samedi 3 novembre 2007, par
Sicko is a film to see : Michael Moore is really a brilliant man, full of humour, provocative and cheeky. His caricatures of life, the institutions and the American system are there to denounce, launch a debate and improve the American health system..
The moral of this film is, of course : « It is best not to be ill in this capitalist country. On the other hand you can be ill in England, in France or in Cuba, where solidarity exonerates you from paying when you are ill. »
This idyllic presentation omits to mention that our health system results in a deficit of 12 billion euros, a deficit which is growing every year. This film is legitimately worrying in showing what could happen in France if social security is not saved and if can no longer reimburse anything, as is the case in America. But this film should not be exploited to perpetuate our health system, of which I would like to expose here the faults.
This film was followed by a debate : I had widely publicised this projection and the hall was full ! The debate was moderated by the organiser of the Nice cine-café, and by a doctor. The doctor immediately steered the debate towards the political and economic aspects : « We must rebuild the left ». He then reminded us that it is solidarity that is important in medicine : « We must finance medicine, which is expensive. It is quite normal, these people are very ill. »
This doctor, apparently used to political debates, did not however reply to the troubling questions which surround our health system.
The spectators had come to see the film but also to debate on the subject of our health system. If I had been able to participate for a longer time, here is what I would have said :
« The health system economy can only be saved if it is managed by good doctors, who listen to their patients, who spend the health system budget with moderation, and are conscientious in avoiding useless expenditure. In particular doctors who avoid prescribing medications which are often thrown into the dustbin by patients : this happens more often than one might imagine ! Avoid prescribing complementary, expensive and useless examinations before having made a complete clinical analysis in order to make a diagnosis. Give firm advice on lifestyle, healthy eating with balance and moderation. Not smoking or drinking alcohol. And, of course, doing everything possible to care for and cure the patients. »
Great economies would be possible if we developed education for all, poor and rich, by informing them about the thousand methods of avoiding illness, of taking better care of themselves, without depending on chemical medication. By adopting ecological medicine.
The people covered by social insurance would be in better health and would consume less medication. Less sick people would mean less deficit and we would thus avoid the increase in subscriptions. But this is not really the argument of the technocrats of the medical left : the only message from this doctor was « We must find a way to finance social security ».
I therefore asked this doctor : « If we have arrived at this point and before discussing future financing, perhaps we should analyse the causes of these chronic deficits and denounce the abuses. Because there are many abuses and there have been for a very long time ! ». I received no reply, as the doctor considered that the example that I had given was only an isolated case.
Yet I have practiced medicine for 25 years in all areas and I can say that I have seen abuses ! I have acted as a replacement for more than 200 doctors throughout France, I have been on emergency standby 3 nights a week. I have had my own practices on French territory. I opened a practice in Guyana…When I give an example it is not just an isolated case as this doctor claimed.
Moreover, Michael Moore demonstrates the scandal of the American insurance companies who insure 55 million Americans based on 15 individual cases, and the qualities of French medicine based on one or two people !
Having tried to speak about the abuses in prescribing, I tried to introduce the subject of preventive medicine.
I gave the example of a patient with a cholesterol problem : it is more intelligent, less expensive and more healthy to suggest to this person that he follow an appropriate diet to reduce his cholesterol level. The reply from the doctor did not really surprise me : « Patients are not doctors and do not know what can be done with a diet ! ». This doctor had not understood that it is his responsibility to give dietary advice. Conclusion : the doctor automatically prescribed an anti-cholesterol drug without worrying about dietary considerations, it certainly takes less time !
I thought that there were now courses in preventive medicine in medical schools. I have the impression that this is a class that the students skipped ! In the hall there were medical students who do stand-ins. As regards preventive medicine, they admitted that, in fact « They had no time to do this ! ».
These young doctors, without experience, and with no reflection on the morality of their work, complained about having 40 patients a day : but precisely, if they had an attitude oriented towards preventive medicine, they would have globally less patients.
The logic of medicine in France results in keeping the waiting rooms full, in spending the taxpayers’ money and in wasting the money of the patients. Patients who are made irresponsible because the doctors treat them like children by not inculcating an attitude of preventive medicine. If everyone had a consciousness of his body and the importance of lifestyle in the avoidance of sickness, we would not be in this position !
Why not explain to them what to do to avoid taking medication ? I think that this is because the doctors do not know the answer themselves. Unfortunately patients do not ask the question, they are too submissive in front of doctors.
We must wipe out this logic which always leads to seeking the means to finance expenses which continue to be excessive. This leads inexorably to patients becoming irresponsible consumers of medication throughout their lives until retirement and beyond (even though this is very expensive). Because the Social Security deficit leads to the increase of social insurance subscriptions, leading to people having to work more. To earn more ? Don’t even dream about it…
Less purchasing power also enslaves people to their debts. If we do not radically change our logical processes, the health system will always be in deficit : this is not serious, we will increase the subscriptions ! French (and American) families are over indebted with easy credit, the health system behaves in the same way : we prefer to borrow than to economise and to avoid waste !
Sustainable development in medicine
We teach every inhabitant of the planet that one should not waste energy. The financing of social security, the money from those who pay for social insurance, this is also energy : human energy.
To show solidarity in our behaviour : this is to think about not wasting money on oneself, because the money is needed for more serious cases. That is what true collective social solidarity implies. It is advice on which patients would do well to meditate. The individualist logic « After all, I pay so I have the right » leads to unacceptable abuses.
There are cases of scandalous behaviour : for example to call the doctor for a home visit for nothing. I have noticed moreover that this happens the most often when it involves people who do not pay. Asking for medicines that they will not take : 40% of prescribed medicines end up in the dustbin, for example antidepressants, fortunately ! The French are not all depressives, quite the contrary. On the other hand, they are tired (those who work) because they have too heavy expenses, too many debts.
My patients are not all rich, have not all studied at a Polytechnic or studied medicine. And yet, thanks to their lifestyles they are not often sick. When they have a health problem, they always attempt to care for themselves in a natural way rather than rushing to the doctor.
Today’s doctors do not listen, do not examine, do not explain anything. They only know how to prescribe extremely expensive complementary examinations and toxic chemical medication. Patients have less and less confidence in certain doctors… And I am only repeating to you what I hear from morning to night.
I think that people have had enough of being taken for irresponsible dummies. This is the reason that the debate after SICKO disappointed more than one person : if this is your case, tell us about it here !