Michael Moore’s latest opus, Sicko, opened here in New York City yesterday and, as one would expect, was very warmly received. The venue — a theater nestled cozily between Lincoln Center and the Ethical Culture School — was a bit surprising, though. The Upper West Side of Manhattan is the mothership for liberals in this country — a safer space for the ultra-liberal Moore could hardly be imagined. In fact, the middle-aged woman I sat next to (who was practically hopping in her seat with anticipation) declared, “He should be here, after all, we’re his people!” One might have expected Moore, ever the provocateur, to have chosen a more controversial spot to debut his take down of the US health care system like, say, Oakland California — home of the Kaiser Permanente health maintenance organization (which comes in for special attention in the film) — but maybe he had something else in mind. More on that in a moment.
Sicko is not a documentary so much as it is a political polemic, though like a documentary it makes its case through presentation of personal histories of people who have suffered extraordinary hardship at the hands of the for-profit health care system we “enjoy” in this country. Likewise, Moore uses interviews with people living and working in Canada, Britain, France and (most dramatically, Cuba), to promote the virtues of socialized medicine. And make no mistake about it, Moore wants socialized medicine. He states it flatly in the [Prescription for Change] that is posted on his website:
1. Every American must have full, uninterrupted health care coverage for life.
2. Private, for-profit health insurance companies must be abolished.
3. Profits of pharmaceutical companies must be strictly regulated like a public utility.
For Moore, there is a fundamental moral flaw in a health care system designed to maximize profits of the providers of treatment (especially the drug companies) and of the insurance companies that are supposed to fairly dispense payments for that treatment. Whatever its virtues on paper, in fact such a system ends up hoarding profits at the expense of sick people who must pay exorbitant sums out-of-pocket to try and get the care they need. Or die trying.
A Sick Country
Early on in the film, we meet a husband and wife who once led happy productive middle-class lives, but after receiving a double whammy of misfortune (his heart disease and her cancer), are reduced to bankruptcy and living in a spare room of their daughter’s house. Another story involves a man dying of renal cancer who, according to his wife, had a fair shot at a cure but had his claim denied because the treatment was termed “experimental”. The man died. Moore presents a number of similar stories, some involving 9/11 rescue workers, and they are very moving, but we have to take the testimony of the victims at face value. More compelling to me was the testimony that the film uncovers of current and former employees of the insurance companies who explain the incentives that led them to callously discount people’s claims and, in the case of one hapless company doctor caught giving a deposition, arbitrarily deny treatment to rafts of people seemingly without a hint of humanity. The nadir of this profit-driven system is seen in startling clips of hospitals “dumping” poor people, who cannot pay for their care, outside skid row shelters in Los Angeles.
Moore hits his stride when he encapsulates the history of the dreaded HMOs and how we came to be saddled with them. There was audible hissing from the audience when the image of Richard Nixon appeared on screen as tapes from the Nixon White House were played of a conversation between Nixon and Ehrlichman in which they speak glowingly of industrialist Henry Kaiser’s new for-profit health maintenance organization. Days later, HMOs were publicly blessed by Nixon in a policy speech. Once in place, it was just a matter of the industry (and its partner in crime, the pharmaceutical industry) keeping the wheels of government greased with sufficient money to make sure things kept going their way, and Moore makes hay calling out the politicians who have collected the most money from insurance/pharma lobbyists including… Hillary Clinton. There is a remarkable section of the film that recounts Clinton’s failed attempt to overhaul the health care system back in the early nineties and her subsequent silence on the issue until very recently. That didn’t go over so well on the Upper West Side. But I think that was the point.
After hammering home the diagnosis of the American healthcare system as corpulent and deeply diseased, Moore travels to other lands looking for a cure for what ails us. Acting the part of a benign innocent, he talks to former Labour MP Tony Benn and others about the virtues of Britain’s National Health Service (NHS), new mothers in France who enjoy state-provided nannies and Canadians who fear an onslaught of Americans eager to marry Canadian for the benefits of their nationalized insurance. Along the way, he pokes holes in many of the stereotypes about socialized medicine that have been drilled into Americans for years. Then things take a bad turn about 90 miles off the coast of Florida.
The movie slides into comic bathos when Moore and a group made up of the sick people we have come to know from their testimonials earlier in the movie head off for a day of health care and propaganda in Fidel’s Cuba. You can imagine what happens. The irony of a lefty propagandist like Moore being co-opted by the king of lefty propagandists was amusing, but uninteresting. I was still thinking about Tony Benn at that point.
Benn, clearly a hero to Moore, presents in moving terms the social contract under which the NHS came into being. It is as complete an enunciation of liberal socialist democracy as I have ever heard and is the heart of the movie. It is clear in the moments when he is speaking that, more than socialized medicine, Moore wants a socialist political culture in America to counter the conservative free-market worldview that informs every area of our lives.
Polemics and Politics
One doesn’t go to a Michael Moore movie expecting even-handedness, or even logic. So the [historical conditions] that led to Britain adopting the NHS are nothing like those in this country? No matter. The fact that the NHS have actually sought to [adopt some methods] of US HMOs in order to modernize their system? Beside the point. Moore is not out to win minds — he’s out to win hearts. Specifically, the hearts of the liberal wing of the Democratic party. When he asks, following the harrowing depiction of poor sick people being dumped on skid row, “Who are we?” — he’s talking directly to the liberal Democrats who he clearly believes have been too complacent in the face of pro-business Republicanism for too long. He knows he’s powerless to change the mind of even one conservative Republican — but it looks very much like Democrats are going to be in the driver’s seat again come 2008 and he wants to do everything he can to set their agenda before the monied interests he so despises start calling the shots.
That’s why this movie opened on the Upper West Side of Manhattan the summer before primary season.