<html><div style='background-color:'><DIV class=RTE>
<P>My mother lives in Canada and receives excellent care for her complex medical problems. So what she does not have a hoveround. However, she now lives in a wonderful bright and modern nursing home that is mostly paid by Canada Pension. Yes I am (gasp) Canadian and have lived in the U.S. since 1983. Every system has its unique set of problems and none is perfect however I find it appalling that so many in this country do not have access to quality health care. This section of the population is swelling yearly. This is unconscionable and unacceptable to me. Is it acceptable to any of you?</P>
<P>I have not seen Sicko and I don't need to. Whenever I go home as I often do I am sorry to say the system here is very broken.</P>
<P>No one is denied health care there, no one is dumped to another hospital or allowed to die in an ER.</P>
<P>J K Khalsa RN<BR><BR></P></DIV><BR><BR><BR>
<DIV></DIV>
<DIV></DIV>
<DIV></DIV>
<DIV></DIV>
<BLOCKQUOTE style="PADDING-LEFT: 5px; MARGIN-LEFT: 5px; BORDER-LEFT: #a0c6e5 2px solid; MARGIN-RIGHT: 0px"><FONT style="FONT-SIZE: 11px; FONT-FAMILY: tahoma,sans-serif">
<HR color=#a0c6e5 SIZE=1>
<DIV></DIV>From: <I><hbutler@pol.net></I><BR>Reply-To: <I>"Trauma &amp; Critical Care mailing list" <trauma-list@trauma.org></I><BR>To: <I><trauma-list@trauma.org></I><BR>Subject: <I>Re: Universal Free Health Care (.......nanny and laundry)</I><BR>Date: <I>Mon, 2 Jul 2007 07:56:36 -0400 (EDT)</I><BR>MIME-Version: <I>1.0</I><BR>Received: <I>from list.mistral.net ([217.154.246.89]) by bay0-mc12-f4.bay0.hotmail.com with Microsoft SMTPSVC(6.0.3790.2668); Mon, 2 Jul 2007 04:57:07 -0700</I><BR>Received: <I>from list2.ftech.net (localhost [127.0.0.1])by list.mistral.net (Postfix) with ESMTPid 79E6F479C5; Mon, 2 Jul 2007 12:56:46 +0100 (BST)</I><BR>Received: <I>from lon-gs3dmrelay.mistral.net (lon-gs3dmrelay.mistral.net[217.154.246.188])by list.mistral.net (Postfix) with ESMTP
id A3FAD47924for <trauma-list@list.ftech.net>; Mon, 2 Jul 2007 12:56:43 +0100 (BST)</I><BR>Received: <I>from lon-gs3dmpop.mistral.net ([217.154.131.28])by lon-gs3dmrelay.mistral.net with esmtp (Exim 4.51)id 1I5KWJ-0008HE-8kfor trauma-list@list.ftech.net; Mon, 02 Jul 2007 12:56:43 +0100</I><BR>Received: <I>from sf01.pol.net ([63.240.86.10])by lon-gs3dmpop.mistral.net with esmtp (Exim 4.51)id 1I5KWG-00081V-4Sfor trauma-list@trauma.org; Mon, 02 Jul 2007 12:56:40 +0100</I><BR>Received: <I>from pol.net (pnjpolsq06 [10.250.20.233])by sf01.pol.net (Postfix) with SMTP id D566E394168for <trauma-list@trauma.org>; Mon, 2 Jul 2007 07:56:36 -0400 (EDT)</I><BR>Received: <I>from 10.250.10.1 (SquirrelMail authenticated user hbutler@pol.net)by webmail.medscape.com with HTTP;Mon, 2 Jul 2007 07:56:36 -0400 (EDT)</I><BR>>May I copy your letter to a
web site?<BR>><BR>> ><BR>> > I have now seen the movie, SiCKO, in its entirety, twice - once on the<BR>> > small computer screen and then, today, in a theater. I went to the<BR>> > theater to see the people, listen to their reactions, and also see and<BR>> > hear the movie in a big screen setting. And, indeed, some of the<BR>> > material is better appreciated in the theater, rather than on the small<BR>> > screen.<BR>> > First, someone has changed the image of the producer, Michael Moore.<BR>> > Both in the movie and on the publicity talk shows, he is less angry,<BR>> > less hostile, and has “cleaned up” in speech and appearance since<BR>> > his previous
movies and books. He is a producer and was very, very<BR>> > specific in what he wished to create, and he created it. He knew just<BR>> > what he needed to show, what he needed NOT to show, and in what order<BR>> > he needed to show the material. Unfortunately, the movie approaches<BR>> > an extremely complex and many-faceted issue in a totally superficial<BR>> > manner, the goal being to elicit emotions and reactions with regard to<BR>> > the dismal state of health care in the United States.<BR>> > Many of the essential elements for the success of our health care<BR>> > network<BR>> > were totally omitted. Just a few of these omitted issues
include: 1.<BR>> > Biomedical research,<BR>> > 2. the long list of medical educational issues<BR>> > (nursing, allied health, pre med, medical school, graduate medical<BR>> > education, continuing<BR>> > education, etc.),<BR>> > 3. Critical Care and all of its ramifications a.<BR>> > Sepsis<BR>> > b. Futility<BR>> > c. End of life
expenses<BR>> > d. Demands of families regarding doing “everything” in<BR>> > critical care 4. Complex operations done (and<BR>> > expected) almost exclusively in the United States, such as<BR>> > thoracoabdominal aneurysms, etc. 5. Regulatory<BR>> > Industrial Complex and its contributions to the cost of health care in<BR>> > the United States<BR>> > 6. Medical legal
issues, although MM has talked about<BR>> > medical legal issues in the talk shows<BR>> > 7. Costs of new pharmaceuticals (the majority of<BR>> > which are developed at great research and safety costs in the United<BR>> > States) 8. and many many others<BR>> > I was sympathetic and in agreement with a number of points that the<BR>> > producer made repeatedly. These include:<BR>> > 1. Condemnation of the greed, cold-bloodedness, profit motive of<BR>> > the insurance industry<BR>>
> 2. Condemnation of the same thing in HMOs<BR>> > 3. Condemnation of managed health care in general<BR>> > 4. Criticism of big money that the pharmaceutical industry<BR>> > throws at politicians (and the politicians who take it)<BR>> > 5. The hundreds of millions of dollars spent by insurance, HMOs,<BR>> > and industry for LOBBYING<BR>> > 7. Condemnation of Sen HR Clinton for her greed in receiving the<BR>> > second highest amount of lobbyist money AND in her ineffectiveness in<BR>> > addressing health care reform in the
1990s.<BR>> > 8. Hassle factor in the sea of paperwork<BR>> > 9. Condemnation of insurance and HMO medical directors and<BR>> > doctor reviewers who are rewarded for DENIALS<BR>> > The producer’s main point throughout the movie and in his final scene<BR>> > was a plea/demand for UNIVERSAL FREE HEALTH CARE FOR ALL (and he<BR>> > tossed in free day care, free college, and free nanny visits to new<BR>> > Mom’s). This is where I totally part ways with his views and<BR>> > motivations. No service is FREE. He visited 5 countries to prove<BR>> > his point about “free” care – UK, Canada,
France, and Cuba and<BR>> > the US. Both access and quality of care in the UK, Canada, France and<BR>> > Cuba, according to what was presented in this movie, are superb.<BR>> > Furthermore, patients and physicians in these countries could not be<BR>> > happier with their respective systems. Based on this movie, the<BR>> > paperwork hassle factor that both docs and patients deal with in the<BR>> > US is nonexistent in these countries. Also, based on this movie, the<BR>> > cost of all these government provided services is not a hardship on<BR>> > anyone or any group. Not a single person interviewed in any of these<BR>> > countries had a remotely
negative thing to say about care, quality or<BR>> > even taxes to support the system. Contrarily, ALL interviews in the US<BR>> > were totally negative – not ONE success story was presented. Hence,<BR>> > my greatest criticism of this movie – bias to the point of deception.<BR>> > There appeared to be a good bit of manipulation of timing of events to<BR>> > support the producer’s position. For instance, when attempting to<BR>> > present the AMA as an organization opposing “healthcare for all,”<BR>> > he showed a portion of a speech from Dr. Annis, President Elect in the<BR>> > AMA in the EARLY 1960s. This was more than 40 years ago. Such mixing<BR>> >
of past and present was common throughout the movie.<BR>> > I listened to and watched the views of the people who accompanied Mr.<BR>> > Moore to Cuba. I have tried to read in the newspapers about just what<BR>> > was done for them in Cuba which they did not get in the United States.<BR>> > One was apparently given a diagnosis of sarcoidosis, which he did not<BR>> > have prior to going (although sarcoidosis is often a dx of exclusion).<BR>> > One was taken off a couple of her medications, something we all do<BR>> > when we see a referred patient. Others were given outlines of<BR>> > treatment plans for them to try when they go home. What else is new?<BR>> >
When any patient presents with continuing symptoms, we manipulate<BR>> > their treatment plans and their medications if there is not an<BR>> > operation or directed acute interventional treatment which is<BR>> > indicated. Quite frankly, I saw nothing in the Cuba trip that gave<BR>> > anything new to any of those accompanying Mr. Moore. I was impressed<BR>> > that while in Cuba, I saw none of them appear to be dyspnec, or<BR>> > lacking energy. I was impressed with their HIKE down the hillside to<BR>> > the Navy Base. Interestingly, neither of the two “patients ” with<BR>> > lung problems (and obese) exhibited shortness of breath. I also
know<BR>> > that the Cubans would also go out of their way to maximize the<BR>> > propaganda opportunities of this visit. Many on this list have been to<BR>> > medical or surgical meetings in Cuba, as have I. The Cuban doctors<BR>> > are very dedicated and hungry for new knowledge. Many of their<BR>> > facilities are often not as well equipped as ours, and I have seen<BR>> > hospitals far different from the examination rooms shown in the Havana<BR>> > Hospital in this movie. If all I had to base my reactions of medicine<BR>> > in Cuba was this movie, I would “know” that there is a state of<BR>> > the art hospital and virtually free pharmacy on
every corner and<BR>> > available to any and all who need services.<BR>> > There are members of this list server who reside in Canada, Cuba,<BR>> > United States, France, and England, and we all respect each other.<BR>> > Each of us knows the many differences in our “systems,” both good<BR>> > and bad. We know the many frustrations with our own “system”. We<BR>> > know of two, three, or even four tiers of care in EACH of the cited<BR>> > countries. We know of rationing by various means and limitations.<BR>> > None of the negative issues in any country except the US were even<BR>> > mentioned, much less openly
discussed. I have been told by Canadian<BR>> > physicians and patients of various problems with that system. I have<BR>> > just been in London for a week and heard about the frustrations and<BR>> > regulatory difficulties of the NHS from the physicians’ points of<BR>> > view. AND I have gotten an “ear full” of the frustrations from<BR>> > French surgeons I know, all of whom have second offices to see<BR>> > “private patients” who pay cash. Mr. Moore cited none of this<BR>> > other side.<BR>> > This is not the time and place to criticize other country’s health<BR>> > care delivery system, for we all have our share of horror stories
and<BR>> > difficulties, as well as great successes. I have cited many of the<BR>> > problems in the United States, and Mr. Moore re-stated many of the<BR>> > problems many on this list have expressed in the past. However, he<BR>> > only gave one side of the story – his side - to push his vision of<BR>> > FREE CARE (up to and including the government doing his laundry) for<BR>> > ALL.<BR>> > Most of the members of this list server have at one time or another been<BR>> > on a debating team. One overstates a point to make a point and picks<BR>> > the most extreme examples of good and bad that can be found to<BR>> > accentuate the point to be
made. Mr. Moore has done that in SiCKO. I<BR>> > would have found this an exceptional piece of film and, indeed an<BR>> > historical event, had he had the insight, intellect and integrity to<BR>> > just as aggressively present the opposite side of the debate. In that<BR>> > way, the American people and the world could have seen and possibly<BR>> > comprehended the many complicated aspects of health care and come<BR>> > closer to a solution.<BR>> > I was interested to see who attended the movie. This is the second day<BR>> > that SiCKO is showing in Houston and is in three movie theaters. I<BR>> > went at a “ popular movie going time.” Several of
the 15 movies<BR>> > showing were sold out 15-30 minutes before the show started. SiCKO was<BR>> > shown in one of the smaller rooms and was only about 25%-33% full.<BR>> > About 15% of the attendees were Medicare age, and 2 people were<BR>> > receiving supplemental oxygen. I was a bit amused to see a lady come<BR>> > in on a “Hover-Around.” I wonder how many people in the UK,<BR>> > Canada, Cuba and France have those paid for by their governments? I<BR>> > saw NO other doctors in the room that I recognized, and I do know many<BR>> > of the Houston doctors. I estimate that about 30 nurses were present,<BR>> > as they were carrying the
flyers sent to nurses across the country by<BR>> > the California Nursing Union. Every time a statement was made about<BR>> > giving FREE anything, such as child care, laundry, cooking, extra<BR>> > vacation time for a honeymoon, (anything to be paid by the<BR>> > government), there were murmurs of approval, sometime clapping, in the<BR>> > theater. Based on the Houston attendance, I would not think this show<BR>> > will have a very long running at the box office. Because it presents a<BR>> > “ you can and should have it all at no real cost to YOU,” I have no<BR>> > doubt that many individuals and groups will “latch” onto this film<BR>> > and champion
it. I cannot envision it having any long term real<BR>> > societal impact on health care, simply because it does not present<BR>> > anything new or offer solutions on HOW we reach this nirvana state that<BR>> > is enjoyed in France, UK, Cuba and Canada. At one point, Mr. Moore<BR>> > emphasized that the US is a country where people are “ afraid of<BR>> > government,” afraid to speak out and demonstrate – implying this<BR>> > was quite different in France, Cuba, Canada and the UK. I’m still<BR>> > puzzled by that premise. When in recent history have Americans had ANY<BR>> > reticence about speaking out and demonstrating???<BR>> > I will admit again that
some of the central core complaints are common<BR>> > among patients, nurses, doctors, organized medicine, and medical<BR>> > professional groups. Those core issues about which there is agreement<BR>> > were cited in the first paragraphs of this review, and I will not<BR>> > repeat them. It would be wonderful if we could unite in addressing<BR>> > THOSE core issues with a massive communication effort to policy makers<BR>> > (inside and outside the government). I am afraid that the solutions<BR>> > are going to be very complex and multifactoral and not as simple as<BR>> > getting the “government to give you free drugs, free doctors, free<BR>>
> hospitalization, and free laundry services.”<BR>> > Kenneth L. Mattox, MD<BR>> ><BR>> ><BR>> ><BR>> > ************************************** See what's free at<BR>> > http://www.aol.com. --<BR>> > trauma-list : TRAUMA.ORG<BR>> > To change your settings or unsubscribe visit:<BR>> > http://www.trauma.org/index.php?/community/<BR>><BR>><BR>><BR>>--<BR>>trauma-list : TRAUMA.ORG<BR>>To change your settings or unsubscribe visit:<BR>>http://www.trauma.org/index.php?/community/<BR></FONT></BLOCKQUOTE></div><br clear=all><hr> <a href="http://g.msn.com/8HMAENUS/2743??PS=47575" target="_top">Get a preview of Live Earth, the hottest event this summer - only on MSN</a> </html>