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Michael Moore told John Stossel that, "All the world health organizations or whatever have confirmed that if there's one thing they do right in Cuba, it's health care. And there's very little debate about that." (ABCNEWS)
By MELISSA SCOTT
Sept. 7, 2007
http://abcnews.go.com/Exclusiva/Story?id=3568278&page=1

"Which way to Guantanamo Bay?!"

Anyone who's seen Michael Moore's film "Sicko" will recall the scene in which he shouts with a bullhorn as his boat takes a group of people, including Sept. 11 workers, to Guantanamo Bay in Cuba, where he says prisoners get better health care than Americans.

After the manned gun towers blow horns at Moore's boat, he takes the group to Havana, where his movie says socialized medicine — government-run medicine — is great for everyone. When Moore's group arrives in Havana, they are taken to a special section of a large showcase hospital.

Moore says in the film, "I asked [the Havana hospital] to give us the same exact care they give their fellow Cuban citizens. No more, no less. And that's what they did."

Watch "Whose Body Is It, Anyway?! Sick in America"
Sept. 14 on "20/20" at 10 p.m. EDT

The Debate

Moore sat down with "20/20's" John Stossel and talked about that claim. When asked whether it really was an average hospital, Moore said, "Yes."

"This isn't just me saying this, you know. All the world health organizations or whatever have confirmed that if there's one thing they do right in Cuba, it's health care," Moore said. "And there's very little debate about that."

In fact, there is plenty of debate. Miami-based Cuban Human Rights activist Jose Carro says Moore's movie paints an inaccurate picture.

"These films that try to portray the health care system as superior to that of the U.S. are lacking in truth," Carro said. He asserts that most hospitals for Cuban citizens are dilapidated, that conditions are filthy and that patients are so neglected that some are starving.

George Utset, who runs the anti-Castro Web site called therealcuba.com, says Moore's group didn't "go to the hospital for regular Cubans. They go to the hospital for the elite and it's [a] very different condition."

Darsi Ferrer, a human rights advocate in Cuba, issued an SOS via telephone, wanting the world to know that ordinary Cubans are "crazy with desperation" over the horrendous state of their health care.

Questioning the Numbers

Moore says that because Cubans get such good health care, they live longer and it is true that a U.N. report claims that they live nearly two months longer. But the United Nations didn't gather any data, said Carro.

"The United Nations simply reports whatever the government in Cuba reports, so that we have no objective way to know what the real statistics are," he said.

Although Cuba claims to have low infant mortality rates, doctors have said the data is misleading because when there might be indications of problems with the fetus, there is a widespread practice of forced abortions.

Julio Alfonso said, "We personally used to do 70 to 80 abortions a day." Yanet Sanchez, a Cuban exile, said she was simply told to submit to an abortion. "They told me I should end the pregnancy," said Sanchez. "It was my very first pregnancy. I wanted to have the child."

Other doctors have said that if a child dies a few hours after birth, they don't count it as ever having lived, which ultimately makes infant mortality in Cuba look better than that of the United States.

"It changes the number, even though the same number of children may be dying or more," said Carro.

Long Life?

Moore disagrees. "All the independent health organizations in the world, and even our own CIA, believes that the Cubans have a pretty good health system. And they do, in fact, live longer than we do," he said.

But when "20/20" contacted the CIA, officials said, "We don't say that Cuba has a pretty good system or that Cubans live longer than Americans."

In fact, the CIA's World Fact Book says Americans live nearly a year longer. Although a U.N. report supports Moore's position, that data comes straight from the Cuban government.

Why believe anything the Cuban government says about Cuba? Moore said, "Let's stick to Canada and Britain and this stuff because I think these are legitimate arguments that are made against the film and against the, the so-called idea of socialized medicine. And I think you should challenge me on these things, and I'll give you my answer."

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By JOHN STOSSEL, GENA BINKLEY and PATRICK McMENAMIN
Sept. 14, 2007

In every area of our economy, when people compete for your business, consumers win. Prices drop and quality improves. And now there's good news: A little competition has begun to improve health care.

There are some doctors' waiting rooms in America that are elegant … and open on Saturdays. Some doctors even take e-mail from patients and give out their cell phone numbers.Top of Form

Of course, those doctors usually work in fields that insurance rarely covers, like laser eye surgery and cosmetic surgery.

Dr. Brian Bonanni is a laser eye surgeon who reshapes eyes so that people can see without glasses. He knows he has to please his patients -- not some insurance company or the government -- because he is paid by his patients.

"I need to be available 24 hours a day," Bonanni said. "I want to be there when a patient has questions, and I want to be reachable."

Bonanni's patients often meet with several doctors before deciding on a surgeon, and they demand to know exactly what it will cost.

Competitive Prices

"I can't get away with not telling the patient how much exactly it's going to cost. No one would put up with it," Bonanni said. "And the difference of a hundred dollars sometimes makes their decision for them."

Laser eye surgeons have to compete for their patients' business. And a result of that competition is lower prices.

"In every other field of medicine, the price is going up faster than consumer prices in general," said Dr. John Goodman, president of the National Center for Policy Analysis.

"[But] the price of Lasik surgery, on average, has gone down by 30 percent."

Prices dropped even though doctors pay for advertising. And while the procedure got cheaper, it also got better.

"When the lasers first came out, all they could treat was nearsightedness," Bonanni said. "[Today] the lasers are faster, more precise."

We see better quality, and lower prices in medical fields where most people pay for care themselves -- cosmetic surgery is another example. The average price of cosmetic procedures has fallen, because doctors compete for patients' business, and if doctors want to get repeat business, they have to offer patients a good deal. It's what happens when doctors respond to you, not your insurance company or the government. And it's happening now, and not just with elective surgery. We're starting to see providers offer everyday health care even in … shopping centers.

Cheap, Convenient Care

A new kind of medical clinic, staffed by nurse practitioners, is popping up in stores like Wal-Mart, in pharmacies and grocery stores. They offer people with sore throats and ear infections convenient care … cheap. Most everything costs $59 or less.

But how can they make money charging so little?

"They're figuring how to do something faster, better, cheaper," said Grace-Marie Turner of the Galen Institute. "They're responding to consumer demand, because they see that they might make some money on this. Profit! And, look who's winning. Moms and dads and kids. Because they now have … easy access to routine health care."

And some doctors are finding that dealing directly with patients changes their practice for the better.

Dr. Robert Berry had enough of the hassles of insurance companies and Medicare and Medicaid, so he decided to stop taking insurance. Instead, he offers his patients a price list, with low prices. How often have you seen that in a doctor's office? With visits often as low as $40, it's hard to see how he makes any money off it.

But Berry said, "Last year I made about the average of what a primary care physician makes in this country."

Competition, Choice, Power

Berry said eliminating insurance paperwork saves him time and money.

"I don't have to hire billers. I don't have to fight the insurance companies to get the money."

And that lets him keep his prices low, which saves money for his mostly uninsured patients. Knowing that his patients pay with their own money, Berry works with them, trying to find ways to save them money.

"They're afraid. They don't know how much it's going to cost," Berry said. "So I can tell them, OK, you know, you have heartburn. Let's start out with generic Zantac, which costs around five dollars a month. But [they say] 'I see Nexium on TV, I see Prevacid.' Yeah, but that costs about $130 a month. They're great medicines, but why don't you try this one first and see if it works."

And sometimes, he said, the $4 pill at Wal-Mart is just as good as the $100 pill.

So when consumers pay for things themselves, saving insurance for the big stuff, doctors deal directly with customers directly and compete by posting prices and working to keep them low.

That way, instead of having governments or insurance companies make decisions for consumers, consumers decide for themselves. Competition gives consumers more choices. And choice gives them power.

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Opinion By JOHN STOSSEL
Sept. 10, 2007

The bureaucrats are worried about your health. They don't think you're making good decisions about what to eat. So, to stop you from eating things that are bad for you, the Los Angeles city council has proposed legislation to forbid the opening of any new fast food restaurants in parts of the city that have high rates of diabetes, heart disease and high blood pressure. The ban would last for the next two years.

Incredible, right? The city government will dictate the kind of restaurants that may open? It sounds more like communist Russia than southern California, but this is what happens when the government pays the bill for our health care. They think that gives them the right to order us around -- in the name of taking charge of our health. Top of Form

The neighborhoods where the Los Angeles bureaucrats propose to ban new restaurants are all in the "inner-city" of south Los Angeles. A higher percentage of the people in those neighborhoods live in poverty and that means more of them use government money (Medicaid) to pay for their health care. Government pays the medical bill.

And as the old adage goes: He who pays the piper calls the tune. I keep learning more about that as I prepare for my Friday "20/20" TV special on health care "Whose Body Is It Anyway? Sick in America."

If government pays for our health care, then government officials have a bigger stake in monitoring our health. It's another reason I'm wary of all the politicians today who demand more government fixes to our health care system.

Almost every one of the presidential contenders has a plan. The devil is in the details. The proposals are full of platitudes like "affordable and accessible health care" and "health care for all." Former Republican Arkansas Gov. Mike Huckabee says we need to get "serious about preventive health care" and Rep. Dennis Kucinich, D-Ohio, says we need "Medicare for all." The Web site of former North Carolina Sen. John Edwards says, "Edwards will offer individuals in Health Care Markets a choice of insurance plans including a public plan based on Medicare…" whatever that means. Sen. Barack Obama's, D-Ill., Web site laments the fact that "less than 4 cents of every health care dollar is spent on prevention and public health."

Nearly all of the Democratic presidential candidates want the government to guarantee some form of "universal health care." Republican presidential candidates have been less aggressive, but Republican governors have already started experimenting. Mitt Romney instituted a universal health care plan when he was governor of Massachusetts and calls the idea of getting everyone in the country insured "an important priority." Republican Gov. Arnold Schwarzenegger has proposed a universal health care plan for California.

That increasing government involvement in health care will invariably lead to government wanting to tell you how to be healthy. Already, the nanny state has banned trans fats in New York City. Now Los Angeles may ban new fast food restaurants?

Come on. Adults should be able to decide for themselves what we want to eat and where we want to eat it.

Give me a break.

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