Saturday, September 13, 2008

Moore's "Sicko" Provokes International Health Solidarity

13 September 2008

Moore's 'Sicko' Brings Debate ;

And, Motivation for International Solidarity

Mike Tolochko

Over 100 activists gathered in Sete, France ; the largest French fishing port on the Mediteranean, to see and discuss Michael Moore's world famous health film, "Sicko;" A full page article in the local newspaper, L'Herault du Jour (4 September 2008) advertised the meeting on the 5th.

In advance of the film showing (In some locations discussions were held after the film), there was a discussion to describe the film.

In that discussion, Francois Liberti the leader of the progressive movement entitled, "Tous Pour Sete" (meaning "all for sete") introduced Jean Luc Bou a teacher; leader of the teachers union; the CGT, and a member of hte French Communist Party. Bou described the importance of the film which was intended for pepole in the USA, but also has strong implications for France.

The discussion was chaired by Jean Solbes; a professor at Montpellier University and a deputy mayor from a neighboring town; Pousol/Minervois. From the United States Barbara Storace a former union health fund director, and Dr. Frank Goldsmith, a health policy activist, described the health situation of the United States.

Interestingly, since Moore film the segments of "Sicko" concerning France were filmed; a couple of yers ago; the initial steps taken by the right wing government of France under Nicholas Sarkozy have been installed. This created some confusion.

Some of the participants at the meeting felt that the film portrayed the French system too favorably.

Some of the questions to the speakers involved the question of why is the US system so poor? Why isn't there more fight back from the unions.

Well; the speakers were able to answer; and the Moore film describe at greater length, the period following WWII. It was in that period when the Western Europen countries were being rebuilt; and, national health systems were established. Each country chose its own path, but they all gave their pepole health systems free from profit and exclusions. They are all established on the principle of social solidarity meaning the well take care of the sick.

In the US, the opposite took place as was described in the meeting and in the film. The speakers were able to be a little more graphic in describing the anti-communism that was unleashed against socialised medicine; and just as important, the attack on the progressive labor movement which made it illegal for Communists to hold union offices. The anti-Communist attack made it possible for right wingers in labor to successfully accuse their opposition of being communists, even when they were not.

This swung the labor movement away from advanced positions on health and other important social and economic, as well as foreign policy issues.

In fact the progressive aspects of the French system, including, home visits from physicians and nurses with a very small co-pay; little or no co-payments for hospitals surgeries; etc. and little co-pays for physician visits so enraptured Moore that he made the question: "This is why we in the US are taught to hate the French so much."

After the film concluded there was wide applause; and; the assembled activists remained to further discuss the ways in which there could be internatioinal solidarity.

The main topics were how those in the US can point to the French system, according to the World Health Organization the best in the world, in trying to win a better system there; and conversely, how French activists can point to the US system as a place that they do NOT want to emulate.

The cubacks being imposed by Sarkozy's right wing government are just beginning, but they are already being felt and fought against. They are familiar. High co-payments for services and the cutting back of the federal health seecurity system on payments in general This puts pressure on he labor-lead Mutelles Societes, who under the French system, fill the gap between what is reimbursed for health services and what the cost/price is. This is similar to USA Medicare system where, for Medicare recipients, what is not covered by Medicare is paid by the union's negotiated health plan. People who don't have this union support must either pay out of pocket or buy private health insurnce, which is very costly.

As one participant noted, when we used to hear about the horors of the US health system we thought that would never happen here, but it is.

It was brought up that Sarkozy's conflicy of interest is a clear one. His brother is the head of the largest private health insurance company in France.


Home visits It is true; and hard to believe that in France; a phsician, and that is almost all physicians, are obliged to not just work in their office, but they must also personally visit people who call with a health problem that is not a medical emergency. These emergencies are taken care of by ambulances. There are two systems. The first system is the regular physician and the other is a group of physicans knwn as SOS doctors. In both cases; the sick person must pay a 22 Euro fee (it goes to 23 in October). This fee is reimbursed by both the national Health Security system and the Mutuelle to whom the preson belongs.

Those people in the US old enough to remember when doctors used to make home visits, but that is long past.

Mutuelles Societt/CMUs

Over 96 percent of French people belong to a Mutuelle. If you are unemployed or disabled you belong to the CMU, enacted a few years ago. Mutuelle and labor leaders fought for this legislation. This was to make sure no one fell through the cracks.

This is a public/private system in France. The labor movement leads the Mutuelles and also plays a significant role in the national system.

French Doctors Association

All physicians in France are private; but they all belong to this Association. In England the UK, physicians are generaly government employees.)

The Association negotiate with the government in setting fees. This is similar to Medicare doctor fee setting in the USA, but in France all doctors participate, even those who may choose to have their own hopsitals.

Hospitals in France

The French have a system of public hospitals and non-profit hospitals. There are some private doctor run hospitals which would be for profit. Sounds similar to the US; but it isn't. Here both the public and non-profit hospitals are run by the same regulations. The payment for administrators is the same. In France you don't have CEOs of non-profits make multi-million dollar salaries.

Stay tuned!