Monday, July 2, 2007

Movie Review - Sicko

To begin with the end is probably the best way to approach the evaluation of any movie from filmmaker Michael Moore. That's because this propagandist is amazingly skilled at ending each of his films with something that no reasonable person could, or should, argue against. As you and the rest of the audience are drawn into spontaneous applause, as the credits roll, you forget the skillful nature he used to cherry pick facts which were convenient for his position and completely ignore any that suggest the bigger picture might just be, well, bigger.

It is indeed true, as the film suggests at the end, that it is sad, sickening and outrageous that rescue workers from 9/11 are able to get health care by going to Cuba but are apparently unable to get that care in the US. This stinks. It's bad. We should all hang our heads in collective shame about it.

As we back up, the premise of the film is clearly "Universal Health Care can do no wrong." To prove this, we first find a couple of Americans who were denied coverage for major trauma incidents: one who lost two fingers and had to pick which one he could afford to reattach and another who was denied coverage for an unconscious ambulance ride to the hospital because it wasn't pre-approved. Next, off to Canada we go where birds chirp merrily as every person is given the best medical care in the world, and with faster service than Moore receives at a fast food drive-through.

From Moore's account, the Canadian health care system is infallible and no one is ever left wanting.

Never mind the fact that I personally know more than one person who has had to leave Canada to get the surgery they need in America.

Also ignored is the fact that the medical devices we see used by the perfect health care systems of Canada, the UK, France and Cuba were mostly invented under the evil free-market system of the United States.

Shame on us for making life saving equipment. Will the evils of profit-minded researchers never end?

Yes, it's pretty hard to argue against the thought that all insurance programs are run by unholy hell spawn and Moore is very careful to spend most of his efforts bashing the system and not the individual caregivers. In fact, doctors are completely untouched in this film. Moore is after the insurance companies. After all, in the US we pay for our insurance and health care, but in these other countries it is "totally free."

I'll skip the Economics 101 lesson about what "free" means in this context.

No mention is made of prevention, diet or any "wellness" approaches to good health. Judging by Moore's own "healthy weight" it's pretty clear that he views health as something the doctor is supposed to care for only after you've fallen ill.

Another thought not covered by Sicko, but something Moore probably has no concern about anyway, is how Universal Health Care would be implemented in the US. In the 1950s, the AMA ran anti-socialized medicine campaigns and claimed it was the ultimate attack on freedom and a huge win for communism. But who would actually get the power with UHC? Universal Health Care is about guaranteed health care and is specifically not about freedom to affordable health care and choices for the type of care you receive. Would UHC simply make the American Medical Association into the total monopoly they wanted to become in 1847 when the AMA candidly told Congress that their intent was to drive away competition in the healing arts and raise the pay of the doctors who swore allegiance to the AMA?

Moore even compares UHC to the "utopia" of the US Post Office and the Public School System.

Wow, why didn't he include the DMV in that list to really give us confidence in the bureaucratic efficiency of this system?

There's no doubt that the richest and most powerful nation in the world should be able to provide care for the least rich and least powerful among us. This rational thought is the siren song that makes this film hard to argue with once you've been mesmerized by the finale. However, the aspects of Sicko which clearly make this a film and in no way a documentary is what is most damaging to the possibility of open dialog over such an issue.

The US sickness care system has problems. It has huge problems. Over 90 million suffer from chronic disease for which the "one drug for every symptom" approach of Western Medicine is a dismal failure. The World Health Organization has ranked the US 37th in overall wellness in the world and that's in spite of being the number one in per capita spending. If that kind of money can't provide care to all those who need it, there's a problem. However Moore would have you believe that the solution is a finger snap away and that the same application of a failed sickness-based paradigm will work just because it's "universal."

1 comment:

Neil LaChapelle said...

Keep backing up, because there are lots of ways to lose sight of the bigger picture. Keep your eyes on the economic and administrative challenges of this problem, by all means, but keep pulling back to bring an additional thought into the picture. Americans abandon their own citizens to struggle and die un/under-treated, and this costs them proportionately more than other nations, where citizens help each other through 'inefficient' state mechanisms.

This may not be an argument for socialized medicine, but it should at least open the question. You have already defined a position based on economic *concepts*, but economic *facts* about international health care do not give unequivocal support for *any* position. This problem can be taken for granted as solved by an ideology or economic preconceptions. Maybe the neoliberal economics we have been swallowing for the past few decades is wrong! Hard facts regarding human bodies, alive vs. dead, healthy vs. diseased, *should* carry more weight in our minds then the currently dominant way we understand economics.