Film Review

Sicko

(July 2, 2007) What kind of a country are we? Michael Moore asks that question toward the end of his film, but has already shown us the sad answer in terms of health care in America. Sicko is a powerful indictment of our for profit health care system, a system that is dysfunctional, if not completely broken, giving us one of the highest costs per capita of any country, and 37th in terms of the level of care. Fifty million Americans (according to the film) are uninsured and millions more discovering that when needed, their insurance companies often find reasons to deny their claims. In Sicko, Moore lets people tell their own stories, all shocking and most heart breaking. Mostly these are, or were, middle class people, either unable to afford treatment, completely denied payment for care by their HMO's, or forced into bankruptcy by the cost of care. He traces the origin of our for profit system from Nixon's decision in 1971 to use Kaiser Permanente's system as a model. There is a chilling recording of a conversation with Nixon and John Erlichman about the reasons. And he traces the opposition to government healthcare, with now hilarious commercials by Ronald Reagan (as the actor) and the AMA. All warned that healthcare is the first step toward socialism, or even worse, communism. Moore then shows some hilarious segments from Soviet worker films. And describes the involvement of the drug industry in promoting the for profit system, including huge amounts of campaign funds to Congress. He initially praises Hilary Clinton for her ambitious plan to provide universal coverage for all at the start of her husband's first term, then suggests that large campaign contributions from drug firms have influenced her.

He interviews two 9/11 volunteer rescue workers, whose severe lung problems were caused by the toxic dust at the WTC site. One has no health insurance, the other's HMO has denied treatment, and the government seems to have abandoned both. No one can remain unmoved listening to this. The second half of Sicko follows Moore as he travels to Canada, England, and France, to look at their health care systems. All have a government health care system, with all citizens (and visitors) entitled to care without charge, and with prescriptions costing much less than here in the US. Moore is more like his old self here, questioning people with his mock naivete. None of the people he interviews complain of long waits, and all are astounded to be asked how much does this cost. He talks to a doctor in England who makes a very good living and shows around his house, to counter the claim that these doctors are underpaid. All of these interviews disparage the idea that government run health care produces long delays, inferior medicine, poorly paid doctors, or outrageous taxes. And Moore makes a powerful point in asking if we can afford a war, why can't we afford health care. Next we see clips of various government officials, like Bush and Rumsfeld, boasting that the "terrorists" in Guantanamo get excellent health care. So in a very Michael Moore gesture, he attempts to take three small boat loads of people, including the 9/11 workers, to Guantanamo for medical care. I don't want to be a spoiler by saying too much, but it is brilliant black comedy, yet moving, that shows us quite dramatically the difference between the availability of health care in Cuba and here.

Moore has made a very clever, witty, truly subversive film, in the best sense. Ultimately his point is that effective healthcare for all cannot be delivered by a for profit system, any more than the police or a fire department could make a profit. We don't expect the police, the fire department, the post office, schools, or the military to turn a profit, and the same should be true of health care. Moore says that healthcare should be a primary function of government, not left to an industry that maximizes profits by either denying claims or pricing policies so high that they are unaffordable for all but the well to do. At the same time that HMO CEOs are paid many millions. One of the most moving scenes (and there are many) in the film is the testimony of a doctor before a Congressional committee, who was employed by an HMO specifically to deny claims. Her pay was proportional to the number of claims denied. You won't forget her.

This is a powerful, fast paced paced film, with Moore's usually wit and humor, but less confrontational, showing us the tragedy and folly of our system. Some argue that he has over simplified and exaggerated, but his essential points seem dead right. I think this is the best film he has made, and an important one. Everyone should see Sicko, and demand that Congress and the White House at last give Americans what is surely a fundamental right: affordable and effective healthcare for everyone.

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