By Mike Magee, MD Someone asked me the other day my thoughts on the documentary film, “Sicko.”1 I said, “See it!” As Michael Moore said in a recent interview in the AARP Bulletin, “It’s not so much about health as about the way Americans treat each other.”2 Everywhere you look, you see a society longing for peace, contentment, and security, instead of our current reality, filled with chaos and uncertainty. Yet the way we’ve structured our institutions and social services, from health to education to transportation, we see – both in the planning, the execution and the financing – heavy emphasis on decentralization and disintegration. Is it any wonder that we feel overwhelmed by complexity and out of control? For as much as we would like to believe in total individual autonomy, and the ability to segregate one part of our lives, or one part of our economy, from another, clearly this is not realistic. Take for example the much publicized downturn in the U.S. housing market.3 It was brought on by the overselling of sub-prime home mortgages to poorly qualified candidates by overzealous salespeople from Countrywide Financial and others. They were spurred on by extra financial bonuses tied to these predator loans. One would think the damage could be contained to those directly involved in the loans themselves or at least to home builders and their suppliers. But in a modern global free market economy, everything ties to everything else. Take the case of Florida, now projecting a $1.5 billion short fall in its 2008 budget.4 The housing slump in the state has caused a decline in revenue from real estate transaction taxes, which are based on home sale prices. These dollars collectively account for a small percentage of the state’s revenues. But in addition, sales tax revenues, which account for as much as 15% to 20% of total state revenues, have taken a dive as well. Why? Well part is related to declines in the purchase of building supplies. But studies also show that homeowners struggling with mortgages are less inclined to splurge on big-ticket items like cars, furnishings and vacation travel.4 This kind of cycle is not brand new. In the recession that occurred in 2002, post-9/11, 37 states faced a collective $13 billion short fall in budget projections.4 In these cycles, high points are followed by low points. For example, over half of the states in the U.S. recorded higher than expected revenues in 2006 and 2007. Based on that, increased services – especially in health care – were funded within their 2008 budgets. These commitments now appear difficult to honor, especially if the financial pressures on citizens force a further decline in property tax assessments. Experts like economist Gerald Prante of the non-partisan Tax Foundation predict a decline this year and next.4,5 That is why states like Florida, with a $71 billion dollar budget projected for 2008, are busy cutting 4% in mostly social services right now.4 It’s a “free-for-all” – every state for staff; every family for itself; and every person for him or herself. We resist rational, national and regional planning, think short-term rather than long-term, and have difficulty incorporating learnings from prior experiences or failings. This lack of organization and security – well illustrated by a health care system that lacks portability and universal access – causes us to over-react and seek control in other ways in our daily lives. Our desire to reassert control over our lives, to achieve balance and harmony, is evident everywhere, but in no place is it more obvious than in the growing obsession to organize closets, kitchens, and garages – if not health care.6 Consider the fact that we now have a National Association of Professional Organizers with over 4,000 members *up from 2000 just two years ago). These “organizers” command any where from $50 to $200 an hour to come into your home and “straighten out your life.” 6, 7, 8 Barry Izsak, the head of the organization, sums up American citizens this way, “They have psychological issues that are impairing their ability make a decision. People are struggling with everything. Their ‘to-do’ lists are growing longer and longer, and people are not crossing things off quickly.”9 In 2006, Americans purchased some $7 billion in products to organize their homes, including over two billion in closets alone.7 What’s driving them? You can get some insight from reading vendor California Closets’ credo. It says they “believe our customers…are to be afforded the greatest dignity and honor when exploring and discovering what it is that will bring sense of harmony and order to their lives.”6 Harmony and order? How about universal health care that isn’t tied to your job and is accessible to all, regardless of your medical condition? How about spending time to really nurture children 0 to 5? How about supporting third-generation women, struggling to care for ill parents or grandparents while serving children and grandchildren? Moore’s “Sicko” captured the voice of Americans worried about a health care system that’s non-portable, highly variable, scary, discriminatory, and disintegrated; a system capable of throwing you and your family into “medical bankruptcy.” But make no mistake about it, Moore’s criticism cuts deepest at the core of American values and a society out of balance. As he says, we’re all “about me, not we.”7 References 1) "Sicko." Michael Moore. www.sicko-themovie.com 2) “Sicko diagnoses ills of US Health System.” www.aarp.org/bulletin/yourlife/sicko.html 3) Levy, J. “Countrywide Financial’s Delinquencies Rise.” March 2, 2007. Http://seekingalpha.com/article/28501-countrywide-financial-s-delinquencies-rise 4) Merrick, A. “Housing slump strains budgets of state and local government.” Wall Street Journal. September 5, 2007. A11 5) Gerald Prante. “Property taxes soar across US Tax Foundation.” December 19,2006. http:/www.taxfoundation.org/press/show/2096.html 6) Schaefer-Munoz, S. “Why the container store guy wants to be your therapist.” Wall Street Journal. March 27, 2007. D1. |
