science is based on quantum physics....humans are not mechanistic beings....we are energetic beings (read "Biology of Belief" by Dr. Bruce Lipton)....and as such pharmaceuticals just don't work....as long as big pharma and greed are in control, things won't change....we need vastly different curriculum taught in medical schools and we need to wean ourselves off of all the drugs.....get real, we are the most drugged-up society in the history of the world....until people realize that one does not need to take pharmaceuticals to be healthy and feel good, we will stay stuck right where we are...the solution is not cheap drugs like they have in Canada, it's really "no drugs" at all...the idea is to take responsibility for your own health and stop being a victim, believing that the doctors and drug companies will take care of you....

Woah... I think this has gotten way off base. I will tend to agree that quantum physics can be used to explain much of what is discussed in the realm of the airy fairy. That does not mean that it is so.

That being said, I take practice several things that are in the category of energy work because they produce results. While the theory behind how some of these things work is fascinating, it does not mean that it is valid.

I say this because in terms of the information that we use to maintain and improve our health, it is vital that we are able to discriminate between useful information, and information that is misleading or incorrect.

To bring this back to the original topic, I will have to say that I haven't watched Sicko yet myself. However, I will say that even though I tend to disagree with much of what Michael Moore has to say, I have a certain amount of respect for somebody who will stick his neck out and make is views public like he does.

I tend to believe that universal health care would be a step in the wrong direction. The big question is, "Which way do we go?"

We tend to have a certain amount of binary thinking. Things have to be one way, or they have to be another way. I've found that its useful to learn to hold opposing ideas in mind and see how they are both right.

In this case, the capitalist and the socialist versions of health care "systems" (Is we have REALLY a system?) both have their merits and their drawbacks.

I've noticed that this discussion has been primarliy focused on what we cannot do rather than what we can do. The United States has a history of innovation. This is a huge problem that also represents a huge opportunity for those who can create a workable solution.

No one group in what is collectively known as the medical industry will likely be able to solve the problem itself. There are simply too many variables to balance. The meddling of government often tends to do more harm than good. What are our other options?

I have my own ideas for possible solutions or partial solutions, but at the moment they are premature. However, I suspect that the solution lies in a new business model that addresses the problems while still being able to out compete much of what is being done with the existing business models most medical practitioners are using.

GT, you are completely wrong about doctors having complete protection. That is a common misconception. Take a dose of the truth from this retired doctor. Insurance companies will take away malpractice insurance or jack up the price the moment a lawsuit is reported. In fact everything that doctors do today is "covering their but*." This is because lawsuits are the biggest threat to continuing in practice. The wellness of patients takes a back seat to protecting the doctor's livelihood. And so it must, because of the likelihood of lawsuits. Almost all doctors do their best to help patients. However, if a doctor tries to help the riskiest patients, she/he is more likely to get lawsuits, and lose her/his job. Most of the time, lawsuits that are based on an emotionally charged jury expectation, will cause the doctor to lose her/his malpractice insurance--with or without the outcome being the fault of the doctor. (Sometimes bad things happen even when everyone did their best.) In addition, it takes a terrible and extremely traumatic toll on that doctor. The most idealistic doctors are the ones who will suffer the most. The uncaring egocentric doctors will suffer least.

If you want doctors to try less, care less, and be self-centered then you should increase the penalties and make doctors more "accountable" for their actions. It would also make healthcare less accessible as doctors would be leaving practice in droves. In addition, fewer doctors would be willing to treat risky patients.

I have already left practice as a result of only two lawsuits. I did nothing wrong, but someone had to pay according to the lawyers. I wanted it to go to court, but the malpractice insurance company didn't want to spend the money on a trial. It was cheaper for them to pay six figures settlements than to take it to court. In the end, I agreed to settle since the insurance company threatened to make me pay if we lost. On the second claim, I agreed to settle, since my malpractice insurance had been taken away from me already.

If you want to take the profit motive away from doctors, you have to remove the costs. I have $160,000 in student loans. I had a $150,000 business loan. I paid thousands of dollars a month for malpractice insurance. I had employees to pay. I had over $150,000 in overhead to run the office every year. On top of all of that, I would see Medicare and Medicaid patients and get perhaps only $25 to $35 per visit for them. How was I supposed to survive?

In the end, looking back at the service that I provided, I thank God for the good that I was able to provide for many of my patients. I looked on my opportunity to be a doctor as a sacred thing. Each day I prayed for my patients and thanked God for the opportunity to treat them, as if I were treating Jesus. It is admittedly still a painful subject to consider the lawsuits and having to quit medical practice.

Bad doctors pay the penalties for their actions when state medical boards take appropriate action. These state medical boards are notified whenever a lawsuit is filed. They are composed of doctors and commonly regular citizens. These boards have the power to weed out bad doctors by having the power to take away their license to practice medicine, or by requiring additional training. They may also impose penalties, fines, etc… Fortunately for me, I was not brought in by my medical board since they found my written answers satisfactory. For many doctors, it is doubly painful to have to re-hash the whole experience again for a medical board.

My answer to the first post is this: A single-payer national health care system would be great. We need to take the profit out of medicine and replace it with doctors that care. At the same time, however, we should remove the costs to doctors, such as malpractice insurance and student loans. The current system is dominated by the concerns of the insurance companies and lawyers.

In order for big change to happen in our healthcare system a small group or committee of dedicated people with absolutely no other agenda has to start it. Our country began with just a few people committed to an idea for improvement. They had to work for years to develop and define it clearly. When our founding fathers made their declaration of independence to the world it was a long time after they began their quest. After making their declaration they still had to get more and more people on board. The point is, I don't think there is anybody who thinks our system is even close to being perfect, but I also don't know of anybody who is actually willing to take charge either. If you know of someone let me know, I'll join in. If someone is willing to support me and my family, I'll lead it.

i can honestly say to the best of my knowledge, this essay is on the money. We need a comlete paradigm shift.

The only part I think needs to be expanded is naming "biology" the only science that healthcare should be using. I find this extremely limiting. Matter and cousciousness are on a continuum and are inseperable.

There are many ways to treat with out "western science", that can be more effective than just looking through the lense of biology, which often can tell you "what has happend or is happening" but not why.

For a great, and scientific, introduction into how consciousness and the immaterial influence matter, I highly recomend "the holographic universe" by Micheal Talbot.

Cheers.

Having read the piece about you in Life Extension magazine I greatly respect your approach to healthcare. I wish you were my doctor. Prevention is what it's all about, no question, but you have willfully missed the point of "Sicko." This excellent film which exceeded my expectations and even added to my knowledge of the outrageous inequities -- or rather iniquities --despite my years of activism on this very issue as a lay member of Physicians for a National Health Care Program (PNHP) which you should join, by the way-- is not about the HEALTHCARE system at all. It's about the MEDICAL--or rather the SICKNESS--INSURANCE "system" which is not a system but a bloody mess!

Please respect the difference.

If you break your ankle and don't have insurance see what happens! No amount of preventive knowledge and glutathione will enable you to walk. You have to go to an orthopedic surgeon who will charge you thousands and the hospital will gouge you many thousands more. It happened to me. And if my accident had occurred in Canada I would not have had to pay anything!! Got it??

Your agenda is sound-- the best way to control costs is to prevent chronic conditions in the first place, of course-- but I'm really disappointed that you are trashing Michael Moore's movie to make your point. He and his film do not deserve it in the least. That would be another movie entirely, one Moore did not choose to make at this time. Please save your criticism for the real causes of the problem: the political and social retardation of this country abetted by a lethargic/apathetic population deluded by a media propaganda machine that Goebbels would envy. A government devoted to private wealth and public squalor, as John Kenneth Galbraith said. And nothing is likely to change in our lifetimes until we get out in the streets and shut down business-as-usual. I'm not holding my breath: as Winston Churchill said, "Americans will always do the right thing after they've exhausted the alternatives." That could take a very long time at this rate.

As for your other comments about Canada, I lived there when their national health insurance program started in the mid-sixties and I had no complaints. Even today, though I am living in the U.S., because I luckily have dual citizenship I have the option of returning to Canada to have surgery to repair a macular hole, a four-hour operation that will be covered and I will only have to wait a few weeks for it. And I've already found a retina specialist and checked his ratings on a FREE Internet site in Canada and they are very high. I tried a similar search for a doctor in the U.S. and so far found only web sites where I will have to pay for the information! Wouldn't you know!

Very few Canadians would switch to the U.S. for-profit "system", believe me. Why are your former Canadian medical school colleagues going south? You know why. The trend these days, however, is the reverse. Fewer Canadian doctors are crossing the border. I know a number who have returned; doctors in general make a perfectly good living in Canada. A single payer system in the U.S. would be one of the best things to happen to Canada because it would remove that avaricious incentive-- better known as the "free market" in the U.S.

The principle of universal coverage must be upheld. Besides you will live longer, as you know, life expectancy in Canada exceeds that of the U.S. by at least three years.