Wednesday, July 11, 2007

Dr. Sanjay Gupta vs Michael Moore

Dr. Sanjay Gupta and Michael Moore got into it on Larry King Live last night. This follows just on the heels of Moore’s blowup the day before on CNN. Moore was rightly upset by a “fact checking” piece by Gupta. Gupta made two glaring errors of fact.

"(Moore says) the United States slipped to number 37 in the world's health care systems. It's true. ... Moore brings a group of patients, including 9/11 workers, to Cuba and marvels at their free treatment and quality of care. But hold on - that WHO list puts Cuba's health care system even lower than the United States, coming in at #39."

Moore never made attempt to hide the fact that Cuba was lower ranked than the US let alone imply that they are ranked higher. Gupta did not retract what he said. Moore showed the list of the rankings displayed in the movie it Cuba is clearly listed as being 39th on the list.

"Moore asserts that the American health care system spends $7,000 per person on health. Cuba spends $25 dollars per person. Not true. But not too far off. The United States spends $6,096 per person, versus $229 per person in Cuba."

The number Moore quoted in the movie was $251 and Gupta corrected the record last night. As for the US number numbers, in attacking Gupta, Moore, as he frequently does, missed the forest for the trees. Moore says that Gupta’s numbers, although from the same source, were from 2004 and his from 2006. This is fair criticism, but Gupta rightly pointed out that the same source that Moore took the Cuban number also listed US costs at $5,700 and Moore should use the same source when making a comparison. What Moore failed to note was the huge increase in US health care costs. In other words, he should have abandoned the Cuban comparison, and pursued another. From 2004 to 2006 US health care costs went up a $1000 per person. This is incredible, but what is even more incredible is that according the same that same source costs are supposed to increase in to $7400 per person by the end of 2007. To put this into perspective, if health care costs the same amount in absolute terms in Canada over the last 2 years, that would represent a 34% increase!

Rhetorically Moore fell down when he insisted on debating whether Americans are Cubans lived longer. Yes Moore did cite the most recent stats showing the Cubans live slightly longer than Americans and Gupta asserted just the opposite, but in the greater scheme of things no one is interested in a photo finish. Moore:

“The 2006 United Nations Human Development Report's human development index states the life expectancy in the United States is 77.5 years. It is 77.6 years in Cuba. (Human Development Report 2006, United Nations Development Programme, 2006 at 283.”

The point to be made here and one Moore makes in movie is why are the Cubans mortality figures even in the same ballpark as the US.

The rest of the debate focused on wait times and here Gupta proved to be the more adapt, graceful and knowledgeable than Moore. Worse for Moore, Moore failed to bring the very things we saw in the movie into this segment of the debate. Whenever, Gupta brought up wait times in Canada Moore would fire back that if you took 5.25 million Canadians out of the equation, i.e., one sixth population or the same percenatage as do not have health care in the states, wait times would be reduced here. That is good point, but an equally powerful one is the one he makes in his movie. Namely, with respect to the US, what matters is not only how long insured people have to wait for a particular procedure once it is approved by their HMO, but also whether the procedure will be approved in the first place. For example, the amount of time Tracy, who had insurance, waited in vain for a bone marrow transplant is not on the books.

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