“If we can find the money to kill people, we can find the money to help people.”
Those words, spoken by former member of the British Parliament Tony Benn, serve as the guiding principle of Michael Moore’s Sicko, a film of such vein-bursting outrage that at any given moment, it was all I could do to remain conscious. From beginning to end, Moore’s usual mix of good humor, uproarious stock footage, provocation, and incredulous narration is the most infuriating film of the year; a collection of numbers, anecdotes, and images that create a flood of such irrefutable evidence that only industry insiders will remain unmoved. And so they will, for no greater force of evil exists in the modern world than those who ply their trade in health care. There are no real heroes to be found anywhere, of course, but it is the health insurance game where the majority of the bile rises to the surface, effortlessly providing villains so complete that Al Qaeda appears monk-like by comparison. Wisely, Moore has decided to focus not on the tens of millions toiling without coverage, but rather on the vast majority of Americans who do, immediately silencing those who might otherwise blame laziness, stupidity, or irresponsibility for assorted financial crises. As such, Moore’s vision presents an America where those who play by the rules, remain employed, and pay their premiums still get royally fucked because they are beholden to a group of bean counters who have patient satisfaction at the very bottom of their priority lists, if it even appears at all.
To be sure, there will be the usual suspects who play “gotcha” politics and will point out factual inaccuracies or minor distortions in Moore’s work, as if he were a social scientist submitting his thesis for peer review. They will forget — as they always do — that Moore does not make documentaries, and it would be improper to hold him to those often mind-numbingly dull standards. Instead, Moore is a propagandist, which sounds shady on its face, but is actually a term of respect, for propaganda is not, by its nature, always false. It can be packed with lies, of course, but at bottom, propaganda’s aim is to convince and persuade, and therefore change behavior; appealing to the heart (and head, though less often) so that a particular aim can be reached. More than that, though, Moore is an entertainer. He believes that issues can be explored, abuses uncovered, and consciences awakened by telling a story with flair, drama, and, yes, a sense of fun. Sicko, like every other film he has done, is delightful in its own right, and is never simply about “learning,” as if that were akin to eating your spinach anyway. Here again, the laughter is sustained, but more than ever, it is a necessity so that we don’t burst into tears with every other frame. Comic irreverence aside, this is a deeply moving film; the kind that can be manipulative (the music cues most of all), but hardly undeserving. In essence, it resonates because it is instantly relatable; there isn’t a person among us who won’t have to face the indignities of hospitalization or illness, and for one of the few times, what we see could in fact “happen to us.”
The personal stories Moore relates (he received over 25,000 alone via email) are heartbreaking and sad, more so because they occur in a country that makes its living pretending to be the beacon of freedom and prosperity. Whether it’s the aging couple forced to move back in with their children after being bankrupted by medical bills, or the shocking tale of the young man with kidney cancer who died because the life-saving bone marrow transplant wasn’t covered, the tragedies pile up so quickly that one is buried in shame. And when we hear testimony from industry folks who admit quite bluntly that they received bonuses and promotions when they made decisions that they knew would cost lives, we not only realize that such people should be labeled murderers, but that the experiment that is the United States of America is irrevocably broken. For those with the money, it can be a paradise of ease and luxury, but for anyone else, even those living relatively comfortable lives, it is mere survival; dancing as fast as you can to stay ahead of disaster. And as Moore relates, how on earth can freedom be extracted from a life surrounded by debt? Fragile lives make compliant workers, and compliance breeds fear, which keeps the status quo locked firmly in place. And if those avoiding the trap of debt have the misfortune of getting sick, the exemptions thought to exist for the “good” ones mysteriously vanish, rendering the barriers of class completely moot. More than we know — or care to admit — most of us are a diagnosis of cancer away from utter ruin, and the roulette wheel of health insurance is the added stress we shouldn’t have to endure.
One of the film’s highlights is the discussion of the origins of health maintenance organizations, surely the most hated aspect of the current debacle. Unearthing some truly delicious Oval Office tapes from the Nixon years, we hear John Ehrlichman (a devout Christian Scientist, so perhaps he didn’t need health care) explaining to the president that Edgar Kaiser’s new scheme is a safely private, for-profit system, which elicits from Nixon the closest thing to an orgasmic cheer you’re likely to hear (that he barely moves above a grunt is precisely the point). All public pronouncements to the contrary, anything Nixon desired for American medicine was unlikely to lower costs or increase coverage, and as HMOs soon dominated the landscape, we know this to be the case. Despite protests that any other form of medical care would put decisions in the hands of pencil pushers in Washington, it is the HMO that has burdened doctors and hospitals with phone calls and paperwork, all to discover whether or not what they’re about to do will be paid for. Apparently, though, faceless bureaucrats are acceptable so long as they occupy corporate suites and not congressional offices. And as anyone who has dealt with an HMO can tell you, efficiency is not exactly a priority at any stage of the game. Whether it’s eliminating “burdensome” tests (read: too expensive and not covered) or prematurely pushing patients out the door, the system, as is, values short-term profit and shareholder satisfaction, not quality care. We are literally being patched together and kept alive at the behest of balance sheets, and it’s appalling that those whose first order is to “do no harm” would stand for it.
We also have the jaw-dropping case of ex-Congressman Billy Tauzin, a pitiful, but all-too-typical dirt bag who used the House floor to regurgitate maudlin speeches about the love he had for his mother, apparently because his pro-industry health-care initiatives were deemed harmful to seniors. Using mama as a crutch, he balked at the notion that he didn’t revere the aged, and to prove his case, he said goodbye to the Beltway and signed on as the head of a snake oil lobbying group called PhRMA for $2 million a year. Checking the organization’s website, we find the slogan “Disease is our enemy. Working to save lives is our job.” While I don’t expect Mr. Tauzin to remind visitors that, in fact, his primary mission is to bribe Congressmen and keep less expensive options forever off the table, I do expect a better mantra than the very one that adorned the gates of Auschwitz. Immediately, I also wondered why lawmakers weren’t forbidden from working for the very industries they once regulated (or, more accurately, rigorously defended from being regulated), but that’s another movie. And another headache. Throughout Tauzin’s creepy monologues (and the parade of Washington power players), it becomes quite clear that nothing short of a well-timed asteroid is going to turn this ship around. And lest you think Moore’s blaming the Republicans alone, he also points out that Hillary Clinton, once the champion of universal coverage, is now a paid whore for the very people who once opposed her plan. It’s an honest, much-appreciated tidbit, largely because it takes health care out of the partisan arena and puts it squarely in the middle of an entire system rotting from within.
Moore also travels abroad to see how the other half lives, and at least in Canada, England, and France, they’re doing quite well indeed. Sure, Moore presents a mere slice of the overall pie, but on the whole, his presentation is honest and accurate. There’s no doubt that these systems, universal and “free” as they are, still have problems, but it’s safe to say that they are far from the Soviet gray zones we’ve been led to believe exist everywhere but our own shores. Wait times seem reasonable, doctors are still very well paid (one London MD lives in a swanky flat with two expensive cars), and patients chirp and sing as if on cue, but even these stories are not the full picture. Moore admits — and well understands — that insanely high taxes accompany such a system, but relief and security cost a pretty penny, do they not? When middle-class Americans can be destroyed by illness, how on earth can our house of horrors be declared superior to that which never produces a patient invoice? Moore hangs out with a group of Americans who moved to Paris to discuss the benefits of their adopted country, and it all sounds so wonderful (longer paid vacations, house calls from doctors, state-funded child care, free higher education), but we also know that the disparities in population also play a role. It’s not fair, then, to make a straight comparison. But again, it’s the larger theme, not the minor contradictions, that prove Moore correct in the long run. In France, as in every other industrialized nation with universal health care, there’s a greater sense of “we” that the United States sorely lacks. Sure, we came together after 9/11 and volunteer hotlines ring off the hook after floods and hurricanes, but these are isolated events, so rare as to warrant headlines. On the whole, we’re a selfish, mean-spirited people, and as such, wholly incapable of shared — and sustained — sacrifice. Would we pay the taxes necessary to join the rest of the civilized world in the health-care parade? Yesterday, today, and tomorrow, I’ll always answer: “Not a fucking chance.”
The big finger-wagging moment occurs when Moore takes several 9/11 emergency workers to Cuba for treatment (initially, he wanted to come to Guantanamo Bay to receive the same health care as the suspected — but untried — terrorists being held there), where he finds able and willing medical staff to provide what the American hospitals would not. The whole thing reeks of totalitarian recruitment films where the “fearless leader” is shown chopping wood to make him more accessible to the masses or something, and anyone with good sense would ask what might happen if the cameras weren’t present. Still, despite its similarity to Fahrenheit 9/11’s “kite-flying in Baghdad” silliness, it somehow rises above the inherent distortion to reinforce Moore’s central point all over again. Yes, Cuba is terribly poor, groaning from years of reprehensible leadership, and — humorously enough — even lower than the United States on the list of the world’s ranking of health-care systems, but it doesn’t take away from the fact that these rescue workers, those patronized as heroes by the very people who didn’t give a shit about them once the feeding frenzy of that day wore off, could not receive proper treatment in the country they helped serve. More to the point, they were left to fend for themselves after being lied to about the air quality and overall safety of the World Trade Center site. Yes, gimmicks can be annoying (and play right into the hands of those who are predisposed to hate Moore) but added together, they are still no match for any one of the stories on display.
Whether it’s the kid who dies because the first hospital she is taken to is not on the insurance company’s approved list, or the deaf child who is allowed only one Cochlear implant because hearing in two ears is “experimental,” or the car accident victim who lacked the foresight to get preapproval for a life-saving ambulance ride, Moore’s film borders on tragic farce, indicting us all in a sick game where death is the only way out. Without any real incentive to do the right thing, the industry moves along like an engorged serpent, swallowing whole the very lives they insist are the reason they get up in the morning. But as services rendered are considered losses, and needy patients gross liabilities, things won’t get better anytime soon. Moore possesses the rebel’s sense of outrage necessary for any good filmmaker, and whatever you might think of his tactics, no one else is stepping forward. Sure, there was no real need to take potshots at Bush this time around, as the problem predates his historically inept presidency, but I was glad to have them just the same. Is it beating a dead horse? Perhaps, but Bush is so criminally stupid that to let up for a moment would almost be playing fair, and nothing that cocksucker has done since the opening bell warrants a pair of kid gloves.
Moore is also less of an intrusion this time around, and when on camera he’s merely a disgusted observer, rather than a prankster in search of sophomoric delight. A person’s health is all he or she really has in the end, and anything that digs into the bullshit just a little bit continues a dialogue that is all too frequently derailed. It’s no surprise that we value profits over people, and that insurance is the biggest con since the Manhattan-for-beads swindle, or that pharmaceutical companies have all the moral compass of a serial killer, but sometimes it takes a consolidation of resources like this film to penetrate our celebrity and trivia-addicted skulls. We’ve created a boondoggle, kids, and the price is being paid in human lives. And remember the words of Mr. Benn, for if we channeled one-tenth of the energy and resources into saving lives as we do in ending them, we’d all be sipping margaritas poolside. Not pain-free, of course, but less burdened. It’s worth the fighting for.