Monthly Archives: June 2007

Sicko Review

Michael Moynihan watches Sicko so you and I do not have to:

Michael Moore is as conspiratorial as ever. The online leaking of Sicko, his new documentary on the American health care system, was an “inside job,” he said. It was an attempt at “ruining the opening weekend’s box office” by those with a “vested interest” in seeing the film fail. And that’s not all. Government officials, the Fahrenheit 9/11 and Bowling for Columbine director told reporters, are so anxious about his paean to Cuba’s health care system that he stashed the master reel in Canada, lest the Bush administration try to seize it.

But the administration needn’t worry about Sicko. As with much of his previous work, Moore’s latest film is, by turns, touching, naïve and maddeningly mendacious, a clumsy piece of agitprop that will likely have little lasting effect on the health care debate. Moore is right that the American system is sick—on this, there is bipartisan and public consensus. The United States has the highest per capita health care spending in the world, with comparatively disappointing results. But his radical prescriptions, which include a call for a British-style, single-payer system, will likely have little resonance with viewers. Indeed, according to a recent ABC News/Kaiser Family Health study, insured Americans are overwhelmingly (89 percent) satisfied with their own care, while broadly concerned about rising costs of prescription drugs and critical of the care others receive.

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Sicko presents us with the case of Doug Noe, whose young daughter Annette was born with an acute hearing disability. When a doctor suggested a pair of cochlear ear implants, Noe’s insurance provider, Cigna HealthCare, approved the procedure for only the left ear, arguing that a two ear operation was “experimental.” But when Noe alerted Moore to Cigna’s intransigence, the company quickly reversed its decision, fearing bad publicity.

Score one for Citizen Moore.

Such heartless penny-pinching, Moore argues, is uniquely American, the logical endpoint of a system that puts profit before people, as the saying goes. But fear not. For according to Sicko, there exists an alternative, modestly utopian alternative. In Europe—specifically France, England and Scandinavia (Moore filmed in Norway, but didn’t include it in the film, he told audience members at the Washington, DC premiere, because it was so generous he feared American audience members would think it was pure fiction)—every health care issue is handled by a squadron of munificent bureaucrats.

But, the viewer is left wondering, who will pay for all this generosity? Don’t governments too suffer from cash shortfalls and ballooning budget deficits; situations that require corners to be cut, beds to be freed up, the cheapest route taken? What of Moore’s implication that, once turned over to the government, things become “free?”

Take the case of four-year-old Elias Dillner. In 2004, Dillner’s parents were told by doctors that their son too would benefit from cochlear implants. After being fitted with the first implant, Dillner’s insurance provider said the second operation could not be “prioritized.” The family would have to wait. “We will do anything,” Elias’s mother told reporters, “even if it means that we have to take out a loan for the operation.” Without insurance, the second procedure would likely cost $40,000.

But Dillner’s truculent insurance provider was not Aetna or Kaiser, but the notoriously generous Swedish welfare state, where health care is “free.” And because there is no private clinic in Sweden that could perform the operation, Elias will sit in a queue, hoping, in lieu of privatization, for prioritization. Swedish legislator Robert Uitto said that the Dillner case was unfortunate, but “People shouldn’t, on principle, be allowed to purchase care in the public system.”

Sicko also introduces us to Diane, whose brain tumor operation was initially denied by Horizon BlueCross because it didn’t consider her condition “life threatening.” She eventually received treatment, but “not without battling the insurance companies,” Moore says.

Jack Szmyt found himself in a similar situation. After waiting two months for his initial diagnosis—he too had a brain tumor—Szmyt was told that it would be another month until doctors could start the necessary treatment. Rather than wait in a queue, he borrowed $30,000 from a friend, and flew to a private clinic in Germany. Had he not sought private treatment abroad, his German doctor said, he would likely have died. When contacted by the media, his insurer, again the Swedish government, said it didn’t consider the assigned waiting period “unreasonable.”

Such examples suggest that Moore’s depiction of European-style medicine as an easy panacea for America’s problems is rather more complicated than presented. Massive queues and cash shortages have plagued all of the systems profiled—and celebrated—in Sicko.

Read the whole thing.

“Freegans”

The New York Times reports:

ON a Friday evening last month, the day after New York University’s class of 2007 graduated, about 15 men and women assembled in front of Third Avenue North, an N.Y.U. dormitory on Third Avenue and 12th Street. They had come to take advantage of the university’s end-of-the-year move-out, when students’ discarded items are loaded into big green trash bins by the curb.

New York has several colleges and universities, of course, but according to Janet Kalish, a Queens resident who was there that night, N.Y.U.’s affluent student body makes for unusually profitable Dumpster diving. So perhaps it wasn’t surprising that the gathering at the Third Avenue North trash bin quickly took on a giddy shopping-spree air, as members of the group came up with one first-class find after another.

Ben Ibershoff, a dapper man in his 20s wearing two bowler hats, dug deep and unearthed a Sharp television. Autumn Brewster, 29, found a painting of a Mediterranean harbor, which she studied and handed down to another member of the crowd.

Darcie Elia, a 17-year-old high school student with a half-shaved head, was clearly pleased with a modest haul of what she called “random housing stuff” — a desk lamp, a dish rack, Swiffer dusters — which she spread on the sidewalk, drawing quizzical stares from passers-by.

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A few of those present had stumbled onto the scene by chance (including a janitor from a nearby homeless center, who made off with a working iPod and a tube of body cream), but most were there by design, in response to a posting on the Web site freegan.info.

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Many freegans are predictably young and far to the left politically, like Ms. Elia, the 17-year-old, who lives with her father in Manhattan. She said she became a freegan both for environmental reasons and because “I’m not down with capitalism.”

There are also older freegans, like Ms. Kalish, who hold jobs and appear in some ways to lead middle-class lives. A high school Spanish teacher, Ms. Kalish owns a car and a two-family house in Queens, renting half of it as a “capitalist landlord,” she joked. Still, like most freegans, she seems attuned to the ecological effects of her actions. In her house, for example, she has laid down a mosaic of freegan carpet parcels instead of replacing her aging wooden floor because, she said, “I’d have to take trees from the forest.”

Not buying any new manufactured products while living in the United States is, of course, basically impossible, as is avoiding everything that requires natural resources to create, distribute or operate. Don’t freegans use gas or electricity to cook, for example, or commercial products to brush their teeth?

“Once in a while I may buy a box of baking soda for toothpaste,” Mr. Weissman said. “And, sure, getting that to market has negative impacts, like everything.” But, he said, parsing the point, a box of baking soda is more ecologically friendly than a tube of toothpaste, because its cardboard container is biodegradable.

These contradictions and others have led some people to suggest that freegans are hypocritical, making use of the capitalist system even as they rail against it. And even Mr. Weissman, who is often doctrinaire about the movement, acknowledges when pushed that absolute freeganism is an impossible dream.

Don Luskin remembers when these people were called bums. J.H. Huebert meanwhile takes on this concept of freeganism:

Of course it is only because of capitalism that people — even college students! — are so wealthy that they can simply throw away such miraculous products as television sets and computers when they’re done with them, and bums (let us call freegans what they are) can live relatively well off them for no money. These people have not “absented themselves from capitalism” — they’re among its least productive (and thus highest paid) beneficiaries.

We’re From the Government…

Radley Balko writes:

A few weeks ago, Rustico owner Greg Engert put a St. Louis Framboise in the freezer to chill and forgot all about it. A few hours later, he went back to retrieve the beer and noticed it had frozen solid. He chipped out a chunk, tasted it, and an idea was born: the hopsicle. He quickly moved to put a variety of frozen beer treats on the menu.

Enter the Virginia Department of Alcoholic Beverage Control. We can’t have people innovating, you know. And we certainly can have people making alcohol fun or interesting. As it turns out, beer must be sold in its original container, or poured immediately into a glass (though I’m not sure how this accounts for deserts or foods made with beer). So the state egency is sending an appropriately official sounding “special agent” to investigate.

Mankiw Does It Again

The Washington Post reports:

Mitt Romney is happy to get Greg Mankiw’s economic advice — except when it’s economic advice conflicting with immigration advice the Republican presidential contender has also received.

Highlighting the challenge a far-flung campaign faces when it comes to message discipline, Romney has had to distance himself from his top economics adviser after Mankiw — a Princeton-trained economist now teaching at Harvard — voiced his support for an immigration bill Romney strongly opposes.

The title of this post is tongue-in-cheek. Of course we all remember the ridiculous Mankiw-outsourcing extravaganza where he was raked over the coals for saying something that is largely accepted among economists. Mankiw responds to the latest non-story:

No sensible voter would think less of a candidate who has advisers who sometimes disagree with him. But a sensible voter should think less of a candidate who has no advisers who ever disagree with him.

Indeed.

I am not really sure that anyone votes for candidates based on their advisers — other than Arnold Kling. If I were inclined to do so, I would likely vote for Obama.

Tyler’s Secret Blog

Tyler Cowen has a secret blog and he is willing to tell you the site address so long as you pre-order his book. The book is taking off, getting as high as #220 on the Amazon bestseller list. The feedback that Tyler has received regarding the secret blog is quite amusing. Here are my favorites:

3. Most people sent in proof of purchase, and were keen to have me look at it, even though I did not ask for it.

4. People asked very earnestly whether it was permissible to show the secret blog to their spouse (it is).

5. Some people wrote me long emails, with complex economic arguments, as to why I should give them the blog for free. But they weren’t willing to simply lie and get the site address.

American Productivity

Austan Goolsbee has written a fascinating piece in The New York Times:

To explain the experience in the United States, one would have to believe that Americans have some better way of translating the new technology into productivity than other countries. And that is precisely what Professor Van Reenen’s research suggests.

His paper “Americans Do I.T. Better: U.S. Multinationals and the Productivity Miracle,” (with Nick Bloom of Stanford University and Raffaella Sadun of the London School of Economics) looked at the experience of companies in Britain that were taken over by multinational companies with headquarters in other countries. They wanted to know if there was any evidence that the American genius with information technology transfers to locations outside the United States. If American companies turn computers into productivity better than anyone else, can businesses in Britain do the same when they are taken over by Americans?

And in the huge service sectors — financial services, retail trade, wholesale trade — they found compelling evidence of exactly that. American takeovers caused a tremendous productivity advantage over a non-American alternative.

When Americans take over a business in Britain, the business becomes significantly better at translating technology spending into productivity than a comparable business taken over by someone else. It is as if the invisible hand of the American marketplace were somehow passing along a secret handshake to these firms.

Read the whole thing.

Health Care Reform

Arnold Kling writes:

My reading of Douglass North is that real health care reform in the United States will not happen because of some wonk’s clever plan. It will not happen as a result of an election. It will only happen when we change some of our beliefs about health care.

Read the whole thing.