Movie Review: Sicko

I've liked all of Michael Moore's documentaries and Sicko was no exception. Apparently trying to head off some of the criticism he usually gets, he toned things down in this one. He doesn't appear in the first part of the film at all, merely narrates it. As a result there are fewer "stunts" in this film; there are no CEO ambushes in Sicko.

The first half of the film is Americans telling various health care horror stories. The ones you've seen in the commericals are all from the first few minutes and he says "but this film isn't about them". They didn't have insurance; instead he covers a lot of people with insurance that were denied coverage by their HMO, usually with tragic results. He also talks with several people who used to work for insurance companies who's job was to deny claims to save the company money. One testified to Congress that her decision to deny coverage for a man ultimately killed him but led to her promotion in the company. Another was employed as an internal investigator to find a reason to deny claims. One woman says her payment was retroactively denied because she once had a yeast infection that she never "declared".

In the US people literally die waiting for help in the emergency room. That happened too recently to make the film, but he did show video tape of an HMO dropping off patients at a free clinic, on the street, delusional, because their insurance had capped off. Apparently this happens frequently at this clinic.

He showed the start of the HMO craze by playing Nixon White Tapes where he first heard of Kaiser Permanente. Nixon interrupts saying he doesn't like these plans. When he's told this is all about private insurance and profits so the incentives are to give less care, he likes it more. Moore then shows Nixon's speech the next day saying HMOs will help Americans. He also graphically shows how much members of Congress are given by the Health Care industry for their campaigns. The prescription drug benefit of 2003 was a boon to these companies and Moore comments how 14 congressional aides moved to insurance companies and the Congressman who led the bill has as well; for a $2,000,000 salary. Nope, no conflict of interest there.

The second half is spent looking for a better system in other countries. He goes to Canada, England, France and Cuba. All these places have single payer universal coverage; that is everyone can get health care paid for by taxes. in this system the practitioners are given incentives to provide better care as opposed to ours in which the motivation of insurance companies is to give less care to save money. Moore spends a lot of time interviewing various patients and doctors and asking "how much does this cost" and they keep saying it's free. It gets a little repetitive but he does clever things to keep it interesting. In an English hospital after being told everything is free he looks for a cashier and has hard time finding it. When he ultimately does it turns out they give cash to patients to reimburse travel expenses. Yeah the cashier pays you, maybe that's why it was hard to find. In France he travels with a night doctor who makes free housecalls within an hour. He also finds that for the new mothers the national system provides nannies for 4 hours a day that take care of the kids and even do laundry. Moore says in the US, the government doesn't do your laundry.

The big stunt is in Cuba. It would surprise most in the US to learn that Cuba actually has quite a good health care system. In the list Moore shows, the US is at 37 which is shameful. The screen shows but he doesn't mention that Cuba is at 39. The crazy thing is that in the US we spend $7,000 per capita on health care, in Cuba it's $250. Moore shows a few clips of soldiers and politicians explaining that detainees at Guantanamo Bay are given good health care. I was a bit surprised that Moore didn't use the opportunity to mention the torture. He then brings 9/11 workers who were denied claims, on a boat just outside the bay and using a bullhorn asks for health care. "We don't want any more care than you're giving the evildoers". Of course they then get good care in the Cuban system.

The point of the film isn't so much to provide an answer merely to say that things can be better and to start public debate. Though I'm not sure what public debate looks like in this country any more. Al Gore's The Assault on Reason does a decent job of describing how broken public debate is. Since everything seems to be money-based, maybe a high box office take for Sicko would spur some action. Public debate by seeing movies, I think I could like that.

Moore doesn't point out the flaws in the other systems. I've heard him interviewed saying their side has been presented enough already. But he does tackle the typical knock on single-payer systems, that socialism is bad. He successfully points out we have socialized firefighters, police forces, Social Security, Medicare, Medicaid, etc. He shows doctors making good livings in socialized programs. He shows people not having crazy wait times. And really...house calls!

The movie is good. Very touching and at times very funny, often in a very dark way. As an internal memo written by a Capital BlueCross employee after seeing the film says "You would have to be dead to be unaffected by Moore's movie..." Like all of Moore's films I think he concentrates too much on anecdotes and doesn't give enough statistics. If there was a little more substance I think it would help his case.

I think what's missing from a lot of the debate is the state of our system. Ever try to make an appointment for a checkup? Last time I did it was a 4 month wait. Critics say that free health care isn't free because they pay higher taxes; but they miss the point that the tax increase is less than the current out-of-pocket cost. Those insurance company profits have to come from somewhere. I'm also surprised that the Republicans aren't for helping businesses by alleviating them of their skyrocketing health insurance costs which make them less competitive around the world. I'm annoyed the Democrats can't make this case.

Michael Moore's site is having some problems today. Yesterday he was on CNN with Wolf Blitzer. They ran this piece before him and Moore went on this 10 minute rant because of all of these factual errors in the CNN piece. Ah, reasoned public debate between journalists and filmmakers.