About five minutes into Michael Moore’s health care documentary Sicko, I had a cold chill run down my spine. We are introduced to a middle-aged couple, both of whom have health insurance and both of whom got sick. While their insurance covered many of their procedures and medications, there were so many expensive co-pays that this couple had to sell their home and move into a spare bedroom in their daughter’s already-crowded house. It’s the kind of moment that makes you think, there but for the grace of God go I. Is there anyone among us who doesn’t have a horror story about their HMO or know someone who does? Haven’t we all hit that brick wall at some point, whether over something large or small? It is this commonality that makes Sicko potentially revolutionary. If it helps stir up the national debate over heath care enough, perhaps we will actually see some change.
Moore begins by interviewing people who have had tragic consequences because their providers wouldn’t cover them. There is the woman whose husband was denied a life-saving bone marrow transplant despite the fact that his younger brother was found to be a perfect donor match. There is the guy who lost two finger tips in a saw accident and the HMO would only pay to have one reattached; he chose the ring finger, which was less expensive. There is the woman who was knocked unconscious in a head-on collision and had to a pay a huge hospital bill because her ER visit wasn’t “pre-approved.” And, of course, there are numerous people who were refused potentially beneficial treatments because they were deemed “experimental.”
The problem, according to Moore, is that our current system (set in place by the Nixon administration) allows health insurance companies to make more profit by denying claims. Therefore, modern HMOs maximize their earnings by rejecting as many claims as possible. In one of the most moving passages, the film shows footage from a 1996 Congressional hearing in which a former medical claims examiner testifies that she was actually given raises because she was so good at “saving the company money.” This did nothing to assuage her guilt over having denied a life-saving procedure to a man who succumbed to his illness.
Later, Moore visits other countries, including Canada, France, and England to see how their socialized system works. He is startled to discover that no one pays for hospital visits or medications in these countries. (In England, hospitals even reimburse travel expenses for patients.) Emergency room visits require little or no waiting. Nothing has to be pre-approved. Interview subjects laugh in his face when he asks how much their treatments are costing; that’s how foreign the concept is to them. These discoveries make Moore – and us – wonder why things are so complicated in America. For the filmmaker, there is perhaps no more shocking discovery than the fact that Al Queda terror suspects held in Guantanamo Bay are given first-class medical treatment that many American’s don’t receive. He promptly loads up a boat full of Sept. 11 rescue workers – all of whom were denied medical treatment for their service-related illnesses – and storms the shores of “Gitmo” to make a point. He ends up in Cuba, where the 9/11 workers are treated wonderfully by the Cuban health care system.
Of course, no modern filmmaker has been as controversial as Michael Moore. Every film he makes comes with a ready-made controversy, and as soon as he releases a new movie, accusations start flying that he manipulates facts to fit his message. With Sicko, there are already gripes that he has presented an unrealistically rosy portrait of the health care system in other countries. My feelings on Moore are the same as always. What he does is a combination of documentary filmmaking and performance art. He sometimes takes things to an extreme in order to be provocative. Let’s face it – if he wasn’t a little outrageous, his messages would run the risk of going in one ear and out the other. By exaggerating things or executing one of his stunts, he forces everyone (including those inclined to agree with him) to seriously confront their own viewpoints. Quite frankly, I think we need someone to assume the role of provocateur in order to ignite debate. Moore is kind of like a modern-day Jonathan Swift in that regard. Sometimes you have to go to an extreme to really get peoples’ undivided attention. Once inflamed, everyone starts discussing the issue, and that’s where the real change can begin.
Is everything in Sicko completely 100% airtight? Of course not. Our health care companies do many things right, and other things they screw up hopelessly. No company gets everything right or everything wrong all of the time. Moore also faces the same problem that any documentary filmmaker faces: when you turn a camera on other people, you run the risk of changing their behavior. Individuals know they are being filmed, and they doubtlessly put their best foot forward. (Notice how many Cuban doctors are standing around watching one of the 9/11 workers get an MRI.) As for presentation of the facts, this is part and parcel of the documentary genre. Any non-fiction film is made by a director who wants to tell a story. That director shoots a lot of footage and then selects the parts that fit into the story he/she wants to tell. I don’t care if it’s Super Size Me or March of the Penguins or Spellbound or Hoop Dreams - there is going to be a director guiding the story and how it is being told.
It is okay to argue over how facts are presented and to discern whether or not there’s another side to the story. This is part of the discourse Moore wants us to have. However, it would be foolish to get so bogged down in it that you miss the larger truth of Sicko, which is undeniable. The health care system in America is broken, and other countries do seem to have some good ideas that we could adopt.
Watching Sicko is an interesting experience. As always, Moore tempers his message with humor. At the same time, parts of the movie are incredibly sad, other parts make you rage at the unfairness of the system, and still other parts boggle the mind as you wonder how we got ourselves into this mess. The best thing I can say about Sicko, or any Michael Moore film for that matter, is that it demands that you think and feel. You cannot view it passively. At every turn, the movie is challenging your perceptions and opinions on our nation’s health care system. On the surface, the topic sounds pretty dry and esoteric. How amazing that someone like Moore can turn it into a motion picture that millions of people will see, enjoy, and talk about at multiplexes. More than anything, I think this is what he wants. All solutions begin with discussion and analysis. Sicko gets the ball rolling by appealing to all sides of the moviegoer: the intellectual side, the emotional side, and the side that seeks to be entertained.
The problems with our health care system are many and they are multi-systemic. In fact, the scope of the problem is so large that there’s no way to address it from all sides in a two-hour movie. Sicko focuses on one single part of the problem. Are HMOs the sole entity creating the problem? Of course not. But Moore’s point is argued well, and it serves as an outstanding entryway into the national debate…one which I hope our presidential hopefuls will make certain continues.
( out of four)
Sicko is rated PG-13 for brief strong language. The running time is 1 hour and 53 minutes.
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