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First look: Sicko by Michael Moore
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.
Innocent Abroad
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.
Posted in Politics 06/23/07 | 
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Pingback by University Update - Michael Moore - First look: “Sicko” by Michael Moore — June 23, 2007 @ 5:59 pm
I live in Britain, and other than paying a prescription fee for medications for colds, the rest of our healthcare is ‘free’, which basically means it’s tax-funded.
I’ve often thought about healthcare in the US, but never wanted to dwell on how it might be if I was one of those who couldn’t pay for an operation, or a drug of some sort.
Last year while on holiday, I was attacked by the local police in Tenerife (apparently, it’s a pass time of theirs to attack and mug tourists.)
The two of them didn’t manage to keep me down, but they did cause a lot of damage to the back of my left knee with a baton and the side left side of my face with a bottle.
I was taken to hospital the next day, where upon I couldn’t get out of the ambulance until I paid them €40.
If I’d known I was going to be charged, I’d have walked.
Then on actually getting into the hospital, I was kept waiting while the paperwork was sorted out.
This was the second day of my holiday. Yeah, great start.
Literally hours before the flight home, the hospital called and I asked me to return urgently.
I was taken to see some finance guy who got this list of bills in front of me, and in his particular flavour of English explained in a matter-of-fact way that I needed to speak with my government back home to sort out insurance details and that if I didn’t, I wouldn’t have got off the island.
With all due respect to the healthcare system of the US and others, you can keep it.
I’d rather be burdened with paying for the healthcare of those that have no job and don’t contribute to tax than face the alternative…
Comment by Wayne Smallman — June 24, 2007 @ 12:24 pm
Wayne, well thanks for ruining my planned trip to Tenerife!
I’m not sure the situation in the U.S of A. is quite as dire as what happened to you, but point taken. There’s something basically suspect about a marketplace model of health care. I think that, over time, we’ll evolve into something more socialized, but it will take awhile — lots of money (and power) at stake.
Comment by SD — June 24, 2007 @ 2:49 pm
“Wayne, well thanks for ruining my planned trip to Tenerife!”
Some people have had a good time, most I know have seen the same bad stuff my friends and I did.
“There’s something basically suspect about a marketplace model of health care.”
Money is always a factor, but it’s a more prevalent factor with private healthcare.
The scary thing is, the government over here are trying to partly privatize certain aspects of the NHS, and the fear is, it’s an agenda that will spread over time and become a system like the one in the USA.
If that goes to the vote, it won’t happen…
Comment by Wayne Smallman — June 24, 2007 @ 5:31 pm
Nice review. I’m interested in seeing this film (tried to watch it when it leaked out online via Google Video) and have only seen the first 20 minutes. From what I’m reading above, I’m not sure I agree with Moore’s suggestion of socialized medicine but there has got to be better way than what we have now.
Comment by Webomatica — June 25, 2007 @ 12:38 am
Being from Canada and very close tot he US border, I am always amazed by how much time the US gov’t and US insurance companies spend telling Americans lies about our healthcare system.
The standard ‘they wait for six months to see a doctor’ is my favourite. This gem was procured from people living in the most remote places…people who refuse to travel to see a doctor. I don’t care where you live, if you are in the middle of goddam nowhere, expect there to be goddam nothing.
Myself, I had cancer. I called my doctor one day with concern over a lump. I was in his office that same day, getting an scan the same day, in to see a specialist three days later and on the operating table three days after that. My treatment followed that a few weeks later and I only ever signed one piece of paper and aside from parking, never paid a dime out of pocket.I am ten years cancer free now.
Canadians live longer than Americans do according to the US and Canadian gov’t websites. Is this just a coincidence or is it that we can get healthcare when we need it and can afford the drugs we need to treat what ails us.
Somehow the drug companies survive doing business here. Amazing isn’t it?
Comment by Stan — June 25, 2007 @ 4:12 pm
Stan, maybe the reason we US citizens (aren’t we all Americans?) don’t live as long is because we’re too busy worrying about how we’re going to pay for healthcare. Just one more thing to stress about?
Only idiots believe anyone who says the US has better healthcare. You know it’s bad when we have to choose between paying the mortgage or getting healthcare.
And the fact that Moore is doing the documentary about it is really no help. He has stirred up too much contraversy. It may be good, but not enough people will care what he has to say because they think he’s narrow-minded or an idiot.
Comment by Jeff — June 25, 2007 @ 6:00 pm
Jeff,
I think his goal is to move the Democratic candidates further left. They will resist, fearing alienating centrist voters in the general election. I doubt the movie will have a lasting effect. His little trip to Cuba will make it too easy to dismiss as lefty propaganda.
Comment by SD — June 25, 2007 @ 8:20 pm
I’m not convinced of two things: 1. that the US has the best healthcare system in the world, and 2. that socialized medicine would be better. As a man living with HIV, I sleep much better at night knowing that I’m not relying on a socialist system to come up with new life-saving drugs.
Comment by Aatom — June 27, 2007 @ 12:02 pm
It’s so sad how everything is so politicized, including this review. I never understand how the healthcare system or the environment can be a “republican” or “democrat” issue. “He’s powerless to change the mind of even one conservative republican!” Why? Because a democrat made the movie? Does that make any sense at all. Why can’t we get rid of all these labels and do what makes sense? Does it make sense to have socialized medicine? If you explain socialized medicine to a majority of Americans, without labeling it as “socialized,” a majority would say it’s a great idea. Slap on the term “socialized” and everyone recoils in horror. Why? How has it been drilled into our heads that “socialized” is the great evil? And how come everyone just parrots that sentiment without spending a single second thinking about it. How sad….
Comment by Meimi — June 27, 2007 @ 7:13 pm
Aatom, the subject of market-driven incentives for research is not dealt with in the film, aside from a suggestion that the pharma companies are gouging because the same drugs are available in other countries (even Cuba!) for much less. Of course, another way to look at it is that US customers subsidize those countries — but as mentioned, it’s not really a documentary, it’s a political statement.
Meimi, I appreciate your exasperation with partisan politics — but these issues are, by their nature, political. They have to be debated and some will come at them from one pole of the spectrum and some from another. I actually admire Moore’s uncompromising stand as a dyed-in-the-wool leftist. At least you know where he stands. My purpose in writing was to point up the political methods he’s employing.
Comment by SD — June 27, 2007 @ 10:13 pm
JUST HOPE YOU DONT NEED MEDICAL CARE
Comment by TERRA — June 28, 2007 @ 12:08 am
hmmm…
reading these comments, a few things come to my mind. first of all, yes, it would be nice to have drug companies in the usa to sell drugs for as cheap as they are sold in other countries, however, the last time i checked most of them are developed in labs in the usa. it’s much cheaper to copy drugs than to develop them oneself.
also, most people may disagree with me about this, but in my opinion, health care is a privilege, not a right. i honestly don’t see why everybody thinks that they are entitled to a service that extends their life expectancy. it seems to me that keeping a person healthy and adding years to his/her life is the single greatest thing that one person can do for another, yet everybody nowadays takes it for granted.
just as a little food for thought, how much would you be willing to pay to add 10 or 20 years to your life?
Comment by rus — June 28, 2007 @ 5:24 am
Of course Moore’s films are polemical in nature, but that does not necessarily mean that what he says is untrue or illogical as you imply. Moore comes from a particular political standpoint and argues his point using polemic and argument to try and convince his audience. He believes in the idea of universal healthcare and it would be hypocritical for him to spend his time defending the pharmaceutical industry, who, after all, have your government and large sections of the media to defend them. Is it not the job of a journalist to challenge authority and the status quo?
Should the health of your citizen’s be jeopardized, literally putting millions of people at risk each year, for the pursuit of profit? Of course not!
However much you like his presentation, if you disagree with the man why not present a set of arguments countering what he has said in the film? Focusing on the man’s personality and style is an easy way of avoiding the issues being discussed.
Thank God however bad our health system is here in Ireland we can at least rely on a basic quality of healthcare. By the way, it is unfortunately getting worse all the time, mainly thanks to our current Minister for health. A neo-liberal who argues that we should be closer to Boston than Berlin and believes that inequality is good for society, she is obsessed with dismantling the public health system and persuading the middle classes into going private. Thank you for your wonderful capitalist ideas! Still, it is a million miles away from your experience stateside.
At least in Britain they still have the excellent NHS. You may argue that the historical conditions were different, but could you explain why you couldn’t set up a similar system right now in America? I fear the answer is simply that there is too much power and profits to be lost for a small number of individuals, and the political will does simply not exist to create a more equal and just society, which actually cares about the basic welfare of its citizens.
And as for going to Cuba, well, it’s a known fact, dispute it if you will, that Cuba, despite years of economic sanctions, has an excellent healthcare system. Propaganda it may be, but true none the less. This is despite not making any “profit” at all. What better way could there be of showing up the glaring inhumanity of American for-profit health care?
Comment by John Higgins — June 28, 2007 @ 5:52 am
rus, I find it very disheartening that you regard healthcare as a privilege and not as a right. As a Canadian, I have been brought up with an entirely different view of healthcare, and I recoil at the sound of privatization of hospitals.
It is perhaps only in America where one would regard the right to property as something more important than the right to a long and healthy life.
While it may be true that most new drugs are developed in the USA, but this is because America is simply the richest country in the world anyways, it is not necessarily because the healthcare is privatized. If all American companies would stop developing there drugs if the government set up a NHS, it just shows that pharmaceutical corporations cannot be bothered with the welfare of the citizens, only their money.
I am very thankful for the health system here in Canada, and I do not understand how you cannot view a long and healthy life as something fundamental in it’s right.
As for your food for thought, obviously nobody can put a cap on what they’d be willing to pay to extend their lifespan, which is exactly why it should be socialized. Just because someone would be willing to pay, does not mean that everyone can always pay. While the American health system works fine for the middle class and up, it is the large lower class that suffers.
Comment by Chris — July 1, 2007 @ 4:29 pm
John,
You may have missed my point in writing the review. It was not to refute Moore’s claims (there are plenty of places on the web for that), it was to give my impressions of the film and comment on why it was debuted in the US in one particular neighborhood of New York and what that might mean.
Rus,
When you say that health care is a privilege I think you are making Moore’s case — he would agree that, too often, it is a privilege of those who can afford it. A country as rich as ours can certainly do a better job of sharing the benefits.
At the same time, I think it is significant that few of the people Moore highlights in the film were suffering from “lifestyle related” illnesses (cancer from smoking, heart disease or diabetes from obesity, etc.), which would complicate the story he’s trying to tell.
Comment by SD — July 1, 2007 @ 11:10 pm
I have lived for 40 years in the UK and nearly 20 years in Canada, so I think I can safely claim some experience of both systems.
No system is perfect. Both in Canada and UK there are private alternatives to public provision. That means some people are prepared to pay for what they think of as superior care. Just as there are private schools in countries which provide public education for free.
In Britain the private health care system is coterminous with the public one, since the Blair government pursued private sector solutions for public sector shortcomings. For example, since the wait list for hip replacements in her area was determined to be too long, my Mum got treatment in private sector hospital at NHS expense. Did not cost her a bean. This is not allowed in Canada.
In Canada length of wait lists for surgery and diagnostics means that many public sector organizations use private sector providers - including the armed services, politicians, police, firefighters and the Workers’ Compensation Board. This last is most significant since WCB saves money by not paying as much compo to people who wait less for their ops at a private clinic.
Canadian public health care is limited. You must pay for - or get insurance for - drugs and prescriptions, ambulances, appliances, most home care, and all dental and optical care. Surgery and other treatments of a non essential kind is also not covered - and this gives rise to concerns about many treatments which are not covered here at all but could help - for example treatments for conditions like autism. Most full time employees get these things covered (more or less) as part of their employment benefits. Some people such as pensioners and the disabled qualify for free provision of some or all of these items.
Some provinces (including BC) charge their residents health insurance premiums in order for them to get health coverage from the public system. The Canada Health Act does not seem to have a problem with this. These premiums can be onerous for those on low or fixed incomes.
In Britain it is now nearly impossible to find an NHS dentist. In Canada it is very difficult to find a GP - many people are forced to use “walk in clinics” to get primary heath care. The shortage of GPs is worst in rural areas but is also a significant issue in large urban areas.
All that being said, I would prefer either system any day to the US system. That is because I have so many “pre-existing conditions” I would never be able to find health insurance that I could afford and that would also provide me minimal care.
Comment by Stephen Rees — July 1, 2007 @ 11:29 pm
Thanks, Stephen, for offering insight into the systems that you have direct experience of. Moore’s film makes a passing attempt to address concerns about the “walk in clinics” that people depend upon in Canada, but just to show that people are perfectly happy with them (of course).
I’m wondering, given that a lot of US health dollars are spent managing people with chronic “lifestyle related” conditions (smoking, obesity related), what efforts (if any) are made in Canada and the UK to prevent these illnesses?
Comment by SD — July 2, 2007 @ 9:37 am
number 2/wayne, thats all fair and nice that you appreciate the system you live in but understand that in the states there is supposed to be a free market.what that means is that the gov is not supposed to be the last say on any one thing and we have anti-monopolistic laws . also, in general, government anythings are f-ed up, they do not nearly produce as well as a corporate competitor will, because a corp needs to provide good service to stay in business, gov programs usually are just above the margin of ‘better than nothing’ and sometimes they are’nt. In the US, no one is turned away from medical treatment, ever, and if you have something debilitating or permanent you have the option to apply for medicaid. Medicaid does not cost money (it can if you want special coverage) and is funded by the goverment. it is also accepted by many specialists and well equipped docors and it is a good system b/c it is hard to take advantage of it. People seem to forget this.
I wouldn’t want universal health care b/c a) why should I have to pay for someone else’s medical treatment b)it is not the role of government(in the US) c) it does the opposite to promote real growth in a medical field d)its anti-capitalistic e)the more power you give a gov the more they have to take away from you f)the people (40 mm or so) in this country that do not have health care includes new-borns, homeless (lets get them some frickin shelters b/f health care), superlow income (can also get medicaid), and perents who simply dont put their children on their plans (should I have to pay for them just b/c parents cvan be assh+les?)….I can go on, but i’ll stop here.
Comment by danja — July 4, 2007 @ 2:26 pm
In the U.S. you can’t get Medicaid just because you have very low income. You can’t even get it if you have NO income unless you are also homeless and qualify for government aid as disabled, which can take as long as FIVE YEARS! I know. I’m disabled and can’t work. And although I contributed to the HMOs and other health insurance policies for thirty five years, I now must wait for the U.S. Social Security system to dawdle along and finally make a decision before I can qualify to receive health care. In the mean time, in order to receive treatment, I have to continuously fill out mountains of paperwork, hire a lawyer that I can not afford, and hope that I can at least get the minimum amount of care to keep me alive until the government gets around to deciding if I’m “really” disabled or not. I think they’re hoping I’ll die so they won’t have to take on the responsibility. That way, they’ll have more money to spent on the war in Iraq. It’s a fucking quagmire and anyone who is willing to investigate will ultimately realize that the U.S. government, HMOs and drug companies have no concern for the citizens - only how much change is jingling in their pockets. I hope the people who doubt this never get seriously ill.
Comment by rmm — July 7, 2007 @ 11:55 am