Friday, August 19, 2011

Sicko (2007)

USA, 123 minutes, documentary
Director/writer: Michael Moore
Photography: Andrew Black, Daniel Marracino
Editors: Geoffrey Richman, Chris Seward, Dan Swietlik

It probably didn't hurt that I got around to seeing this the first time only days after the passage of the health care reform bill last year, when it was still possible to believe, or hope, that the travesties documented by Moore's film might finally be on the wane. To be sure, some of the most grotesque of them have been eliminated, such as preexisting condition clauses. But as more information emerges about the particulars of the reforms—more usefully thought of as health insurance rather than health care reforms, though there's little question the insurance reforms at least have been badly needed—and getting them implemented, along with the super-toxic political environment now in play, likely mitigates a good deal of that.

Sadly enough, Sicko is almost certainly still as relevant as the day it was released, now and into the foreseeable future. One of Moore's shrewdest strategies here is to place his primary focus not on the uninsured, which for so long dominated the public health care debate, but rather on those with health insurance, who blithely believe with the masses of insured people that they are personally backstopped in the event of setbacks and calamities to their health.

Moore makes quite clear that that is almost certainly misplaced faith. I've still got a pretty strong sense that Sicko qualifies overall as Michael Moore's best. It's the most restrained and thus the most effective, and he's got his hands on a real live issue of life and death for most Americans. It's heartening to see how assured his filmmaking has become. For the most part the tone remains admirably low-key here, almost somber. It opens the space nicely for the one prank Moore does play, enabling it to become a genuine and unforgettable knockout punch.

I feel constrained to mention Moore's reputation for playing fast and loose with facts, and equally constrained to point out that most of those making the charges are self-declared political enemies with little credibility themselves, the same kind of people who routinely set out to destroy, for example, Al Gore. I concede that Michael Moore is fat.

Perhaps I'm inclined to miss it, perhaps Moore is working a kind of sleight of hand here by keeping the focus so resolutely on the experiences of people with whom it's very easy to identify, but it's hard for me to see the distortion here. Some of the people interviewed, and with amazing stories, include former employees within the health insurance industry, speaking with varying degrees of regret about the things they have seen and done. The stories from people denied care by the insurance companies are heartbreaking and infuriating, fostering a deeply paralyzing sense of helplessness. It feels real because so much of it corresponds with experiences I know of personally, both among friends and family and my own as well.

Every time Moore parrots right-wing talking points about government interference in health care, I found it remarkably easy to substitute "insurance company" for "government." How is it credible, for example, particularly as one gets to real-life experiences, to believe that an insurance company bureaucracy is somehow more enlightened or effective than government bureaucracy? Or that insurance company "death panels" (to borrow the term of art more often applied to government), directing doctors and other providers on what care they can and cannot provide, are somehow more compassionate than government mandates for patients to have living wills?

It's more than clear at this point that insurance companies are efficient at one thing and one thing only—maximizing profits. Which does not necessarily involve delivering quality health care. Moore exposes that in devastating fashion here, calmly going at it point by point. As he roams the world patiently talking to both medical patients and health care professionals, including doctors, about the state of health care in their countries, plying them with right-wing talking points, questioning the efficacies of socialized medicine and who's really paying the bills and who's really making the life and death decisions and who's really telling the doctors what they can and cannot do, traveling to Canada, the UK, France, and finally Cuba, a picture is gradually drawn, one that only becomes more stark as he loads in the statistics.

It's not flattering to the state of health care in the United States. In fact, it's downright depressing. As the lies of the right-wing opponents of a reasonable public health care policy are stacked up and exposed, and as the penetration of those lies into one's own consciousness is grasped in the realization of how deeply we have all been duped, even viewers already predisposed to Moore's position, the picture comes into a very sharp focus.

Then the prank, and it's a good one. Moore finds a handful of volunteer 9/11 workers and other victims of the health insurance industry who are literally very sick and at risk of dying, in desperate need of care but with absolutely no resources left to them. He puts them on a boat—a fleet of boats as it turns out, because he has found so many of them—and he takes them to the Guantanamo Bay prison facility that houses "enemy combatants" imprisoned without any niceties of legal procedure—Gitmo—because Moore has learned via public congressional testimony that those prisoners are all afforded first-rate health care. Of course he and his group is turned away—how he even managed to get there is excised from the picture evidently by requirement of the Dept. of Homeland Security. Moore's next move is to take them to Cuba, where they receive the care they so desperately need.

It's not hard to see the easy propaganda political points getting being scored on so many sides here: by Moore, by the Cuban government, among others. Yet the plight of the 9/11 rescue workers did not appear to be any less critical for all that, their inability to access American health care seemed plausible, and Cuba gives them the care they need.

Then, in what seems less propaganda and more genuine (and thus has the likelihood of being the more propagandist), one of the picture's most powerful moments: Cuban firefighters ask to meet the 9/11 rescue workers to honor them for their work and effort and service. It's a beautiful, unforgettable scene. And incidentally it provides hope on a very late note, where so little otherwise exists here, that maybe, if we try hard enough, we can get these issues sorted out right and resolved one of these days.


  1. All good points. And I especially appreciate your optimistic conclusion. I would like to think so because the inaction in this area is mind-boggling to me. I mean, what are the arguments against reform, a single-payer system, medicare-for-all, other than bogey words like socialism and big government? As if the latter, as you point out, could possibly be more unaccountable than big health insurance corporations. And, which face it, are the only thing in the way of meaningful reform, not the democratic electorate, but the health insurance industry. (Same imbalance applies in relation to financial reforms.) For me, the problem isn't so much finding a solution to a health care problem but how do we put corporate power in its place and get it out of the way of common sense public policy reform.

  2. That's how I see it too, a matter of controlling the corporations. How that's done is sadly anybody's guess. Thanks as always for your great comments!