Sicko Is Socko

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Lions Gate / Everett

A still from Michael Moore's movie Sicko.

George W. Bush recognized there was a crisis in the American health care system. But he thought the problem was that physicians' six-figure incomes weren't high enough. "Too many good docs are getting out of the business," the graduate of Yale and Harvard said in his homespun way in September 2004, two months before he was reelected. "Too many OB-GYNs aren't able to practice their love with women all across this country."

These days it's almost too easy to make fun of the President; he's a lame duck who needs medical attention, and fortunately he can afford it. (And if he couldn't, his bills would be paid for by the people, as is the health care of all Senators and Congressmen.) Besides, Michael Moore had his instructive Bush-bashing in Fahrenheit 9/11, the highest-grossing documentary of all time, earning $119 million at the domestic box office and lots more overseas. [an error occurred while processing this directive]

So after beginning Sicko with this Bush malapropism, Moore stays pretty clear of Dubya jokes, pausing only to mention the extravagant amounts the medical industry gives to elected officials (including one-time health-care reformer Hillary Clinton). Instead, he lards his new documentary with stories of ordinary Americans whose health insurance did not cover the diseases and accidents their plans should have paid for and whose prescription drugs were unaffordable.

Like Donna and Larry Smith, both in their 50s, both career workers, both with HMOs. But when she got cancer and he had heart trouble, the bills mounted so fast that they had to sell their home and move to Denver into their daughter's basement. That humiliation saved them just enough money that they could spend the rest of their life savings on treatment and medication.

Moore isn't the first to say that the health care system is sick — that it's riddled with inequities and iniquities. He's never the first to address a gut issue, whether it's corporate greed (Roger & Me), American violence (Bowling for Columbine), the politics of terror (Fahrenheit 9/11). But he's the one who does it the noisiest, with the highest entertainment value, mixing muckraking with showmanship, Ida Tarbell with P.T. Barnum. His new movie — which has its world premiere tonight in Cannes, and opens in North America June 29th — fits honorably in that tradition. As both harangue and movie tragicomedy, Sicko is socko.

Moore is such a big fat target, metaphorically speaking, that he attracts attacks from swarms of ideological critics, thus bringing his message to more people. Last week, for example, the Treasury Department indicated it would investigate Moore for taking a trip to Cuba to check out Castro's medical system. (Guess what he found? It's better than ours!) Moore shot back with an open letter that claimed the Bush Administration was "abusing the federal government for raw, crass political purposes." It was his way of saying thank you for all the free publicity.

Moore has a genius for confrontational stunts — demanding a meeting with General Motors Chairman Roger Smith, chatting up an addled Charlton Heston on gun control, buttonholing Congressmen to see if any of them had actually read the Patriot Act — but the Cuba jaunt tops them all. It begins when he hears Congressional testimony indicating that detainees at Guantanamo were getting free colonscopies and nutrition counseling. (One female soldier cited in the film says, "They get way better health care than I do.") So he rounded up several volunteer rescue workers from the World Trade Center site who had suffered respiratory and other diseases and said their medical plans did not cover treatment for all their ailments.

Off they sailed, from Florida to Gitmo, in the vagrant hope that 9/11 heroes might get the same high-end care the government said it was lavishing on 9/11 terror suspects. His bullhorn pleas met with silence, Moore took his cargo of the ailing — the rescue workers, Donna and Larry Smith and a few others featured in the film — to Havana, where they got excellent, imaginative, sympathetic care from a local clinic. (At least one of the patients returned on her own, and told the Associated Press she received the same level of treatment.)

Already, without having seen the film, anti-Moore websites have collected claims that many Cuban hospitals, unlike the one shown in Sicko, are dilapidated and crawling with cockroaches. Uh-huh. That means they're almost as bad as Walter Reed's Building 18, to which Iraq-vet outpatients were sent. Moore doesn't bother to address this point, which helped galvanize public opposition to the war. (Was it too late for inclusion in the film, or too easy a target?) Nor, when he asserts that "18,000 of them [Americans] will die each year simply because they didn't have health insurance," does he trouble to note that that's more than five times the number of U.S. military deaths in the four-plus years of the Iraq occupation.

"What has become of us? Where is our soul?"

Sicko traces the birth of the privatized health system to Richard Nixon, who in 1971, on one of the White House tapes, noted that the scheme would work for insurance companies "because the less care they give 'em, the more money they make." Hardly anyone would deny that since then, the HMOs and pharmaceutical companies have made billions while Americans have health care below the standard of other industrialized countries, and pay more for it. (Even the flacks for HMOs acknowledge that the system needs reform.) Or that patients are routinely denied procedures they should be entitled to. "You're not slipping through the cracks," a claims adjuster, since reformed, tells Moore. "They made the crack and are sweeping you toward it."

I'm sure scholars of the U.S. health care system, even those without a political grudge, will be able to poke holes in some of the movie's arguments, and address some important points the movie ignores. The upside of this populist documentary is that there are no policy wonks, crunching numbers and reducing patients' anguish to sterile statistics. The downside: There are no policy wonks, crunching numbers and saying soberly how much a national health care plan would cost U.S. citizens. In a 2hr. movie, Moore could have taken a couple mins. to tote up the expected tab.

Like most docu-dramatists, Moore loves to show the tears of those screwed by the System; in Sicko, at least seven interviewees start crying as they describe the lack of attention their maladies got. And when they're not getting misty over the inhumanity of it all, you may — when you see surveillance footage of mentally disoriented outpatients from the high-end University of Southern California hospital who are put in a cab and dumped near an L.A. Skid Row homeless facility when their coverage runs out.

Moore also likes to play Santa Claus. One child, who had been approved for one but not two cochlear implants when she started losing her hearing, received an OK for the second implant from CIGNA after her father waved the red flag of Moore's interest in the case. The filmmaker also sent $12,000 anonymously (well, not any more; it's in the movie) to a Moore-hating blogger who was going to shut down his site to pay for his wife's hospital bills. Most photogenically, Moore brought his 9/11 boat people to Cuba.

They might have gone to Canada, France or Britain, three other countries with generous government health plans. Moore has fun showing the cashier's window at a London hospital, where patients don't pay anything, they get money for the trip back home. Any prescription under the U.K. National Health plan, he suggests, costs only about $12. And in France, the government will pay not only for health costs but for nannies. They'll even cook for you, and do your laundry. If Sicko doesn't win over the audience at tonight's black-tie world premiere, Moore's francophilia should do the trick. I'd take odds on a 15-min. standing ovation.

The chronically scruffy auteur may play the game tonight and get all tuxed up. But he's still a blue-collar kid from Flint, Michigan — the car town that became a poor town when GM closed many of its plants. A classic entertainer and a professional mensch, he knows how to couch a daunting issue in human terms. In Sicko, as he said at a Cannes press conference today, the larger questions are: "Who are we? What has become of us? Where is our soul?"

He's latched onto an issue that affects more Americans more directly than gun violence or Islamic terrorism. The folks in Flint needn't worry overmuch that al-Qaeda will bomb the Longway Planetarium (whose Classic Vinyl laser show begins today), but they can count on getting ill and needing to pay the bills. It's something most Americans worry about; Moore says they shouldn't have to. As he said to AP: "We are the richest country in the world. We spend more on health care than any other country. Yet we have the worst health care in the Western world. Come on. We can do better than this."

And what will America's top guerrilla docu-comic do after Sicko? "I think it's time for a romantic comedy," he told TIME. But surely there are other bones of contention sticking in his throat. The political use of religion should appeal to this leftie who's still a practicing Catholic. Or how about the threat of climate change and the waters rising over Moore's Manhattan home. What if he were to blend the two issues? He could take as his text this quote from God, straight from the Bible: "I establish my covenant with you, that never again shall all flesh be cut off by the waters of a flood, and never again shall there be a flood to destroy the earth."

If you want me to cite chapter and verse, it's Genesis 9:11.