What would the run-up to a presidential election be like without Michael Moore? His new film, "Sicko," like his last one, "Fahrenheit 9/11," is a very hot button indeed. But the healthcare industry mess that he documents cuts across party lines. He focuses on one segment of the healthcare equation – the health insurance business – leaving aside any substantive discussion of Big Pharma or hospital malfeasance or the nearly 50 million Americans without health insurance.
"Sicko" is essentially divided into two parts. In the first, he offers up a diagnosis of corporate insurance corruption; in the second, he posits a cure for the disease.
We hear from the mother of an 18-month-old baby who, denied emergency room access, died of a seizure. We see the widow of a man who, denied coverage for a medical procedure, died of kidney cancer. The parents of a deaf child are told that insurance will only pay for a cochlear implant in one ear, since a double implant is deemed "experimental." And so on, ad nauseum.
For just about anybody who has had to deal with the health insurance merry-go-round, these stories will seem tragically routine. Moore isn't fomenting anger here; he's simply documenting it. At one point, à la "Star Wars," a list of preexisting conditions for which one can be disqualified for health insurance scrolls into deep space. It appears to include everything but hangnails.
Moore's point here, and it is well documented, is that the health insurance industry is in the business of maximizing profits, a practice often at odds with good healthcare. He shows a well-known clip from Congressional testimony in 1996 by Dr. Linda Peeno, a former medical reviewer for Humana, stating that her job involved denying claims in order to save the company money.
The end result of all this is that, according to Moore, the US has the worst infant-mortality rate in the Western world and ranks 37th – one notch above Slovenia – in global healthcare.
Moore's solution to this crisis, which occupies the second half of the film, is to replace private health insurance with a national universal healthcare system, and he demonstrates the efficacy of this approach by journeying with his camera crew to France, England, Canada, and, yes, Cuba.
His forays into these countries, where he interviews happy-faced patients and expats and caring physicians, does not remotely serve as a controlled study. According to "Sicko," no one waits very long for a medical appointment in Canada, which I'm sure will be news to all the Canadians who are wasting away in waiting rooms. Moore repeatedly refers to the "free" medical care the French receive, as if no heavy taxation were involved. He also doesn't deal with the two-tier medical system that exists in these countries, and the immeasurably quicker treatment one receives if one occupies the upper tier.
The Cuban expedition is the most specious part of the movie. Several sick Americans, including 9/11 rescue workers denied treatment through their insurance companies, arrive with Moore at Havana Hospital and almost immediately are given first-class, high-tech treatment for their ills. Leaving aside the matter of Cuba's history of human rights violations, does it not occur to Moore that his arrival with a camera crew might tip off the Cuban authorities to orchestrate a propaganda moment?
As Dr. Leonel Cordova, a physician who defected from Cuba in 2000, stated recently in The New York Times, party officials and foreigners get the Moore treatment, but for the 11 million ordinary Cubans, hospitals are ill equipped and patients "have to bring their own food, soap, sheets – they have to bring everything."
Barring a middle-class revolt, it's extremely unlikely that, whatever its virtues, universal healthcare could ever take hold in America. Still, I'm glad Moore made his film. It may incite lawmakers in a position to help – at least those who don't feel the need to don windbreakers and baseball caps – to trumpet their faux proletarian credentials. Grade: B+
• Rated PG-13 for brief strong language.