Sicko

I watched Michael Moore's documentary today. About the American health system under its Health Maintenance Organization (HMO) which manages medical and health care through private health insurance coverage.

Of course the American health care system was shown in a bad light, less the situation in Guantanamo Bay. It was compared to the system in Canada, Britain, France and even Cuba...it's like a typical non-fiction, easy-to-read, filled with interesting snippets of information type of book (ala Undercover Economist, Freakonomics, Blink etc..)

Well, it's pretty one-side but it's enough to make you wonder if the situation in Singapore will ever get to that state. For example, a carpenter who sawed two of his fingers off, his middle and ring finger, was asked which would he want to re-attach back. The middle finger will cost USD60,000 and the ring finger will cost USD12,000. Ever the romantic the carpenter decided to re-attach his ring finger and at the same time save some money. Nope, he didn't have health insurance. But the documentary unfolds to show that even with health insurance, the situation isn't that fantastic for the insurees who, because of chronic or compounded health issues, become bankrupt or are refused coverage by insurance companies.

Must watch. It's a laugh and cry and be totally bewlidered within a span of 30 seconds documentary. But one-side. And here is why....

The countries that are depicted to have universal and socialised medical care do have their own set of problems and challenges but they are not mentioned at all. The British National health Service (NHS), Sécurité sociale of France and the Canadian Medicare all have their own criticisms but it is fortunate that nobody who is in need of medical care is turned away.

(click to enlarge)

Looking at the graph (from wikipedia) above, comparing USA with the rest of the countries, you can see the following facts clearly:

(1) The co-relation between per capita expenditure on health care and life expectancy is not strong (unless you take Australia and USA out)

(2) Likewise for the percentage of government revenue spent on health.

(3) Although the government pays only 44.6% of health cost, Americans aren't having their life expectancy cut by too much.

(4) The data show that although the American government pays the least percentage of health cost but they also have the highest per capita expenditure. Two possible reasons: Americans are a very unhealthy lot and/or health care in America is super expensive.

The latter reason seems to hold water because in the movie, a respirant which cost USD120 cost only 0.05cents in Cuba. Further evidence is found in the column on healthcare cost as a percentage of GDP. Americans pay 50% more than the next in line.

My personal experience with NHS during my 3 years of studies in Britain was fantastic. I did not fall sick during my three years there. But there was an untreated wound I got when I was in Singapore on my left hand which got really nasty during my first winter. It was a type of tropical marine infection (I got the injury in the vapid waters of Sembawang). My uncle, a fisherman, had his finger amputated two years ago from a similar infection. I received the medical care, they prescribed the anti-biotics and even the post-treatment follow ups totally free of charge. They had some problem with the diagnosis because not many people in the University of York health clinic had ever seen a tropical marine infection.

A friend of mine who had hyperthyroidism received her regular treatment while she was in UK totally free. The many times that I brought her to hospital for her check ups, she never had to pay a single cent. Medication was free although the doctor did recommend surgery to remove part of her thyroid which was not a common procedure because this could lead to permanent hypothyroidism.

A graduate student who was there with his family welcomed another member of his family while living in York. The baby was born in UK and when they left the hospital, not only did they not pay a cent, the hospital actually reimbursed the cab fare incurred when the wife was sent here when she went into labour.

I suppose there isn't a perfect healthcare system. Singapore's healthcare isn't too bad. I have not heard of anybody being turned away by hospitals because they do not have enough money to pay. At least no reports yet. There is going to be an introduction to means-testing in the health industry. Keeping my fingers crossed.