Sicko opens Friday in select theaters.
If any movie ever seemed capable of starting a revolution, Michael Moore's Sicko is that film. But of course, no mere movie can cause a revolution; intolerable conditions do that. And that's the key to Sicko's success. It targets a subject that's already a revolution waiting to happen: the U.S. health care system.
Easily Moore's best, most skillfully argued film, Sicko arrives at a moment that's propitious both socially and cinematically. A decade ago, hardly anyone would have considered a documentary feature an instrument capable of having a major impact on public policy. Now, with the credibility of the mainstream corporate media besmirched by their acquiescence in the implementation of an unnecessary, drastically unpopular war, the nonfiction film has emerged as one of the few public forums where common sense and individual vision stand a chance against collective credulity and mass-produced disinformation.
Though Moore had a lot to do with that sea change, his own success as a celluloid polemicist has, ironically, been mixed at best. Bowling for Columbine became the highest-grossing nonfiction film in history, but it provoked no widespread demand for gun control. Fahrenheit 9/11 nearly quintupled the earnings of its predecessor and provided an important early rallying-point for Americans opposed to the Bush administration's disastrous invasion of Iraq. Yet its skewed analyses, freehanded way with the facts and Moore's outsized persona were so easily demonized by right-wing pundits that many progressives eventually deemed him a liability in the campaign to unseat Bush in 2004.
As if scalded by the attacks from left and right alike, Moore seemed to slink from the limelight to lick his wounds. In the meantime, Al Gore's An Inconvenient Truth roared into theaters in 2006 and, though its earnings were only a fraction of Fahrenheit 9/11's, accomplished what Moore had yet to do: It pushed public perceptions on a crucial issue (global warming) toward the kind of tipping point that actually affects policy.
Moore's detractors may have assumed that he'd been ridiculed past any hope of mainstream effectiveness, and that Sicko would thus be easily marginalized and dismissed as another rant by a wooly-minded, discredited provocateur.
They could not have been more wrong. Unless I miss my guess, Sicko will easily break the earnings record held by Fahrenheit 9/11, but its real victory will lie in placing health-care reform alongside the Iraq war at the top of the agenda in the election of 2008. Leave aside for the moment what that might mean in the presidential race. In the congressional races, it could assure significant gains in both houses for the Democrats, assuming that notoriously inept party unequivocally embraces the cause of universal, government-funded health insurance for Americans.
The United States is the only Western country without such a system, and as a result some 50 million citizens are without any health insurance at all. But Moore begins Sicko by announcing that the film isn't for or about those folks. It's for those who have insurance and imagine that they are protected, that the system is designed to give them the health care they need and therefore, if not perfect, it's essentially a viable operation.
On the contrary, Moore asserts, it's a sham, a tottering behemoth and a thorough disgrace to the richest, most technologically advanced nation on earth.
It would no doubt require a movie of 50 hours to even begin examining the ways the system doesn't deliver what it promises. But the handful of cases Moore offers are plentifully telling. One woman loses her 2-year-old daughter because her HMO won't approve the nearest hospital for emergency treatment of a breathing problem. Another's husband dies after a company denies the only treatment that offers hope of curing his cancer.
Then there's the 50ish couple who have to move into the cramped basement spare room of one of their five children. They were solidly middle-class Americans with health insurance until, what with deductibles and co-payments, a series of ailments wiped out their savings and reduced them to homelessness. I would say see the movie before deciding that their humiliation is preferable to the simple respite of death.
The reason the system produces loss of life and anguish rather than well-being and peace of mind is simple: It's designed to maximize profits, not health, and that militates denying care as often as possible. Here, not all of the casualties are on the receiving end. Moore listens to one HMO worker bemoan turning herself into "a bitch on the phone" to deny help to those seeking it, and he shows the '90s congressional testimony of a doctor whose conscience wouldn't allow her to keep handing out death sentences to needful customers just to save her bosses money.
The bottom of this grotesque moral totem pole is the chilling security-camera footage that Moore uncovers of addled, confused patients, mostly elderly, being taken from hospitals and simply dumped on the street because they can't pay their bills.
How did a system that produces such Dickensian horrors ever come into being? Moore locates a significant sound bite in a 1971 taped White House conversation where Richard Nixon listens to his domestic policy advisor John Ehrlichman boosting an industry plan for privatized health care. Its virtue, Ehrlichman says, is that it's aimed at money-making, which means it actually produces less care. Naturally, Nixon sells the plan on TV the next day by saying it will produce the best care, and for all Americans—wrong on both counts.
Much of the film's second hour is spent with Moore traipsing abroad, not only looking at the universal health care systems in Canada, Britain, France and finally Cuba, but also listening to various Americans who've benefited from the care in those places. Though U.S. health-industry propagandists invariably assert that these systems produce inferior care—it would be hard to find unbiased studies supporting that claim, especially in the case of France—what's really striking is how much worry and waste is eliminated when private payments and the companies handling them are taken out of the picture. People get sick, they go to the doctor or the hospital and get treated: simple as that. In some places, doctors are paid extra (yes, by the government) for getting patients to quit smoking or other preventive measures. The guiding principle is health, not money.
It's perhaps a bizarre relic of the Cold War that Americans, alone in the industrialized world, naturally assume that the government should be in charge of police and fire departments, libraries, postal service, the military, the air-control and interstate highway systems, etc., etc., yet somehow buy into the propagandists' absurd argument that "socialized" medicine would instantly result in a cadre of Comrade-Stalins-on-the-Potomac banishing small-town doctors from their practices. Meanwhile, in France, not only is top-quality health care free from cradle to grave, but ailing citizens get house calls—remember those?—upon request.
If you could strip away the propaganda and disinformation, and give Americans the choice between France's system and ours, how big do you suppose the landslide would be in favor of the Gallic alternative? Ninety-five percent?
But there's the rub, right? Americans aren't given the choice. When Moore's in London, he visits parliamentarian Tony Benn, who says that Britain's universal health care has one thing at its root: democracy. Created by a nation just emerging from the devastation of World War II, the British national health system has had the unequivocal backing even of conservatives like Margaret Thatcher because the citizenry overwhelmingly views it as a fundamental right. "It's as uncontroversial as votes for women," Benn notes.
Viewed from that angle, it's clear that all of Michael Moore's films have the same subject: American democracy, its promise and the many powerful forces that keep that promise from being realized. Not just a populist, he may in fact be the Last Jeffersonian Idealist, the kid in civics class who really believed that if Americans were given the facts and a clear choice, they would make the wisest, most enlightened decisions.
Our problem right now, of course, is that American democracy is largely a joke. The people aren't in charge; money is. Money—and a poisonous form of ideology—declares a war in the Middle East that Americans come to despise, and warehouses our wounded soldiers in substandard facilities like the Walter Reed Hospital. (Meanwhile, as Moore scathingly notes, al-Qaeda captives at Gitmo get free, top-quality treatment.)
Money likewise will do everything it can to prevent democracy having anything to do with changes in our scandalous health-care system. Money deploys squadrons of lobbyists in Washington, and makes sure that politicians from both parties are in its pocket. Sure, the Democratic party as a whole may be more likely to embrace the reforms that Moore advocates—the coming battle is bound to reveal the GOP in its role as shameless shill for the super-rich—but Moore very pointedly notes that Hillary Clinton, having failed to reform health care in the early '90s, has done such an about-face that she's now by far the most popular Democrat with the health-care industry.
Money, though enormously powerful, is not monolithic, and that's one thing that Moore's pat leftism overlooks. In An Inconvenient Truth, Al Gore wisely pointed up the benefits to business of confronting global warming. The same is true with health care. If we do ever get reform, one big reason will be that the present system has proved to be as onerous for many businesses as it is for individuals.
But Moore's basic point is incontestable: Reforming health care will mean rescuing American democracy, pure and simple. Let's hope it's not too late.