Theatrical Review of Sicko

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The more I think about Marc Achbar and Jennifer Abbot's extraordinary documentary "The Corporation" (2004), the more I think it deserves to be viewed as a cornerstone of 21st century documentary cinema, a foundational text against which any other documentary that deals with the business world, even tangentially, needs to be measured. The film's conclusion was that if the corporation is granted legal status as a person, a psychological evaluation of that person reveals, quite simply, that the corporation is a psychopath. It is a "person" that is legally mandated to maximize profit at any cost. Questions of morality or ethics aren't even relevant; the corporation can't help itself, it was bred to make money and nothing else.

Michael Moore's "Sicko" is a logical development of this argument. When Moore, never shy about pre-shoot publicity, announced that his newest project would tackle the American health care system, many people guessed at who his primary target would be: the administration, fat-cat CEOs, hospitals, pharmaceutical companies, or private insurers. Turns out it's a little bit of each, but Moore eschews his usual scattershot to approach to focus on a narrower thesis: that it is irresponsible, if not downright insane, for a country to allow its health care decisions to be determined by private, for-profit insurance companies.

Evidence that the private insurance companies are psychopathic constitutes the bulk of the film. Moore uncovers one case after another in which insurance companies denied paying clients proper care in the name of cost containment. Some of the examples are amusing. One woman was knocked unconscious in a car wreck and rushed to the hospital. Her insurance company denied payment for the ambulance ride because it was not pre-approved. Another woman's policy is cancelled retroactively, meaning she is on the hook for bills previously paid, when some company bean counter uncovered the fact that she once had a yeast infection which she failed to disclose as a "pre-existing condition" on her application.

Other psychopathic crimes by insurance companies are far grimmer. One woman describes how her husband's bone marrow transplant was rejected as an "experimental procedure," leading to his death from cancer soon after. In one of the most difficult scenes in the film, a mother describes how she rushed her 18-month old daughter to the hospital after she ran a 104 degree fever. Kaiser-Permanente would not allow the girl to be treated at the hospital because it was not an "in-network" provider, and during the hours it took to drive the girl to an approved hospital, she died.

Industry insiders provide evidence of how systemic the psychopathic illness really is. A doctor testifies that her salary and career advancement potential were tied directly to the number of claims that she denied at Humana. Any paid claim is referred to in the industry as "a medical loss" and the entire corporate culture is designed to reject as many treatments as possible in order to bulk up profit margins.

At this point, the free marketers are already screaming, "I suppose you think nationalized health care would be better, huh?" Well, yeah, or at least that's what Moore sets out to prove by visiting Canada, England and France to check out how well their health care systems function. Capitalist wingnuts have long preached to the American public that national health care, which they prefer to call "socialized medicine" as a sop to those who are nostalgic for the Red Scare days, has been a disaster in these countries, producing sub par standards of care and enormous waiting times. Moore finds little evidence of this when he asks Canadians how long they had to wait in the ER: maybe an hour, at most. When asked how much they had to pay for a hospital stay, British patients (and doctors) look puzzled, wondering why anyone would have to do something as odd as "pay" for treatment at a hospital. Moore spends a lot of time marveling at the French system which provides not only free health care for all, but even state-sponsored nanny service for new mothers: the government actually does your laundry for you! Plus they get as many paid sick days as they need. After all, if you're sick, you're sick, how can you set a fixed amount of days for being sick?

Moore easily deflates the cheap Commie-baiting rhetoric of American politicians regarding the evils of "socialized medicine." However, at this point, he runs into the same problem that plagues most of his films. Anecdotal evidence is one of the least convincing forms of argument (though generally the most entertaining one), and Moore skimps on the hard facts. He confronts the issue of higher taxation in France only in the most glancing manner, by showing that a middle-class French couple still enjoys plenty of life's amenities: beyond their apartment rent, their major expenses are for food and holidays. But he doesn't mention that the French also pay more than a third of their annual income to cover national health care costs. To me, this still sounds like a sensible deal, but it's just the sort of figure that might lose a lot of on-the-fence American viewers raised in the "from my cold dead hands" culture of I, me, mine.

Moore openly invites criticism, if not outright derision, when he takes a group of sick 9/11 rescue workers to Cuba. Unable to get treated properly in America, they are greeted with open arms by a generous Cuban hospital, but it's fair to ask whether that magnanimous welcome had a little something to do with the fact that the American refugees were accompanied by Michael Moore's camera crew. While most third-party surveys do support the idea that Cuba has a remarkable health care system, it's tough to swallow Moore's portrayal of the island nation as a medical utopia for not only all of its citizens but for the rest of the world as well.

The film's gaping logical holes are not the result of laziness, but rather an intentional strategy by Moore who knows that any ensuing attacks on his film simply provide him with more time on the national stump to rebut them. Still, you have to swallow a lot more than happy pills to believe that Moore is as naïve as he portrays himself (Wow, you mean you French guys get free college education too? Golly!) or that the health care systems in Canada, Britain, France, and Cuba are as utterly flawless as he shows them to be.

What should be indisputable, however, is Moore's basic argument that it is a national disgrace that the world's (allegedly) most prosperous country would deny so many of its citizens a standard of health care enjoyed by most of the rest of the Western world. Moore places some of the blame on America's perceived lack of a sense of community: in Britain, France, etc, it's a question of "we", in America it's a question of "me." There's something to that overgeneralization, but I think we can't ignore one the truly "Sicko" developments in America over the past three decades or so: the rise of the cult of privatization. And for that, I refer you back to "The Corporation," because it's just too psychopathic for me to even put into words.

On the DVD Town scale, "Sicko" rates an 8 out of 10.

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