Celebricabinet

There is good news and bad in the proposed selection of Dr. Sanjay Gupta as Surgeon General in an Obama Administration. The good news is that a high-profile choice like Gupta, much bigger and more well-known than any Surgeon General in decades, could begin a new conversation on public health in America, with a great deal of authority. One of the biggest problems with our health care system is that it's a disease care system and not a health care one. Our lifestyles are too sedentary, our diets are too high in fat, our attention is not paid to what goes into and through our bodies. Gupta can have an impact on that. Here's Ezra Klein.

But Gupta is not leaving CNN and Time to give out medals. The surgeon general has an informal role as the country's leading medical and lifestyle educator, and it's that role the Gupta is uniquely positioned to fill. There's not a doctor in this country with half his media training and experience, nor one with a rolodex of editors and reporters a tenth as large.

Expect Gupta to be doing more than health education, though. According to Howard Kurtz, Gupta has negotiated "an expanded role in providing health policy advice." And if he's advising the project, he'll almost certainly be advocating for it, too. Which means Sanjay Gupta, arguably the nation's most trusted health care authority, will back on TV screens arguing for Obama's universal health care plan, lending it his credibility as a doctor, a trusted media presence, and the nation's surgeon general. It's a far cry from the days when Ira Magaziner and Hillary Clinton were reform's best known advocates.

The bad news is that Gupta is at the least an adjunct Villager, and his most controversial moment in recent years consisted of shouting down Michael Moore, mainly because he was Michael Moore. It was unpersuasive and abrasive, and does not portend well.

You don’t have to like Moore or his film; but Gupta specifically claimed that Moore “fudged his facts”, when the truth was that on every one of the allegedly fudged facts, Moore was actually right and CNN was wrong.

What bothered me about the incident was that it was what Digby would call Village behavior: Moore is an outsider, he’s uncouth, so he gets smeared as unreliable even though he actually got it right. It’s sort of a minor-league version of the way people who pointed out in real time that Bush was misleading us into war are to this day considered less “serious” than people who waited until it was fashionable to reach that conclusion.

Gupta's role on Obama's health care bill will probably be just to publicly elucidate the policy. But if he treats it with the same disrespect for the facts, that would not help the cause. Stick to lifestyle reports, Sanjay.

Accuracy Watch

It somewhat annoys me that Michael Moore is practically the only filmmaker or political writer that elicits a spate of fact-checking stories. How come there's never a "Actually, everything Sean Hannity says is bullshit" expose on CNN or in a magazine? But Moore apparently passed the test, although the word "mostly" had to be squeezed into the assessment of SiCKO as "accurate" for the sake of balance.

Moore covers a lot of ground. Our team investigated some of the claims put forth in his film. We found that his numbers were mostly right, but his arguments could use a little more context. As we dug deep to uncover the numbers, we found surprisingly few inaccuracies in the film. In fact, most pundits or health-care experts we spoke to spent more time on errors of omission rather than disputing the actual claims in the film.

Sorry that a two-hour film didn't have the context that would normally be required of a 1,000-page research paper. How about somebody checks if CNN puts things in the proper context?

It's just truly infuriating to have to go through this "shockingly, Michael Moore isn't lying" nonsense every single time.

A Couple Other Things About SiCKO

• Michael Moore has affected this sing-songy voiceover delivery somewhere along the line. He sounded like a normal person in Roger & Me, for example, but in this film he too often sounds like he's delivering a nusery rhyme. I think there was a point to the technique in Fahrenheit 9-11, like he was talking in the manner of George Bush or something, but now it just annoys.

• There's a real rousing sequence from the British Labour stalwart Tony Benn, where he talks about how societies that are demoralized are easily controlled. I do think that's a key feature of the way political power manifests itself in this country, where far too many people don't vote because they don't feel like it makes any difference. Indeed, political consultants have a vested interest in keeping voter turnout low and confined, so the electorate is knowable. In other words, politicians have a directive NOT to inspire.

• In the production notes, Moore laments that John Edwards' health care plan "gives tax dollars to private insurers." I think that's a gross misreading. In fact, Edwards would regulate the insurance industry through guaranteed issue (allowing anyone to sign up for insurance regardless of pre-existing conditions), and would use tax dollars to build a public system that could compete with the private for-profit system in the free market (and it would win, because it wouldn't have any fealty to shareholders).

OK, that's it.

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.

SiCKO Sicking Out The Insurance Industry

There are a lot of reviews on the Web about SiCKO, Michael Moore's newest film about the health care industry. Maybe it's because a lot of what I watch are the news shows, but the ads seem to be ubiquitous and the movie is two weeks from wide release. And Moore barnstormed through Sacramento this week, trying to leverage the message of the film into meaningful legislation on reforming the broken health care system, both in California and across the nation.

So it's no wonder that this film is seen as a 800-megaton bomb among the gatekeepers who want to maintain the health care status quo.

Fans of Michael Moore's movies aren't the only ones eagerly awaiting the release of "Sicko." The U.S. health-care industry has the film's late-June premiere circled on its calendar as well.

For-profit providers of health care are the controversial and award-winning filmmaker's latest target.

"I don't think Michael Moore set out to make a balanced movie," said Karen Ignagni, president America's Health Insurance Plans, a trade group. "He set out to make a movie about government-run systems and imposing them on the United States as the solution to the health-care crisis."

This is the kind of rhetoric that could only come from a frightened interest group. There's no way that an industry with a vested interest in keeping things exactly the same is going to be balanced either, nor are they going to see a recitation of the facts about the broken system as balanced, either. So the trades have no choice but to go on the offensive, and attack Moore instead of defending what everyone knows is a crime in health care.

Industry concerns have also been aired in public. Managed-health-care provider Amerigroup Corp.'s chairman and chief executive, Jeff McWaters, in his remarks at a recent investment-banking conference, listed the film's coming release among the "headline risks" for the industry overall.

The trade group that represents the drug industry, Pharmaceutical Research and Manufacturers of America, issued a statement last month deriding both the movie and Moore himself.

"A review of America's health care system should be balanced, thoughtful and well-researched to pin down what works and what needs to be improved. You won't get that from Michael Moore," the group's senior vice president, Ken Johnson, was quoted as saying. Johnson also called Moore a "political activist with a track record for sensationalism."

Moore "has no intention of being fair and balanced," Johnson said.

Neither do insurers, because for them, it's a matter of survival.

Michael Moore is not always the best vehicle for this kind of issue-based advocacy. He makes his points with a blunt instrument that elides the complexities and smooths over the rough patches (like health care in Cuba, for example). But he's dead-on right when he says this, and it's why the insurers are scared to death:

Nonpartisan or not, though, Moore is hoping the film will have a significant impact. "I'm hoping that the candidates will come forth with plans that provide true universal health coverage, free of charge, to every American, and plans that eliminate the private health-insurance industry," he said.

He also hopes, he said, that the film sparks a movement "to eliminate private, profit-making health-insurance companies.

"There's absolutely no room for them in this country," he said.

I don't think this will happen overnight, and welcome solutions that move us in that direction, like John Edwards' plan to put public and private plans in competition and mount studies to remove patents for breakthrough drugs that make the pharmaceutical industry billions. But ultimately, this is the answer that works in every industrialized nation on Earth, and it can work here.

Moore the Single Payer

Jim Kenefick is one of the several making a cottage industry out of hating Michael Moore. He runs Moorewatch.com, so his entire life (online at least) is consumed with the award-winning director.

Well, take a look at this story and see how it clearly illustrates the difference between liberals and conservatives.

Filmmaker Michael Moore has come to the rescue of his harshest critic.

For several years now, Jim Kenefick has been railing against the Oscar-winning director on Moorewatch.com. Recently, Kenefick wrote about the difficulty he was having paying his wife's medical bills. Fellow conservatives guided him toward a cheaper health insurer, but Kenefick said he still had trouble making payments.

"Someone e-mailed me and asked if an 'anonymous' benefactor could offer to pay my first year's premiums - $12,000," Kenefick wrote on his site.

He was skeptical when the check arrived. "I opened a whole new account at my bank, waited for it to clear, checked twice with bank personnel to make sure it wasn't a scam, and waited a full 60 days before spending the money. At that time, I started drawing on it and paying the monthly premiums until it was gone."

We can now confirm to Kenefick that his secret benefactor is none other than the dreaded, detestable, loathsome Michael Moore.

What conservative friends of Kenefick's were willing to do was give him some other options and say "pay the man." YOYO - You're on your own - is the guiding principle there. Not so for Moore.

Moore didn't contact us. We heard it on our own. Yesterday, his reps said they couldn't reach the director, who is in France getting ready for tomorrow's screening at Cannes of his new movie, "Sicko."

One friend of Moore's did say, "We sure are happy Jim's wife received the care she needed."

Kenefick admitted the $12,000 "was like manna from heaven at that time. ... My business was almost dead, my wife was very, very ill, and I was racking up a few little health problems of my own. That money made it possible for us to begin to turn our lives around."

My thoughts about Michael Moore are somewhat conflicted, but there's no doubt that he cannot be beat when it comes to these kinds of matters. A vociferous critic of his was struggling with a problem that is the subject of his next movie. What better way to show how a more rational health care system can lift people up and give them the ability to succeed that to do this? It might be used in the movie, it might not. But it doesn't matter; it's illustrative of his entire point while also being completely disarming.

But get this, Kenefick still isn't happy with Moore.

Having suspected Moore might be his secret patron, he contends that his bete noir made the gift just to publicize "Sicko," which takes aim at America's health-care system and, we've heard, touches upon Moore's covert generosity.

"I knew he was using me," said Kenefick. "Moore is going to try to make me into one of his little puppets."

Kenefick wants it known that "I'm not an idiot. I know when to say yes to something, even if the string attached is obvious. What kind of moron turns down a free 12 grand?"

Does this sound completely bogus to you, or does Kenefick just have Moore on the brain all the time that he would naturally assume that he was the benefactor? And should I admire Kenefick for the fact that his appreciation cannot be bought, or should I consider him maybe the most ungrateful person of all time?

Either way, Moore has done it again. And there's a larger point. A society that's not constantly fretting about how to pay for medical bills is a BETTER SOCIETY, and the "magic benefactor" can easily be a single-payer system that would cost less than we pay for health care now, and provide better quality service. Moore is a genius at finding real-world ways to illustrate his point of view. This is an excellent example.

(h/t Filmick)