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He speaks of a 100% free medical care in France and neglects some side charges. Dr Jacques COULARDEAU, University Paris Dauphine, University Paris 1 Pantheon Sorbonne & University Versailles Saint Quentin en Yvelines. To emphasize the Cuban episode he compares with the care the prisoners in Guantanamo get (free top notch medical care) and the care some rescue workers at Ground Zero after the 9/11 attacks get in the US, and the care they managed to get, for free in Havana from Cuban doctors. For instance in France brand name drugs that have an equivalent generic, and cheaper, version on the market are only reimbursed on the basis of this generic drug's price. The verdict once again does not stand the slightest possibility to appeal.
Michael Moore thus compares the US system based on the full exclusion of 50 millions Americans from health care and the partial exclusion of million more under the title of denial, the denial of one particular treatment to specific Americans by their own private insurance companies, a denial that can go as far as a full rejection of the client by the insurance company and the cancellation of their contracts and all benefits. In England they introduced a flat payment per prescription to encourage economy on drugs. The verdict is obvious. But he is under a wrong impression as for France where the health system is not paid by the state but by contributions paid by working people on their salaries and this money is used to reimburse the medical expenses of people up to a certain point and managed by elected councilors representing the workers and employers equally and chosen by their electors on union lists from the trade unions or the employers' unions. But altogether Michael Moore's discourse is true and right, when we keep in mind that we have to think of the people who always try to get undue or abusive advantage of a generous system, and that we have to consider being economical with drugs and treatment because it is also a syndrome of our advanced stressful societies that many people, and at times those who are least stressed, look for some medical care when none is needed and they use a lot of time of doctors, nurses and other medical personnel for no reason at all except getting some attention.
This is an important shortcoming of the film: how much money is wasted by private insurance companies in the US to employ people, at times highly paid people, just to deny services to clients, and patients, and how much money is wasted on law suits by clients who are dissatisfied or on damages paid by the insurance companies when they lose these lawsuits. But Michael Moore does not explore the easy abuse these systems are the victims of from some people who are inconsiderate in overusing medical assistance or care. The state only intervenes for the people who do not work through subsidies or contributions to the "social security authority" to compensate for the contributions these people do not pay. Then he compares with the systems in four countries: Canada, Great Britain, France and Cuba. That would vastly account for the denial procedure that has to bring in a profit after paying for the expenses it incurs, money that could be used paying for hospital bills or doctors' fees. He notes the flat rate of a prescription in England (about ten dollars) but does not wonder why it exists. It is a complex system. He is probably right with Canada and Great Britain, and definitely with Cuba, when speaking of a state system.
This film though has a shortcoming. To make his point he follows the cases of quite a few people in the US who suffered these "ailments" or "ills" of the US health system. All of them have a globally free universal system where only some marginal costs are charged, at most. In France a small part of doctors' fees and prescriptions is not covered at all, even by the cooperative or private complementary insurance companies, by decision of the state in an attempt to curb down expenses and particularly abusive expenses. Finally let's keep in mind too that any system, private or public produces a bureaucracy and then a wasteful exploitation of an economic niche in society. Some people dying because of these denials, even infants, some people living in total discomfort, poverty, dependence even, because of the bills that ate up their homes, savings, and all other amenities they may have had before getting sick. This political documentary is a manifesto against private medical care in the US and for universal free health care, what some have called socialized medicine. And what's more about 30% of medical expenses are covered by cooperative, or private, insurances that everyone is supposed, if so is their choice, to get and to whom they pay premiums that are at times higher than the basic contributions.
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