Private health care: poor pay with their lives
Sicko Michael Moore, 2007, US
Sicko is the latest film by US documentary maker Michael Moore, acclaimed for his films Bowling for Columbine and Fahrenheit 9/11. The film is an indictment of the US health service, targeting the parasitic insurance companies which run the industry. Sicko starts with a scene of a man stitching up his own leg – quite simply because he was too poor to afford medical insurance. Moore then interviews an uninsured man who cut off two of his fingers in an accident. He had to choose between paying $72,000 to have both fingers sewn back on, $60,000 to have just the main digit sewn back on or $12,000 for the smaller finger. But Moore says the focus of the film is not so much about the 47 million people in the US who are living without medical insurance but those lucky ones with it.
In the US if you want health cover you have to pay for it. According to USA Today the average cost for a family health insurance policy topped $10,000 in 2005. Yet, as Moore’s film highlights, even paying those huge fees does not guarantee that you receive treatment if you are ill. With the aid of former insurance workers and doctors, the film demonstrates that in the cold pursuit of profit the insurance industries adopt all means at their disposal not to honour a claim. One of the film’s most cruel examples was that of a poor black woman who had managed to scrape together enough money to pay for health cover for herself and her daughter. When her daughter became ill in the middle of the night she took her to the nearest hospital. However, her insurance company refused to cover her at this hospital and forced her to take her sick daughter to another instead. She died on arrival. This is just one case out of many shown in the film highlighting the human suffering that this unjust system inflicts.
This state of affairs exists in the US because health care is a commodity like any other. If you can’t pay you go without. If you pay a bit you may get treated – depending on conditions x, y and z. There is no intention of providing a quality service to all. Excessive premiums and super-inflated medication are the results of this profit-driven system. The insurance corporations and pharmaceutical giants, like the oil and arms companies, have huge political clout. Sicko illustrates that successive US administrations have been financially backed by the ‘health’ sector including the current Bush administration and Hilary Clinton, Democratic nominee favourite for the next presidency. As a result legislation has always favoured those running the industry. From the McCarthy era of the 1950s up to the 1970s, a climate of anti-communism and right-wing fervour was prevalent in the US. ‘Socialisation of health care’ was presented as a dangerous move towards communism by the US ruling class. This reactionary sentiment culminated with Nixon’s decision to fully expose to the market what limited health care provision existed and set in place the trend which exists to this day.
This film is aimed at a US audience to whom Moore hopes to demonstrate the insanity of their system of health care while showing that there are alternatives. He does this by visiting Canada, Britain, France and Cuba and compares these countries’ socialised health care systems to the US model. The contrast is remarkable. State-controlled systems are clearly shown as providing better care and paid for through taxation (and directly by the state in the case of Cuba). When he asks a woman from the US living in Paris why the French have better health provision she replies it is because the French people have a history of protest and demand security and welfare: ‘In France the government is afraid of the people, in the US the people are afraid of the government.’
The only real weakness in Sicko is that Moore over-praises the NHS and paints it as a utopian example of health provision. There is little mention of the long waiting lists and moves towards privatisation that have and are continuing to erode such provision. The existence of a two-tier system, where the rich can receive quicker treatment, is not mentioned. As a US film maker educating others in the US about their system Moore can be forgiven for this oversight. British viewers, though, should take heed and realise that privatisation of the NHS will lead to the same inequalities and insecurities as those existing in the US.
In response to the issues dealt with by the film Rudy Giuliani, former Mayor of New York and now Republican nominee for the US presidency said: ‘I had prostate cancer, five, six years ago. My chance of surviving prostate cancer, and thank God I was cured of it, in the United States, 82 percent. My chances of surviving prostate cancer in England? Only 44 percent under socialised medicine.’ The percentages he gives are questionable, but there is no doubting that he received excellent health care provision. The US system can be the best in the world provided you are a member of the ruling class and have got the huge financial means to buy into that system. But for the majority there is no such privilege and comfort, just anxiety and insecurity.
The true political strength of the film comes out when Moore takes some sick 9/11 firefighters to Cuba for treatment. In a hilarious scene in which queues form to board a boat from Miami to Cuba, Moore turns on their head prevailing US stereotypes about Cuba being a backward and dangerous enemy. The firefighters, heralded in the US media as heroes just after 9/11 had been left to rot by the US ruling class. Suffering from chronic lung disorders after inhaling the ash from the towers the firefighters were given treatment in a Havana hospital – treatment no better, no worse, than the average Cuban would get. For the first time in years they had a full medical check, a diagnosis of their condition, surgery, medication and full dental care to boot. One woman was in tears because she found it so difficult to believe that in a third world country she was shown such compassion and support yet in her country, the world’s richest, she was left to fend for herself. Intentionally or not the film demonstrates that only a planned socialist economy can provide, and most importantly guarantee to provide (unlike in the case of Britain, France and Canada) full and top quality health provision for all.
Political, comical, timely, informative, thought-provoking, terrifying – Sicko is documentary film-making at its very best. A must see.
Apologies to readers of FRFI 200: This review was printed with spell-check errors which were not the fault of the author. These have been corrected in this website version of the review.