Issues & Ideas

Grieve for the U.S. health system

It isn't surprising that critics of Michael Moore's Sicko are desperate to quibble with his finer points. After all, denial is the first stage of Elizabeth Kübler-Ross's model of dealing with grief, and the tragedy before us is, of course, the agonizing death of an inadequate medical system.

Denial is normal when faced with the sad state of American healthcare. Who wants to hear that roughly one in six of us are uninsured and can't get access to care? Who cares that we have the 37th-best medical system in the world? Who needs to know that 18,000 American citizens may be dying each year because this country's system is not comprehensive or universal? This data came from the World Health Organization and the Institute of Medicine? Well, who are they to judge?

Anger is the next logical step. Come on, this is American healthcare! This country's got moon men, purple mountains' majesty and a per-capita healthcare expenditure that's twice as much as that of any other industrialized nation. It should make our blood boil that we don't nearly get what we pay for. And yet we all have a story about a family member, friend or ourselves that relates to the substandard treatment patients receive in this country -- stories that range from the exasperating to the infuriating.

It may seem sensible to bargain with private insurers when confronting our fate at their hands. Massachusetts is grappling with a plan to mandate private (and some public) health insurance coverage for all citizens. Those who can afford to are pumping money into the coffers of health insurers, while the state takes up the slack for the rest. But flooding the private insurance market with public money is a feeble solution. And wouldn't it make more sense to transfer this largess to actual medical care, thus eliminating the inefficient profit-taking middleman?

I came to medical school with the idea of improving the healthcare system for the sake of my future patients and my future career. But so far, all I've learned at school is that struggling daily against health insurers and HMOs leads to a deep depression on the part of health practitioners. I've spoken to dozens of doctors about my future. They are accomplished people; many are role models, a few are my heroes. Yet every single one has tried to discourage me from entering the profession. The business side has overwhelmed the art of medicine.

Again, echoing Kübler-Ross, all that remains is to accept our fate. Or, we can accept the best solution available, a universal single-payer system that eliminates private insurers and provides cradle-to-grave coverage for all.

So when you hear arguments and proposals that deny the facts, that take issue with what Michael Moore is documenting, that urge us to bargain with private insurers -- and in general, ask us to wallow in self-pity -- be prepared to accept the worst.

Or you can get out there and fight for your life with the rest of us.

The writer is a second-year student at New Jersey Medical School and a co-president of the local student chapter of Physicians for a National Health Program -- -- an organization that advocates for single-payer universal healthcare in the United States. He is the son of Liza Gross, The Miami Herald's managing editor/presentation.