THE BOOK--Playing The Percentages In Baseball

The baseball equivalent of the current American health care system is Luis Aparicio batting leadoff.  It works if he “reaches base”, but the problem is that he doesn’t “reach base” enough.

"To fudge some facts is to accuse someone of purposeful deception.”

Is that intended to sound indignant?  There cannot be any doubt at this point that Moore has engaged in widespread purposeful deception.

If Gupta or CNN want to argue that Moore has fudged his facts, then they should make their case.  If that report that Gupta presented is the best he can do, he’s an utter failure.

It’s very simple to dispute his facts, isn’t it? 
1. This is what Moore presents as data.
2. This is where he got that data.
3. This is the context to that data.
4. Here’s another context to consider.
5. Here’s the data for that context.
6. Here’s the source for that data.

Viewer can decide which data to believe.

Instead, Gupta sometimes showed #2/4/6, and furthermore, HE made the conclusion for us by saying that Moore was deceptive.  If this was a court case, and this is what Gupta presented, he wouldn’t even get a trial, for insufficient evidence.

This is similar to that Scott Boras piece, where the reporter never bothered to investigate anything Boras said (see my blog entry of a few weeks ago).

Anyone want to argue Moore’s data (from a movie which of course is not required to be objective and without passion), then follow the guidelines above.

Something along these lines, then? 

http://www.spinsanity.org/columns/20020403.html

Yes, that is mostly good.  I could have done without all the extra adjectives thrown in.  For example, a point-by-point as Moore has shown on the link I provided at the top makes things easier.  He cites CNN, shows what he actually says, and he cites his source material.

Some other site did the point-by-point for Fahrenheit 9/11, which I think Moore countered as well.

In terms of debate, and being able to follow the merits of the discussion, this is the best way for people to make up their own minds.

Cherry-picking stats as Gupta did and then accusing someone else of fudging data is preposterous!

Anyway, I look forward to a point-by-point analysis by somebody on Sicko.

DJH, thanks for that great website.  Here’s their take on the 9/11 movie:
http://www.spinsanity.org/columns/20040702.html

Except for the very last sentence, it was an excellent piece. 

Moore’s movies are basically what a prosecutor would do: use facts, and try to weave them to create circumstantial evidence to tell your side of the story (plus add some satire).  It is obviously not a documentary.

"It’s obviously not a documentary.”

He sells his films as documentary and people consume it as documentary.  I find the former dishonest and the latter dangerous.  Advocates of important issues, such as health care reform or global warming, have plenty of facts on their side without having to resort to thumb-on-scale “documentaries.” (I haven’t seen “Manufacturing Dissent” yet, but I think I ought to.)

Personally, I can do without Michael Moore’s take on ...well, anything.  Given enough time, I prefer to read/view analysis and not advocacy.  But beyond advocacy, Moore has become another “infotainer” on par with Bill O’Reilly.  I don’t form my opinions based on O’Reilly’s “facts”; Moore gets the same treatment from me. 

Moore’s defenders often say that his films are valuable because they “create dialogue.” First of all, they don’t create dialogue, at least not between folks who previously had opposing viewpoints.  Second, that excuse is in the same vein as the yahoo who claims that his outrageous claims were meant as “a social experiment.” Give me a break.

I think it’s fair to say that Michael Moore is an infotainer on par with Bill O’Reilly, and you can say Stephen Colbert.  They use any combination of facts, opinion, and satire to get their point across.

I don’t think any of them help create dialogue, but they do expose their viewpoints in an entertaining, and therefore, long-lasting, manner.  And, they allow us to continue talking, not necessarily in a dialogue manner, but in a lawyerly “exposing the evidence” manner.

O’Reilly however gets a thumbs down from me because his ratio of facts to opinion is way too low.  And Colbert gets a huge thumbs up because he has the same ratio of facts/opinion as O’Reilly, plus an enormous satire level.

***

One impressive piece by Colbert was when he was talking to a congressman and asked him about the 10 commandments, and the congressman said it should be on the wall.  Colbert asked if he believes in it, that it’s important to have it up, that he’s religious, so he wants to see it up there.  The congressman said yes.  So, Colbert said: “Ok, what are they?”.  Congressman stammers.  “What?”.  He repeats: “What are the 10 commandments?”.  Silence.  Colbert drags it out.  His point made, he goes on to the next question.

Now, in some other skit weeks earlier, he had told someone that you should cut scenes, and juxtapose the answers and questions, because “it works for me”, or “I do it” (can’t remember which).

Because of that, we can’t take any of his takedowns of politicians at face value.  But, that’s unimportant.  More important is that it’s likely true that you have a segment of people who say they believe in something and they probably don’t.  That this poor congressman was used as Colbert’s pawn is ok with me.  It was fantastic.

I have to say that it was likely that Colbert did not do the juxtaposition, and that this congressman actually didn’t know the 10 commandments.

It’s just that with satirist like Colbert and Moore, you never know.

Some other site did the point-by-point for Fahrenheit 9/11, which I think Moore countered as well.

I suspect you’re thinking of this piece (http://www.davekopel.com/Terror/Fiftysix-Deceits-in-Fahrenheit-911.htm); Moore did respond to some of the points, and his response (and counterresponses) were incorporated into the piece.

Also of interest is this very recent open letter to Moore by John Pierson (http://www.indiewire.com/people/2007/06/first_person_jo_1.html), who helped Moore get distribution for Roger and Me, in part taking Moore to task for the fact that he actually did succeed in interviewing Roger, despite the premise of his film being the opposite (I’m oversimplifying, it’s worth a read).

I don’t understand how you guys think Moore’s films don’t create dialogue.  What’s going on in the comments here, right now?  I guess I kind of agree with you on O’Reilly - I don’t think he creates dialogue, I think he tends to breed a lot of “Yeah, me too!” inside people’s minds.  But I could be biased because I’m a lot closer to Moore’s politics than O’Reilly’s.

I’m so glad to be alive in an era where the internet provides a medium for people to question what’s going on around them.  If Bush’s presidency had occurred 10 years ago, I’d know nothing about the habeas corpus and wiretapping stuff that’s come out.  Sure I’d be blissfully ignorant, but I’d be ignorant. 

Moore, to me, also fills something similar.  He may be completely off base, and we might be able to sit here and pick apart his films and the facts therein… but at least he’s asking questions.  Because someday, he might make a film that most of us DO agree on, about a topic most of us agree something must be done about.  And we’ll be educated, informed, and ready to speak up.

I don’t understand how you guys think Moore’s films don’t create dialogue.  What’s going on in the comments here, right now?

Well, one might argue that the problem is that we’re discussing “Is he telling the truth?” and “Should he be?” instead of discussing the issues he raises.  He raises a lot of fog in front of his questions, I think.

Moore’s work is agitprop.  He makes no bones about it.  His greatest failures thus far are precisely that his agitprop has not changed the world.  His work had not elected many (if any) from his side of the aisle.  He may fail again with ‘Sicko’.

On the facts, though, Moore has picked a subject on which opposition is indefensible.  The US health care system is broken, full stop.  The data run only one way.  There is no way to torture it any more.  Anyone (like Gupta) who tries to ‘gotcha’ those who point out the emperor’s new clothes deserves all of Mr. Tiger’s ire.

And I bet dollars to donuts that any of the rest of you who are defending the US health care system have a) unusually good health insurance and b) no clue about what health care is like in the rest of the developed world.

One of the problems with debating “facts” is that often they are not “facts” at all.  For example, “satisfaction with something” as in the percentage of people who are satisified with their country’s health care or with their own health care experience is certainly not a “fact,” and I don’t think I need to explain why, at least on this blog.  The number of people who responded “X” or “Y” to a survey given by “Z” and set up with “M” methodology is a fact (and even that can probably be “spun").

And yes, it is true that people can and do “spin” just about anything without necessarily reporting incorrect data.  One does not have to dispute someone’s facts in order to dispute their point of view.

From what I can tell from Moore’s rebuttal to the CNN piece (and I have not seen it or Moore’s latest movie), the “facts” presented and disputed by both sides are a quagmire.  To wit:

DR. SANJAY GUPTA, CNN: “(Moore says) the United States slipped to number 37 in the world’s health care systems. It’s true. ... Moore brings a group of patients, including 9/11 workers, to Cuba and marvels at their free treatment and quality of care. But hold on - that WHO list puts Cuba’s health care system even lower than the United States, coming in at #39.”

THE TRUTH:
“But hold on?” ‘SiCKO’ clearly shows the WHO list, with the United States at number #37, and Cuba at #39. Right up on the screen in big five-foot letters. It’s even in the trailer! CNN should have its reporter see his eye doctor. The movie isn’t hiding from this fact. Just the opposite:

I would have to see the CNN report, but this sounds like bad reporting by CNN.

I say, “Look, Cuba and the U.S. are ranked close to one another in health care (according to some WHO report).  We are the richest and most powerful country in the world, Cuba is a piece of crap country and yet their rankings are similar.  That does not say much about our health care.”

CNN says: “Lichtman shows us how great Cuba’s health care system is, but he must be an idiot, cause they are ranked 39 in the world.  Not too good. 

That is deceptive reporting by CNN. They are not reporting my message accurately at all, which is simply that Cuba and the U.S. are similarly ranked and I think that is a travesty.

I don’t know if I am accurately stating what both sides said as I did not see any of the pieces.

The other thing is that I have no idea whether 37 or 39 is good or bad in terms of rankings.  Are 1-36 countries like Darfur, Iraq, North Korea, Timor, etc., or are they more developed countries?

And what exactly are these “WHO rankings?” To equate them with “quality of health care” is not a “fact” at all.

The fact that the healthcare system in an impoverished nation crippled by our decades-old blockade (including medical supplies and drugs) ranks so closely to ours is more an indictment of the American system than the Cuban system.
Although Cuba ranks lower overall than the United States, it still has a lower infant mortality rate and longer life span. (see below)

I don’t like adding the infant mortality rate and life span issues.  For one, they are not the same thing as “health care” (which is being discussed) and longevity at least can have more to do with diet and lifestyle than health care.

And unlike the United States, Cuba offers healthcare to absolutely everyone. In an independent Gallup poll conducted in Cuba, “a near unanimous 96 percent of respondents say that health care in Cuba is accessible to everyone.”
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.”

Well we know that the U.S. does not have “national health insurance.” I am not sure that means that we “don’t (or do) offer health care to everyone.” I don’t even know what that means.  If a person with no money or no insurance gets sick, they can get health care in the U.S.  I am not sure where and how and how good, but it is available.  If that same person wants laser eye surgery, they ain’t going to get it.  Everything in between, I don’t know, and I don’t know about Cuba or the other countries with “national health care.” When I was in Portugal a few weeks ago, our driver told us that he needs knee surgery from a football (soccer) injury but because it is not an emergency he has to wait like a year.  If he could not work or walk, he would get it sooner.  Makes sense to me.

And whether health care is “accesible to everyone,” again, whatever that means, is NOT the same thing as quality of health care.  There are a million permutations to “quality of health care.” For example (one of a million), my parents have medicare as do most older people I think.  When my mother was ill, it was almost embarrasing how easy it was for her to get quality health care.  Basically she was able to see almost any doctor and get any medicine, procedure or operation she needed for free.  All we had to do was call the doctor, even the best ones we could find.  They all took mecicare.  As far as when she could get in to see them, it completely depended on the patient load at each doctor and how serious her condition was.

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.

Obviously CNN screwed this up and they should apologize on air.  Still, I don’t even know what the point is.  What a country spends on health care depends on their economy, how much they pay their workers, etc.  A doctor in Cuba may make $1000 a month whereas here they probably average 10,000 a month.  And what does “spend money on health care per person” even mean??  I can say that about just about any so-called “fact.”

Cont. in next post.

CNN: The United States ranks highest in patient satisfaction.

True, but even when the WHO took patient satisfaction into account in its comprehensive review of the world’s health systems, we still came in at #37.

Of course.  CNN can certainly say that Americans are very satisfied with their health care.  Whether that means that our health care is good or not is another story.  And certainly that does not let one compare it to other countries.  What if 96% of Americans are satisfied with their health care and 96% of the French are also, but it turns out that one country’s health care is way better than the others?  Certainly possible.  And again, who is conducting the survey and of whom and how? 

When we hear the results of a survey we don’t always know who was surveyed, how, and what the exact language of the questions were.  All of these things are important in terms of understanding the results.

Patients may be satisfied in America, but not everyone gets to be a patient. 47 million are uninsured and are rarely patients - until it’s too late. In the rest of the Western world, everyone and anyone can be a patient because everyone is covered.

Of course this is critical, which gets back to my
“method used for the survey.” If only patients are surveyed, what if in one country 10% of people end up as patients and in another 90% end up as patients.  “Patient satisfaction” would be a BS “fact” in terms of each county’s quality of health care.  I can get great quality in anything real cheap if I limit the quantity!

CNN: Americans have shorter wait times than everyone but Germans when seeking non-emergency elective procedures, like hip replacement, cataract surgery, or knee repair.

What the hell does that fact mean!!!  Of course a country that has national health insurance for everyone will have long waiting times for elective procedures!  I assume that in those countries that have NHI, if you can pay cash you can get an elective procedure real quickly!  I don’t see the point of this “fact.”

I can say this a hundred times, but I have traveled enough to know that if you have good insurance or lots of money, the U.S. has by far the best health care (or ONE of the best) in the world.  That does not mean that the health care system in the U.S. is not a total disaster (and I don’t know whether it is or it isn’t).  But that just brings home the point of what we mean by “quality of health care.” I assume that Moore and his brethren are basically talking about the poor and the lower and middle class people who don’t have insurance or who can’t really afford it.

This isn’t the whole truth. CNN pulled out a statistic about elective procedures. Of the six countries surveyed in that study (United States, Canada, New Zealand, UK, Germany, Australia) only Canada had longer waiting times than America for sick adults waiting to schedule a doctor’s appointment for a medical problem. 81% of patients in New Zealand got a same or next-day appointment for a non-routine visit, 71% in Britain, 69% in Germany, 66% in Australia, 47% in the U.S., and 36% in Canada.

Oh, come on!  These are BS statistics and a BS question!  Anyone who is sick in this country can walk into a “quick care” medical facility (OK, maybe they don’t have these in all parts of the country) and get same-day medical care.  If you need to see a specialist, or have something complicated, that is another story.

One way America is able to achieve decent waiting times is that it leaves 47 million people out of the health care system entirely, unlike any other Western country. When you remove 47 million people from the line, your wait should be shorter. So why is the U.S. second to last in wait times?

And there are even more Americans who keep themselves out of the system because of cost - in the United States, 24 percent of the population did not get medical care due to cost. That number is 5 percent in Canada, and 3 percent in the UK.

Yes, all of these wait times and satisfaction statistics are BS, as I already stated.  It IS important to look at how many people can and do have access to what kinds of medical care.  THAT is important and fairly straightforward.

CNN: (PAUL KECKLEY-Deloitte Health Care Analyst): “The concept that care is free in France, in Canada, in Cuba - and it’s not. Those citizens pay for health services out of taxes. As a proportion of their household income, it’s a significant number … (GUPTA): It’s true that the French pay higher taxes, and so does nearly every country ahead of the United States on that list.”

Well, no shizitt!  You mean health care in countries with NHI is not free?  I thought that the doctors worked for free and everyone donated the materials to build the medical facilities.

If everyone has to pay 300 a month for health insurance, only people who make decent money will have any insurance.  If that same 300 a month is taken out of our taxes, then EVERYONE gets to have health insurance!  Why is that?  Because people that make a lot of money pay more taxes and therefore pay for medical care for the poor and middle class who pay less taxes.  Now, whether you like that idea or not (the rich paying for the poor’s medical care) is another story (and you have to be pretty cold NOT to like it), but to imply that our system and theirs is really the same because their system uses taxes and is not “free” is such a BS argument it makes my blood boil!

CNN: “But even higher taxes don’t guarantee the coverage everyone wants … (KECKLEY): 15 to 20 percent of the population will purchase services outside the system of care run by the government.”

Whether it is 15%, 20%, or 10%, so what?  Of course if you have money in countries that offer NHI, you can and should use that money to get better health care.  That is what money is all about in a capitalist country!  In a benevolent capitalist country, you provide decent services for the poor and the rich get to get excellent services.  Unless you believe in communism or socialism (which is fine by me) that is the way it works, which is also fine by me.

CNN: “But no matter how much Moore fudged the facts, and he did fudge some facts…”

This is libel. There is not a single fact that is “fudged” in the film. No one has proven a single fact in the film wrong. We expect CNN to correct their mistakes on the air and to apologize to their viewers.

I don’t know about that.  I don’t know exactly what “fudging the facts” means.  I think that just about everyone fudges facts when discussing contentious issues in the public domain.  Just because guys like O’Reilley and Moore (and everyone else I guess) doesn’t think they do, doesn’t mean that they don’t (which is wherein lies one of the problems when accusing someone of “deliberately misreporting or misrepresenting facts").

Click on my name for an mp3 of a good discussion of Sicko, a couple of other films about health care, and the health care in general.  Ezra Klein is particulary good.  I’m about as free-market, anti-government as they come, but Ezra is very persusive.  The speakers come from both sides of the debate and everyone comes across as being interested in truth than hyperbole.

If health care is Cuba is so much better, why doesn’t Michael Moore live there?

#16 - I don’t believe that Michael Moore ever claimed that the health care in Cuba was better.  Also, I think most people concede that health care in the US is pretty good, if not great, if you can afford it.  I think mostly people claim that we are paying a lot more for it than other countries and that a segment of our population does not receive quality care because they do not have health insurance for one reason or another.

QUESTION/16: c’mon.  Is the *only* reason to choose where to live based on your health care needs?  Of course not. 

But, as one of the 9/11 workers who went to Cuba for his healthcare needs said: “If they convict me, I hope they send me to Guantanamo Bay with the terrorists.”

***

The sad fact is that if everyone agrees that the healthcare solution doesn’t work well enough, why don’t both sides provide a better solution.  The status quo (i.e., I’ll shoot down your idea without providing my own idea, and therefore, live with this nonideal solution) doesn’t work.

***

This is the same as the immigration status quo.

If Americans would be forced to go through the immigration process (took me almost 4 years to get my green card, and I qualified under a fast-track program!), you’d understand why there is the problem we have.  A guy in the exact same position as me (age, job function, education) applied to Canada, and he got it in less than 1 year.

Imagine waiting 7 years in an impoverished country for something that should take less than 2 years.  What would you do?  To them, breaking a US law on this matter would be akin to you as a 18yr drinking a beer.  That’s what you are up against.  You put a Chinese wall on the problem, and people will scale it.

I know you don’t think it’s the same, but if you are on the other side, that’s what they think.  And, there’s nothing special about you.  You’re lucky to have been born here.

The reason the two sides won’t come together for a solution is because they want opposite solutions.  What we have now, in both health care and immigration, is what a compromise looks like.

On health care one side wants some form of universal coverage and the other side wants open markets.  The middle ground is pretty much what we have: I highly regulated market with (misguided) tax incentives.

On immigration one side wants a completely closed boarder and the other wants it open.  Right now it’s semi-open.

If Michael Moore looked like George Clooney, would you discard his discussion so quickly?  If he didn’t ruffle feathers would there be the reaction?  Do you believe the broadcast media are free to say what believe?

Big Pharma indirectly writes my check, so I try to keep my mouth shut.  I’m sure you would too.  Whether you agree or not, judge the facts--not the reporter.  No one will ever tell you the truth--you will have to draw your own conclusions, interpolating somewhere between a number of compelling lies.

Further to my post 18:

http://www.dallasnews.com/sharedcontent/dws/spt/stories/030908dnsporangdominicans.353b912.html

IIRC, immigration fraud for non-citizens is a 10-yr ban from USA.  I don’t know who told Daniels “1 year”.  As for “second chances”, America (as most countries I gather) don’t care to give second chances to non-citizens who try to circumvent the system.

And the former ICE’s backdoor channel in trying to get the Rangers players in, almost certainly wouldn’t be accompanied for a work visa.  I find it hard to believe that he could swing that kind of deal.