Friday, July 06, 2007

The Master of Spin

(I haven't seen "Sicko" and probably won't. Since I tend to agree with Moore's
general tilt on things, I don't feel as guilty about criticizing him without actually
parsing every word as I would if I disagreed with him. However, a friend sent me

this memo from a Blue Cross/Blue Shield exec. Here's my response -- about
the memo and Moore in general, but not about the movie itself.)



Interesting. I put Michael Moore in with Abbie Hoffman as someone who raises constructive hell but isn't much for the real spadework of reform. Standing outside a building with a bullhorn and shouting for the CEO to come out and talk with you is a good stunt, but guaranteed not to actually produce the conversation -- so the question becomes, did you want a conversation, or just the airtime?

As someone who is a player in the game, I got about half an hour into Fahrenheit 911 and switched it off -- the purposeful editing was too distracting and most of the revelations were things I already knew. But I was glad it was out there because it was shaking people up.

Similar thing here -- I don't expect fair treatment or an intelligent deconstruction of the health care crisis, but I'm glad he's raising hell. Unlike Jane Fonda or Cindy Sheehan, he manages to be obnoxious without being ineffective and that's a gift -- my comparison to Abbie Hoffman is not to be taken lightly. While Tom Hayden and people like that were doing the real work of stopping the war, Abbie was getting kids out into the street and, frankly, that had a helluva to do with the eventual end of our involvement.

Of course, Abbie was also a pro at finding a parade already in progress and leaping in front of it with his baton, and I don't see Moore doing that, so that's a point in his favor. (But I still have great affection for Abbie.)

The memo itself seems pretty straightforward and sensible. I'm not clear on the practical difference between non-profit and for-profit and I think he places too much emphasis on it. That's definitely corporate spin. The rest seems reasonable -- he gives Moore a lot of credit but he recognizes that Moore isn't looking for a fair, objective examination of the topic. However, his admiration for Moore's ability to spin is apparent and he doesn't seem to bear any ill-will towards him.

Very interesting!

14 comments:

ronnie said...

I was also impressed at this guy's civil tone.

I am really confused by one thing, though (and while you admit you're not clear either, you may not be the right person to ask). Are there non-profit health insurance providers in the US? If so, wouldn't their coverage be cheaper and less exclusionary than for-profit, which must answer to shareholders? Why on earth isn't everyone gravitating to these non-profit providers? Surely they'd become the providers of choice for large corporations, etc?

Sherwood Harrington said...

Yes, ronnie, there are non-profit providers down here, and, yes, they are the providers of choice for many large corporations and other employers, including mine.

Here's the outfit that provides us with our health care -- and which has been instrumental in maintaining a very fine quality of life, all things considered, for my family: Kaiser Permanente.

Mike said...

My take on the profit-nonprofit thing is that, on one level, it matters because a non-profit won't have investors screaming for larger profit margins. But on the street level, you'll still have cost-cutting issues that will create many of the same issues. What I suspect it does mean is that the degree to which "greed" drives up costs is only slightly diluted in impact but is much harder to track -- that is, do doctors have to make so much, does the cost of malpractice insurance play into that, etc. -- and how much of the costs exist outside the non-profit itself in the cost of drugs, for example. After all, most hospitals are non-profits, so you can't just blame the costs of medical care on the profit motive without digging deeply. It's easier, but less accurate, to simply dismiss it as greed that can be pinned on the person who actually says, "No, we can't do that" than to trace it back to the reasons why.

Still, if Sicko can humanize some of the most egregious examples of how it all comes down on the patient, it's a contribution -- that's why I don't dismiss his work.

Incidentally, for those struggling with the memo, the PDF version is much, much easier to read than the thing posted on the web site. See the line of red type at the top.

Dann said...

All alone again. [sigh]

Sorry. Mr. Moore is out in wacko land....again. His mansion must be built there.

You simply cannot compare Cuba's separate health care system that provides top quality care for party officials and selected visitors from other countries to the US's system that is available to everyone. At least not and retain any shred of credibility. Cuba's main health care system, the ordinary Cubans get to use, is a shambles.

Mr. Moore brings only heat to any issue he attempts to address. No light.

The US health care system is not perfect and is in need of repair. Burning it to the ground does not fit the description of "repair".

I do like Mike's description of the BCBS exec's memo.

Regards,
Dann

Mike said...

Sorry, no fight this time. Cuba doesn't really have a functioning economy, so their 'system' doesn't count. The Canadian and European systems are worth looking at, but, as I said, the problem isn't stirring up the interest -- it's the difficult job of describing a solid, fair system that works in our economy would look like. But as long as the conversation is dominated by people who pooh-pooh systems that work under slightly different economies, we get nowhere.

As I said (or at least meant to suggest), the benefit of having a Michael Moore is that he moves people away from the belief that their system is the only right system, and gets them to ask questions that don't begin with "Please, sir ..."

Which is why I called him a spinmeister -- we've got so many people spinning in favor of the existing system that it's good to see someone reversing the direction.

ronnie said...

Dan, you are just wrong on this one. Cuba's system is truly universal. It is no way limited to "party officials" or any political or social elite. One of the things we noticed there was the perfect teeth everyone from the groundskeepers up had. There are pre/postnatal clinics set up in *every town in Cuba* as a government policy. (This goes a long way to their having the lowest infant mortality rate in Latin America.) Some tourists take along supplies for them, as the blockade makes supplies difficult to obtain, which is the main flaw of the system. We saw a clinic with a few people waiting inside and they looked like ordinary manual labourers and housewives to me. The elderly all looked to be in very good health as well. What you posted, that time, isn't a difference of opinion, it's fiction, I'm happy to say.

You forget that one of the luxuries of dictatorship is that you can force funds to be directed anywhere you want them to be directed. Castro has very carefully made the health care system the jewel of his revolution alongside education (there is almost 100% literacy in Cuba) because he is a wily old fox who knew that those two things would keep his people content enough to stop counter-revolution, and it's worked extremely well. (The US has helped enormously by blockading the country, giving a very convenient demon to blame all the country's problems on. The seige mentality has made for a powerfully independent and united people.)

You may not like that the Cuban education and health care systems are excellent, but that they are can't be denied, and the reason why is obvious.

Dann said...

Ronnie,

Cuba has accomplished a great deal using fewer resources; at a cost to other aspects of Cuban life. There are some facets to their approach, such as a strong emphasis on prevention, that do serve as an example for other countries. In fact, prevention was a primary component of the recent reforms in Massachusetts that Mitt Romney helped usher through the legislative process.

Also it is important to note that there are significant to note that there are differences between the two nations in terms of malpractice insurance requirements/costs, product liability issues, etc.

Successful aspects of Cuba's health care system do not automatically mean that every aspect of the Cuban health care system is up to snuff.

And with regard to Cuba's two-tiered health care system, I believe that I am on firm ground.

Regards,
Dann

Mike said...

Having already noted that Cuba's economy is not healthy enough to compare systems on an apples-to-apples basis, I'd be willing to believe that the clinics in the back country are not as well equipped as those in areas tourists are apt to see.

But the sources Dann cites are hardly the observations of neutral observers and I certainly wouldn't accept them as representative either.

And it's not the point anyway. Leaving the question of the war aside as too divisive, let's look, instead, at the money we poured into cleaning up after the Savings & Loan debacle.

You're still left with a questions of priorities. We spent a boatload of money on that, Fidel spent a boatload of money on trying to make his people healthy.

The relevant question is, if we can look at the S&L and say, "Wow! We'd better fix that!" then why can't we look at our medical system and say the same thing?

And, if the answer is that our system already works really well, then, gosh, it won't cost so much to make it better, will it? Because it isn't perfect, is it?

ronnie said...

The Cuban-American National Foundation? An openly anti-Castro group? Why don't I just cite Granma, then?

As for the MSNBC story, I never said there weren't hospitals where foreigners were treated. However, your claim was that "You simply cannot compare Cuba's separate health care system that provides top quality care for party officials and selected visitors from other countries to the US's system that is available to everyone", implying that the existence of such facilities meant that good health-care is not available to average Cubans. That's not, on the whole, the truth. There was a clinic at our resort; there was also a perfectly-normal-looking clinic in Puerto Padre, and brother, that's as deep into the boonies as it gets in Cuba.

As far as "Babalu Blog", an anonymous blog is not a primary source, and his linked articles are all from "Cubanet", yet another anti-Castro website.

Sorry, that's not firm ground, it's quicksand.

ronnie said...

By the way, your phrase:

"the US's system that is available to everyone"

made me literally LOL :)

That must be in your fantasy world where things are going well in Iraq and if we just stay the course, western-style democracy will blossom there :)

ronnie

Dann said...

Mike,

The relevant question is, if we can look at the S&L and say, "Wow! We'd better fix that!" then why can't we look at our medical system and say the same thing?

Sure. I agree. 100%.

But nationalizing our health care system [the rest of the way] would be akin to not only relaxing S&L regulation, but totally eliminating it. It would destroy the portions of our health care system that have great value while returning very little by way of improvements.

Ronnie,

I'm sorry you don't like my sources. I believe they provide sorely needed balance. At the least, MSNBC should be considered "unbiased" and their story clearly indicates that there are separate facilities being operated in Cuba.

Perhaps you are familiar with Gijeong-dong in North Korea??

Regards,
Dann

Nostalgic for the Pleistocene said...

I swear, Dann, you'll think i'm mocking you but i'm not, i mean this - if we were in a war i thought we oughta be in i'd want every soldier/sailor/Marine to be like you: smart, calm and focused, basically kind, and absolutely utterly relentless.

Haven't seen Sicko but if MM focuses so heavily on insurance companies i think he's erring. They're part of the problem, but when drugs and equipment (an MRI machine costs about 2 million bucks) are profit-making industries, and priced based on an assumption that patients' insurance will pay (in the case of imaging, it's a step removed but patient fees pay the facility's bills), i have a very small spark of sympathy for them. Not a big spark - they don't say no to the big guys, its easier to say no to the patient. They have the "Let's impose sanctions" mentality. The patients may get care but they also go bankrupt.

Yeah, our system is "available" to all, but when a test that was $900 in 2002 is now $4000; when 2 hours in the emergency room with a blood test and a dose of demerol costs $2000 ... You do know medical debt is the leading cause of personal bankruptcy in the US, i hope.

The flip side of your own blog entry assertion that the money drives innovation (No argument), is that ONLY profit-potential research is encouraged. Who's gonna research environmental, or food-additive casues, or natural and dietary solutions?? These things reduce US industry profit, they don't make money. So who'll "invest" in the research? A lotta people would stop taking $1000/mo of pills. So those solutions are getting less attention here but more outside the US.

MM may be advocating full socialism, but, hey, whatever his idea of a solution, the godawful flaws in the system are still getting attention. "Not perfect" and "needs repair" are WAY too mild terms for this monster.

ronnie said...

I'm sorry you don't like my sources. I believe they provide sorely needed balance. At the least, MSNBC should be considered "unbiased" and their story clearly indicates that there are separate facilities being operated in Cuba.

We seem to be at cross-purposes here. In the post you are responding to, I said:

As for the MSNBC story, I never said there weren't hospitals where foreigners were treated. (Emphasis added.) However, your claim was that "You simply cannot compare Cuba's separate health care system that provides top quality care for party officials and selected visitors from other countries to the US's system that is available to everyone", implying that the existence of such facilities meant that good health-care is not available to average Cubans. That's not, on the whole, the truth.

I never denied separate clinics exist. I am suggesting you are implying that average Cuban health-care is sub-par (and that is somehow related to the separate clinics). I am saying it is not and I will stand by that until an unbiased source - not connected to the very powerful Cuban-American anti-Castro lobby - says so.

ronnie

ronnie said...

A final note:
After CNN ran the ususual "Michael Moore is spinning and his facts are 'fudged'" piece prior to an interview with Moore, Moore furiously accused CNN of dropping the ball on health care just like they'd dropped it on the Iraq war. Today, his website published a well-researched, well-sourced refutation that shows many of Dr. Sanjay Gupta's claim about Moore's facts in that hatchet piece were themselves incorrect or misrepresentations.

I can't say this surprises me. I see so many things reported about Canada's health care system that I know to be untrue that I just assume reporters lazily rely on health industry "experts" for their information and don't bother to question whether what they're being fed is accurate.

My guess is that Moore knows the reputation he's developed over the first two films, and is not going to risk getting caught out in outright misrepresentation again.