Friday, June 08, 2007

SiCKO is Boffo but Not Anti-Pharmaco, per se

While the pharmaceutical industry is part of Michael Moore's -- and many other people's -- "Axis of Evil" consisting of pharmaceutical companies, hospitals, and insurance companies, he does cut the industry some slack in his new movie "SiCKO," which I saw yesterday at a special screening in New York City. Pharma is merely a "necessary evil," whereas insurance companies are just not necessary at all -- at least the for-profit insurance industry.

Regular readers of Pharma Marketing Blog and Pharma Marketing News are well aware that I have been trying for some time to be invited to a pre-release screening of SiCKO (see, for example, "Moore: Please Don't Ignore Us Pharma Bloggers").

Finally, two days ago I received a call form the producers (The Weinstein Company) notifying me that there will be 3 or 4 screenings in New York in the coming days. I picked the earliest possible day, which was yesterday.

I must say that the PR experience was underwhelming, especially in comparison with the treatment I received at Dorland for the screening of Centocor's disease awareness movie INNERSTATE (see "Innerstate Private Screening: Philadelphia Style"). There were no producers present, not even PR people to answer any questions. I was merely greeted by a young woman who asked my name, handed me the PR material, and instructed me to take a seat in the screening room.

There were no goodies, no water even, but the seats were plush, living room-style upholstered chairs. The latter were much more comfortable than the conference rooms chairs at Dorland!

There were only about 3 or 4 of us in the audience. Frankly, I was expecting more reporters and bloggers to be there.

I've been reading for some time about how Moore et al will be reaching out to bloggers in Washington, DC and San Francisco. If my NYC experience is any indication, this hastily prepared PR effort to "reach out" to journalists and bloggers, hardly did the PR about the effort justice. Perhaps the NYC-area bloggers are not as important as are the DC-area or SF-area bloggers.

Or perhaps us pharma bloggers are not as important to Michael Moore as we thought.

One hint that this may be the case comes from a statement in the press materials:
"While major pharmaceutical firms are profit-obsessed corporations that bankroll Washington politicians and often lie about their research and development costs, the filmmakers viewed prescription drugs as 'a necessary evil' that may ultimately help patients. The same can be said for hospitals-though they, like Pharma, should be regulated and run more efficiently, people obviously need them.

Such allowances, however, couldn't be made for private insurance -- 'a completely unnecessary factor when it comes to health care,' says Megan O'Hara, one of SiCKO's producers. To make his point even more emphatic, Moore decided not to concentrate his efforts on the 45 million Americans who lacked medical insurance, but instead on the majority who are covered and were denied benefits or became strangled with ridiculous bureaucratic red tape."
SiCKO does indeed focus on the health insurance industry with only a few references being made to pharmaceuticals. It does, however, blast Billy Tauzin, CEO of PhRMA, for his support of Medicae Part D legislation and his subsequent reward from the drug industry of a $2 million salary.

I particularly liked the video clips of Tauzin in late night Congressional sessions challenging other lawmakers with "no one here loves their momma better than me." He sounded like Al Jolson!

But, as promised, SiCKO is not about Moore confronting CEOs and other corporate bigwigs as he does in his other movies. Pharma had feared this would happen when SiCKO was just a gleam in Moore's eye: Ken Johnson, senior vice president of the Pharmaceutical Researchers & Manufacturers of America (PhRMA) trade group told a journalist that industry executives were "freaking out and pulling their hair out." Indeed, Big Pharma went on lockdown. "Michael Alerts" were sent out to company employees working for at least six major drug companies, warning them to watch out for Moore and his film crews. "We ran a story in our online newspaper saying Moore is embarking on a documentary - and if you see a scruffy guy in a baseball cap, you'll know who it is," a Pfizer spokesman told the L.A. Times. Late last year, CNBC reporter Mike Huckman noted "the level of paranoia was extreme" when he covered a drug company's analyst conference, questioning the reason for the high anxiety as "The Michael Moore Effect."

Moore does believe, however, that pharmaceutical companies should be more regulated "like Con Edison," which I take to mean government oversight of drug pricing.

But he does not dwell or even mention price controls in SiCKO.

His approach is very similar to the approach Centocor took in its INNERSTATE "drugumentary": he focused on real problems of real people and let them tell their stories. I dare say that any one reading this could find him or herself in the shoes of one of these people some day, God forbid.

Take the fifty-plus year old couple who had to move into a single room in their daughter's basement after they went bankrupt paying medical bills. The father had multiple heart attacks and the mother had cancer, I believe. Both had good jobs -- the wife was a newspaper editor and the husband a machinist -- and "good" medical insurance, which maxed out and left them high and dry -- or rather low and wet in their daughter's basement.

The film focused on these kinds of Americans, although it did start out with an uninsured guy stitching his own wounded knee -- pretty gory! But, as Moore says, this is not a film about the 45 million Americans without health insurance; "it's about the rest of us 250 million Americans with insurance."

SiCKO's main message is that the profit motive should be removed from health insurance, presumably by having a national health insurance program as they do in the UK. The movie documents how health insurance companies deny coverage to maximize profits, which, Moore reminds us, is a fiduciary responsibility of all corporations with stockholders.

Moore visits several other countries that have national health insurance, including Canada, the UK, France, and Cuba. All but Cuba are rated superior to the US in health care quality by the World Health Organization. A clip in the movie from a British news story claims that the poorest British citizen has a longer life expectancy than the richest American.

SiCKO attempts to counter all the familiar arguments against national health insurance: lack of care, physician dissatisfaction, etc. It does this by interviewing people like the GP in the UK who owns a late model Audi and a $1 million apartment in London and whose annual salary (including benefits) is about $200,000. How does he rate this? Outcomes, my friend, outcomes. If his patients do better, he makes more money. But let's not focus on this and move on with my review.

Not that such anecdotal evidence proves anything, but it really makes a good impression when you hear these stories from real people rather than from PhRMA or the AMA.

BTW, Moore also blasts the AMA on this issue, especially during the "Hillary" years when then first lady Hillary Clinton tried to implement a national health insurance program. AMA, claims Moore, orchestrated an all out attack along with other self-interested parties to defeat Hillary's efforts. And Moore doesn't spare Hillary, who he claims was bought by the healthcare industry for the sum of about $800,000 in campaign contributions.

So, surprise! Moore and Hillary are not a pair!

SiCKO will give many people something to think about and cry about. I'm not going to get into the crying here except to say that at many points in the movie, there wasn't a dry eye in the screening room!

One thing I left the movie thinking about is how can Americans change this so that, as Moore says, there is more "we" than "me" inherent in how health care is managed in this country?

"Remember how we all felt right after 911?" Moore asks at one point. He was referring to the sense we all had of being "we" Americans and sharing what we have with others in order to survive and flourish. Although this feeling was short-lived after 911, Moore suggests that that was the feeling in Britain after WWII -- when the country was devastated by war -- that led to its National Health System (NHS), which is, it seems, beloved by the Brits. "If anyone were to suggest that we get rid of NHS," said one former British Labor party member, "there would be a revolution."

Will it take another American Revolution to change our healthcare system? No necessarily. It may only take one person.

That was my other takeaway from SiCKO: one person can make a difference.

Speaking to an older conservative Canadian riding around in a golf cart, Moore discovered that the most revered person in Canada is NOT Wayne Gretzky, but Thomas Clement Douglas. Looking up the history of the Canadian health system in Wikipedia, I find that Douglas introduced universal public medicare to Canada. Mysteriously, Moore did not say much about Douglas in his film -- perhaps due to the fact that Douglas was a socialist, albeit a democratically-elected socialist.

Of course, socialism (democratically elected or not), is the great bogey straw man that AMA raised against Hillary in the 1990s and which has been consistently raised every time national health health care is discussed here in the US.

Moore points out that we already have socialism here, but would never call it that. His examples are fire departments -- we never pay to be rescued by firefighters; they are our heroes -- and public schools.

Speaking of firefighters and heroes, SiCKO exploits the lack of health care received by some 911 volunteers. We all know by now the story of how the movie shows these people getting expert care in Cuba. Aside from the propaganda value, you have to shed a tear seeing Cuban firefighters standing at attention to greet and hug the Americans saying all firefighters and 911 volunteers are "family."

Too bad we are not "family" when it comes to treating fellow Americans. That a hospital can get away with dropping off indigent women in skid row rather than treating them is a travesty, no matter whose "family" you belong to -- conservative or socialist or in between. That, I think is the main takeaway from SiCKO that Moore desires us to have.

13 comments:

  1. John Galt10:39 AM

    Mack wrote "Too bad we are not "family" when it comes to treating fellow Americans. That a hospital can get away with dropping off indigent women in skid row rather than treating them is a travesty, no matter whose "family" you belong to -- conservative or socialist or in between. That, I think is the main takeaway from SiCKO that Moore desires us to have."

    Oh, but the real tragedy is that they didn't give you water and treat you like a VIP --rolleyes--

    ReplyDelete
  2. Grow up, already! and submit a real comment like a grownup!

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  3. Anonymous11:42 AM

    John, don't waste your breath.

    The pseudonym "John Galt" says it all.

    A grownup thought from a follower of Ayn Rand? That's as oxymoronic as it gets.

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  4. Like this film will have any real impact. More than 50% of the USA is against continuing the WAR in Iraq and the war goes on.
    http://www.pollingreport.com/iraq.htm

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  5. Our country is in danger, but not to be despaired of. Our enemies are numerous and powerful; but we have many friends, determining to be free, and heaven and earth will aid the resolution. On you depend the fortunes of America. You are to decide the important question, on which rest the happiness and liberty of millions yet unborn. Act worthy of yourselves.
    Joseph Warren, Boston Massacre Oration, 1775

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  6. Anonymous9:24 AM

    Moore didn't mention anything about lawsuits in his film, how would our government deal with that? Patients suing to try to get money for any less than perfect outcome? Medicine isn't a perfect science, and the UK, France and Canada know that. The US has let lawyers sue for millions, how did John Edwards make his billions? The government would be bankrupt with lawsuits if we had National Healthcare.

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  7. Thanks for your comments.

    Remember the 911 victims fund? Didn't the families have to sign a waiver to forego civil suits to receive coverage from the gov't? Same thing for universal health coverage.

    QED

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  8. Anonymous3:35 PM

    Thanks for your reply. If families have to sign waivers, and there are no more medical malpractice suits, do you think congress, of which most are lawyers, are really going to vote for National Health Care?

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  9. Sorry, I cannot solve ALL our problems. Do you want to kill all the lawyers? Other than that, I do not know how we can bypass Congress except for rebellion!

    Whatever the solution, it takes strong leadership.

    Congress is a bunch of followers, not leaders.

    So, my solution to your problem with Congress is to elect a strong leader who has the vision to make these kinds of changes.

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  10. About what was said about lawsuits - I haven't seen Sicko yet, so I don't know what exactly MM says, but the current proposal for universal health care, HR 676, provides for a government-provided, single-payer insurance system with no deductibles, copays, etc. that reimburses doctors for the care of their patients. However, health care is still provided privately, and doctors would presumably still be held accountable for their errors. So lawsuits would not be directed at the government, but rather private physicians.

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  11. Probably the most realistic soln.

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  12. Anonymous4:03 PM

    Maybe realistic, but there would be massive retirements of physicians. Universal Health Care could not pay them enough to be able to handle malpractice insurance premiums. So when they overhaul the insurance industry, which don't get me wrong, is needed, they would need to enact some meaningful tort reform to make it work. The one physician shown in the film is in the vast minority. We know of docs who after spending years getting an education are making $40K/year for 60/70hr work weeks and looking at alternative careers.

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  13. I guess you are talking about docs in the UK. They may have spent many years getting educated, but how much did they pay for that education?

    Not that I really know the answer, but if this country had its priorities straight, it would support physician education.

    If all expenses were paid in return for X years of national health service, maybe that would help.

    Afterward, like in the UK, physicians who want to make more money could go into private practice and work for the wealthy.

    This sort of thing is even happening here, except that while the wealthy get concierge care, the rest of us are stuck in waiting rooms or, if we are so unlucky as not to have insurance, thrown out in the streets after getting minimal emergency care.

    Then there's "consumer-directed" insurance. Don't get me started on that!

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