The problem with American health care, Moore argues, is that people are charged money to avail themselves of it. In other countries, like Canada, France and Britain, health systems are far superior - and they're free. He takes us to these countries to see a few clean, efficient hospitals, where treatment is quick and caring; and to meet a few doctors, who are delighted with their government-regulated salaries; and to listen to patients express their beaming happiness with a socialized health system. It sounds great. As one patient in a British hospital run by the country's National Health Service says, "No one pays. It's all on the NHS. It's not America."
That last statement is even truer than you'd know from watching "Sicko." In the case of Canada - which Moore, like many other political activists, holds up as a utopian ideal of benevolent health-care regulation - a very different picture is conveyed by a short 2005 documentary called "Dead Meat," by Stuart Browning and Blaine Greenberg. These two filmmakers talked to a number of Canadians of a kind that Moore's movie would have you believe don't exist:
A 52-year-old woman in Calgary recalls being in severe need of joint-replacement surgery after the cartilage in her knee wore out. She was put on a wait list and wound up waiting 16 months for the surgery. Her pain was so excruciating, she says, that she was prescribed large doses of Oxycontin, and soon became addicted. After finally getting her operation, she was put on another wait list - this time for drug rehab.
A man tells about his mother waiting two years for life-saving cancer surgery - and then twice having her surgical appointments canceled. She was still waiting when she died.
A man in critical need of neck surgery plays a voicemail message from a doctor he'd contacted: "As of today," she says, "it's a two-year wait-list to see me for an initial consultation." Later, when the man and his wife both needed hip-replacement surgery and grew exasperated after spending two years on a waiting list, they finally mortgaged their home and flew to Belgium to have the operations done there, with no more waiting.
Rick Baker, the owner of a Toronto company called Timely Medical Alternatives, specializes in transporting Canadians who don't want to wait for medical care to Buffalo, New York, two hours away, where they won't have to. Baker's business is apparently thriving.
And Dr. Brian Day, now the president of the Canadian Medical Association, muses about the bizarre distortions created by a law that prohibits Canadians from paying for even urgently-needed medical treatments, or from obtaining private health insurance. "It's legal to buy health insurance for your pets," Day says, "but illegal to buy health insurance for yourself." (Even more pointedly, Day was quoted in the Wall Street Journal this week as saying, "This is a country in which dogs can get a hip replacement in under a week and in which humans can wait two to three years.")
What's the problem with government health systems? Moore's movie doesn't ask that question, although it does unintentionally provide an answer. When governments attempt to regulate the balance between a limited supply of health care and an unlimited demand for it they're inevitably forced to ration treatment. This is certainly the situation in Britain.
Writing in the Chicago Tribune this week, Helen Evans, a 20-year veteran of the country's National Health Service and now the director of a London-based group called Nurses for Reform, said that nearly 1 million Britons are currently on waiting lists for medical care - and another 200,000 are waiting to get on waiting lists. Evans also says the NHS cancels about 100,000 operations each year because of shortages of various sorts.
Last March, the BBC reported on the results of a Healthcare Commission poll of 128,000 NHS workers: two thirds of them said they "would not be happy" to be patients in their own hospitals. James Christopher, the film critic of the Times of London, thinks he knows why. After marveling at Moore's rosy view of the British health care system in "Sicko," Christopher wrote, "What he hasn't done is lie in a corridor all night at the Royal Free [Hospital] watching his severed toe disintegrate in a plastic cup of melted ice. I have." Last month, the Associated Press reported that Gordon Brown - just installed this week as Britain's new prime minister - had promised to inaugurate "sweeping domestic reforms" to, among other things, "improve health care."
Moore's most ardent enthusiasm is reserved for the French health care system, which he portrays as the crowning glory of a Gallic lifestyle far superior to our own. The French! They work only 35 hours a week, by law. They get at least five weeks' vacation every year. Their health care is free, and they can take an unlimited number of sick days. It is here that Moore shoots himself in the foot. He introduces us to a young man who's reached the end of three months of paid sick leave and is asked by his doctor if he's finally ready to return to work. No, not yet, he says. So the doctor gives him another three months of paid leave - and the young man immediately decamps for the South of France, where we see him lounging on the sunny Riviera, chatting up babes and generally enjoying what would be for most people a very expensive vacation. Moore apparently expects us to witness this dumbfounding spectacle and ask why we can't have such a great health care system, too. I think a more common response would be, how can any country afford such economic insanity?
As it turns out, France can't. In 2004, French Health Minister Philippe Douste-Blazy told a government commission, "Our health system has gone mad. Profound reforms are urgent." Agence France-Presse recently reported that the French health-care system is running a deficit of $2.7 billion. And in the French presidential election in May, voters in surprising numbers rejected the Socialist candidate, S�gol�ne Royal, who had promised actually to raise some health benefits, and elected instead the center-right politician Nicolas Sarkozy, who, according to Agence France-Presse again, "plans to move fast to overhaul the economy, with the deficit-ridden health care system a primary target." Possibly Sarkozy should first consult with Michael Moore. After all, the tax-stoked French health care system may be expensive, but at least it's "free."
Having driven his bring-on-government-health care argument into a ditch outside of Paris, Moore next pilots it right off a cliff and into the Caribbean on the final stop on his tour: Cuba. Here it must also be said that the director performs a valuable service. He rounds up a group of 9/11 rescue workers - firefighters and selfless volunteers - who risked their lives and ruined their health in the aftermath of the New York terrorist attacks. These people - there's no other way of putting it - have been screwed, mainly by the politicians who were at such photo-op pains to praise them at the time. (This makes Moore's faith in government medical compassion seem all the more inexplicable.) These people's lives have been devastated - wracked by chronic illnesses, some can no longer hold down jobs and none can afford to buy the various expensive medicines they need. Moore does them an admirable service by bringing their plight before a large audience.
However, there's never a moment when we doubt that he's also using these people as props in his film, and as talking points in his agenda. Renting some boats, he leads them all off to Cuba.
Fidel Castro's island dictatorship, now in its 40th year of being listed as a human-rights violator by Amnesty International, is here depicted as a balmy paradise not unlike the Iraq of Saddam Hussein that Moore showed us in his earlier film, "Fahrenheit 9/11." He and his charges make their way - their pre-arranged way, if it need be said - to a state-of-the-art hospital where they receive a picturesquely warm welcome. In a voiceover, Moore, shown beaming at his little band of visitors, says he told the Cuban doctors to "give them the same care they'd give Cuban citizens." Then he adds, dramatically: "And they did."
If Moore really believes this, he may be a greater fool than even his most feverish detractors claim him to be....
What Moore doesn't mention is the flourishing Cuban industry of "health tourism" - a system in which foreigners (including self-admitted multimillionaire film directors and, of course, government bigwigs) who are willing to pay cash for anything from brain-surgery to dental work can purchase a level of treatment that's unavailable to the majority of Cubans with no hard currency at their disposal.
As the Caribbean sun sank down on Moore's breathtakingly meretricious movie, I couldn't help recalling that when Fidel Castro became gravely ill last year, he didn't put himself in the hands of a Cuban surgeon. No. Instead, he had a specialist flown in - from Spain.
