Reviewed by Sam Hatch
“People should not be afraid of their governments. Governments should be afraid of their people.” - V
It comes from another Moore altogether (British comics genius Alan Moore), but that Jeffersonian phrase from the groundbreaking graphic novel (and subsequent film) V For Vendetta is at the heart of the matter being probed by filmmaker Michael Moore in his newest piece of docu-tainment, SiCKO. It's an incendiary film (also one of his most focused and artful) that portrays the failings of the American for-profit health care system. Moore doesn't always play fair, but in this case I find that to be a strength of the film. People don't need to see a dry, balanced account of the situation; they need someone to put a fire under their asses. This film should do the trick.
That anarchic sounding quote is paraphrased by a US citizen now living in France, whom Moore interviews during a segment comparing our current healthcare morass to the number one system in the world (according to the World Health Organization). She points out that in other democracies, the government works for and with its people, whereas in America the citizens live in a state of fear, a legion of wage slaves trembling at the feet of the people who are supposed to be acting in their best interests. It's a fascinating observation, mostly for the fact that it points out that a nation of natural born rebels has been put to sleep.
The film begins with a few commercial healthcare horror stories, including a man who is forced to sew up his own ghastly leg wound without assistance, and another who must choose which of his two missing fingertips he can afford to have reattached. We meet Donna and Larry Smith, an older couple with skyrocketing medical costs who are forced to sell their home and move into their daughter's spare room. We meet a woman whose husband died of kidney cancer despite having a viable donor. We meet a father whose hearing impaired daughter needed two cochlear implants, yet was told by his insurance company that one was approved while the other was considered ‘experimental'. He resolved the matter by threatening to bring Michael Moore to the doorstep of that company to raise a stink. Suddenly, the ‘experimental' surgery was approved.
Moore has made himself a household name through his constant portrayal of the little guy versus the soulless corporate giant. Failed attempts at interviewing CEOs have been his bread and butter, populating segments from his numerous films and TV shows over the past two decades. With SiCKO, he seemed to sense that the shtick wasn't going to work (in fact, he has far less personal screen time than usual). Shortly after the release of his anti-Bush screed Fahrenheit 9/11, the word got out that his next targets were the HMOs. One can imagine the immediate, manic flurry erupting amidst those corporations' public relations departments, and surely all their foyer receptionists were given orders to shoot to kill if any remotely overweight liberal came bounding along with a camera crew.
In this case he didn't need that overused crutch. We know insurance companies are corrupt. We know they don't care. We know they will let people die for money. That's not to say that the insurance companies aren't represented at all in the film, not that they'll like what shows up on screen. After tossing out a fishing net from his blog looking for the public's worst insurance horror stories, he wound up getting quite a few missives from people within the targeted organizations. Some of their stories appear on tape, including a woman weeping over the fact that she lies to customers constantly and has to live with the stress of stringing them along with false hope. There's an even creepier gentlemen who worked professionally for years looking for loopholes and ways to retroactively cancel policyholders' accounts when their medical costs suddenly became too high. There's also stock footage of ex-Humana exec Dr. Linda Peeno testifying in court that she personally made thousands of dollars out of fanning the flames of other people's misery.
Like most of Michael Moore's films, this will undoubtedly be nitpicked to pieces by his adversaries. It's a tiresome cycle, mainly because of the pointlessness of the micro-focused attacks. We all know that Mikey likes to showboat (and thankfully we are treated to far less scenes of him standing around awkwardly while his subjects are bawling their eyes out) and drop ‘idea bombs' without a journalistic intent on covering all of the bases. Yet hardly any of the anti-Moore debunking I've seen addresses the inherent truths in his pieces. It's just a constant stream of “He changed the timeline of an interview, therefore everything he says is null and void.” So in a worst-case scenario he's fooling me into gaining knowledge, or lying to me to give me the truth.
Interestingly, there's a segment in the film wherein one of his many vociferous online adversaries faces a personal crisis involving his wife's medical bills. Moore reveals that he shelled out $12,000 ‘anonymously' to the guy so that he could keep his website going and take care of his wife. You can easily say that it was a stunt, since it makes Moore look better than his enemy and also ties into his newest film's subject matter. There's also the fact that his anonymous donation was rendered public through inclusion in this documentary. If it were a completely altruistic act, he never would have mentioned it at all.
Predictably, the beneficiary of his donation has since come out against the way the events were portrayed on film. This one blogger's assault pretty much sums up the bulk of online vitriol against Moore. He details every single instance where Moore altered the events, stretched timelines and manipulated the audience's emotions (kinda like every other summer blockbuster). Yet never does he refute the fact that a) Moore cut him the check and b) he kept the money. So if Moore's incessant tampering with evidence somehow doesn't obscure the inherent truth behind it, what's the problem?
Having worked in the health care industry for a time, I can attest to the truth behind his accusations. While working in collections I grew accustomed to those classic terms ‘experimental' and ‘denied'. The insurance companies that create contracts with clients go out of their way to renege on those contracts without being found out. And the people bend over and take it day after day. I loved the story of the woman whose ambulance ride following an auto accident was denied because it wasn't ‘pre-approved'. I was in a rear-ender last year and remember being petrified when asked if I wanted an ambulance ride to the hospital. I couldn't remember the specifics of my plan, and was going to risk permanent cervical damage instead of being faced with a near-thousand dollar bill.
Which brings up another problem with the system – mainly that the ‘costs' of medical services aren't realistic. The insurance companies will only pay a fraction of the cost of a surgery, leaving the doctor to ‘write off' the remainder. Sometimes a multi-thousand dollar procedure will only pay out a few hundred bucks or so. But if someone uninsured gets that procedure, they don't pay what the insurance companies pay the doctors – they pay the entire amount. And just because you have insurance doesn't mean much either – some plans have insane restrictions and deductibles that render their coverage useless. Affordable plans for underprivileged persons pay so poorly that specialized practices are forced to deny them care, thereby punishing poor people for being poor and perpetuating prejudices against them.
Indeed, SiCKO unveils footage of a woman who was kicked out of a Los Angeles hospital and dropped off by a cab near a random shelter – left to wander the streets in her hospital gown with no idea where she was. It's a shocking alternative to that of the rest of the world, where societies have deemed it prudent to actually take care of their citizens who have little to no resources. Sure, we have some publicly funded plans like Medicare and Medicaid, but if they work so well why was this woman dumped on the sidewalk like a load of garbage? Moore does pen a bit of a love letter to universal healthcare systems such as Canada's Medicare and England's NHS, and goes on location to hospitals and clinics feigning shock when people explain how simple (and cost free) medical care is.
It's a bit of a whitewash, since surgical waiting lists and other drawbacks are omitted (there's no mention of Canadian hospitals dumping patients in hallways, not that it doesn't happen here too); yet for all the complaints Canadians have about their system, they certainly don't want ours in its place. Higher taxes, lack of equipment and underpaid doctors are common arguments against socialized health care, but Moore tours numerous hospitals well stocked with modern equipment. He also tours the home of a young British doctor who shows off his new Audi and million-dollar flat. He then interviews a randomly selected British couple and probes into how they can live comfortably while paying for the country's healthcare with their taxes.
He also visits France (with that number one healthcare system), and interviews a group of American ex-pats who are reveling in the opportunities offered there. This is opposed to the Stateside way of taking on an insurmountable debt at a young age, thus being forced to work like a drone forever in fear of not paying bills or losing insurance coverage. We also learn that there are doctors who still practice house calls all night long, and that the government will supply nannies to new mothers to help with housework. It's a funny, cartoonish segment that plays on American fears and hatred of the French. Mike goes so far as to posit that our Anti-French mindset was propagated on purpose to sway Americans from coveting their way of life.
The most controversial segment of the film is a jaunt to Cuba, another target of American hatred. Moore even shows a map of the country burning with hellfire accompanied by the Satanic laughter of dictator Fidel Castro. He's not really opining on Cuba's greatness, but is merely trying to clear the air of hysterics so that he can present his case. Likewise, he points out the near insane reaction of Americans towards anything 'Social' – i.e. those who fear that socialized medicine would mean turning the country into a Commie hellhole. He wisely points out that our government has already implemented other socialized institutions (libraries, the postal service etc.) yet we're not all wearing uniforms adorned with hammers and sickles.
The Cuba incident stems from an investigation into the numerous healthcare problems sustained by rescue volunteers following the attacks on 9/11. Moore shows a montage of goodwill scenarios with firefighters and policeman receiving countless accolades for their bravery. It's all the more sobering when he cuts to a modern day ‘fundraiser' which is in essence a cheap raffle in the back of a tiny bar. The people in need are non-government volunteer rescue workers who now find themselves forgotten and lost in the system with permanent health problems and no way to pay their bills.
Moore juxtaposes this scenario with imagery relating to the Al Qaeda detainees held at the US occupied Guantanamo Bay detainment camp in Cuba. Following public relations nightmares such as the incidents at Abu Ghraib, we see a litany of military men testifying as to the humane conditions the captive terrorists receive. Come to find out, they have healthcare services at their disposal (for free), and are just as well taken care of as an average fully insured American. This leads Moore to stage one his most inspired gimmicks, as he and the injured 9/11 workers take three boats from Miami to see if they can convince the US Armed Forces at Gitmo to assist in their care.
Needless to say the welcome wagon never comes, so Moore and his crew head to Havana to investigate the Cuban version of universal healthcare. Obviously, much of this should be taken with a grain of salt, since Castro's regime must have been delighted to stage events and prove how superior they are to Americans. Moore insists that his friends were given the exact same treatment that an average Cuban would receive, but there's no way to justify that claim. One rescue worker finds that her $120 asthma inhaler costs less than a dollar there. This fully stocked Cuba is at odds with other claims of a shabby system where sutures must be bought on the black market. Yet no matter how staged or manipulative the following scenes are, the montage of 9/11 rescue workers shedding tears of joy over being treated as worthwhile human beings (by the people who are their supposed enemies) is powerful as hell. As is the moment where they encounter local fire fighters who wish to pay their respects.
The question that arises is if a country that hates us can show that much warmth and humanity to our people, why can't we? There's even a brief interview with Che Guevera's daughter who wonders aloud why the most powerful country in the world can't provide care to it's citizens while small third world countries can somehow pull it off. Indeed, the WHO ranks the United States 37th in health care, right above Slovenia (and Cuba as well, to be fair). It's obviously a broken system, implemented so that less care can be given for more money received. (Illuminated in the film by shocking audio and video footage of President Nixon embracing the corrupt notion of Edgar Kaiser's Permanente HMO)
America is described as a nation that makes the best out of everybody else's good ideas, except for this particular one. Contrary to common arguments, we don't have to implement a system exactly like any one nation's. We don't have to adopt the areas where Canadian Medicare fails. We don't necessarily have to adopt the controversial two-tiered public/private system. It sounds clichéd as hell, but if we can put a man on the moon surely we can find a way to create an amalgamated solution that trumps the rest of the world. Essentially, our lack of capability and compassion towards our own citizens makes us look like a bunch of Neanderthal dumbasses (sorry, insurance cavemen).
When British politician Tony Benn explains that the U.K.'s National Health Service was inevitable due to the nature of democracy, it feels as if he's talking about an altogether different kind of democracy. Moore points out how deep the pockets of the health industry go, and how PhRMA's aggressive lobbying effectively crushes any effort at health care reform (most notably Hillary Clinton's vain efforts in the nineties). Much like the scenario with the electric car, it's yet another tale of dinosaurs and their money – and how they'll do anything to protect it. Of course there are ways to make money doing positive things, but there's always that frightening prospect that being noble won't make quite as much money.
Which leads back to the statement at the heart of the film, that our government (with tautly wound ties to plenty of dinosaur money) is not even remotely afraid of its people. As Moore points out, we're a nation of wage slaves kept in check through massive personal debt and a climate of fear. In a way, true believers in the American way are no different than the suckers at the slot machines in Vegas. We keep circling the drain, stretching to make ends meet, always holding on to that fantasy that we can hit that jackpot. Unfortunately, it's harder now than ever to make that a reality. Unable to resist un petit peu of Bush bashing, there's a clip in the film of the President meeting with Mary Mornin, a woman in her fifties who states she has to work three jobs. He takes it as a boast, and says that her plight is something to be celebrated, a ‘uniquely American' trait.
If being poor is our birthright, thanks but no thanks. Though while watching this film I started to feel less sorry for the downtrodden in the film, and more sorry for the cackling rich vultures behind it all - complacently oblivious to what could be in store for them. As I said, we're a nation of natural born rebels, and I think that trait can only be suppressed for so long. I don't think everyone who sees this movie is going to want to move to France. I think they're going to stay here and be pissed off. And when enough people get pissed off enough, they very well may see fit to do something about it. And then an entirely different film quote becomes applicable. It was the uniquely American character John Nada in the John Carpenter film They Live who said, “I came here to chew bubblegum and kick ass. And I'm all out of bubblegum”. After seeing SiCKO, you might think it's time to kick some ass too.