In following up on my last post on Michael Moore v Dr. Sanjay Gupta this time as both of them appeared on Larry King Live my initial thoughts are that I've known a great many Doctors like Gupta who clearly thought they were the smartest guys in the room and treated everyone else with a level of disdain and contempt that was obvious. But Gupta takes that to a whole new level. Many (but not all) Doctors are already a bit arrogant, but that's nothing compared to Gupta The Great Brain Surgeon who clearly would be the biggest
Details over the flip.
As he has promised on Wolf Blitzer's The Situation Room, Moore provided a fact check of Gupta's "Fact Check" and pointed out exactly which errors had set him off in detail.
- Gupta's CNN report charged that although Moore complains that America is only ranked 37th in Health Care by the World Health Organization (WHO) - it neglected to point out that Cuba's care which Moore touts is at number 39. Moore points out that this is clearly shown in the film and is even visible in the trailer.
- Gupta's CNN report argues that Moore overestimates the amount spent by America on heathcare at 7,000 per person instead of their number which is $6029, and that they underestimate the amount spent by Cuba as being $25 when their number is $229. Moore counters with data from the U.S. Dept of Health & Human Services which states the figures at $7,092 in 2006 and $7,498 in 2007, while the Gupta's data for Cuba is just flat wrong. SiCKO uses a BBC figure of $251, the WHO's figure is $229.
- Gupta's report claimed that Americans live longer than Cuba, Moore points out the the UN says they don't. (77.5 years for the U.S., 77.6 years for Cuba)
- Gupta's report claimed Americans have the highest patient satisfaction rating. Moore points out that this might be because they just don't know what there missing, and that patient satisfaction is just one of the factors included in the WHO report (where we placed 37th) and then again, the people who would have the biggest complaints the 47 Million people who are uninsured aren't being included in those surveys. Ask everyone (including ME and My WIFE) and Americas satisfaction rating will plummet I promise you!
- Gupta's report claims that Americans have shorter wait time for elective procedures than Germans, but Moore points out that this claim doesn't cover the averate wait times for All Procedures in all six industrialized nations included in the study - of which America ranks next to last at number five, just ahead of Canada. All five of the other countries surveyed (Canada, U.K., Germany, Australia, New Zealand) have nationalized health care except the U.S.
- Gupta's report claims that SiCKO alleges that healthcare in these other countrie is free, when it isn't - it's paid for via taxes and the tax rate in all the countries that rank ahead of us are all higher than ours. Moore counters that he never said it wasn't paid for by taxes. "France is Drowning in Taxes" he says, but also that Americans are going bankrupt trying to pay their medical bills. How's that for "drowning?" BTW I've been Bankrupt - it's not fun.
- Gupta's report claims that even after paying all those taxes, people in these countries still aren't satisfied with their care and that 15% stll pay for private insurance. Moore counters that this figure is only 11% in the U.K., but that this doesn't replace their access and use of the existing system, it's just a supplement (PDF).
- Gupta claims that SiCKO - "Fudged the facts". Moore (correctly) calls this "Libel"
King himself - neutral "unbiased" CNN employee that he is - sets the stage: although CNN made one "minor teeny tiny error" by just being off by 900% on the cost of healthcare in Cuba, Michael Moore is clearly a crazed madman.
Part 1.
Full Transcript.
KING: By the way, that report that you just saw was updated from the version that ran yesterday. The original report did have one error.
Before I get to Michael Moore, let me ask Sanjay to -- what -- what happened with that correction?
GUPTA: -- Yes, we made a mistake, Larry, with regards to the per capita spending for Cubans. Michael correctly -- he said $251 in the movie. We said $5, misquoting him $25 per capita in the piece. And that was a mistake of ours. It was an error of transcription and it's -- we want to get these facts and figures right, as a doctor and a journalist, so we corrected that. But we wanted to make sure we just made that very transparent.
See just minor problem, nothing to see here - move along now move along. But geez, that Moore guy, what a grouch.
KING: Michael, what ticked you off so much about that report?
Well, gee I'm guessing... Everything!
MOORE: -- Well, there's still a lot of facts that remain untrue in that report.
I'll start with the per capita that we spend in this country per person. The film says nearly $7,000 per person in the United States we spend on health care every year. Dr. Gupta said it was around $6,000.
Unfortunately, he's using old statistics from 2004. My statistics are actually from Mr. Bush's Health and Human Services Department, from 2007. And that's only one of a number of things he uses. The Cuban longevity list --
Since Larry can't do math in his head, "let's see 7 - 6 carry the 0" he has to interrupt Micheal mid sentence with this urgent burning question.
KING: But how -- how vast is the difference?
MOORE: -- He's using -- well, you mean the longevity rates?
KING: No, between what he reported of being spent and you report being spent?
MOORE: -- It's a -- it's about a $1,400 difference now. This year Health and Human Services says that we're going to spend about $7,400 per person in this country, not 6,000, as Dr. Gupta said. He's using 2004 statistics.
For those of you who are math challenged like Larry, the difference is a 24.3% increase between Gupta's numbers and Moore's over the course of 3 years or an inflation rate of about 8.1%. (The projected increase between 2006 and 2007 is 5.7%) The current rate of U.S. inflation (as of this month) is 2.69%. It's highest peak since 2004 has been 4.65% in Sept of 05. I'm not an economist, but to me it seem that either way you cut it that means the average rate of profit for healthcare - compared to the general inflation rate - is about 3 to 5% greater.
So Gupta has out-of-date information which is off by 24% compared to current figures. Does he apologize? Does he correct himself? Frack No!
GUPTA: Well, you know, look, we try and look for some of the best sources that we can possibly find, because we think we owe that to our viewers.
You know, Michael has a lot of different numbers here and he's pulling them from different places. One quick example -- Michael, I think you're going to agree with me on this --
MOORE: Oh --
GUPTA: Just hang on one second. $251 is what you cited in the movie as the per capita spending, which I just corrected, by the way -- you heard that -- per capita in Cuba. You have $229 on the Web site. So your Web site and your movie, first of all, don't jive.
Just for the record, Gupta is wrong again... Moore's Site says:
SiCKO: In the U.S., health care costs run nearly $7,000 per person. But in Cuba, they spend around $251 per person.
The 2006 United Nations Human Development Report says Cuba spends $251 per capita on health care. (Human Development Report 2006, United Nations Development Programme, 2006. http://hdr.undp.org/hdr2006/statistics/indicators/52.html)
But then again, anyone who knows the web knows that a site can be scrubbed, and I've been in a ER waiting room all night so what do I know? So lets check the cached version of the page.
As of July 10th, Moore's page used to say this.
SiCKO: In the U.S., health care costs run nearly $7,000 per person. But in Cuba, they spend around $200 per person.
* The World Health Organization puts Cuba's per capita health spending at approximately $229 American dollars. WHO, "Core Health Indicators, Country, Indicator and Year selection, 2007,"
http://www.who.int/whosis/database/core/core_select.cfm
In the pursuit of truthiness, Michael updated his page after the 10th - the day he appeared on Larry King, so it probably did say what Gupta said it said on that day on that on page (although Moore's factcheck page in reponse to Gupta's report which he put up before his King appearance had both the $251 and $229 figures shown in contrast).
The difference between the two figures - both of which are current - is? 9.6%
Gupta's been off by 900% and by 25% - while Moore in all fairness has had a 9.6% discrepancy between two equally respected agencies the WHO and the UN but what's interesting is that in the film and in his webpage update Moore has gone with the higher number rather than pushing the lower Cuba figure in order to make Americas healthcare system look bad. He knows that he doesn't have to "cherry pick" the worst number in order to do that - it looks bad all on it's own.
Gutpa continues his attack claiming that Moore has been dishonest in his sourcing.
That's -- where you pulled the $251 number was a BBC report, which, by the way, stated that the per capita spending in the United States was $5,700. You chose not to use the $5,700 from one report and chose to go to a totally different report and you're sort of cherry picking data from different reports.
In his report Gupta used WHO figures to argue that Moore left out mention of Cuba being ranked at #39, when he didn't leave it out. They then skip to the UN/BBC and mistated those figures on Cuba, then they used DHHS figures on the U.S. of $6000 which are three years out-of-date but they also ignored the UN figure of $5,700.
I happened to check on the source of that $5,700 figure - it came from the UN Human Development Report for 2006 and like the other figures used by Gupta - is for the year 2003 and is four years out of date. But lets just ignore that the numbers are stale a second and pay attention to what else it says. Of the top ten ranked nations for Human Development, the U.S. is way down at number 8 and what we spend on health care is nearly twice that of all the other nations whom out rank us!
Health Care Expeditures Per Capita
See that? Yippee.. we're number 8! We're Number 8!
Up yours Netherlands.
Go U.S.A!
(Pssst. Even if you use all 2003 data. We're still Number 1 in spending, but not in results!)
And Moore is the one "Cherry-Picking?"
No, Moore is simply using the most current data. The UN hasn't yet released it's 2007 HDR report yet - so there simply isn't any more current data for Cuba - but that report will probably give us 2004 numbers for Cuba and the U.S. both. It also probably wouldn't be a stretch to expect that the UN's $5,700 figure for '03 is probably going to match HHS's $6,029 figure for '04, and confirm HHS's methodology. HHS simply doesn't have data or projection from Cuba, that's not what they do, but it does for the US and if HHS has actual numbers for '06 and projections for '07, so why not use them?
Cuz Sanjay says so.
MOORE: I'm using President Bush's own statistics from Health and Human Services. And I put this up on my Web site so people can go and source it themselves. And, in fact, when I --
GUPTA: Michael, you're using projected numbers, though, right?
You're using projected numbers?
And we're using actual numbers.
MOORE: What I did -- yes, in the --
GUPTA: You're using projected numbers.
MOORE: And in the movie -- right.
And in the movie I use the number from Health and Human Services, which as I said, nearly $7,000 per person and Health. And Human Services, last year, said it was a little over $7,000.
Note to Sanjaya: Numbers from last year are not "Projected". Gupta is trying to argue here that his data from 2003/2004 is somehow more accurate than Moore's data from 2006!
Did I mention he was a prick?
Oh and by the way, Moore had sent all this information to Gupta's producer in an email - before the report ran.
MOORE: I -- let me just finish, though. I posted this e-mail that we had with your producer a day before this report ran so that you had all the facts. You ran the story knowing that the facts were wrong and I posted this five minutes ago --
KING: But, wait a minute.
MOORE: -- and (INAUDIBLE).
KING: Why --
GUPTA: Michael, just -- just, if I can say --
MOORE: So people can read this for themselves.
GUPTA: Just because you say they're wrong, I mean it doesn't make it so, Michael. I mean we try and do what you do. We try and get the best available data --
MOORE: I'm not the one saying it's wrong. President Bush says you're wrong.
This right here is the part that gets me, Gupta apparently doesn't trust Bush's HHS (no wonder) or the UN, but he completely supports the WHO (as long as they say exactly what he wants the hear) and he has the nerve to get pissy about it.
GUPTA: We -- you took issue with the ranking of the United States health care versus Cuba, 37 versus 39. We used World Health Organization data. We used the World Health Organization data for the numbers that you just heard in terms of per capita spending. We used the World Health Organization data for mortality rates, as well.
I mean you say that was flatly untrue in terms of -- of the mortality in Cuba versus the mortality in the United States.
Michael, you just can't say things like that without backing it up.
I can show you the data. You've seen it yourself, which I think is most irksome, because you know that there's data out there that actually shows --
Irksome? IRKSOME!? Moore sent his data to Gupta's producer before he does his report - Gupta ignores him, then criticizes him for the data that he used, even though it's more up-to-date and accurate than Gupta's numbers are (but not significantly different as to indicate a different fair reading of their meaning) - then scolds him like a twelve-year-old for "not backing it up."
Let I said, Mega-prick.
If this egomaniac was flying a plane, and Captain Sanjaya was off by 25% on a flight from New York to LA due to a "clerical error" he'd either wind up 700 miles in the middle of the Pacific Ocean or crashing into the Grand Canyon. Not exactly what I'd call the "friendly skies."
What the WHO Data for the year 2005 which shows is that the Male Mortality Rate between US and Cuba is actally the same, both have a 75-year life expectancy. The difference comes with women, in the US the WHO figures give them an 80 year average, while Cuban women have a life expectancy of - get this - just a measly 79 years. In both areas 32 nations rank higher than the U.S. on average life expectancy with San Marino being the highest for men at 80, and Japan as the highest for Women at 86.
Rather than "not backing it up" Moore uses UN figures which show a difference between the U.S. and Cuba of 1 tenth of a percent, which equates to roughly 5 weeks.
I double-checked those figures as well (PDF table 10, Page 315) and what I see in the current UN data is that averaged between the years 2000-2005 the U.S. life expectancy is 77.3 and Cuba's is 77.2.
Five more weeks? Yee hah!!
That's still a lot closer than being 900% or even 25% off the mark I would think.
The scandal here isn't that Cuba is better than us on any specific issue on the whole, it's how did a nation that's been under an international embargo for the past 40+ years can even get anywhere near us while we're paying 22 Times what they pay even if you use apples-to-apple comparison of same/year same/source numbers from the WHO?
If you look at the numbers, any numbers, there's no real way you can conclude that America is getting the "best bang for it's buck" on healthcare. What we really need to be talking about is why? and on that point lets leave it to the Goopster to keep the waters nice an muddy.
Part 2.
Gupta: And you brought up the point, Larry, maybe the numbers aren't that wildly different. But I think the numbers are important here because I think the issue here is that I think it blackens the eyes of people who are actually trying to do something about health care, who actually want to know the numbers, who want to do right by their bodies and their loved one's health. It makes it very hard to advance the argument if you're not getting the numbers right.
Oh, so using out-of-date "wrong numbers" and being off by 900% and 25% blackens whose eye exactly?
This sounds a lot like that ole - "don't point out to the troops that their getting killed, it might hurt the troops" line. As if they haven't noticed The Dying, the Braindamage, the loss of limbs and the PTSD yet. Let's not bring up the statistical information that shows that we pay far more and get less or just barely what they get in Cuba, or France or Germany or Canada or New Zealand or England - let's just keep clapping for the Health "Tinkerbell" Industry so she just won't flop over on her side and die.
You wouldn't want Tinkerbell to die would you?
I also think the whole idea, Michael, of just calling it a free system I think is a little bit nebulous to people who don't fully understand what you mean by that. Yes, you've got to raise taxes significantly. I mean France is drowning in taxes. They're running a $15.6 billion debt. I mean it's very hard to pay for this sort of thing. And to just call it free and say it's free, I think, makes it very -- it's murky, Michael, at best. And I think that's what I have difficulty with when you're trying to really advance a scenario here where we can get health care for everybody. KING: Good point. Michael?
MOORE: Well, he just used the line from my film where I said the French are drowning in taxes. That's my line.
Right?
GUPTA: Well, look --
Let's get back to that 2003 UN per capita chart - the one Gupta berated Moore for not using - and add to it the percentage of GDP the that top ten nations spend both from private and public sources on healthcare with France added into the mix just for fun. (PDF Table 6, Page 301)
France just may be "Drowning in Taxes" but they certainly aren't spending all of that money on their Healthcare system. The U.S. Pays far more on it's private health care system as an overall percentage of it's GDP than France does on it's Public System. Japan literally spends about half what we do on healthcare yet Japanese women have the longest average life expenctancy in the world. Spin that.
There is no evidence anywhere that we would have to "tax ourselves to death" in order to account for all of the people that are currently uninsured in our country. At the end of President Clinton's second term we were running a budget surplus, Medicaid, Medicare and even Social Security were effectively solvent for decades. If we can afford to spend $600 Billion on killing people we can afford to spend a fraction of that to keep tham alive and healthy.
No matter what happens we are going to have a hybrid public/private system much like all these other countries, what's different and something Michael has eloquently pointed out is that people in these other countries don't have to worry about going broke to pay their doctor bills. People don't have to defer care until they absolutely have to do something because of the cost and the painful inconvenience.
When you call 9-11 and say "My House is on FIRE!" or "Someone is trying to Rob ME!" the first questing isn't "Who's your private insurance carrier" or "How are you going to pay for this?" - it's "HOW. CAN. WE. HELP. YOU?"
Anyone think we should be privatizing our police and fire departments? Anyone seriously think that those services are "Socialized?" Then why the hell do you have to prove you're insured before you can see a doctor? The people of our nation are our most precious national security asset, and should be protected as such.
As I said, I just got home from an Emergency Room after about 14 hours of waiting. On some previous visits we've been there for or as long as 23 hours before we even saw a doctor. The U.S. government mandates that all hospitals with an emergency room have to see all patients regardless of their ability to pay. One thing that could be done quickly to dramatically improve the healthcare situation in this country would be to simply expand this practice to also include preventative and maintenance trips to any doctor regardless of whether you have private insurance or not.
Medicaid and Medicare, our two current "socialized" care systems, shouldn't be limited to this Emergency Only/Triage type of care where people are in the worst shape possible. We should allow anyone, anywhere, anytime to see any doctor as a walk-in for preventative care. If we did people would be far less likely to end up in an Emergency Room with conditions that have become chronic in the first place. In the long run, this would lower costs rather than raise them.
The second step would be to outlaw insurance companies from denying care without consulting a licensed on-staff physician, and to ban care-denial insentive pay. People shouldn't get bonuses for blocking someones access to treatment.
The third step would be to ban the exclusion of care for pre-existing conditions. Free Marketeers like to present this view that people can simply "shop around" for the best price and quality of healthcare if they aren't happy with what they have - but that simply isn't true. If you have an ongoing chronic condition, most 80/20 plans won't accept you - so that choice is foreclosed to them. If people really could leave a lousy healthcare provider, the loss in revenue just might give them some incentive to improve. Right now that isn't the case and they have no more motivation other than maximizing their profits on the backs of the American public and their employers.
The problem that Hillary Clinton ran into 14 years ago was that she tried to solve every problem in the U.S. healthcares system all at once. There are large and small problems with both the public and the private aspects of our system, and we might find ourselves much further down the line if we look at these issues individually and knock them down one domino at a time.
Vyan
Update: After posting I had to go to pharmacy to pick up some Cipro for my wife. It used my last dollar, but was worth it. I expect she'll be fine, for now - no thanks to Dr. Sanjaya.
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