Larry and Donna Smith had it good. He worked as an engineer, she as a newspaper editor. They had a happy family and their health—the middle-class American dream. Then Donna was diagnosed with cancer; and Larry had a heart attack, and then another, and another. And the real nightmare began. Although both had health care coverage through their employers, that insurance did not cover all their medical bills. To pay their debts they had to sell their home. Now in their mid-50s, Larry and Donna live in their daughter’s spare bedroom, with the boxed-up remnants of their former life crammed between their daughter’s computer table and the double bed.
So begins Michael Moore’s newest documentary, “Sicko” (re-leased on DVD this week), which confirms our worst fears about the American health care system. Health care for many of the insured in the United States is like living on a flood plain:not too bad as long as it doesn’t rain much. But God help you if it does.
In “Sicko,” as in his previous efforts “Roger & Me,” “Bowling for Columbine” and the Academy Award-winning “Fahrenheit 9/11,” Moore grounds his argument in the compelling stories of ordinary people. In our reality-TV era, people on television are typically served up as “characters,” with a first name and essentially stereotype: the mom, the old guy, the jock, the Southern hick. One of Moore’s singular and most overlooked achievements remains his ability to present instead three-dimensional human beings with whom we identify and empathize. By the film’s end we want to know what happened to Larry and Donna, and also, among others, to Reggie Cervantes, a 9/11 paramedic who wept on discovering that her $120 inhalers cost 5 cents in Cuba, and to Dawnelle, whose infant daughter died when her health insurance refused to pay for emergency treatment at a nearby hospital. Moore keeps his eye and his camera on the “little guys” who have been forgotten by society or hidden away. To see and hear their stories is deeply affecting.
At the same time, unlike other Moore films, “Sicko” does not spend much time pointing fingers, perhaps because we’re all already aware of who the bad guys are: H.M.O. executives, pharmaceutical companies and bought-off politicians. The film offers few antics and no dramatic showdowns. If “Sicko” confronts anyone, it is us, the American people, for what we have grown willing to accept for ourselves and others. “What has become of us?” Moore asks in the film. “Where is our soul?”
After hearing horror stories about our own system, we see in Moore’s trips to Canada and Europe health care so vastly superior as to be laugh-out-loud funny: not just free trips to the emergency room, but doctors making house calls, bonuses given to physicians for healthy patients and nannies for newborns who will cook your meals and do your laundry. (The line forms here.)
Of the dozens of non-Americans Moore interviews abroad, not one offers a single complaint about his or her health care. Moore intends this to be telling, but it comes off as patently untrue. The fact is, health care in other countries is not perfect—the wait time for procedures alone is a standard complaint. A simple acknowledgement of that fact, along with a little more systematic analysis of our own health care system, would have helped Moore’s credibility.
Even with this sometimes-grating flaw, however, the fresh perspectives of non-Americans about health care invite further reflection. When Moore asks a group in France how many sick days they receive, one woman responds, “How can you limit sick days? If you’re sick, you’re sick.” Likewise, after he was diagnosed as cancer-free, a French cancer survivor tells Moore, his doctor asked him if he would like to go back to work. (Can any of us imagine even being asked this question?) When he said no, the doctor prescribed three months off, which he spent on a beach in the south of France with full salary. Being cancer-free, we discover, is not the same as having fully recovered.
Aha moments that bring us to a new understanding of what is and what could be infuse “Sicko” at its best and are the core of Moore’s lifelong project. Knowledge is understood as power; illumination calls forth action. In the past his methods have frequently veered into outrage, sarcasm and stunts. Avoiding these approaches here, Moore makes a more persuasive argument.
Why do bad things happen to good people? In the field of health care, Moore posits, it is because “bad things” cost less. Treatments mean financial losses; our free-market system runs on profit, not care. But as “Sicko” shows, there are other, more humane options. Crisis stands alongside possibility.