Sicko A Study of Sexuality and Health among Older Adults in the United States was the title of an interesting article published two weeks ago in the New England Journal of Medicine.

You probably heard of this study, that was reported at great length in the media all over the world. The paper concluded that many older adults are sexually active. Okay. Nothing that surprising or brand new here, yet interesting to know.

Only, there was another great article published in the very same issue of the New England Journal of Medicine that received much less attention from the media. Its title was Healing Our Sicko Health Care System, by Jacob S. Hacker, Ph.D. The article dealt with the last movie by Michael Moore bearing this name in a level-headed way, not at all hagiographic of a movie of which the limitations were underscored. Quoting its first paragraphs:

ImageThere is a scene in Sicko — Michael Moore's controversial new film about U.S. health care — that captures both the power and the limits of Moore's cinematic polemic.

A mother is speaking about her 18-month-old daughter, Mychelle, who became ill one evening with vomiting, diarrhoea, and a high fever. At the nearest emergency room, Mychelle is treated by a physician who suspects, rightly, that she has a life-threatening bacterial infection. But rather than give her antibiotics, the doctor calls her insurer, whose physician-gatekeeper tells him that Mychelle is not covered at the hospital and must be taken to another facility. The doctor repeatedly says that Mychelle needs care, and he is repeatedly told that she must be transferred first. Finally, nearly 3 hours after arriving at the hospital, wracked by seizures, Mychelle is taken to the approved facility. She dies 15 minutes later.

As Mychelle's mother, Dawnelle Keys, recounts this awful sequence of events, a swing hangs empty in the background. Even if we had not witnessed multiple tragedies already — a woman seriously injured in a car crash whose insurer denies payment because she doesn't obtain "prior authorization" to visit the emergency room, an elderly couple who move into their daughter's storage room because they cannot afford their medicine, an uninsured man forced to choose which of his two fingers to have reattached after an accident — we'd know how the story ends.

And yet, when the moment comes, and Dawnelle Keys's voice cracks as she describes losing her daughter, the effect is still devastating. We can't but wonder how our rich, powerful country can let so many citizens face such unnecessary pain and loss. How could a government "of, by, and for the people" fail so miserably to protect the people from such vast and preventable tragedies?

ImageIndeed. I have heard so many stories of the same kind from chat friends living in the United States. Each time, I feel sorry... and angry too, probably because I am a doc myself, and I live in Europe. It seems surreal to see such failure in the richest and more powerful country in the world, while the right to be treated has been a fundamental right in European countries for decades.

A few years ago, USA was ranked 37th in the World Health Organization's ranking of the world's health systems, and at the same time, about $5 billion a month are spent in Iraq? There must be an error somewhere.

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