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"Sicko" an incisive diagnosis of U.S. health care

CANNES. France (Hollywood Reporter) - This is the movie where Michael Moore gets a few Michael Moore haters off his back.

Michael Moore arrives for a gala screening of his film "Sicko" at the 60th Cannes Film Festival May 19, 2007. REUTERS/Eric Gaillard

“Sicko” posits an uncontroversial, if not incontrovertible, proposition: The health care system in the U.S. is sick. Even a right-wing Republican, when denied care by his HMO or stuck with an astronomical bill, is going to agree. Disagreement might arise over the prescription Dr. Moore suggests. But he makes so much damn sense in his arguments that the discussion could be civilized -- except for the heat coming from the health care industry, with billions of dollars in profits at stake, and certain politicians whose pockets are lined with industry campaign donations.

Not that “Sicko” avoids Moore’s usual oversimplification and cute stunts. But the gist of his arguments is sound, and only a wealthy HMO executive would claim no problems exist in American medical care.

“Sicko” undoubtedly will follow his previous docus in attracting wide viewership from audiences normally not attuned to the docu experience, so boxoffice should be considerable in North America. While the discussion is, as always with Moore, a uniquely American one, audiences in Europe and other markets will want to eavesdrop for the sheer fun of seeing Americans wallow in problems they solved years ago.

The movie begins with horror stories. So much so that Moore is not always able to lighten things up with his usual brand of comedy. But he does manage some sick humor as he recounts the travails not only of the 47 million uninsured Americans but also of those who think they have health insurance, paid for with years of premiums, only to be denied a medical procedure they desperately need.

He traces this tragic situation back to an Oval Office deal cooked up by President Nixon -- caught on the infamous White House tapes -- to foist managed health care on the unsuspecting public. Nixon loves it because it’s not some do-good government program. “It’s for profit,” he enthuses.

Indeed it is. Tales unravel about how a successful medical claim is called a “medical loss” by the insurance industry and how denying claims can lead to promotions in that industry. The film details how the health industry spent more than $100 million to defeat President Clinton’s universal health care package and currently maintains four D.C. lobbyists for every member of Congress.

Most of the rhetoric against having universal health care focuses on the words “socialized medicine.” The question Moore has is this: While a policeman coming to your rescue or a fireman answering an alarm does not ask for payment and therefore represents government assistance, why do Americans place their crucial health care needs in the hands of for-profit insurance companies?

Those countries that have tried “socialized medicine” have seen patients suffer long waits and bureaucratic interference in doctors’ decisions, according to politicians opposed to universal health care. “Just ask a Canadian!” thunders the previous President Bush, referring to that county’s health system.

Moore takes up the challenge, going not only to Canada but also to Britain and France to ask. In Canada he encounters a man who caught a hockey puck the wrong way and sliced off all the fingers on his hand. “Socialized medicine” put the fingers back. By contrast, an American who sliced off only two finger tips was told one tip would cost $60,000 to repair but the other only $12,000.

He chose the $12,000 operation.

In a London hospital, Moore milks the no-cost system for all the humor it’s worth as he desperately searches the facility for any sign of a billing department. He finds none. Finally, he spots a cashier sign. But he is dumbfounded to learn this is where people who paid for transit to the hospital can get reimbursed for that cost.

In France, the search for pre-existing conditions has dramatically different implications than in the U.S.: Whereas American insurance companies scrutinize enrollment forms for signs of a pre-existing condition that wasn’t disclosed so as to deny a claim, in France it is to determine potentially better or even preventive treatment.

Why do even conservative citizens of these countries want universal health care? How did this all come about? “It all begins with democracy,” says a former British MP. In Britain, where the National Health Service was founded in 1948, any attempt to dismantle the system would spark genuine revolution, he says.

The MP’s opinion that some in the U.S. government want citizens to have poor health and education so they remain “scared and demoralized” and unwilling to vote might strike some as extreme. But when Moore turns his camera back on the U.S., where private hospitals in Los Angeles have taken to dumping destitute patients at homeless shelters on skid row, it is clear that this industry needs regulation.

Moore’s final trip abroad is the one that made headlines recently with the news that the U.S. Treasury Department is investigating him for possible violations of the U.S. trade embargo restricting travel to Cuba. Yes, Moore did take several of the sick people he visited earlier in the film to Cuba, including rescue workers suffering from the effects of working at Ground Zero yet denied necessary care by the government. And in the poverty-stricken land of Fidel Castro, they get state-of-the-art diagnostic services, treatment programs and, in one case, a five-cent drug that would cost $120 in the U.S.

Sure, this is a stunt and fails to deal with the chronic unemployment and economic malaise of that Communist state. But if you can get that quality of health care in Cuba, why not in Nebraska? It all begins with democracy.

Screenwriter-director: Michael Moore; Executive producers: Kathleen Glynn, Bob Weinstein, Harvey Weinstein. Producer: Meghan O’Hara; Co-producer: Anne Moore; Editor: Christian Swietlik, Dan Swietlik, Geoffrey Richman.

Reuters/Hollywood Reporter