Hire Google for your denialist campaign!

An alert reader noticed that when he performed a Google search on ‘Sicko’, guess who pops up in the sponsored links? Why, our good friends at AEI, a denialist organization second only to CEI, but since they have a lot of the same people working for both it’s really just academic which one you’re arguing with. When you need your crappy industry defended from public criticism, you can always rely on AEI or CEI to chomp at the bit and pretend there is “no problem”.

What’s even more interesting is that Google actually solicited ads (fixed link) to combat Sicko’s bad PR for the insurance industry. How’s that for “do no evil”?

AEI’s criticism is pretty weak:


First they criticize a film-maker for showing anecdotes.

Moore labors mightily to get the truth of the first claim somehow to rub off on the others. He thrives on anecdotes: We see specific cases of the misery caused by U.S. healthcare bureaucracy, and hear about better outcomes in, for example, Britain’s National Health Service (NHS).

I suppose he should have just filmed facts and figures for 2 hours? Anyway, in my review of the movie I predicted this would be the line of denialist attack. The problem with Moore’s coverage of foreign health care systems was that he did provide mostly glowing reports, he could have devoted more time to describing each of their drawbacks since that not only would have helped deflect criticism, but shown us what parts of each system are worth emulating. But that doesn’t stop AEI from quoting little nuggets out of context to make that Canadian system seem soooo scary.

Similarly, Canada is singled out for special praise by Moore, and he asks patients in a Canadian waiting room how long they’ve been literally waiting (half an hour or 20 minutes), but failed to show another great anecdote: Canada’s waiting list calculator. It allows you to calculate how long you’ll have to wait for surgeries. The median wait time for open heart surgery in British Columbia is three months, while the wait time for a corneal transplant is 2.5 months.

In Manitoba, Canada, the median wait time for “emergency cardiac surgery” is five days. And in the Canadian city of Winnipeg, the median wait time for cataract surgery is four months. These wait list calculators are all available online, scary illustrators of what happens in government-run healthcare systems.

Wow, median wait times are high! Notice when one goes to the actual sites to see what qualifies as “emergency cardiac surgery”, for instance you see what this surgery is – coronary artery bypass grafting. Not all emergency cardiac surgery as they suggest. They’re not waiting 5 days to perform angioplasty for patients undergoing a heart attack, and for many patients that require CABG aren’t necessary having an MI, it might be unstable angina or detection of significant blockages that is the need for the surgery. But to hear AEI tell it, if you have a heart attack you’ll wait in a waiting room for 5 days before they’ll see you in Canada – this is total BS. Leave it to AEI to make triage look like negligence.

And complaining that people have to wait for cataract surgery (not corneal transplant as they mistakenly link)? I mean really. Quick doctor, this patient is going blind from cataracts! If we don’t operate within the next 5 years, she won’t be able to see!

Then they suggest that the recent violent protests France were over taxes!

Moore also holds France up as an ideal. Yet despite income tax rates as high as 71% (including social security contributions) and an enormous public sector, young people, immigrants, and many other Frenchmen are deeply worried about the future. In 2005, “As France declared a state of emergency… to contain violence by enraged youths, Europeans watched with bewilderment and growing alarm at the continued torching of cars, at the destruction of businesses and homes, and at the defiance of police efforts to bring the rampage under control.”

Wow, hear that? All those disaffected poor Muslim youths who rioted last year were upset about taxes, not mistreatment by the government. Very smarmy AEI. Then check out their conflation of income with disposable income.

Moore’s documentary focuses instead on a happy, wealthy couple. They have an income near 8,000 Euros per month. This couple is hardly representative: 90% of single French people have a disposable income of less than 2,100 Euros per month. 90% of French families with two children have a disposable income of less than 5,300 Euros per month. It would be like interviewing an American couple on the Upper East Side of New York, or in Laguna Beach.

Actually the point was they weren’t wealthy, and there is a difference between income and disposable income, which AEI conflates to try to make this couple seem exceptional.

Then they suggest that we’ll lose our precious drugs!

Moore makes much of price controls–prescription drugs are cheaper outside of the U.S., and Moore is delighted that British hospitals charge a flat fee for them. But this comes at a price: new drugs are introduced first to American consumers, and many new cancer drugs available to Americans are simply not available to patients in socialized healthcare systems. A report by the Swedish Karolinska Institute, published in the Annals of Oncology, found that the U.S. uptake of lung cancer drug erlotinib is 10 times the European average. The same goes for the uptake of colon cancer drug bevacizumab.

And if the US socializes medical care the drug companies will release drugs in Tuvalu first? The author believes that drug companies in the US won’t actively pursue approval of their drugs with the American government? It also assumes we adopt a system that restricts which drugs can be used – not a requirement of socialized medicine by the way. One should also remember what is new is not always better, this is medically stupid thinking. And doctors that practice medicine by throwing the newest stuff off their shelves at their patients aren’t doing them a favor.

AEI also attacks the Cuba trip – which was obviously scripted. I doubt anyone could go to Cuba with a camera crew without government minders, but nevermind:

More disturbingly, when Moore went to Cuba to get healthcare for several sick Americans, they became a pawn in Castro’s propaganda machine. Of course the sick American patients Moore brought to Cuba received excellent care from Castro’s system–as the Cuban Mission Head in the audience probably thought, what better PR for Castro than to demonstrate that his system, while producing abject poverty for most people, at least provides good healthcare for the on-camera few? Meanwhile, medical supplies of all kinds are in chronically short supply in Cuba, particularly essentials such as aspirin. Cuban officials blame the U.S. embargo, but in a normal economy, private companies would spring up to fill any shortages of products such as aspirin, medical gloves or syringes–not so in Cuba.

So, Cuba is poor just because of Castro’s policies? An idiotic 50-year embargo hasn’t helped? This guy is actually suggesting that our little embargo has nothing to do with poverty and short supplies in Cuba? Is he freaking kidding? This is the stupidest argument yet. Cuba, if it had a “normal” economy would have all the advantages of the rich Western country – but those foolish Cubans have instead chosen to be embargoed by the largest economy in the world. The fools!

We should have done the same with Castro as we did with China, make them capitalists by trade, rather than isolate and impoverish them with an embargo that has done nothing to shorten Castro’s reign. If anything it’s just extended it.

This is the usual denialist garbage, statistics quoted out of context to suggest we’ll all die of waiting under a socialized system, and individual citations of incompetence and neglect – like those don’t happen in hospitals all over this country in our private system. I don’t think Moore was suggesting that socialized medicine would free us from incompetence – the straw man AEI happily attacks – I think he was suggesting that socialized medicine could free us from financial ruin from sickness – a problem the denialists are unable to address.

And shame on Google for soliciting advertisement from these liars.

I’ll leave you with this cartoon from Tom Tomorrow which pretty much sums up the conservative arguments against universal healthcare.

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Comments

  1. The trackbacks on that “Google Health Advertising Blog” indicate some back-and-forth on this. See, e.g., here.

  2. Steve Murphy

    Very much bang on with the Canadian situation (which is where I am). The wait times are indeed triage related. Horror stories of ER wait times always leave out the fact that most people in the ER are not there because of real emergencies – many are there because of Canada’s real healthcare problem of too few primary care physicians (GPs) and RPNs to intercept patients. There are exceptions where the wait list has gotten dangerous and there are cases where the ER was overwhelmed with a boatload of true ER cases but not near as much as the media imply. There is also a fair number of studies that note a lot of cases that become surgery cases could have been deflected with preventative care – and no I don’t mean quackery 🙂

    Love the criticism of Moore for using anecdotal evidence from organizations that use the same tactic to scare people; my irony meter burned out long ago with AEI and CEI

  3. Gerdien de Jong

    Moore makes much of price controls–prescription drugs are cheaper outside of the U.S., and Moore is delighted that British hospitals charge a flat fee for them. But this comes at a price: new drugs are introduced first to American consumers, and many new cancer drugs available to Americans are simply not available to patients in socialized healthcare systems. A report by the Swedish Karolinska Institute, published in the Annals of Oncology, found that the U.S. uptake of lung cancer drug erlotinib is 10 times the European average. The same goes for the uptake of colon cancer drug bevacizumab.

    “New” drugs are enormously expensive, and often just slightly different versions from an older drug when the patent runs out. It is well known that ‘generative’ drugs (I hope I got the term right) that are made by small companies after the patents of the large companies run out are as good, at a fraction of the cost. The price is for the American consumer to pay: in dollar, not in healthcare. The suggestion: newer is better above just does not work.

  4. An argument that should also be made whenever waiting lists are compared between countries with organized medical care and countries with banana republic medical care is that even if the official waiting lists are longer in the countries with organized medical care (a claim that is hardly universally true), this would not be surprising, nor prove anything much.

    After all, in a system where care is less than universal, part of the ill population will never get on the official waiting lists in the first place. I.o.w., the correct way of computing mean and median waiting time would be to estimate the number of ill people without insurance and count them as having a waiting time equal to their average remaining life expectancy, since they never receive any aid whatsoever.

    Of course, this is never done by the market-worshipers.

    – JS

  5. Of course, this is never done by the market-worshipers.

    Holy cow, JS. I had you pegged for a market-worshipper. 🙂 That’s the problem with being over on the dark side; you can’t really see who else has crossed over.

    Because it’s dark.

  6. That’s the problem with being over on the dark side; you can’t really see who else has crossed over. Because it’s dark.

    That conjured up some pretty funny mental images. Thanks.

  7. Have you seen the memo?

    Read bullet 4 of the “misperceptions cultivated by the movie” section on page 2. It’s directly out of “Thank You For Smoking”.

    Nice talking points at the end.

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