Michael Moore vs. Sanjay Gupta

[Taranne]

Rapidement, les faits. Fat Mike vient de sortir un nouveau film, Sicko, sur le système de santé américain, bon pour la corbeille d'après lui. ll est malheureusement tombé sur un os lors d'une interview pour CNN ou le spécialiste de la chaîne en matière de santé, Sanjay Gupta, l'a accusé de manipuler les faits. Mike a répondu et CNN a répondu à la réponse. L'un des points de discorde porte sur les coûts comparés des systèmes américains et cubains:

POINT NO. 2:

FROM MOORE'S WEB SITE:

CNN: "Moore asserts that the American health care system spends $7,000 per person on health. Cuba spends $25 dollars per person. Not true. But not too far off. The United States spends $6,096 per person, versus $229 per person in Cuba."

"The Truth" (from Michael Moore's Web site):

According to our own government -- the Department of Health and Human Services' National Health Expenditures Projections -- the United States will spend $7,092 per capita on health in 2006 and $7,498 in 2007 (Department of Health and Human Services Center for Medicare and Medicaid Expenditures, National Health Expenditures Projections 2006-2016).

As for Cuba -- Dr. Gupta and CNN need to watch "Sicko" first before commenting on it. "Sicko" says Cuba spends $251 per person on health care, not $25, as Gupta reports. And the BBC reports that Cuba's per capita health expenditure is… $251! (Keeping Cuba Healthy, BBC, August 1 2006). This is confirmed by the United Nations Human Development Report, 2006. Yup, Cuba spends $251 per person on health care. As Gupta points out, the World Health Organization does calculate Cuba's per capita health expenditure at $229 per person. We chose to use the U.N. numbers, a minor difference - and $229 is a lot closer to $251 than $25.

CNN RESPONSE:

CNN has corrected and apologized for an error in transcription in our report. We did so on television and online.

CNN had said that in the film Moore reported Cuba spends $25 per person for health care when the film actually reported that number to be $251. We regret that mistake.

However, we originally fact checked Moore's reporting because he uses numbers for each country from different reports and he compares a number that describes actual spending to a projection from another source.

He sources his number from Cuba to a BBC report. In that same BBC report, the number cited for U.S. spending is $5,711. Moore doesn't use that number, but instead a higher number found in another report (as cited by Moore above) from the Department of Health and Human Services' National Health Expenditures Projections. That projection is that the United States will spend $7,092 per capita on health in 2006 and $7,498 in 2007 (Department of Health and Human Services Center for Medicare and Medicaid Expenditures, National Health Expenditures Projections 2006-2016). Actual numbers for the years 2006 and 2007 are not yet available, which is why CNN could not use them.

We believe the most accurate comparison of statistics comes from analysis of numbers from the same report and the same year.

CNN used the WHO's World Health Statistics 2007 report for both the Cuban and U.S. data. That report uses the latest information on actual dollars spent, in this case from the year 2005. These summaries of actual expenditures -- not projections -- reported by CNN are: Cuba-$229, U.S.-$6,096.

Both of these numbers come from the same report and provide consistency under statistical analysis.

The only controversy here is within Moore's numbers. Moore uses $251 to describe Cuban health care spending in his movie, but when CNN e-mailed Moore's production company to verify numbers, his own staffer e-mailed back that $229 was the correct number.

As Gupta said, CNN's numbers and Moore's numbers aren't far off, but we believe ours are a fairer comparison.

[…]

POINT NO. 9:

FROM MOORE'S WEB SITE:

GUPTA: "Well, I mean, he pulls $251 from this BBC unsourced report … Where you pulled the $251 number was a BBC report, which, by the way, stated that the per capita spending in the United States was $5,700. You chose not to use the $5,700 from one report and chose to go to a totally different report and you're sort of cherry picking data from different reports … Well, why didn't you use the $5,700 number from the BBC report?"

"The Truth" (from Michael Moore's Web site):

Actually, the number "Sicko" cited for per-capita Cuban spending on health care -- $251, a number widely cited by the BBC and other outlets -- comes from the United Nations Human Development Report, helpfully linked on our Web site. Here it is again: http://hdr.undp.org/hdr2006/statistics/indicators/52.html.

That U.N. report does list American health care spending as only $5,700, but it's a few years old. Since then, the U.S. government has updated its projections for health care spending, to $7,498 in 2007. So we used that number. It's the most recent, and comes right from the Department of Health and Human Services. If the Cuban government gave a figure on 2007 projected health spending, we'd have used it.

CNN RESPONSE:

To reiterate, we believe numbers should be compared apples to apples, oranges to oranges. Moore himself says the data he's citing from the U.N. Development Programme is dated. Consistency is important in statistical analysis and is not present in Moore's comparison.

Intervenant dans le débat, l'économiste de gauche Dean Baker apporte son soutien à Michael Moore, sur la base que "It is common to use data from different sources, when data from the same source is unavailable. If there is reason to believe that there are important differences between the methodology used by the different sources, then this should be noted." Je suis un peu sceptique, dans la mesure où les arguments de CNN sont beaucoup plus profonds, mais bon j'admets ne pas m'y connaître suffisamment pour juger; y a-t-il un "spécialiste en sciences sociales" - puisque c'est la qualification requise d'après Baker - pour m'éclairer et me dire qui a raison et qui a tort?

[Fredo]

Moore est coutumier du fait, non seulement il joue au sophiste et avec les nombres mais il s'arrange au montage pour conduire le spectateur à tirer de fausses inférences en rapprochant des extraits et/ou en les sortant de leur contexte. Bowling for Columbine est un chef d'oeuvre de manipulation et d'hypocrisie en ce sens. Il vaut le coup d'être vu, puis de lire les critiques et analyses qui ont été faites dessus.

Pour en revenir à la méthodologie, il est évident que de travailler avec des sources diverses peu comparables est un grand risque. Cela n'empêche pas qu'on peut faire une méta-analyse, une méthodologie particulière à employer dans ce cas mais qui demande alors beaucoup de sources. Je doute qu'il soit intéressé par une démarche de recherche et veuille faire un état de l'art sur les sujets qu'il traite.

[José]

Ce qui relève de la plus haute débilité, c'est de comparer deux choses tout à fait différente : d'un côté le système de santé le plus performant et avancé du monde et de l'autre côté, ça : http://www.therealcuba.com/Page10.htm

Par ailleurs, il est assez significatif que la dictature cubaine ne fournit aucune statistiques fiables sur la santé. En fait, zéro statistiques : le site de l'Institut national e Statistique cubain est vide : http://www.sld.cu/webs/estadi/

Sinon, les quelques rares chiffres que la dictature fournit sont biaisés. Ainsi, le régime se vante d'un excellent taux de mortalité infantile, même inférieur à celui des États-Unis. Oui, mais, le taux des avortement y est le double de la moyenne américaine, ce qui veut dire que l'on n'hésite pas à Cuba à liquider par la voie la plus rapide toutes les grossesses problématiques.

Enfin, pour mémoire, si le système cubain de santé fut jamais excellent, ce ne fut pas grâce au socialisme : avant 1959, le système de santé cubain était le 3e meilleur des Amériques, derrière les États-Unis et le Canada, et supérieur aux systèmes de santé autrichien, italien, britannique, etc.

[José]

A Prescription for SiCKO

Michael Moore’s sloppy approach to the health-care debate.

By David Gratzer

Fourteen years ago, Harry and Louise joined us in our living rooms and told Americans about Hillary Clinton’s health-care proposal. To liberals, the insurance industry-sponsored TV spots represented the worst of American politics: the negative tone, the oversimplifications, the dramatic accusations. Robin Toner, writing in the New York Times, suggested that the ads “played on people’s fears.”

ClintonCare wasn’t sunk solely by two fictional characters sitting around a kitchen table. The complicated nature of the plan, coupled with the White House’s bungled strategy, did more to damage the cause than advertising executives could ever have fantasized — by the end, even Hillary Clinton’s Senate predecessor, Daniel Patrick Moynihan, came out opposed.

But even after Harry and Louise went to TV heaven, joining Morris the Cat and the Glad Man, the ads left a lasting impact on the liberal psyche: lampooned at the Academy Awards, described in countless books, and even earning their own entry on Wikipedia. How, though, have liberals reacted to Michael Moore’s documentary, which has much the same bravado? Unsurprisingly, they have been lavish in their praise.

Moore suggests in SiCKO that American health care doesn’t simply need a shot of government assistance, it needs radical surgery — of the government takeover kind. Moore sees no role for private insurance, waxes poetic about price controls (particularly for pharmaceuticals), and looks to Cuba as a role model. There are, of course, well-reasoned people who favor some type of government-based health-care solution. Moore’s documentary distinguishes itself not because of its argument — goodness, almost every prominent health economist in academia makes a similar case — but by its fast and loose nature.

Moore claims that ERs don’t overcrowd in Canada. Yet a recent government study suggested that only about half of patients are treated in a timely manner. Moore suggests that Britain offers quality medical care; meanwhile, one in eight Britons waits more than a year for surgery. France is held up as the promised land, with free health care, doctor home visits, and even laundry service for new moms. Not a word, however, about the heat wave of 2003 that killed 13,000 elderly because the hospital system was unresponsive.

The factual errors are plentiful. Moore claims that HMOs arose from a Nixonian plot, hatched out in secret in the White House. He plays a grainy tape to make his case. Actually, the legal groundwork for this type of managed care was laid by the HMO Act of 1973; co-sponsored, incidentally, by Senator Edward Kennedy. Moore explains that after Nixon embraced HMOs, health care became scarce, leading to shortages (he plays accompanying footage of a hospital ER with 18-hour waits). Moore’s hard-luck stories are all unverified. The saddest case involves a young man with renal carcinoma, in need of bone marrow transplant, who has been denied the procedure by his HMO. Actually, there is no evidence that such an intervention would have been helpful; no doctor would advocate this procedure.

Moore’s argument would not have survived, in other words, a basic fact-check. Yet, the reviews are sterling. Brilliant, important, enthralling are all words used to describe it.

Liberal columnists have been particularly effuse with their praise. Pulitzer Prize-winning columnist Clarence Page gushes: “He uses the same big-screen pop culture that brings us Paris Hilton and ‘American Idol’ to summon our eyeballs to something truly valuable: a vision of how much better America’s health-care system could be.”

Ezra Klein of the American Prospect, who writes often on health reform, offers an absurd explanation of his fondness for the film: It’s not actually about health care, rather it’s a metaphor for “American exceptionalism.” The New Republic’s Jon Cohn — arguably one of the smartest voices on the Left in this debate — concedes some “trepidation” at the beginning of his review because “Moore has not always been the most intellectually rigorous storyteller.” And in SiCKO, he finds “intellectual dishonesties and arguments without context” — but finds a way to makes peace with the film: “Still, by the time the final credits ran, it was hard to get too worked up about all of that. Because, beyond all the grandstanding and political theater, the movie actually made a compelling, argument about what’s wrong with U.S. health care and how to fix it.”

Even Canadian columnists forgive Moore for his creative interpretation of facts. In “Moore is Right,” Toronto Star columnist Thomas Walkom gushes about the film, but recognizes that the portrayal of Canadian ERs is a stretch — “To any Canadian who has ever been forced to go to emergency, this would seem unbelievable.”

How does Moore manage to simplify an argument to the point of absurdity, yet walk away with so many endorsements from people who know better? Perhaps liberals simply cherish the documentary as a day-dream — a fantasy world reshaped by leftist ideas.

And Moore offers a wonderful world. It’s not just that the Canadians like their government-run health care; they’re so damn magnanimous about it — the Canadian senior doesn’t mind paying for his countryman’s health care because “he would do it for me.” The sharply dressed British doctor maintains that the public sector pays a good salary, rejecting the idea of American-style compensation. He can’t own “six homes,” but why would he want to? And the French? Not only do they have post-natal laundry service, they are all so pretty and chic!

For 14 years, liberals have wondered about the world that could have been if not for Harry and Louise. Moore wistfully paints that picture.

But if liberals have endured 14 years of regrets, the rest of us have faired pretty well. As it turns out, the disaster scenarios liberals predicted in the early 1990s never came to pass. The percentage of uninsured remained stable; health spending didn’t hit 19 percent by 1999, as the Clinton White House forecast; corporate America never collapsed.

Instead, over these years, American health care has enjoyed some modest successes: the rise of consumer-driven health care, first and foremost. And American medicine continues to innovate and excel. Death due to cancer has, adjusting for aging, dropped 1 percent a year, every year, since the early 1990s.

If Americans have fared well over this past decade and a half, people with socialized medicine have not — just as Harry and Louise warned would happen in the U.S. with HillaryCare. Thus, at a time when Americans are celebrating their medical achievements, Moore’s beloved French are examining their health care system. In 2004, Health Minister Philippe Douste-Blazy didn’t mince his words: “Our health system has gone mad.”

That is not to say that reforms aren’t needed here. It’s just that Michael Moore has nothing to contribute to the debate. Maybe that’s because Harry and Louise weren’t so wrong after all.

— Dr. David Gratzer, a physician, is a senior fellow at the Manhattan Institute. His most recent book is The Cure: How Capitalism Can Save American Health Care.

http://article.nationalreview.com/?q=ZmFkY…DhmMWFkYmZkNjg=

[José]

L'un des points de discorde porte sur les coûts comparés des systèmes américains et cubains…

What Sicko Left Out

by Humberto Fontova

That Michael Moore got some of his most heated rebuttals on Sicko from CNN bemused many Cuba watchers. CNN, after all, was the first network to receive benediction from the Maximum Leader to open a Havana bureau. For years their Cuba correspondent, Lucia Newman, performed magnificently, amply keeping up CNN's side of the bargain.

So Havana could not have been pleased with CNN's recent insolence towards Michael Moore. Any discord between two of Castro's most dutiful mouthpieces was clearly unhealthy for the regime. But no problemo. As we soon saw on Larry King Live, the spat was a fluke, a regrettable blip in an otherwise even record. Happily for Moore's Cuban case officers, within days, the matter was quickly patched up. Moore's threat to become "CNN's worst nightmare!" proved bombastic and hollow, identical to his films.

The spat originated earlier on Wolf Blitzer's show when CNN's medical wiz Dr Sanjay Gupta accused Moore of fudging figures by claiming that Cuba spent $251 per person on health care. Sanjay said the actual figure was $25.

Turned out, Gupta had goofed and Moore was right. How could he not be? He used the figures reported by a Stalinist ministry to the U.N. and confirmed in person by Moore's Cuban host, the pediatrician Aleida Guevara (Che Guevara's daughter.).

"In the report CNN says that I fudged the facts," challenged Moore. "They didn't find a single fact that I fudged."

Quite true. Michael Moore did not fudge a thing. And neither did the New York Times' Herbert Matthews when he claimed in June of 1959 from Havana, "This is not a Communist Revolution in any sense of the term. Fidel Castro is not only not a Communist, he is decidedly anti-Communist." Castro confided this to Matthews in person and for the record. The New York Times also acquitted Che Guevara from any reddish taint. "It gives me great pain to be called a communist," bristled the aggrieved Argentine at the crackpot smear.

Soviet GRU agents slept in Che's (stolen) Havana mansion even as the New York Times transcribed and published Guevara's pained denials of this malicious Birchite smear.

So if Che Guevara's daughter confirms to Michael Moore – in person and for the record – that Cuba spends $251 per person a year on health care, then, by golly, CNN (of all people!) should know it's perfectly true!

As eagerly expected by Michael Moore's Cuban case officers, Sicko's screening was the signal for their other propaganda assets to chime in: "Communist Cuba's universal free health system has achieved low child mortality and high longevity rates on a par with rich nations since Fidel Castro's 1959 revolution," wrote Anthony Boadle from Havana's Reuters Bureau last week.

An infant mortality rate that plummeted from 13th lowest in the world (lower than in Germany, France, Japan, Israel among many other first world nations) during the unspeakable Batista era to 40th today, that finds most of the nations behind it in 1958 now ahead of it – this rate qualifies as an "achievement" in the lexicon of news agencies that have earned a Havana bureau.

This current infant-mortality rate, by the way, is also kept artificially low by an abortion rate of 0.71, the Hemisphere's (and hovering among the world's top five for the past two decades) highest, which "terminates" any pregnancy that even hints at trouble. Cuba's suicide rate is also currently the Hemisphere's highest, triple its rate during the unspeakable Batista era.

Of course any foreign journalist who attempted to practice his profession in Cuba would be quickly escorted to the airport in a firm chokehold. Any Cuban who tried anything remotely of the sort would instantly and involuntarily enroll in the regime's free (though somewhat cramped) lodging, it's foolproof weight-loss regimen, and get free electroshock treatments to boot.

In case some have forgotten, Cuba is a Communist state almost perfectly patterned on the Stalinist model. I say "almost" because in the early stage Castro and Che deviated somewhat by actually jailing more political prisoners per-capita than Stalin. As such, material rewards are granted exclusively by the state and relentless police-state control is the regime priority.

"Health-care" is important only so far as a function to bamboozle foreign press agencies, academics and filmmakers (which has proven a laughable cakewalk). As such, the rewards issued by Castro's Stalinist regime to Cuba's doctors (a monthly salary of $22) are dwarfed by those awarded to the dedicated and intrepid staff of Cuba's Ministry of the Interior. These latter and perform the vital functions in maintaining the viability of the Castro fiefdom.

According to the International Labor Organization, during the unspeakable Batista era, Cuba workers were more highly unionized as a percentage of population than U.S. workers and earned the 8th-highest wages – not in the hemisphere – but in the world. Cuba had a higher per-capita income at the time than half of Europe's, double Japan's, along with the lowest inflation rate (at 1.4) in the Western Hemisphere. The Cuban peso of the time was valued slightly higher than the U.S. dollar and was fully backed by Cuba's Gold reserves. My parents paid $3.50 a month to a private-sector HMO for full health care coverage for their entire family during the 50's.

For Cuba's indigent (or those who preferred buying a couple bottles of Rum or lottery tickets with their $3.50) the unspeakable Batista regime maintained the Calixto García, Reina Mercedes, Emergencias, Hospital de Maternidad, and El Infantil hospitals – all providing what socialists term free health care, in the manner of New Orleans Charity Hospital.

The U.N.'s World Health Organization has a fetish for infant-mortality figures, regarding them as the be-all and end-all of nation's health index. As such, Castro, whose fiefdom was awarded a prestigious UNESCO award in 2000 – is absolutely anal (Ha-Ha!) in reporting carefully doctored (shall we say) figures on Cuba's infant-mortality rate to the WHO. And Michael Moore Sicko relies on these U.N. figures exclusively.

In April 2001 Dr. Juan Felipe García MD, of Jacksonville, Florida, interviewed several recent doctor defectors from Cuba. Based on what he heard his report may discomfit some Sicko fans. "The official Cuban infant-mortality figure is a farce," asserts Dr. Garcia. "Cuban pediatricians constantly falsify figures for the regime. If an infant dies during its first year the doctor often reports he was older. Otherwise such lapses could cost him severe penalties and his job."

A samizdat smuggled out of Cuba in January 2003 by Mario Enrique Mayo reported that Dr Olga Oropeza from Camagüey province was severely reprimanded by her hospital chief Leonardo Ramirez for delivering a premature baby. "That could raise this hospital's infant-mortality rate!" Ramirez berated the terrified woman.

According to a report by the Association of American Physicians and Surgeons, the mortality rate of Cuban children aged 1 to 4 is 34% higher than the U.S. (11.8 versus 8.8 per 1000). But these don't figure into U.N.-spotlighted "infant-mortality rates," you see. So apparently the pressure (so far) is not on Cuban doctors to fudge these figures.

The Association of American Physicians and Surgeons also reports that the current maternal mortality rate in Cuba is almost FOUR TIMES the U.S. rate (33 versus 8.4 per 1000). Peculiar (and tragic) how so many mothers die during childbirth in Cuba? And how many 1–4 year olds perish, while from birth to one year old (the period during which they qualify in U.N. statistics as infants) they're perfectly healthy?

This might lead a few people to question Cuba's official infant-mortality figures. But such people would not get a Havana bureau for their agency or network, much less a visa to film a documentary in Fidel Castro's fiefdom.

http://www.lewrockwell.com/fontova/fontova66.html