Moore's latest documentary movie, "Sicko" opened last Friday.  I haven't seen it yet, but it should be entertaining.  While Moore's tactics and style may be controversial, the movie promises, at the very least, to continue the national discussion of healthcare.  One such issue the movie highlights  is the World Healthcare Organization's ("WHO") 2000 survey which ranks countries from best to worst in terms of healthcare.  The U.S. ranks only 37th, two slots ahead of Cuba, and lower than Morocco, Oman, and many others.  WHO's criteria for the rankings were: 1) Good health: "making the health status of the entire population as good as possible" across the entire life cycle; 2) responsiveness: responding to peoples' expectations of respectful treatment and client orientation by providers; and 3) fairness in financing: ensuring financial protection for everyone, with costs distributed according to one's ability to pay.  Criteria number 3 almost guarantees countries such as France and Canada, with government-sponsored universal plans, the ones idealized by Michael Moore, will receive a higher ranking than the U.S. 

    In any event, the U.S.'s low ranking is disturbing in light of the fact that we have the most expensive healthcare system in the world based on per capita expenditures.  These excessive costs are attributed to many factors including rising costs of medical technology and prescription drugs, an aging population, and very high administrative costs resulting from a complex multi payer system.  It has been estimated that between 19 and 24 per cent of the total dollars spent on healthcare in the U.S. is for administrative costs alone.  See Woolhandler, Himmelstein, "The Deteriorating Administrative Efficiency of the U.S. Health Care System," New England Journal of Medicine, 324: 1253-1258 (May 2, 1991).  In contrast, payments for victims of medical malpractice, including attorney's fees and costs, amounted to less than 1% of the total healthcare costs.  See  Kessler, Daniel P. and Mark McLellan. "The Effects of Malpractice Pressure and Liability Reforms on Physicians' Perceptions of Medical Care," Law & Contemporary Problems, Winter 1997, p. 81.  Moore's solution seems to be government sponsored universal healthcare.  Such systems certainly have  benefits, but also numerous drawbacks including potentially substandard care and long wait times for such care. 

    These issues are vital to the economic and political future of the country.  They must be carefully explored and solutions must be implemented.  Whatever course we decide to take, however, the rights of those injured from negligence must be protected.   In our rush to repair the system, lets take care not to re-victimize the victims of malpractice by forcing them to bear the financial burdens of the system's failures.