For anyone who wasn’t worried about the growing privatization of the Canadian medical system, Michael Moore’s new film, “SiCKO” can hopefully serve as a much-needed eye-opener. The new documentary examines the American private health care system –its massive human and financial costs– and its failure to thrive in anything beyond creating huge profits for big businesses. The film raises important questions about the reasons why, despite all the obvious negativities, a for-profit medical system exists in the United States. We in Canada must also ask why the government of Canada is currently on the slippery slope of imitation and what the alternatives are.

Disturbing and Widespread

There are many unsettling individual horror stories in SiCKO of those forced to live under the US health care system, where there is no guarantee of care unless you can pay. It’s worth remembering that these are not isolated incidents, but widespread symptoms of a system where the most recent data from the US Census Bureau indicate that 46.6 million people live completely without health insurance (a rise of about 1.3 million from the previous year). Most of these people are workers who aren’t covered by their employer or the government, and cannot afford private coverage. All of them are just a car crash away from financial and medical ruin.

Even when covered by some form of medical insurance, the profit-driven priorities of the providers still make receiving adequate care extremely difficult. Debt due to medical bills is the largest single cause of personal bankruptcies in the US, and according to a Harvard medical study, 76% of those who filed for bankruptcy were actually covered under some sort of health insurance. A woman in “Sicko” was stuck with the ambulance bill after a car accident because she didn't clear the charge with her insurer before receiving the ambulance. She had been unconscious at the time.

There is an always-growing list of studies outlining the deficiencies in the quality of private care, but a good example is a major analysis of all the studies comparing mortality rates between not-for-profit and private for-profit hospitals in the US published in the May 2002 edition of the Canadian Medical Association Journal. The massive study found that because of profit-maximizing corner cutting, death rates in for-profit hospitals were significantly higher than in not-for-profit hospitals, despite the extra money paid by hospital users. Inefficient Too

So if it’s more expensive for patients, hard to access, and there are no guarantees of better care, what are the benefits of private medicine? Is it the efficiency and streamlined nature of the system? Sorry, no. The US spends more of its GDP on healthcare than any other developed nation, and yet according to a recent World Health Organization report sited by Moore, is ranked 37th in healthcare.

Where does all the money go? A study in the International Journal of Health Services found that in 2003, administration costs in the US health care system ate up about $400Billion, or about 25% of total health care spending.

The rest? Check out the profits of the major healthcare companies. In 2005, Johnson and Johnson earned profits of $10Billion, and in 2007 Wall Street predicts their global profits at $15.13Billion. The pharmaceutical industry alone is more than twice as profitable as auto, computer, and telecommunications industries.

The Bottom Line

The bottom line is not very complex. In a system where profits are the priority, and where those with the most money make the most decisions, the majority of people are left out. This is especially alarming when what we are being “left out” of is access to adequate healthcare a matter, literally, of life and death.

In Canada, businesses have the same priorities as the US. They have been working very hard to turn back the clock on public healthcare gains people in Canada had to fight extremely hard to get. In June 2005, they were able to secure a major victory when a Supreme Court ruling struck down a Quebec law that prohibited private health insurance to cover procedures already offered by the public system. This opened the doors wide open to the possibilities of increased privatization

In the province of BC there are now 70 private surgical clinics, including 23 providing outpatient general surgeries on a for-profit basis. An estimated 50,000 patients obtained surgery at for-profit clinics in 2005, according to the Vancouver Sun, paying between $700 and $17,000 each in facility fees.

A huge Trojan Horse for private healthcare is the “public-private partnerships”, or P3s. These are deals where the government pays a for-profit company to provide formerly public services, with contracts lasting decades and profits guaranteed in writing. With all this underhanded privatization, there is a lot more of it than most of us thought. In 2005, the government spent $98.8Billion on public health care. About $43.2Billion was then spent on private!

They Won’t Stop Here

Does anybody really think that these healthcare corporations are going to stop at where they are, when they know that the further Canada slips towards the US model the huger their profits get. Anyone who says private healthcare in Canada is really just an issue of a few people paying a bit more and shortening the wait lists for the rest of us is either naïve or on some company’s payroll. To those who say it is an issue of democracy and freedom of choice: what kind of choices do those 46 million people in the US without health insurance have?

Cuba’s Way: A Better Way

"The life of a single human being is worth a million times more than all the property of the richest man on earth... Far more important than a good remuneration is the pride of serving one's neighbour. Much more definitive and much more lasting than all the gold that one can accumulate is the gratitude of a people.” - Che Guevara, 1960, “On Revolutionary Medicine”

The most interesting aspect of SiCKO is Moore’s visit to Cuba. He doesn’t deny the challenges the country faces, but is right in enthusiastically pointing out that Cuba spends only $251 per capita for all of its inhabitants to receive free, universal healthcare. Compare that to $5,700 per capita in the US, which guarantees nothing.

Despite a cruel and far-reaching US blockade, Cuba has the highest life expectancy in Latin American, the lowest infant mortality rate (at 6.22, lower than the US), and has 5.9 doctors for every 1000 people, compared with 5.5 in the U.S, 1.7 in the U.K, and 2 in Canada. Medicines are also incredibly cheap. A September 11th rescue worker who traveled with Moore to Cuba bought a refill for her asthma inhaler for 5 cents. It would have cost $120 in the U.S.

Cuba also absolutely excels in its ability to help those in other countries. As of March 2006 there were 25,000 Cuban health professionals working for free in 68 nations, and 27,000 young people from around the world are currently studying medicine free of charge at the Latin American School of Medicine in Cuba!

How does Cuba accomplish this? By following the words of Che, and treating the provision of healthcare as a sacred human right, not as something to be bought and sold. When a government is not continually making space for corporations to create more profits, the possibilities of free, universal healthcare, create incredible possibilities for humanity.

Which Way Forward?

Imagine if the US allocated even only the $400Billion a year it spends on administrative costs for healthcare, to health programs following the Cuban model. Consider what it would be like if the Canadian government was more concerned with making space for patient beds instead of corporate contracts. SiCKO should serve as an important reminder of the two directions that healthcare in Canada can go. Towards the US model, or towards the Cuban. The stakes are high, because it’s our lives that are at stake. People across Canada must continue to demand a complete end to the privatization of healthcare, and for free, universal, and accessible healthcare for all.



Back to Article Listing