Good catch, John.
Interesting.

I think that Hammock is wrong to call what produced the items that we all use “greed”. What produced those items was self-interest, which is not the same as greed. Greed is when you are willing to do anything, regardless of ethics or legality, to obtain something. By the definition that John gave, the word “deserve” means what you earned. For example if you sold 10 widgets at $10 each, then you deserve $100. Ripping them off by only delivering 9 would be an example of greed.

Self interest and the profit motive is what built this country. It is what produced the best medicines in the world and the best medical procedures in the world. It produced electricity for everyone, the automobile, the airplane.

None of those things would have been invented and created, if not for the incentives inherent in capitalism.

In the system that Moore believes in, which is government ownership of everything, there is no incentive to work harder, there is no incentive to increase production or to come up with new ideas to increase productivity.

Anytime an outside consultant is hired to come in and increase productivity in a plant of warehouse, they almost always end up creating some type of incentive program. It happened at Genesco where I work. The incentive program increased the pay of the employees and made them happy, while the increased productivity made the stores and the company happy. It increased the bottom line which in turn caused the company to grow and sell shoes for less.

Economies are better when there is incentive to produce. Economics is not really that complex. It is essentially an understanding of human nature. Adam Smith had that understanding, as did Milton Friedman. People like Moore, Hugo Chavez, Castro and others do not.

Michael Moore has been critical of the government’s Katrina response. Everyone has been critical of the VA medical system. State-run health care in Virginia (and national healthcare in Canada, Great Britain, and pretty much everywhere else) is a complete joke. Only a fool would believe that a country as large and problematic as the United States could run ANY sort of national healthcare system without 1.) tons of red tape (VA) 2.) tons of fraud (Medicare/Medicaid, the Canadian health care system) 3.) a marked DECREASE in health care quality (really, has anyone who support a national health care system ever been in one of our existing government-funded health clinics?) The government/national institutions can NEVER do a service as efficiently (or as well) as the private sector.

And this thing ate all my line breaks.

Well said, Ron and Glen. Moore effectively derides America’s healthcare system with horror stories he solicited over the internet in preparing for his film. I wonder if Moore thought to fish for horror stories in countries with socialized medicine? Doubt it.

How do you respond, though, to the fact that life expectancy in the U.S. is lower than in industrialized countries with national health services? That infant mortality is higher here? That the rates of heart disease and diabetes are higher here, and that the outcomes for those who have them are worse here than in those other places? These are objective measurements. Then there are subjective things like surveys measuring satisfaction with the health care that people receive; again, people in industrialized countries with national health services give their systems higher positives than we do here. And that includes Canada and Britain. Clearly, all systems have their faults and horror stories. But equally clearly, the places with national health services are doing something right and keeping their citizens both healthy and satisfied. And they do it while spending about half of what the US does on health care per capita. Do you think that those other folks are somehow inherently better at running things than Americans are?

I’m no great fan of Michael Moore’s, to be sure. But I don’t know how the health care system can cost as much as it does while providing outcomes as poor as it does, if greed (however you want to define it) isn’t involved somehow.

[…] comment thread discussing Sicko and markets in health care. One of the commentators, Hammock, says this: I’m glad that there is greater public discussion of the flaws in the U.S. health care system. […]

I’d respond a couple of ways, though this isn’t nearly as pithy or “moving” as a cinematic crocumentary . . . Americans pretty much foot the bill for the rest of the world’s pharmaceutical and medical research . . . Americans have more economic and personal freedom than other places, so they can make all manner of stupid choices . . . Americans endure higher crime rates (maybe we should outlaw crime) which affects life expectancy . . . Americans at least have the CHOICE to waste money on expensive (and sometimes hopeless) procedures/treatments. Here’s some of the same assertions.

Americans pretty much foot the bill for the rest of the world’s pharmaceutical and medical research

There’s plenty of successful drug research in other countries. Drug companies that operate there manage to make a sustainable profit. The problem is that American drug companies aren’t satisfied with sustainable profits, and ask for more. Greed.

Americans have more economic and personal freedom than other places, so they can make all manner of stupid choices . . . Americans endure higher crime rates (maybe we should outlaw crime) which affects life expectancy

If most of the diseases that get people in the US refused affordable coverage were lifestyle related, this argument would have some merit. But, of course, people get refused affordable health care coverage for all sorts of diseases that have no lifestyle component whatsoever.

Americans at least have the CHOICE to waste money on expensive (and sometimes hopeless) procedures/treatments.

Again, those treatments aren’t what drive up the cost of ordinary health care in this country. And they don’t explain the huge numbers of people who die here from lack of ordinary, affordable preventive care, or those who are kicked to the back of organ transplant lines because they can’t afford the tens to hundreds of millions of dollars the procedures cost.

I don’t have much time to respond, but I’ll be back . . . your comments deserve some serious fisking. Moore et al use a creative mix of comparing costs and outcomes and perceptions and horror stories.

There is successful drug research in other countries paid for by pharmas that make their serious profits selling drugs in America. We’re not talking about aspirin factories, we’re talking about Eli Lilly and Merck, companies that make their profits off of patented medicines rather than mass production of medicine.

Ned, I’m not defending Moore or his movie (whichh I haven’t seen). I’m pointing out weaknesses in our current health care system that seem to me to indicate that greed is in fact a serious obstacle to good health in this country.

Ron, do you not see a problem with the foreign pharma companies making excessive profits in the US? Or are you arguing that greed isn’t motivating the price structure they impose here? They are profitable even without the windfalls they get here, you know.

I’m sure they are, and I do see a problem with it, but that’s the way everything goes. Everything has a variable price structure. Health care, medicine, PS3s, cars, food… what I’m saying is someone has to foot the bill for research and still tick the quarterly profits. They’ve decided that the US, the richest country on earth, is that country (I have a long, complicated theory on how to drive down the price of health insurance using the free market).

OK, I understand where you’re coming from. Not the same place as I am, but certainly a consistent, definable place. And I’d be interested to hear anyone’s long, complicated theories on how to fix health care. I approve of and appreciate simplicity, but anyone who looks at the current situation and says that there’s a simple way to fix things is, um, what’s the word I’m looking for, uh, yes, crazy, that’s it.

I’m not saying I like the fact that companies fatten the bottom line on the strength of our economy, but them’s the breaks. I’d rather live here than sub-Saharan Africa. And my theory doesn’t address health care (as I think that’s comparable to most of the rest of the civilized world), but it does address the price of health insurance.

Health care and the price of health insurance are not unconnected.

I agree, but under the current system there is no impetus to reward people for good behaviors or punish them for bad behaviors. My long and complicated blog post should be up shortly.

Ron’s point was (one part of) mine . . . that America is underwriting (either with our federal budget or with our family budget via health insurance premiums) the global pharma market.

My other point about lifestyles and crime was aimed at the life expectancy figure being used. Those issues (unhealthy lifestyles and crime) are hardly related to the type of healthcare system we have.

If life expectancy and infant mortality rates are affected (which they are) by these issues unrelated to healthcare system, then it is fallacious to argue that our relatively high costs of healthcare (which are higher due to higher pharma research and sales prices) and our relatively low life expectancy (which are lower due to lifestyles and crime) should lead us to opt for “national health services.” See?

Even if we factored out the entire murder rate, we’d still have a shorter life expectancy than those other countries. The gap would be smaller, but it would still exist.

Next, many of the healthy/unhealthy lifestyle choices I think you mean have a lot to do with the unavailability of preventive care, the cost of drugs/programs to quit smoking for those who can’t do it cold turkey, the availability/affordability of treatment for drug addiction (which seems to be lower in countries with better health education), and other things included as part of the national health services provided in other countries.

There’s also the fact that people with diabetes and heart disease (two of the three most common lifestyle-related illnesses) seem to recover better and, on the whole, remain healthier apart from those diseases in most industrialized national health countries.

Re. murder rates, who says?
You didn’t reference infant mortality–and evidence that states that offer prenatal care etc. for free have only slightly higher rates of use and much higher expenditures.
What preventive care is going to keep someone from overeating?
Is “health education” a function of “national health services”? Do we not have it in the U.S.?
You wrote: “There’s also the fact that people with diabetes and heart disease (two of the three most common lifestyle-related illnesses) seem to recover better and, on the whole, remain healthier apart from those diseases in most industrialized national health countries.” I’m curious why your assertion is limited to most “national health” countries–why isn’t it always true?