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Michael Moore’s Sicko is rolling out in US theaters to generally positive reviews. The premise is simple: for any industrialized country, universal health care should be a no-brainer. Unfortunately, certain institutions of the US medical-industrial complex (e.g. insurers) and many voters do not accept this notion. For video on a piece by CNN’s resident neurosurgeon/reporter Sanjay Gupta that really got to Moore, see this and this.

What I would like to see is a comparison between the Finnish system and the US system. Having been in both, it’s clear to me that the Finnish system wins hands down in terms of life-cycle costs and quality. On the other hand, the variability of quality of US health care can be good for the lucky and the rich — it focuses resources very well. For example, when former Disney CEO Michael Eisner started to have a heart attack, he drove his car to Cedars Sinai in Los Angeles, because he knew that was where the good care was. Such thinking would be odd in the Finnish context. Also, the Finnish system keeps slogging toward a diagnosis until it gets it right (or at least in the ballpark), while doctors in the US may be brilliant diagnosticians or lose interest and never figure out the problem. Second opinion is a big deal. It’s an interesting trade-off the Americans have made: sacrificing reliability and consistency for spectacular successes and a system that badly serves two-thirds of the population.

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