A Canadian's point of view re: U.S. healthcare

Moore’s right: U.S. system sick

ChronicleHerald.ca, July 15, 2007
SILVER DONALD CAMERON

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["But Moore is not out to make an intellectually gratifying film, or even a superlative work of] documentary art. He is out to spark change, which is driven not by intellect but by emotion. If Sicko’s emotional power improves the lives of millions of deprived Americans, Moore’s achievement will dwarf the Oscar he has already won."

MICHAEL MOORE is that rarest of rarities — an uncompromising leftist who is extraordinarily entertaining and funny. And wealthy. Asked recently how he felt about being a multi-millionaire, he declared, "You know why I’m a multimillionaire? ’Cause multi-millions like what I do."

They do — and Moore’s current film, Sicko, perfectly fits Abraham Lincoln’s sage observation that "people who like this sort of thing will find this the sort of thing that they like." Conversely, people who do not like this sort of thing will find Sicko the sort of thing that they do not like. What’s most striking about reactions to Sicko is the way the reactions reflect the people who are doing the reacting.

The film is about the awful mess that is health care in the United States. That phrasing already tells you what I think — that health care, like defence, policing, education and diplomacy, should be provided by government from tax revenues. Is Sicko the kind of thing a person like me would like? Absolutely.

In the U.S. system of for-profit health care, 40 or 50 million Americans have no health insurance at all. (The usual figure is 40 million; Moore says 50; Kurt Loder of MTV, one of Moore’s more trenchant critics, says 47 million. In any case, it’s roughly the population of England.) As Sicko opens, a man with no health insurance is stitching up an ugly gash in his own knee. Moore then announces his film is not about those who have no coverage, but about those who do.

And those who are "covered" turn out to be almost as badly off as those who are not. A baby dies because her mother takes her to a hospital not approved by their Health Management Organization. A 22-year-old woman is denied coverage for ovarian cancer because she is "too young" to have that disease. A bone-marrow transplant is denied as being "experimental."

An HMO executive, a physician herself, does a heartfelt mea culpa for her role in denying, denying, denying. But that’s what the HMOs reward. HMOs are for-profit corporations. The less they pay in benefits, the more they keep in profits.

Is there a better way to do health care? Of course there is. In some respects, the United States is a parallel reality, resembling the normal world but warped like light in a prism.

Everyone else in the industrialized world has figured out a superior way to provide health care. It’s called medicare.

So Moore visits Canada, Britain and France, and finds that medicare is the sort of thing that he likes. And, in a brilliant rhetorical flourish, he finds some 9-11 rescue workers whose health has been ruined by their work at Ground Zero. They were once hailed as heroes. Now they’re bankrupt and coughing their lungs out. They can’t get decent health care. And nobody cares.

But their enemies — the alleged terrorists interned at Guantanamo Bay — have first-rate free health care. So Moore assembles a flotilla of small boats and takes his 9-11 heroes to Guantanamo, demanding similar care. When that fails, he takes them to a Cuban hospital, where they receive excellent care at minimal cost, a propaganda coup for both Moore and the Cubans.

But Moore fails to note the defects of medicare, like waiting lists, and that gets him into trouble with the critics.

Kurt Loder, for instance, notes that when "governments attempt to regulate the balance between a limited supply of health care and an unlimited demand for it, they’re inevitably forced to ration treatment."

Well, sure, limited supply and unlimited demand does indeed mean that health care must be rationed, and not just in countries with medicare. The U.S. also rations health care, but it does so on the basis of your ability to pay, and to get your claim past the guard dogs at the HMOs. Is that more democratic, more moral, more just?

Loder finds Sicko "breathtakingly meretricious," and scorns the idea of handing over health to "the same government that’s already given us the U.S. Postal Service and the Department of Motor Vehicles." But it is equally meretricious to pretend that progressive governments run the medical system. They don’t. They just provide health insurance. And yes, they certainly influence the medical system, but so do the HMOs and the pharmaceutical companies in the U.S.

Vancouver blogger Darren Barefoot rightly notes that too many critics miss Moore’s point about U.S. healthcare by obsessing over his portrait of Cuba. But Barefoot also describes Sicko as "an emotionally compelling film, but not necessarily an intellectually gratifying one."

Perhaps. But Moore is not out to make an intellectually gratifying film, or even a superlative work of documentary art. He is out to spark change, which is driven not by intellect but by emotion. If Sicko’s emotional power improves the lives of millions of deprived Americans, Moore’s achievement will dwarf the Oscar he has already won.

Everyone else in the industrialized world has figured out a superior way to provide health care. It’s called medicare.