Ask Americans what they think about health care and you’re bound to get conflicting answers. On the one hand, polls show that the country is broadly dissatisfied with the cost and administration of the current system and find qualified support for universal health insurance. On the other hand, Americans overwhelmingly reject the reduced choice in doctors and treatments, as well as the waiting lists and rationed care that are the attendant features of the socialized “universal” model. There is, it seems, no simple cure for the system’s ills.
Step forward Michael Moore. In each succeeding venture, Hollywood’s favorite guerilla documentarian has managed to reduce politically fraught issues like gun ownership (Bowling for Columbine), and the war on terror (Fahrenheit 911) to intellectually shallow agitprop that revels in naming enemies -- it’s the NRA’s fault!; it’s the Bush administration’s fault! -- while offering little in the way of substantive argument. As entertainment, Moore’s films are watchable; as political commentary, they are often execrable (recall the kite-flying children in supposedly serene Saddam-era Iraq from Fahrenheit).
Sicko follows this familiar script. Rather than confront the complexities of the healthcare debate, the film settles on a culprit -- it’s the insurance companies’ fault! -- and presents a simplistic, mendacious and deeply disingenuous paean to government-run healthcare.
Emotional exploitation is Moore’s specialty. In Sicko the effect is achieved by presenting human-interest stories devoid of any context or mitigating factual evidence. Sympathy, not the hard work of reasoning through the merits of what a government-run system would entail, is required of the viewer.
Accordingly, we meet a husband and wife -- he with serial heart problems, she a recovering cancer patient -- forced to move in with their children after being bankrupted by medical co-pays. Following them is an inspiringly good-natured gentleman who recounts his Hobson’s choice of being forced to decide between reattaching his ring finger for $12,000 or his middle finger for $60,000 after accidentally loosing them to a table saw. (A romantic at heart, Moore informs us, he chooses the ring finger.) And there is the tearful widow who blames an insurance company for denying her late husband a possibly life-saving bone-marrow transplant. It would take a stone-hearted misanthrope to remain unmoved by this cast of unfortunates.
Never an enemy of excess, Moore has more. Lest anyone doubt the unmitigated evil of the insurance companies, Moore parades before the camera several former medical screeners eager to expiate for their sin of denying the claims of patients seeking coverage. One reveals with unconcealed horror that the intent of these companies is “to maximize profit,” and insists that he has to “atone for that mess.” For good measure, Moore deadpans that insurance companies make “obscene profits.”
What have we learned from all this? Very little, save that medical care is often disconcertingly expensive and that insurance companies, in common with all businesses everywhere, need to make money. Yet, unless we are predisposed to agree with him, we are no more convinced of Moore’s claim that what the country urgently needs is single-payer health care. After all, that would simply shift the burden of providing coverage from private companies to the government. And who can credibly say that government bureaucrats will succeed where businesses struggle?
Moore’s answer: Canada can. Turning his lens on the national healthcare system of our northern neighbors, as well as the government-run systems in Britain and France, Moore suggests that the healthcare they provide is “free,” efficient and effective. Not only that but these systems actually increase longevity: “It turns out that Canadians live three years longer than we do,” Moore cheerfully reports. Who can argue with that? As it happens, many. For in his extended advertisement for government-provided insurance, Moore leaves lacunas large enough to drive an ambulance through.
Consider Canada. Moore deflects a popular knock against the Canadian system -- long waiting times for elective surgery -- as so much political propaganda. But that fails to explain why thousands of Canadians, wait-listed for surgical procedures, every year check into American hospitals to get the care they need. Just last week, the president of the Canadian Medical Association blasted the country’s political leaders as hypocrites for publicly singing the praises of the government system while seeking care in private medical clinics. The “public system needs the support of the private sector,” he concluded. As for life expectancy, medical experts agree that this is less a testament to the success of universal health care than a measure of external factors -- such as rates of violent crime, poverty, obesity, and drug use -- disconnected from specific healthcare systems.
Equally unconvincing is Moore’s celebration of the British National Heath Service. Affecting a faux-naiveté, Moore marches about London’s Hammersmith Hospital, where he earns puzzled looks from patients by asking them where they go to pay for their health care. At last locating a cashier in the hospital, Moore discovers that its purpose is not to charge patients but to reimburse them for transportation home. It’s all free, don’t you see?
Only it isn’t. Contra Moore, there really is no such thing as a free lunch -- or free healthcare. Lack of funds, in fact, is a central reason why the National Health Service is annually mired in debt. A 2006 audit, for instance, conservatively estimated that the system had a nearly $700 million budget deficit. Most inconveniently for Moore, the single largest deficit was posted by none other Hammersmith Hospital. Additional blunders abound. Moore makes much of a British doctor whose Audi sedan and million-dollar salary he considers proof that government healthcare is no less rewarding than a private alternative. But the inconvenient truth is that the NHS has a notoriously difficult time attracting doctors, who prefer private practice to an ill-recompensed post in the government system. It turns out that a “free” system doesn’t come cheap.
France’s system is widely considered among Europe’s best, but it too suffers from structural flaws. Except in Moore’s world, where Americans are urged to worship at the altar of French health care. In an unintentionally comic moment, Moore interviews an American expatriate who raves not only about the health care but the local culture. By way of example, she points to street demonstrations in France, speculating that these aren’t seen in the US because Americans are too cowed by their government to rise in protest. Of course, an alternative explanation might be that living in a country whose economy vastly outperforms those of its European counterparts does not inspire one to take to the streets. Meanwhile, not a few of those demonstrations are borne of the fact that many Frenchmen, in contrast to a credulous filmmaker, see real problems in their system. Ultimately, the notion that Americans must immediately adopt the French model is about as convincing as the bloated filmmaker’s assurance that he is ready to give up “freedom fries.”
Having spent much of Sicko mocking those who see universal healthcare coverage as a form of socialized medicine, Moore chooses to end his film on an curious note: with a good-will trip to communist Cuba. (It has hardly silenced objections to Moore’s far-Left agenda that he has relied on health care workers outfitted in red scrubs to promote Sicko.) Along for the trip, Moore packs the standard set of regime-issued talking points. Gushing over Cuba‘s health care system, Moore praises the country’s generosity in sending doctors abroad to care for the sick. Characteristically, Moore omits to mention that these doctors often travel under strict security due to their repeated tendency to defect upon leaving Cuban soil. To underscore the alleged glories of Cuba’s system, we get Aleida Guevara, daughter of the revolutionary-turned-mass-murder, lecturing that the United States can’t care for its citizens. Moore swallows it whole. “What’s our problem?” he demands of Americans.
A compelling case could be made that “our problem” is Michael Moore. Given the seriousness of the issue, one thing the healthcare debate does not need is political hucksters selling radical cure-alls. That doesn’t mean the current system can’t be bettered. It just means that Moore’s prescription in Sicko would make it infinitely worse.