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Sick JokeMichael Moore gathers our rage at America's health-care system.

By Dana Stevens
Posted Friday, June 29, 2007, at 1:29 PM ET

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Still from Sicko. Click image to expand.

Even those viewers who are ideologically in sync with Michael Moore can find plenty to critique in his methods: the gimmicks, the deck-stacking, the deliberate neglect of opposing points of view. On the other hand, even Moore's worst ideological enemies would be hard put to dispute the basic argument of his new film Sicko (Weinstein Co.): The American health-care system is a sick joke and has been for a very long time.

We don't need Michael Moore to tell us this, of course. We get the clue from the ruinous medical bills that arrive in our mailbox, from our friends' gruesome stories of conditions untreated and claims denied, and even from the mouths of our own doctors. (My GP never misses an opportunity to grouse about the insanity of the insurance labyrinth.) The prize anecdote in our household was when, before having a child, I called my private health insurer to ask about a "family plan": How's this for a family plan, an Oxford rep told me, scarcely bothering to conceal her amusement. Your baby can be covered at the same full-price premium you're paying now, in essence doubling your rates. The people in Moore's documentary, many of whom he found after soliciting their stories on his Web site, tell tales that follow that same Lewis Carroll logic to far darker places.

After offering some brief glimpses of the hell inhabited by those with no health coverage at all—the film opens on a guy stitching up his own slashed knee, then visits a man who had to choose which finger he could afford to keep after a table-saw accident—Moore states that this isn't a movie about them, or their nearly 50 million uninsured compatriots. Instead, he's chosen to focus on Americans who have insurance and find themselves screwed up the yin-yang anyway. This is a wise choice from a rhetorical point of view, because by exploring the dilemmas faced by those who have shoveled out premiums for decades, Moore can show that our status quo doesn't just have a few soft spots—it's rotten to the core.

To give away too much about these people's stories would undermine one of the film's great strengths: the quiet dignity with which the subjects tell their tales themselves. Babies dying on the ride between the nearest hospital and the nearest in-network alternative. Spouses dying of cancer because the HMO deemed lifesaving procedures too "experimental" to try. (Isn't that the whole point of being experimental?) Moore listens to these stories without undue editorializing—for all his bullying of those in power (and, occasionally, the audience), he's a soft touch as an interviewer.

In one of the movie's best segments, insurance-industry insiders frankly admit that their profession is rapacious. A former medical director for an HMO, testifying before Congress, delivers a scathing rebuke both of the insurance industry and of her own role in denying patients care. Another whistle-blower describes the industry's tactics with stark clarity: "You're not slipping through the cracks. Somebody made that crack and swept you toward it." A woman who does customer service for a major insurer weeps as she recalls denying sick customers coverage, then adds, "That's why I'm such a bitch on the phone to people. … I just can't take the stress."

The lighter second half of the film takes us on a three-country tour of free universal health care. Moore dashes around Canada, Britain, and France collecting anecdotal data about the superiority of those country's systems—and even if his methods are thoroughly unscientific, it's hard not to swoon with envy at the French SOS Médecins system, with doctors whisking from house call to house call in jaunty white cars. In a London hospital, Moore wanders around looking for the billing department in vain. All this is packaged with the usual Michael Moore jollity, interspersed with vintage clips from a Soviet-era musical about wheat-threshing and a '50s-era LP, recorded by Ronald Reagan, about the dangers of socialized medicine.

It's during the movie's finale, when Moore takes a boatful of sick Americans to Guantanamo Bay in search of free health care, when the deck gets stacked high enough to wobble a little. I don't begrudge him the prank, or the visual gag of shouting "Can we get some medical care?" through a megaphone—I confess to being a sucker for this kind David-and-Goliath political theater. But when Moore gives up on the prison and herds his flock, including three ailing 9/11 rescue workers, through the streets of Havana, his tone becomes almost reverent. An old Irving Berlin tune about the wonders of this tropical island paradise plays on the soundtrack—ostensibly ironically, but Moore seems to take it at face value. The scenes in a Cuban hospital, where the sick Americans tearfully thank their kind caregivers, are the only ones in the film that feel staged. I wish Moore could realize that he doesn't need to disavow dissenting ideas in order to build his (essentially airtight) case.

This folksy tour of the health-care crisis brings to mind the saying of another American populist, Mark Twain: "Everyone complains about the weather, but no one does anything about it." In a democracy, of course, complaining about something is doing something about it, as long as some of that griping is done at the polling booth. In that spirit, Sicko is less a documentary than a clearinghouse of rage. Though it has its share of voice-over exposition and comic stock footage, the film's real purpose is to aggregate individual health-care horror stories into a portrait of the profit-driven and (literally) inhospitable place our country has become.

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Dana Stevens is Slate's movie critic.
Sicko movie poster on Slate's home page courtesy www.michaelmoore.com.
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Remarks from the Fray:

The question unresolved by the lies of omission in this documentary is what is the real comparison between the systems. Yes people can be under served in our system but Mr Moore never searches for the horror stories in the other systems. He puts himself in the position of Jane Fonda seeing only what she wants to see and declaring North Vietnam a wonderful place.

Unfortunately this pandering to a narrow point of view focuses the debate on a particular change not on finding the best solution. There are many possible solutions and Moore's films are not meant to look at facts but to twist facts in order to incite the passions of his fans thus closing minds to other possibilities.

The film looks at the congressional testimony but doesn't challenge this new Democratic Congress to make simple laws well within their purview to improve the current system: Creating a CDC type org to determine which procedures are medically valid and forcing all insurers to include them as covered alternatives; Medical insurance fraud policies which include harsh penalties and mandatory prison time for the guilty; Removal of malpractice from the current tort system and creating a special arbitration system with appropriate patient safeguards. These are of course incomplete suggestions but could be fleshed out and combined with other ideas to solve the problem or at least improve our current imperfect system.

Again, unfortunately, Moore only seems to feel happy when he can use other peoples problems to attack those he doesn't like. He can lie to himself and his fans and say I'm doing a great service when all he's doing is clouding the debate with misinformation and twisted facts.

--morganb

(To reply, click here.)

The writer seems surprised and amused that when the number of people under the insurance policy doubled the price doubled also. Why is that strange? Usually when you buy two things, they cost twice as much as one. It is not as if healthcare for infants is particularly cheap; there is lots of routine care and seriously ill infants are very expensive to care for.

The surprise that health care costs money is typical of most commentators. People for some reason think that they should not have to pay for health care. Or that the government should pay for it.

Oh people in general do say that health care is too expensive; but then they cheer on Michael Moore when he rails against insurance companies that won't pay for experimental treatment. Why should insurance companies pay for expensive and unproven treatments? If we care about the overall costs of our health care system that is an obvious place to start. In the U.S., new and proven treatments are covered much sooner than in nationalized systems. Those systems ration healthcare by not approving more expensive treatments and having long lines for treatments that are approved.

Bottom line is that healthcare costs money and well-off writers for Slate should not be surprised when they are asked to pay for it.

--SFBurke

(To reply, click here.)

I'm well-known for defending many elements of present-day Cuba. The medical system is one of the pretty much unassailable elements of the Cuban Revolution programs.

Health care in Cuba is universal, and the quality in many areas is equal to that of a 1st world system. There are, from those who study this area, few cases of neglected people or groups who fall through the cracks. Their ratio of doctors to general population dwarfs ours: 596 doctors per 100,000 citizens vs. 279. The percentage of births attended by a skilled health professional is 100%.

This isn't just propaganda -- until Pres. Bush's blocked educational exchange between Cuba and the US, it was extremely common for US medical students to visit to study the effectiveness of Cuba's system. It was also common for education professionals to visit for similar reasons -- adult literacy in Cuba is around 95%. And even the World Bank has sent representatives there to study their system. Their view is that economic disaster is a fate worse than socialized medicine. She suggested that the developing world adopt Cuba's medical model as the strategy for fighting the [AIDS] pandemic."

It's not hyperbole to say that one can get far better medical care in Cuba than the US. It may be ironic, but it's hardly stacking the deck to compare a country that is viewed as villainous with the virtuous US, and find our own medical system, at least, very wanting.

--HopefulCynic

(To reply, click here.)

(6/30)

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