SiCKO To My Stomach-O

I spent a good portion of the day at a screening of Michael Moore's SiCKO (finally, this blogging thing gets me a perk!). It's definitely going to get this country talking. One thing I always say about the health care debate is that you cannot easily fool the country into thinking it's going well. Unlike Iraq, which only is happening in news reports and doesn't impact the lives of anyone without a family member or friend over there, everyone in this country has participated in the giant ball of crap that is our health care system. And so the horror stories Moore collects will be quite familiar.

The film's genesis is from a segment on Moore's old show The Awful Truth, when he held a mock funeral out in front of an HMO for a man who was denied an organ transplant. Actually there are almost no confrontations like that in this film. Yet Moore is ever-present, more visible than in Fahrenheit 9/11, despite the fact that many of these stories tell themselves. Yet there is a raw power in hearing from regular people run down by a for-profit health care system that values the bottom line over human life. A lot of the tales are familiar - Blue Cross of California retroactively cancelling anyone who dares to use their insurance coverage for treatment; LA-area hospitals dumping homeless people who couldn't afford to pay their bills at Skid Row in front of social services centers; 9/11 rescue workers contracting respiratory illnesses and having trouble collecting any benefits from the city. There's not much about the drug companies, surprisingly, and little about the value of preventative care. But the fact that we have a broken health care system does shine through. In fact, Moore plays this amazing clip from the Nixon tapes about the origins of the HMO system that almost reads like a parody:

John D. Ehrlichman: “On the … on the health business …”

President Nixon: “Yeah.”

Ehrlichman: “… we have now narrowed down the vice president’s problems on this thing to one issue and that is whether we should include these health maintenance organizations like Edgar Kaiser’s Permanente thing. The vice president just cannot see it. We tried 15 ways from Friday to explain it to him and then help him to understand it. He finally says, ‘Well, I don’t think they’ll work, but if the President thinks it’s a good idea, I’ll support him a hundred percent.’”

President Nixon: “Well, what’s … what’s the judgment?”

Ehrlichman: “Well, everybody else’s judgment very strongly is that we go with it.”

President Nixon: “All right.”

Ehrlichman: “And, uh, uh, he’s the one holdout that we have in the whole office.”

President Nixon: “Say that I … I … I’d tell him I have doubts about it, but I think that it’s, uh, now let me ask you, now you give me your judgment. You know I’m not to keen on any of these damn medical programs.”

Ehrlichman: “This, uh, let me, let me tell you how I am …”

President Nixon: [Unclear.]

Ehrlichman: “This … this is a …”

President Nixon: “I don’t [unclear] …”

Ehrlichman: “… private enterprise one.”

President Nixon: “Well, that appeals to me.”

Ehrlichman: “Edgar Kaiser is running his Permanente deal for profit. And the reason that he can … the reason he can do it … I had Edgar Kaiser come in … talk to me about this and I went into it in some depth. All the incentives are toward less medical care, because …”

President Nixon: [Unclear.]

Ehrlichman: “… the less care they give them, the more money they make.”

President Nixon: “Fine.” [Unclear.]

Ehrlichman: [Unclear] “… and the incentives run the right way.”

President Nixon: “Not bad.”

Stunning.

When Moore visits other countries (Canada, England, France, Cuba) to look at their not-for-profit systems, the film is on slightly shakier footing. It was a little odd to see a few minutes of the likes of Bill Frist and Duncan Hunter extolling the great medical care at Guantanamo for detainees (I guess they need it after a full day's torturin'). I understand why he did it, to play on their field and say "Why do we have this great care for Al Qaeda but not for these 9/11 heroes," but it didn't ring true. It also was strange to end the film with this portrait of the great Cuban health care system, when in a graphic earlier in the film of the top countries at delivering health care (the US is 37th), Cuba is BELOW the United States. The stuff with the expats in France, who seemed to be trying to one-up each other ("We get free laundry! We get 10 weeks off! No, 13!") looked odd as well. But there was a great truth in there, where a woman says "In France, the government is afraid of the people, but in America the people are afraid of the government."

This is very true. And the final message of the film, that we are all in this together, that we must think in terms of "We not me" and care for our fellow man, is in the spirit of the common good that underlies most of the progressive movement. Moore tells his tales with a blunt instrument, and yes, he blurs the edges a bit. But not everyone is going to sit and read the 300-page report that underscores the failed health care system in America and the need to adopt a better plan similar to those abroad. We do need to see health care as a basic human right, enshrined in the Declaration of Independence as something that is inalienable, and work to provide it to all of our citizens no matter what. And I think this film will inspire discussion along those lines.