CNN has launched another report that attempts to defend Dr. Sanjay Gupta when he claimed Michael Moore "fudged facts" in his movie Sicko. Mr. Moore and Dr. Gupta have faced each other down a number of times since the original report leading to a firestorm of finger-pointing and attempts by both sides to show the other side to be lying. Since this all originated from the original CNN report by Dr. Gupta I created this diary to analyze his report as much as possible. Hopefully you can see why Mr. Moore reacted as he did to CNN’s original report as well as decide for yourself whether Mr. Moore has indeed "fudged facts".
The video for the original report by Dr. Gupta can be found here
The report begins by Wolf Blizter introducing the story on his show The Situation Room:
Blizter intro: But the movie is being criticized by some who accuse Mr. Moore of playing loose with the facts. Michael Moore is standing by...But first a reality check from our CNN chief medical correspondent Dr. Sanjay Gupta.
Dr. Gupta: Sicko throws some hard punches at the American health care system and Mr. Moore presents a lot of facts throughout the movie, but do they all check out? Keeping them honest we did some digging...
Dr. Gupta’s report then seeks to identify errors in Sicko’s reporting.
"Mr. 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."
This is the only statement that Dr. Gupta explicitly claims is "not true". The graphic scribbles out $25 which Mr. Moore has never said. CNN later acknowledged the reporting error when they admitted that Mr. Moore said in the movie Cubans pay "$251 per person per year". CNN cites numbers slightly different that Mr. Moore’s when Dr. Gupta says "Not true. But not too far off. The United States spends $6,096 per person, versus $229 per person in Cuba." Mr. Moore and CNN use two different sources for their numbers. Mr. Moore uses the United Nations Human Development Report and CNN uses the WHO's World Health Statistics 2007 report. Both are valid sources and proper citations make both statements factually correct. To claim this is fudging facts is wrong. CNN can argue all they want about what are the more accurate numbers or which citation is more reliable but upon submission of the source by Mr. Moore, Dr. Gupta should have retracted the claim that Mr. Moore "fudged facts".
No other data is challenged in Dr. Gupta’s report. Instead, Dr. Gupta attempts to imply that Mr. Moore’s overall contention, that government-provided healthcare is superior to privatized healthcare, is wrong under the guise of "fact checking" the movie ‘Sicko’. He does this by suggesting Mr. Moore has failed to be forthcoming with some information. In other areas he suggests that Mr. Moore is saying something that he has not said. Furthermore, Dr. Gupta attempts to provide information or data, without citing his source(s), that contradicts Mr. Moore’s claims regarding healthcare inside and outside of the US. This "data" that Dr. Gupta presents no longer challenges any facts presented by Mr. Moore but merely attempts to convince the viewer that errors are being identified. This is most effectively accomplished by construction of the report as I demonstrate below:
- Wolf Blitzer introduces the piece by Dr. Gupta saying that Mr. Moore is being "loose with the facts"
- Dr. Gupta’s report is called "’Sicko’ reality check"
- Dr. Gupta’s introduction: Sicko throws some hard punches at the American health care system and Mr. Moore presents a lot of facts throughout the movie, but do they all check out? Keeping them honest we did some digging...
- Dr. Gupta and CNN use an incorrect quote from Sicko regarding what Cubans pay per person per year for healthcare. They identify this as "not true". It isn’t. And Mr. Moore never said it was.
- The rest of the report is filled with opinions, misdirection, and vague statements. But no more facts are challenged. A few facts are listed but these facts do not contradict anything Mr. Moore has said and there are no citations provided.
- Dr. Gupta concludes: "But no matter how much Mr. Moore fudged the facts, and he did fudge some facts..."
What follows now is a logical analysis of the majority of Dr. Gupta’s report. Upon reading this you can see how not a single fact was challenged which should lead the viewer to question what Dr. Gupta and CNN are using as their reasoning to claim that "he did fudge some facts"
Dr. Gupta and CNN implicitly claim to catch an oversight by Mr. Moore when they identify Cuba ranked at 39 in overall healthcare quality as determined by the WHO (two ranks lower than the US). Whether Dr. Gupta is claiming to be "keeping them honest" here with pointing out Cuba’s number 39 position is difficult to say since Dr. Gupta never claims that Mr. Moore was hiding this fact. Nor does he admit that the fact is pointed out to the audience in the movie. What we do know is that the CNN graphic covers up Cuba on the list in the clip from the movie and the phrase "Hold on!" by Dr. Gupta in his report about "keeping them honest" certainly suggests the intention to show the viewer that an oversight is now coming to light. If not intentional it is at the very least misleading by design. Why? Because any report which claims to do a fact check and simply revelas information already present in the movie without acknowledging the presence of such information in the movie is misleading.
clip from Sicko shown by CNN during Dr. Gupta's report:
Dr. Gupta’s report suggests that although the overall quality ranks closely to Cuba, the increased cost likely translates to higher patient satisfaction. The identification of short wait times for elective surgeries is then used as supporting data for the high "patient satisfaction". Although Dr. Gupta has not cited any evidence for his claim of "high patient satisfaction" both he and Mr. Moore point out that the ranking of 37 and 39 by the WHO include "patient satisfaction" in their analyses.
Dr. Gupta continues:
"So Americans DO pay more, but the United States also ranks highest in patient satisfaction".
He cites no evidence for the patient satisfaction data but uses data on "elective procedure waiting times" in the same sentence in an apparent justification of "patient satisfaction". He says Americans wait times are shorter than every country except Germany for "non-emergency elective procedures like hip replacement, cataract surgery, or knee repair." "That’s not something you’ll see in Sicko as Americans tell their tales of lack of coverage, and suffocating red tape."
With some fancy word play Dr. Gupta has suggested that Sicko falsely claims that Americans are dissatisfied with their quality of care. But what he is in reality saying is Mr. Moore has failed to inform the audience that American wait times are shorter than every country except Germany for "non-emergency elective procedures like hip replacement, cataract surgery, or knee repair." If this is a rebuke of Sicko’s claim about long wait times why did Dr. Gupta choose non-emergency elective procedures to prove his point? And do cataract surgery, hip replacement, and knee replacement represent a proper sampling group for gauging the average American’s waiting time for treatment? Has he left out emergency room visits for a reason? What about treatments that are more evenly spread out over the entire demographic range of hospital patients instead of elective procedures common in the elderly? Are the individuals receiving hip replacements, cataract surgery, and knee surgery on government-subsidized programs like Medicare or Medicaid?
Dr. Gupa:
"The film is filled with content Canadians and Brits sitting in waiting rooms confident care will come, but in Canada you can be waiting for a long time"
Dr. Gupta doesn’t give a statistic on waiting times for Canadians, and to the best of my recollection, Mr. Moore did not either.
"A survey of six industrialized nations found that only Canada was worse when it came to waiting for a doctor’s appointment for a medical problem"
No source is listed by Dr. Gupta. In addition this survey at best offers an opposing view on the average wait time experienced by Canadians but once again does not find any facts "fudged". Mr. Moore’s report of short wait times by Canadians is obtained from interviews with Candians themselves.
Although this "survey" certainly challenges the "content canadians" who speak to Mr. Moore’s camera in the film read the quote again carefully.
Shortest waiting times for a doctor’s appt (of 6 total countries surveyed)
- ?
- ?
- ?
- ?
- United States
- Canada
I would just like to briefly mention here that the survey Dr. Gupta is using lists only 6 countries and the United States is next to last on the list. But enough about that.
So Dr. Gupta uses this survey to challenge the viewers into questioning either the accuracy or the honesty of the "content Canadians" in the film. Think about it, if this survey is a more accurate representation then one of 3 possiblities exist:
- The Canadians were lying to Mr. Moore’s camera
- They represented a disproportionate sample of the average
- The film was edited/created to filter out the negative feelings to carefully portray Canadian healthcare in a way that is consistent with the maker’s intention (propaganda)
Dr. Gupta mentions a survey that disputes Mr. Moore’s claim. This is not the identification of fact fudging. At best this is data that points out that those interviewed by Mr. Moore do not represent the national average. In order for it to be fact fudging there would have to be a numerical or statistical claim that was either changed or completely fabricated. Mr. Moore has made no such claim. An example of fact fudging would be claiming that Mr. Moore has said that ‘Cubans pay $25 per person per year for healthcare’ when he in fact never said that. An example of fact fudging would be saying that ‘Canadians wait an average of 45 minutes less than Americans for emergency room treatment’ when there is no study that supports it. Dr. Dr. Gupta has not identified the changing of scientific data or the fabrication of data by Mr. Moore.
More from Dr. Gupta's report:
Expert:
"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 and as a proportion of their household income...it’s a significant number"
Mr. Moore identifies in the movie that healthcare is paid for in those three countries through taxes. Dr. Gupta has not uncovered anything here that was not presented in the movie. Dr. Gupta and CNN fail to take this to the next logical step and compare the financial impact on a family of paying higher taxes "proportionate to their incomce" as opposed to paying for private healthcare coverage. Furthermore the statement "it’s a significant number" is not explained and is open to complete speculation on the part of the viewer. In a report that claims to be "fact checking" Mr. Moore’s film such a statement should either be explained or removed. Leaving that statement in the report results in a statement of "significance" in a report that claims Mr. Moore is "fudging the facts" without attributing anything to the "significance". This allows the journalist to provide the appearance of scientific credence to the overall claim of the piece without leaving himself open to a challenge of the facts that he’s using to back up his story. Why is it a significant number? Is it a significant proportion of their monthly income? Is it a significant increase in taxes as compared to Americans’ taxes? What is the control group to which this significance is attributed? In the absence of any more information, and in the context of the sentence, it can only be assumed that the added amount to taxes as a result of government-provided healthcare is a significant increase as opposed to non-government provided healthcare costs. But they didn’t exactly say that. And if it were, significance literally means a low probability that the observed phenomenon happened by chance. So a significant increase in their taxes simply means that, if compared to someone who did not have healthcare added to their taxes, a person’s taxes would be noticeably higher and not likely the result of chance. What it does not necessarily mean, is a large increase to their taxes. The word ‘significant’ can sometimes be used as a synonym for ‘large’ and it sounds to me like the lack of definition of the term ‘significant’ with no elaboration of why it is significant was purposeful in order to once again let the viewer draw their own conclusions as to the meaning of it. In a report that seeks to debunk claims put forth by Mr. Moore I would expect any such connection to be drilled into the audience until the point was beyond arguable. They did no such thing here. I question their motives for leaving such an ambigous statement in the report.
Dr. Gupta:
"But even higher taxes don’t give all the coverage everyone wants"
Expert:
"15-20 percent of the population will purchase services outside of the system of care run by the government"
There’s no elaboration on what the economic or demographic breakdown is of this "population" or what these "services" even are. Under this same category of items listed as "services outside of the system of care" what are the statistics on those "purchases" in the United States currently? If the attempt is to compare and contrast US private healthcare with government-run foreign healthcare then certainly a claim that identifies "services" that obviously must be sought "outside of the system of care" in those countries should demonstrate how that differs from our private healthcare system. Are collagen injections part of that 20%? Laser hair removal? Botox injections? If so, suggesting that tax-paid universal health coverage is inferior to privatized healthcare coverage is both misleading and incorrect. Misleading because no one in their right mind would consider collagen lip injections as essential to healthcare. Incorrect because it’s highly doubtful private healthcare pays for such services in the United States. Of course, I can’t make such an argument since CNN and Dr. Gupta failed to elaborate on these "services" or what segment of the population that makes up the "15-20%" is purchasing them. Additionally, this segment once again attempts to "fact check" Mr. Moore but simply does not do so.
Dr. Gupta:
"But no matter how much Mr. Moore fudged the facts, and he did fudge some facts..."
After careful analysis of Dr. Gupta’s report and Mr. Moore’s responses I believe any reasonable person should conclude that Dr. Gupta failed to perform any fact checking on Mr. Moore and is falsely accusing him of "fudging facts". I can assume that this journalistic piece was created by first forming a conclusion and then followed up with the best facts available to support that conclusion. This is anti-science and Dr. Gupta and CNN should be ashamed of the piece. The body of the report fails to accomplish what the introduction claimed it would do and the conclusion was not supported by the data presented. The report presented by CNN and Dr. Gupta thus appears to be a ‘hit-piece’ on Mr. Moore and should bring into question the motives of Dr. Gupta and CNN in creating and presenting such a travesty of American journalism. At best, Dr. Gupta is a poor scientists and a worse journalist; at worst he is attacking a piece of investigative journalism at the defense of our corrupt, privatized healthcare system.