Comforting the Sick

I read this review of Michael Moore's new movie, SiCKO. What I like the most, though, are the comments at the bottom. They show you all sides of people. There are lots of comments supporting the column and movie, but several that are against it as well. Most of the "against" comments read like this one: If MM is ragging so much about how awful the American healthcare system is, then why doesn't he explain why so many Europeans and Canadians still come to this country to use our services? Both he and those he's interviewed tout their systems as ideal, but yet they come here...go figure. A legitimate question, which I think I can answer. The people who come to America to buy (emphasis on buy) medical care have enough money to do so. In socialized medicine, everyone is entitled to the same rights. This doesn't sit well with some people, particularly those who can buy their way to the top of the list in a for-profit healthcare system. As an example, let's assume that there are 5000 livers available for transplant in the US this year (an arbitrary number, don't write me about how it's inaccurate). If there are 10000 people who need those 5000 livers, the problem is obvious: how do we decide what 5000 people get livers and which 5000 don't? There are 2 basic solutions: Socialized medicine: The 5000 people that have been waiting the longest, or have the most extreme medical need, get the livers. The other 5000 don't. For-profit medicine: Determine the median utility function of the 10000 needy individuals. Set the price point of a liver transplant such that only 5000 out of the 10000 people can afford it. the people who pay more get the livers, the others don't. Now, if you have enough money, you will obviously pick the for-profit case, since you can get the liver you need immediately. This is the answer to the comment above, and why "so many Europeans and Canadians still come to this country to use our services". The for-profit system helps to establish a caste system in the US. The rich receive more benefits. In the US, you are entitled to as much healthcare as you can afford - just as in the US legal system, you are entitled to as much "justice" as you can afford (see the OJ case). The other argument against socialized medicine is that it will stifle medical development. Companies will not develop new, innovative treatments without the promise of profit that will result. I see three problems with this argument: 1. Much of the money for development of advanced health care drugs and procedures comes in the form of grants. I have linked federal statistics on grants before, and I will link the relevant medical ones again (as soon as I can remember where to find them). 2. Once a new drug is developed, avenues such as patent protection can help to ensure that companies still recoup the costs of development - exorbitant pricing is not the only way to recover an investment (at least the portion that wasn't funded by other people in point 1). 3. (The abstract one) The argument implies that we must satisfy a company's hunger for profit in order to be healthier. The whole point of socialized medicine is to help those who can't help themselves, even if we have to sacrifice a little in order to do it. You know all that Christian stuff that the Republicans are always preaching? Helping others, even if it does not result in personal gain, might still be a good idea. The Neoconservative problem here is that they end up worshiping two different Gods: the Christian one requires us to love our neighbors as ourselves. The economic one requires us to make as much money as possible, regardless of the effect on others. Typically, the economic God wins out.