Cinema Junkie by Beth Accomando

In Sicko (opening June 29 at select theaters), Michael Moore essentially asks the American health care system to bend over for an examination. And as the poster for the film promises, this might hurt a little.

Back in 1989, Michael Moores Roger and Me revitalized the documentary genre by proving it could be both entertaining and profitable. He continued this tradition with Bowling for Columbine and Fahrenheit 9/11 (which I believe is the highest grossing documentary to date with some $220 million in worldwide box office receipts). In an era when most people get their news from Leno, Letterman or The Daily Show , Moore has tapped into a style of filmmaking that appeals to a mainstream audience. He has found a way to be funny and entertaining as he deals with serious issues. So when Michael Moore decides to take on an issue, that issue is bound to be talked about in the press.

This time out Moore takes on American health care. Although nearly 50 million Americans (almost a fifth of whom are children) are uninsured, Moore chooses to focus on people who actually have insurance but found their coverage severely lacking when they needed it most. This choice is a smart one because if he had focused on the hardships of the uninsured, many might have tuned out to his message, dismissing the problems of the uninsured as something that those people simply brought upon themselves. But by focusing on insured people who were denied care some of whom had been fully employed and had been paying into the system for decades Moore strikes a nerve. He suggests that people with insurance shouldnt feel overly safe, any of the horror stories he reveals could happen to you.

When Moore started his film, he put out a query to the general public asking them to tell him about any bad experiences they might have had with the health care system. In no time at all, he received tens of thousands of responses. For about the first 40 minutes of the film, Moore keeps himself off camera and narrates the stories of some of these people. Theres a couple who has gone bankrupt paying for care that their insurance denied, a woman whose husband was denied an operation that might have saved his life, and a number of people refused procedures that the insurance company called experimental.

We also hear from a physician named Linda Peeno who worked for Humana. At a government hearing, she stepped forward to make what she called a confession. She explained how she denied coverage to a man who subsequently died and yet no one has held her accountable for her actions. Instead, her company rewarded and promoted her because she saved the company money. That's powerful stuff.

All this sets the stage for the second half of the film in which Moore enters the scene to suggest some other ways to go about providing health care. He goes to Canada, France and England to see what national health care is like. He finds happy people with nothing but satisfied stories of the free care they have received. Of course its not entirely free, it has been paid for out of their taxes, and he never seeks out anyone who has even the most modest complaint. He also points out that doctors working for the government in England drive expensive cars and live in million dollar homes. He makes this point to prove that a nationalized system does not mean doctors with struggle to get by on government wages. But he doesn't examine if those high salaries are putting undue stress on England national health care. Moore also takes a group of 9/11 rescue workers who have failed to receive adequate care or coverage from their U.S. insurance for the health problems they experienced after 9/11. Moore takes the lot of them to Cuba and finds that the treatment they received from that third world country puts American health care to shame.

Moore assembles a lot of compelling footage and personal stories. He does not try to serve up a lot of statistics but rather tries to persuade through anecdotal evidence. This approach proves compelling because the personal tone of these individual stories invites our sympathy and compassion. But sometimes Moore undercuts his message and his impact by the way he chooses to present his material. His humorous (or as he would term it "satirical") approach to the subject matter is sometimes difficult to take when the people he is talking to are dying. Moore also tries to play average Joe America as he constantly expresses shock and awe at the stories he hears from those in national health care systems. But this surprise is forced and obviously fake, after all he has chosen to interview these people precisely because he knows they will support the claims his film is making. There are also very disingenuous moments as when he yells out from a boat to the guard tower at Guantanamo bay, asking to be let in so the 9/11 rescue workers can get medical treatment at the military base. The scene is an exercise in cinematic manipulation as Moore has no real intentions of making contact with anyone at Guantanamo.

Similarly its annoying when he arrives in Cuba and tells us that he told the Cubans to treat them just like anyone else. I guess that would be just like anyone else who arrives from America with cameras and a media celebrity like Michael Moore. Now Moore has made a point that one of those rescue workers (who spoke Spanish) snuck out of the hospital and then re-entered without any of the cameras or crew, and she claims she received the exact same treatment. Well maybe thats true or maybe the hospital that had just admitted her, recognized her again. Either way, Moore doesn't need to take this kind of approach. Why can't he respect the audience's intelligence more and simply be more direct in presenting his material.

My problem with the film is that I think Moore could have removed all these contrived and condescending elements and made a stronger film. He weakens the material he has by resorting to what has become his familiar schtick. When dealing with documentaries I sometimes find myself conflicted because I have to consider the film both for the merit of its content and the artistry with which that content is presented. An Inconvenient Truth , for example, is a film that everyone should see because it contains information people should know. Yet it was a badly made film in the sense that it was essentially a filmed lecture. Sicko is another film that people should see because its a catalyst for a very necessary discussion. Yet I also have to criticize Moore for some of the tactics he employs.

Also, Moores film leaves us in a bit of a quandary. He shows us that our health care system is broken. He shows us that corporations are greedy and ill-suited to a job that involves peoples well being. He condemns politicians as corrupt or at the very least tainted by their ties to the pharmaceutical and medical industries. He even reveals his disappointment in Hillary Clinton, by first showing her valiant attempts to create a national health care system in the U.S. but then ending with her selling out and taking money from those with a vested interest in maintaining the status quo. So with all these options looking so bleak where do we turn? Do we really want the government running a national health care system? What choices does Moore leave us with? What we leave the film thinking is that we need a major overhaul, but were not left with a real sense of what to do next.

But maybe Moore wants to leave with a bigger question, a question about who we are as a nation. What kind of people are we if we dont care for those in the greatest need? In some ways, Sicko is Moores least controversial film because it addresses an issue that cuts across a lot of lines. Most people regardless of political party, race, gender or religion will probably concede that health care is a problem. But no one seems willing to address that problem or offer a radical solution to fix it. Hopefully Sicko will put the issue in the spotlight and force decision makers, politicians and maybe the health care industry itself to come up with some new ideas.

Sicko (rated PG-13 for brief strong language) is not Moore's best made documentary but he deserves praise for forcing an issue to the forefront of national debate.

-- Listen to Beth Accomando and Scott Marks discus Sicko on the KPBS Film Club of the Air .

-- See the Full Focus TV segment about Sicko featuring Beth Accomando and nurse Gerry Jenkins.

Companion viewing: Roger and Me, Moores TV shows The Awful Truth and TV Nation , The Death of Mr. Lazarescu Sheila Levine
June 30, 2007 at 07:09 AM
First of all, 4 out of 5 Americans are satisfied with the health care system, so it is really a non-issue (this will likely be the reason the movie Sicko flops). Second, collectivized, totalitarian provision of goods and services by a centralized government which redistributes wealth based on "need" is itself the most sickening thing an American could ever support. People are not born with any "right" to health care, nor any "right" to any other product of the human mind which depends upon the willing, voluntary cooperation of another human being. This smacks of Marxist Communist Russia where such ideals originated. The answer to your "problem" is this: get rid of the governmental over-regulation, the restrictive licensing, the state supported tort threat, the unionism, and all other legislative and regulatory phenomena which are essentially conferring a monopoly to those currently in the business. This will promote competition, competition drives quality up, prices down, and everyone wins. Monopolies discourage competition (indeed, sometimes deliberately destroy it), drive quality down, innovation down, prices up, and everyone EVERYONE loses. By the way, that is the answer to ANY problem in the free market, not just health care, so re-read it. And learn it. Spread the word. -----

Beth Accomando
July 02, 2007 at 11:56 PM
Sicko just posted the second highest open for a documentary. The California Report just ran a feature on July 2 (http://www.californiareport.org/domains/californiareport/) about single payer health care that includes some interesting information. As for Shelia's post, I would just ask are the 4 out of 5 you refer to people who are already insured? What about the nearly 50 million who have no health insurance, are they satisfied? Or do they not count? Also, if you queried those "4 out of 5" people further would they say that they are worried about health care costs or about losing their health care if they lose or change their jobs? As for your "answer" to the problem, is it worth risking the health and well-being of people to see if the forces of the free market (unencumbered by any government laws or restrictions) would actually result in better, cheaper, more readily available health care? I think the profit motive would continue to make insurance companies a less than ideal gatekeeper. Also I would be interested to know if you saw Sicko and took the time to listen to what the people interviewed have to say. I might answer a survey by saying I'm currently satisfied with my health care but that doesn't mean that I don't have any concerns or worries or that I think it's perfect. Thanks to Shelia for posting.

Sylvia Hampton
July 05, 2007 at 10:50 PM
SICKO is getting rave reviews and audiences are cheering at the end. The next thing they want to know is what can they do to solve the problem. There are several websites including Moore's that will take you to groups working to pass (again) SB840 in CA and this time get Gov ARNOLD to sign it (he vetoed it last year.) Other bills only serve to keep the profit-making insurance companies in the picture. They are the ones that need to go. Visit onecarenow.org and sign up or go www.myspace.com/onecarenoworg for videos and more.

Sheila Levine
July 11, 2007 at 08:37 PM
Use reason and logic, for once in your life. And while you're at it, use them all the time, too. Read the eloquent words of Mark Valenti who put it so succinctly: About ten years ago, I believed in the seemingly lofty goal of "universal health care". Who wouldn't support that goal? Doesn't everyone have a "right" to health care? I was just a kid then. It was easy to agree with a meaningless campaign promise such as "Affordable Health Care for All". It takes effort to actually research the topic and understand economic logic, history and facts. Once I questioned the sound bites, I realized that government intervention in the market (e.g., Medicare, FDA, physician licensing, insurance regulations) is the reason for artificially high health care prices. So-called Universal Healthcare amplifies all problems because it: 1) Destroys patient incentives to find the best possible prices for the best possible services/products available. I have worked in the health care field in various capacities for the past ten years and I see a majority of patients who currently receive "free" (read: taxpayer-funded) healthcare continually seek care for the most minor afflictions. Why wouldn't they? It's "free" to them so they visit the doctor's office several times a month. "Free" prescriptions for over-the-counter medication such as Tylenol are very common. Patients who refuse to wait for an appointment make their way to the ER for things such as headaches. If you were ever an ER nurse, I know you can verify this. The current U.S. mostly statist healthcare system also decreases incentives to "shop around" for people who are not receiving direct taxpayer-funded care. If you are paying a set amount per month and your copay is ten dollars per office visit no matter where you go, why bother to look for a better price? Government imposed wage controls during the 1940's carry a large part of the blame for this current state of affairs. Unable to offer competitive salaries, companies started to offer healthcare benefits as a way to lure prospective employees into jobs. 2) Destroys physician incentives to provide competitive care and destroys drug companies' incentives to provide new drugs and treatments. The "brain-drain." With no incentive to provide quality care, physicians and nurses leave the government-monopolized area for better opportunities in a freer country. Shortages result. Drug companies are hindered by price controls and regulations and soon cease research and development of new medication. In the U.S., start-up drug companies cannot afford to run the FDA gauntlet, so the market is dominated by a few established corporations. 3) Steals from your wallet to pay for my health care (and vice versa). Yes, you do have a right to health care, just as you have a right to food, shelter and property. However, you have no "right" to force others to provide these things for you - All "free" medical care is paid for through taxes stolen from other people. I know of one seemingly healthy individual who went to his physician's office 51 times in 26 months. He receives "free" health care from the State, so his trips did not cost him a dime. Who pays for his medications? Who pays for the physicians', nurses' and office staff wages during his visits? If you work within the health care industry, I would bet you could recount similar stories. In my experience, this type of abuse is the rule, not the exception. 4) The quality of "free" health care will deteriorate and the average citizen will get sicker. As the poor and middle-class wait in agony for simple procedures, those with resources can travel to other countries for treatment. But hey, your moral arrogance and justification of coercion makes you feel good, doesn't it? 5) Destroys your privacy. Suddenly your problems are mine and mine are yours. If you are eating unhealthy foods or driving a motorcycle without a helmet, I have a direct interest in your business - you are going to see a doctor on my tax dollars. Your neighbors might support government bans on smoking, "unsafe" sex or other "risky" behaviors to reduce costs. Politicians will use the federal bureaucracy to force you and your family to comply with programs such as the "New Freedom Commission on Mental Health". 6) Destroys your liberty. When you blindly support a system that gives politicians and bureaucrats the power to force others to follow a plan, those politicians and bureaucrats will receive their orders from those with the most money - and you can guarantee this will not be you, your friends or your family. The power of government will be used against you as you are forced to use medicines or accept treatments from well-connected health care companies. A quick search shows that the pharmaceutical companies gave $29,370,351 to political campaigns in 2002. Who do you think has the ear of those elected politicians? You? On the other hand, if government power is eliminated (e.g., abolish the FDA - whose restrictions benefit the most powerful companies by eliminating most competition), those same companies would have to use their funds and resources to sell their drugs to the most people in the least expensive, most reliable and safest way. They would need to outperform their competitors to get your money - otherwise they lose business. Great Britain's National Health Service (NHS) was created on July 5, 1948. As with all government programs, bureaucrats underestimated initial cost projections. First-year operating costs of NHS were 52 million pounds higher than original estimates as Britons saturated the so-called free system. Many decades of shortages, misery and suffering followed until 1989, when some market-based health care competition was reintroduced to the British citizens. [Sheila added:] Heck, why should government stop at Socialized Health Care? If we're going to be complete Totalitarians by which the government provides all our goods and services like the Soviet USSR and other communist nations did (and failed), why not government-made cookies, government-made movies, and EVERY OTHER thing we ever consume and pay for? WHY STOP AT HEALTH CARE? It's a Sicko who believes that government intervention in any service industry needs to be anything but decreased and completely eliminated.

Beth Accomando
July 20, 2007 at 03:53 AM
Are you advocating that all schools, libraries, police, fire, military and parks all go private as well? The argument you post from Valenti, a self-described "free-market libertarian and anarcho-capitalist (2002-present)" doesn't convince me. I agree with one of his statements but not his conclusion. He says:"A quick search shows that the pharmaceutical companies gave $29,370,351 to political campaigns in 2002. Who do you think has the ear of those elected politicians? You?" The answer is not likely. Yet to me that's proof that for-profit health companies want to insure that the government stays out of their way. Without any government regulations or oversight, the health care industry would strive to make greater profits at the expense of the poor, the unemployed and those with pre-existing health problems. For-profits have no incentive to cover people who will cost them money because there is no way to make a profit off them. Although I find both the government and politicians flawed I have even less faith in handing health care completely over to the private sector. I can only hope that intelligence and compassion (both of which are necessary) will help us to find a balance between the government and the private sector. As for who I'd like to see make my health care decisions, it's my doctor and maybe that's why I find the information from the non-profit organization Physicians for a National Health Program convincing: http://www.pnhp.org/ Here are some additional links: http://www.commondreams.org/archive/2007/07/02/2232/ http://www.fair.org/index.php?page=3124 http://www.thenation.com/docprint.mhtml?i=20041115&s=mintz http://seattlepi.nwsource.com/opinion/248786_codebluesecond18.html And if you are going to criticize someone for not using reason and logic, maybe you should avoid the government-made cookies argument. I think it weakens your case. Thanks to both Sylvia and Shelia for taking the time to post.