With the release of SiCKO in 2007, Michael Moore took discussions of single-payer, government-sponsored health care from the fringes of national political debate to center stage. But it should be obvious by now it will take more than a movie to get the insurance companies out of the health care system. It will also take more than the Affordable Care Act to create a truly just health care system. Time for more movement-building for single-payer. Here is the review of SiCKO I wrote for OpEdNews (July 13, 2007) at the time of its release.
On a recent road trip I found myself on a brief stop in Eureka, Illinois, a small, tree-lined town of modest hills in the central part of the state. Eureka is the home of Eureka College, the alma mater of former President Ronald Reagan. With some time to spare, I decided to visit the Ronald Reagan Museum on the college’s campus.
The museum’s tribute to the college’s most famous C-student graduate is modest in size. Among the collected letters and memorabilia on display there is little to dispel Reagan’s reputation as an intellectual lightweight. Hollywood memorabilia, yes, rigorously delineated expositions of political thought, well, not exactly. Instead, dewy letters to Nancy and movie publicity photos (including that one with Bonzo the chimpanzee) charm visitors from under glass.
But there was one item I found intriguing. An old vinyl record album from 1961 displayed a dapper Reagan posed next to a provocative title: “Ronald Reagan Speaks Out Against Socialized Medicine.” Reagan’s concern on the recording was a bill then in Congress to finance medical care for all Americans over age 65. This was the legislative initiative that in 1965 would become law as Medicare.
As a “free-market” ideologue, Reagan ludicrously painted the Medicare initiative as just a short step from the dreaded future of the Bolshevik collective (or, at least, the socialism of Norman Thomas and the Socialist Party). The recorded speech was also more than just a personal project by a crackpot voice from the right-wing wilderness. In fact, Reagan’s lecture on the evils of “socialized medicine” was sponsored by the American Medical Association (AMA).
It’s hardly a news flash that this C-student turned B-movie actor was already earning an F in social policy long before his see-no-evil act as the President in denial of the AIDS pandemic. For a career spent regurgitating folksy bromides about freedom, fair play, and other nice ideals, the old studio actor in truth was never more than a facile card reader for America’s most well-heeled and rewarded. When it comes to health care, Reagan spoke for those who needn’t bother themselves with such trivialities as the cost of monthly health insurance premiums, co-payments, deductibles, and other concerns more suitable to “the help” who ran Reagan’s ranch.
The story of Reagan’s LP recording against the dangers of socialized medicine is resurrected in Michael Moore’s new film, SiCKO. It’s one of many educational lessons Moore offers from the sordid story of how American health care has long been sacrificed to the greed and folly of the “free market.” In SiCKO, it’s also mostly “the help” who do the talking. From customer service reps for managed care to a retired machinist with heart problems to cancer patients and injured 9/11 volunteers, Moore lets ordinary Americans bring to life the broken reality of our health care system. He takes the same approach when he investigates national health care in Canada, England, France, and Cuba. In these countries he discovers regular folks and medical personnel who consider universal, government-sponsored health care as indelible a part of the civic landscape as the way Americans might view their local fire department.
Social-Democratic Values: Health Care is a Human Right
Give Moore credit. With SiCKO he has overnight taken the proposal for single-payer, government sponsored national health care from the fringes of national political debate to center stage. In doing so he brands for-profit health care as immoral, and calls for the elimination of insurance companies from the health care system. It’s a tour de force exposition of the perversity of turning health care into a commodity. More positively, SiCKO is an exposition of social democratic values that say society has an obligation to care for people in time of need. In this sense, SiCKO is less a movie about health care “reform” than a bold and brilliant vision of what our society could be, if only human needs came before profit.
SiCKO also puts to shame the mostly turgid debates over health care “reform” that have long hung over the stale air of American politics. In truth, the last quarter century both major parties have basically acquiesced while corporate America colonized the health care system. Even the Clinton administration’s complicated mess of a reform initiative sought in the end to preserve the insurance-based system, seeking a more rigorous “managed competition” of employers and insurers for the benefit of expanded coverage. The plan’s fatal mistake was that it was a conundrum built on a desire for compromise with the insurance industry. But instead of compromising the industry declared war, opposing what they viewed as unholy government interference in their pursuit of profit.
Fast forward 14 years and Hilary Clinton is now a favorite of health care and insurance lobbyists, recipient of more of their campaign money than any other candidate. But so also are Democratic candidates Barack Obama and John Edwards, both of whom predictably propose health care reforms that keep insurers in the medical profit loop. As for the Republican candidates, well, they’re all insured, so what do they care about reform?
Some critics of SiCKO complain that Moore doesn’t allow the health insurers to defend themselves on-screen. Nor does Moore address the complexities or problems of national health care in other countries. True, but so what? As Moore notes, Americans are already exposed constantly to the health industry’s point of view, thanks to multi-million dollar public relations campaigns. As for national health care in Canada, France, England, and Cuba, Moore seems justifiably more concerned with simply demonstrating the basic viability of national health care. In this two-hour movie, SiCKO shows Americans that free, guaranteed health care paid for by the government is not only possible but basically works. When has a mass American audience ever been exposed to that idea before?
Of course, with a message like this, expect a backlash. Take “hip” MTV correspondent Kurt Loder. He calls Moore a “socialist con man” for touting single-payer health care, informing us that the French system Moore praises is troubled with a $2.7 billion deficit. Ironically, that’s about how much the Bush Administration spends every 9 days on military action in Iraq. But don’t hold your breath for Loder (he called Moore’s 2003 Oscar antiwar acceptance a “witless flip-out”) or other conservative opponents of national health care to apply the same fiscal criteria to brand the Iraq war as unworkable.
Apparently it’s sufficient for the Rolling Stone contributing editor to assume France’s deficit just has to be the result of the inherent boogey of government social programs, eliminating any need to actually analyze the contradictions of French society. Some French unions point out that lower wages, unemployment, and recent large tax breaks to business have depleted public contributions to the social security system that manages the health services. The French government itself cites longer life expectancies, improved (and more expensive) medical care, and increased pharmaceutical costs for contributing to the deficit.
No doubt socialized health care in France, England, and Canada faces political challenges from the right. New French President Nicolas Sarkozy has declared his intent to reduce social spending, touting the prevailing corporate wisdom that for France to remain “competitive” in a global economy, the public must accept lower living standards. But whether France will embrace the downward spiral of the world’s middle class, sacrificing a 35-hour workweek for the 48-hour workweek of Indians, or 16 weeks paid maternity leave for the 12 weeks unpaid leave of the United States, is a political matter to be determined by the French people.
More SiCKO backlash comes from writer Gen LaGreca, whose viewpoint essay for the Bloomington, Illinois Pantagraph (July 1, 2007) expresses incredulity that Moore thinks people have actually a “right” to health care “simply because they need it.” LaGreca compares a national health care system to the government dispensing Belgian chocolates and filet mignon to the public under a mythical state “Foodcare” program. If the health care system has deteriorated, she says, it’s because of the “despotism” of “crippling regulation.” For this libertarian writer it seems that the revolt against tyranny begins with the rallying cry: No One Has the Right to Health Care! It’s apparently enough in some circles now to just club the poor, huddled masses to death with your barbarian ideology.
SiCKO is a humanitarian antidote to such wretched thinking. But excluding the “free-market” ideology freaks, the SiCKO backlash is mostly rather tepid. Perhaps that’s because when it comes to affordable health care, even many conservatives can’t help but recognize that the system is in trouble. SiCKO is also an antidote to all the policy experts whose “expert opinion” always seems to come down on the side of suggesting solutions-any solution, but preferably complicated solutions-as long as it prevents the idea of single-payer, national health care from ever being taken seriously.
Sometimes this game of political obfuscation involves catchy soundbites. Take Michael F. Cannon, director of health policy studies for the libertarian CATO Institute, who in 2004 told Fox News host Bill O’Reilly: “The problem is not that we have 43 or 45 million Americans without health insurance. The problem is that we have 280 million Americans without health savings accounts.”
This is the Bush Administration solution, of course. The White House wants Americans to use insurance only for major medical bills, pay high-deductibles, and rely on savings accounts for more routine health services. Supposedly, this scheme will make Americans more prudent users of health care. It’s all part of the idyllic Republican vision of the “ownership society,” an Orwellian term for the further dismantling of employer-based coverage. In fact, insurers are now in overdrive to sell cheap, high-deductible health plans to what they call the “young immortals” market: the healthy, uninsured young people who are not likely to file claims.
Sometimes the obfuscation involves what their promoters like to present as delightfully innovative business solutions. Take former America Online CEO Steve Case, whose new career as a healthcare investment executive is inspired by images of the dollar signs lurking in walk-in “mini” clinics at Wal-Mart stores. Case gives speeches in which he speaks of a future health system that creates incentives for healthy living by offering “bonus points” redeemable for “awards” from movie chains and airlines. And profits for Case, no doubt.
Other times the miasma involves just deluded ideology. Like that of Republican Presidential candidate Rudy Giuliani, who proclaims “market-based” solutions as the only acceptable avenue for health system reform. No word yet whether Gulianni plans to abolish Medicare should he be elected. Or Star Parker, president of the Coalition for Urban Renewal and Education, who wants us to believe that the “power of individual choice” and the “creativity of the marketplace” would better replace the supposed burdens of Medicare. Parker calls Moore’s vision of guaranteed health care “pornographic.”
Then there is the esteemed committee of health policy experts from Harvard University’s Program for Health System Improvement, who propose a 20-year plan for health reform in three stages and write things like: “Our national government should contribute to and stimulate local innovation by creating a competitive process, in which appropriate, interested localities can bid to receive matching federal seed money to initiate their innovation. The anchor corporations, local health plans, local philanthropic organizations, research universities, and others will match the seed money and provide specific business plans that present detailed information about how each entity will fulfill its roll in the proposal. Federal and state governments will provide regulatory relief if appropriate and will help to evaluate whether the plan can fulfill its stated goals.”
Accordingly, the Harvard panel’s bold vision for decades of experimental system tweaking proclaims the possibility of reducing the number of uninsured from 45 million to 30 million over 10 years. Please note that this reduction will occur during stage two of their plan.
Executive profiteering. Uninsured millions. Rising premiums for policies that increasingly offer fewer benefits. Is Moore wrong for declaring this reality immoral? Is he such a radical for arguing that insurance companies should have zero role in health care? Actually, the answer to the latter question is yes. The leading Democratic candidates for the party’s presidential nomination, John Edwards, Hilary Clinton, and Barack Obama, all seek to set the health reform bar low enough that the insurance companies responsible for the current broken system remain a part of the system. But should we really expect different from politicians who say they’re opposed to the Administration’s war in Iraq, then reject an immediate pullout and repeatedly vote the money necessary to continue that war?
The virtue of SiCKO is that it frames the issue of health care in larger, more principled terms. After years of ideological assault on the very idea that society and government should provide more than bare-bones social services, Moore’s movie resurrects a nobler vision of society. SiCKO challenges us to think of ourselves not as individual consumers, or health care “customers,” but as citizens with rights and common human aspirations and needs.
In this sense, SiCKO speaks to that “radical revolution in values” the Rev. Martin Luther King, Jr. once said this nation must undergo if it is ever to become a land of real justice. Not to take anything away from Moore, but the splash the film is making partly reflects the simply vacuous state of our political-media culture; so rarely is a mass American audience exposed to ideas that suggest the possibility of far-reaching social change. Consequently, the movie is proving to be an empowering experience for many audiences, from the impromptu post-film discussions in lobbies to union nurses setting up single-payer information tables.
As I left the theater in Champaign, Illinois where I saw the film, young college students seeking signatures on petitions for guaranteed health care greeted me. Their enthusiasm for the cause reminded me that the film’s most compelling thought was expressed by the American woman living in Paris who said to Moore, “In the United States, the people fear the government. In France, the government fears the people.” Certainly if European countries have more extensive public health care systems than the United States, it’s because of their history of stronger unions and mass working-class political organizations. It’s because of their exercise of democracy from the grassroots up.
This is the power of SiCKO. It wants us to believe in our own power as Americans to change society for the better.
Published by Mark T. Harris
Mark T. Harris has contributed to Utne, Dissent, Z, The Oregonian, and other publications. He is a featured contributor to "The Flexible Writer," fourth edition, by Susanna Rich (Allyn & Bacon/Longman, 2003); and "Guide to College Reading," sixth edition, by Kathleen McWhorter (Addison-Wesley, 2003). For several years he was the Choice Books columnist for Chicago's Conscious Choice magazine. View all posts by Mark T. Harris
If you listen to what the leaders of both political parties are saying, it seems unlikely that the diagnosis offered by “Sicko” will be contested. I haven’t heard many speeches lately boasting about how well our health care system works. In this sense “Sicko” is the least controversial and most broadly appealing of Mr. Moore’s movies. (It is also, perhaps improbably, the funniest and the most tightly edited.) The argument it inspires will mainly be about the nature of the cure, and it is here that Mr. Moore’s contribution will be most provocative and also, therefore, most useful.
“Sicko” is not a fine-grained analysis of policy alternatives. (You can find some of those in a recently published book called “Sick,” by Jonathan Cohn, and also in the wonkier precincts of the political blogosphere.) This film presents, instead, a simple compare-and-contrast exercise. Here is our way, and here is another way, variously applied in Canada, France, Britain and yes, Cuba. The salient difference is that, in those countries, where much of the second half of “Sicko” takes place, the state provides free medical care.
With evident glee (and a bit of theatrical faux-naïveté) Mr. Moore sets out to challenge some widely held American notions about socialized medicine. He finds that British doctors are happy and well paid, that Canadians don’t have to wait very long in emergency rooms, and that the French are not taxed into penury. “What’s your biggest expense after the house and the car?” he asks an upper-middle-class French couple. “Ze feesh,” replies the wife. “Also vegetables.”
Yes, the utopian picture of France in “Sicko” may be overstated, but show me the filmmaker — especially a two-time Cannes prizewinner — who isn’t a Francophile of one kind or another. Mr. Moore’s funny valentine to a country where the government will send someone to a new mother’s house to do laundry and make carrot soup turns out to be as central to his purpose as his chat with Tony Benn, an old lion of Old Labor in Britain. Mr. Benn reads from a pamphlet announcing the creation of the British National Health Service in 1948, and explains it not as an instance of state paternalism but as a triumph of democracy.
More precisely, of social democracy, a phrase that has long seemed foreign to the American political lexicon. Why this has been so is the subject of much scholarship and speculation, but Mr. Moore is less interested in tracing the history of American exceptionalism than in opposing it. He wants us to be more like everybody else. When he plaintively asks, “Who are we?,” he is not really wondering why our traditions of neighborliness and generosity have not found political expression in an expansive system of social welfare. He is insisting that such a system should exist, and also, rather ingeniously, daring his critics to explain why it shouldn’t.
Opens today in Manhattan.
Written and directed by Michael Moore; edited by Christopher Seward, Dan Sweitlik and Geoffrey Richman; produced by Mr. Moore and Meghan O’Hara; released by Lionsgate and the Weinstein Company. At the Lincoln Square, 1998 Broadway, at 68th Street. Running time: 123 minutes.
NYT Critic’s Pick
Running Time2h 3m
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Last updated: Nov 2, 2017