Sicko [2007] - Optimum Home Entertainment

A missed opportunity to promote American health care reform

The American health care system is, by common consent, dysfunctional. It presents an easy target for any campaigner to scandalize us with its sometimes corrupt, arbitrary and venal practices. However, to be persuasive, the arguments need to be accountable, honest and evidence-based.

Michael Moore's production is gimmicky and superficial. Moreover, it is shamelessly manipulative, treating us to heart-jerking scenes of tearful, hopeless cases bankrupted by medical bills or grieving over someone who died from treatment refused. He then tours other countries health systems viewing them without exception through rose-tinted spectacles. As grateful, sobbing American patients scoop up cheap medicines in Cuba, he comes to the conclusion that "socialized medicine" not only can work, it is to be welcomed.

But the truth is that no country has a fully socialized system and those that are closest to it (like the UK) are also approaching melt-down. Every advanced country in the world is wrestling with the intractable problem of finite resources colliding with infinite demand.

American insurance companies need to reduce the number of policy-holders falling sick, and of ex-patients having relapses. They therefore have a powerful incentive (not present in socialized systems) to undertake sickness prevention programs.

The big diseases that health systems have to deal with are eminently preventable, in fact they are self inflicted: cancers, heart disease, osteoporosis, diabetes and so on. I, as a nutritional anthropologist and a Brit, find myself frequently commissioned by the American health system to give courses to doctors and their patients, something that never happens in my own National Health Service - or "National Sickness Service" as some wags call it.

Michael Moore certainly gives many good reasons for not falling into the clutches of the American healthcare system: the politicians in the pay of Big Pharma and the Insurance Companies, the arbitrary nature of health cover, the total absence of cover for many citizens. But the bigger message is that it is no fun for anyone to fall sick wherever they are in the world - and it is possible, in large part, to avoid it! Deadly Harvest: The Intimate Relationship Between Our Health and Our Food One only has to contemplate an obese Michael Moore shambling around before the camera to wonder how long before he too will succumb.

There is an intelligent, thoughtful and well researched documentary to be done on health systems (by all means holding up the American system as one to be avoided) - but this is not it.

OMG !

Shocking, yet fascinating viewing.

Quite moving at times.

Well worth a watch.

Interesting Doc

Well, you certainly learn new things in this documentary about the state of American Health Care. I had a vague notion that they paid for their treatments, but I had no idea it was so mercenary. And at times, utterly merciless.

Of course the facts do get kinda paraded before us with the usual Michael Moore selective-in-yer-face spin. The stunt with the 9/11 rescue workers smacked of blatant sensationalism, but I am glad they at least got treatment for their efforts. Michael's portrayal of a wonderful free NHS doling out money for travel expenses made me giggle. Yes, we have a good health care system but the way Moore was banging on about it, you'd think the bed pans were plated with gold. I would have preferred a more balanced view. Instead of Doctor I-Have-An-Audi, he should have talked to a nurse and anyone on the waiting list for an operation. The same goes for his portrayal of the French system. All pros and no cons. Oh, and a governmental laundry service too! Wheee!

Still, majorly biased viewpoints aside, this is quite an eye opening documentary featuring the plight of US citizens at the mercy of powerful Health Insurance companies and corrupt politicians. It is truly deeply shocking how these people can so easily weigh the cost of a human life against a loss of some profit.

One to watch and wonder about long after it's finished.

The vision of Europe seems limited

This political documentary is a manifesto against private medical care in the US and for universal free health care, what some have called socialized medicine. Michael Moore thus compares the US system based on the full exclusion of 50 millions Americans from health care and the partial exclusion of million more under the title of denial, the denial of one particular treatment to specific Americans by their own private insurance companies, a denial that can go as far as a full rejection of the client by the insurance company and the cancellation of their contracts and all benefits. To make his point he follows the cases of quite a few people in the US who suffered these "ailments" or "ills" of the US health system. Some people dying because of these denials, even infants, some people living in total discomfort, poverty, dependence even, because of the bills that ate up their homes, savings, and all other amenities they may have had before getting sick. Then he compares with the systems in four countries: Canada, Great Britain, France and Cuba. All of them have a globally free universal system where only some marginal costs are charged, at most. The verdict is obvious. To emphasize the Cuban episode he compares with the care the prisoners in Guantanamo get (free top notch medical care) and the care some rescue workers at Ground Zero after the 9/11 attacks get in the US, and the care they managed to get, for free in Havana from Cuban doctors. The verdict once again does not stand the slightest possibility to appeal. This film though has a shortcoming. He notes the flat rate of a prescription in England (about ten dollars) but does not wonder why it exists. He speaks of a 100% free medical care in France and neglects some side charges. He is probably right with Canada and Great Britain, and definitely with Cuba, when speaking of a state system. But he is under a wrong impression as for France where the health system is not paid by the state but by contributions paid by working people on their salaries and this money is used to reimburse the medical expenses of people up to a certain point and managed by elected councilors representing the workers and employers equally and chosen by their electors on union lists from the trade unions or the employers' unions. The state only intervenes for the people who do not work through subsidies or contributions to the "social security authority" to compensate for the contributions these people do not pay. And what's more about 30% of medical expenses are covered by cooperative, or private, insurances that everyone is supposed, if so is their choice, to get and to whom they pay premiums that are at times higher than the basic contributions. It is a complex system. But Michael Moore does not explore the easy abuse these systems are the victims of from some people who are inconsiderate in overusing medical assistance or care. In England they introduced a flat payment per prescription to encourage economy on drugs. In France a small part of doctors' fees and prescriptions is not covered at all, even by the cooperative or private complementary insurance companies, by decision of the state in an attempt to curb down expenses and particularly abusive expenses. For instance in France brand name drugs that have an equivalent generic, and cheaper, version on the market are only reimbursed on the basis of this generic drug's price. But altogether Michael Moore's discourse is true and right, when we keep in mind that we have to think of the people who always try to get undue or abusive advantage of a generous system, and that we have to consider being economical with drugs and treatment because it is also a syndrome of our advanced stressful societies that many people, and at times those who are least stressed, look for some medical care when none is needed and they use a lot of time of doctors, nurses and other medical personnel for no reason at all except getting some attention. Finally let's keep in mind too that any system, private or public produces a bureaucracy and then a wasteful exploitation of an economic niche in society. This is an important shortcoming of the film: how much money is wasted by private insurance companies in the US to employ people, at times highly paid people, just to deny services to clients, and patients, and how much money is wasted on law suits by clients who are dissatisfied or on damages paid by the insurance companies when they lose these lawsuits? That would vastly account for the denial procedure that has to bring in a profit after paying for the expenses it incurs, money that could be used paying for hospital bills or doctors' fees.

Dr Jacques COULARDEAU, University Paris Dauphine, University Paris 1 Pantheon Sorbonne & University Versailles Saint Quentin en Yvelines

The best advert the NHS has ever had!!

Having been a fan of Moore for many years I approached this with a little caution.Mainly because it has been proved that like all filmakers Moore won't allow the truth to get in the way of a good story especially with very clever editing and changing timeframes within a story.
In all honesty this film is really aimed more at his fellow Americans than his other films have been.Here he exposes the "truth" behind Health Care Insurance.He does it with the usual clever use of archive Public Information Films and adverts and interviews with industry employees and "victims" of the Health Care Companies.
Where the film falls down is in the 2nd half where we are treated to a fairly skewed vision of our own much maligned NHS.Don't get me wriong I would much rather have the NHS rather than the nightmare of the US but we all know about bed shortages,waiting lists,some vital drugs not being made available to those in real need etc.Also the doctor that is featured clearly works in a Hospital where there is no shortage of nurses or equipment.Even if he is on £85k a year I am not so sure I would like the mortgage he would have on his £500k house!!The point that Moore seems to make here is that the house is worth one million dollars,clearly an attempt to get that materialistic American audience of his hot under the collar.As for the French section that really appears to be all a bit too good to be true.Interestingly he gets Americans living in Paris to comment on what they experience with Health Care rather than Parisians.We get one French family who appear pretty healthy anyway!Again clever film making especially when you consider that the French pay much higher taxes than we do,something that Moore ignores in the search for the story.
The 9/11 rescue workers exercise using Cuba to make a point also felt a little incongruous and left me feeling cold and I felt that he has already beaten that drum elsewhere to better effect.Also I felt that he makes the point at Cuba's expense.A sort of "no matter how bad they might be those Cubans sure know how to look after their own".Unlike the US.
Possibly the most chilling part of the film is at the beginning when he shows people who don't have medical insurance which makes a better case for an NHS model than anything else.Perhaps that's the direction in which he should have taken the film?