Sicko

Review

On June 29, two momentous films will open nationwide: Sicko, which will radically alter your perspective on health care in this country; and Ratatouille, which will radically alter your perspective on rats in the kitchen. A cynic would say there’s a better chance of a rodent’s becoming a professional chef than America’s getting universal health care—but that would underestimate the big, bellicose rat at the center of Sicko.

Michael Moore is a polarizing figure, by which I mean he polarizes me. He’s a blowhard and a national treasure. His methods are suspect, yet his work is indispensable. Think of him as a Shakespearean fool—a court jester—with the slashing fury of a crusader. When the counterculture imploded in the late seventies, the left lost its sense of humor, and tools like Rush Limbaugh learned to appropriate its prankster spirit. (The Republicans reinterpreted speaking truth to power as razzing feminists and the liberal media.) At the height of Reagan/Bush I torpor, Moore’s Roger & Me reclaimed the left’s antic legacy. But there were questions: Was Moore using his camera to bludgeon ordinary people? Did he fudge the chronology? Yes and yes. The oaf was always undermining his own credibility. I tsk-tsked when he turned his 2003 Oscar win into an occasion for grandstanding about the invasion of Iraq: He had a point, but did he have to be so shrill? Yet in the end, he shamed many of us when he called Iraq a “war for fictitious reasons.” No one had put it more succinctly. Why didn’t we rise up?

Maybe we will this time. Sicko is Moore’s best film: a documentary that mixes outrage, hope, and gonzo stunts in the right proportions; that poses profound questions about the connection between health care and work; and that throws an unforgiving spotlight on what is, in both senses, the elephant in the room. The Bush administration was able to stonewall in the face of Fahrenheit 9/11, but this film will hit the working class—even the Republican working class—in the kidneys with a large stick. Who can’t relate to this movie?

Who hasn’t been flabbergasted by an insurer’s denial of payment? You could find millions of anecdotes—and Moore, good sensationalist that he is, comes up with doozies. Some are ghoulishly amusing: a guy who gets two fingers cut off but doesn’t have the coverage to have them both reattached is given a choice between his ring finger ($12,000) and his middle finger ($60,000). (Figuratively speaking, Moore gives the insurance company that middle finger.) A woman who is rushed semiconscious to the hospital after a head-on collision—and denied reimbursement for the ambulance ride on the grounds that it wasn’t preapproved. A little girl going deaf qualifies for an implant in one ear but not both, until her father threatens to contact Moore and the company calls back saying, “Good news!” Everyone—Moore, the dad, the audience—has a good chuckle over that.

But the laughter is short-lived: Moore works his way from the absurd to the poignant (a retired couple loses their home after multiple heart attacks and cancer) to the tragic. Insurance companies deny claims (because, say, a malignant tumor is not deemed life-threatening), and patients die before the appeals process runs its course, leaving behind stricken spouses and children. It’s hard to keep from weeping when a mother tells the story of how Kaiser Permanente wouldn’t let her little girl—who couldn’t breathe—receive treatment at a hospital that wasn’t one of theirs. She didn’t make it to one of theirs.

Kaiser Permanente emerges as the supervillain, if only because of an astounding 1971 Oval Office recording. On the tape, John Ehrlichman convinces a dubious (or drunk) Richard Nixon to go along with Edgar Kaiser’s scheme to create a for-profit managed-care system on the grounds that hospitals would have incentives to give less care. That’s how the current health-care system all began. Really, Moore didn’t need to do much besides shine a light on these scoundrels: people like ex-congressman Billy Tauzin, who proclaims, his voice quavering, that he loves his mother, he loves that old woman, and that’s why the Congress must pass a senior-citizens drug bill. Once Congress does, Billy Tauzin leaves to make millions lobbying for drug companies. A repentant former HMO bigwig, Linda Peeno, explains to Congress that she owes her success to denying a procedure to a man who could have been saved. Every time you pay out, it’s a loss. “You’re not slipping through the cracks,” says an ex-employee, tearfully. “Somebody made that crack and swept you into it.”

Stories this potent don’t need whacking emphasis, and Moore employs his sorrowful persona: sympathy for the neglected, befuddlement over why, why, why this has to be. The second half of Sicko is a travelogue; our reporter shambles up to Canada and over to the U.K. and France to see how people bear under national health care—the dreaded “socialized medicine.” (Moore has great fun with clips of a lusty Soviet agrarian musical.) He asks a Canadian how much a procedure set him back and receives a look of incredulity. Money? Where’s the billing office in this English hospital? Billing office? For what? How can you French people afford to have kids with all these taxes? Oh, the government gives us six months paid maternity leave and a nanny to help with diapers. Moore overdoes the slack-jawed-wonderment thing, but the differences are uncanny. He’s in riskier territory when he whisks some folks—among them hobbled ground-zero volunteers denied government assistance—off to Guantánamo (because its defenders boast of its superior medical care) and (failing to gain entrance) to Havana. It is astounding that in Cuba you can pay a nickel for an inhaler that goes for $120 90 miles north. One suspects, however, that there are trade-offs in the area of civil liberties.

The larger issue in Sicko transcends medicine. Moore argues that Americans take dead-end jobs for health insurance, then stay in them because employers have them over a barrel. He says if you transform health care, you’ll remake society for the better. Of course, powerful people are willing to pay through the nose to make sure that particular theory never gets tested. Moore doesn’t mention one of my favorite TV shows, House, which is regarded in some quarters as daringly frank because its physician protagonist (the incomparable Hugh Laurie) uses painkillers indiscriminately and insults people. But does that man run tests! In an instant, he and his team of residents will suit up and perform a cat scan or open someone’s bowel or do exploratory neurosurgery (they’re very versatile)—anything to solve some pesky medical mystery. Given the realities of managed care, House might be our culture’s most powerful opiate. After Sicko, how can we watch it the same way? How can we let our politicians feed us sugar pills?  — David Edelstein

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