Michael Moore’s SICKO
by Janette D. Sherman, M.D.
Published in The San Francisco BayView
July 21, 2007

Contrary to what many of us thought Michael Moore’s film, Sicko is not about the nearly 46 million of us who have no insurance. This film documents some of the 250 million Americans who do have insurance. It becomes clear that care — or lack thereof — is controlled by the insurance and pharmaceutical industries abetted by Congress and the President.

If you can come away from this film without being in tears or outraged (or both) you are stronger than I am. Anyone, paying attention, knows that the US leads dozens of countries in high rates of cancer, infant mortality, low birth weight babies, asthma, diabetes, and hypertension, to name but a few. World wide, the US ranks 37th in health statistics, just behind Slovenia.

When Moore put a call on his web site for medical horror stories, little did he know he would get over 25,000 responses. The stories range from the rejection of Laura Burnham’s auto accident ambulance ride because it was not “pre-approved”, to Frank Cordille who at age 79 works as a custodian to preserve insurance coverage for his wife.

One of the most heart-rending accounts was that of the Pierce family. Mr. Pierce had advanced kidney cancer and a bone marrow transplant was recommended. His brother was a perfect match, but the transplant was denied as “experimental.” His wife worked at a medical center in Kansas City. She appealed to the Board of Trustees of their health plan, to no avail. They were a mix-race couple. He died. She asks, was it because he was black?

Larry and Donna Smith, he a union machinist who had a series of heart attacks, and she an editor who developed cancer raised and educated six children. After they got sick, could not work, and the co-pays for their insurance became too high, they had to declare bankruptcy and move into their daughter’s storage room.

Perhaps the most troubling examples were the 9/11 rescue workers. Because they were volunteers and not on an official payroll, John Graham, William Marr and Reggie Cervantesy were denied full medical care from the $50 million fund that had been established for victims.

Learning that prisoners at Guantonimo, Cuba had free, universal medical care, Moore took the 9/11 workers and Donna Smith on a boat trip to “Gitmo.” To no one’s surprise, they were not admitted to the prison base, but the four did receive care at Havana Hospital. Moore asked that the four get “the same medical care as any Cuban citizen, no better, no worse.”

For 45 years, we have been told that Cuba is evil. Moore posits, “We overthrew the dictator we liked with one we don’t like.” But we learn something good about Cuba: universal medical care costs a citizen $251.00/year, while the average cost in the US is $6000/year.

How did we get to this place? In 1971, President Nixon announced A “New Health Strategy.” This was the beginning of the for-profit HMOs (Health Maintenance Organizations.) Early in the first Clinton administration, the president named Hillary to lead the President’s Task Force for National Health Reform, but like the earlier effort, when universal single-payer health care was mentioned, those making money off ill health mobilized and bought politicians, the press and everyone they could influence. We see no end of scare messages of socialized medicine, lack of access, long waiting lines, and rationing of medical care. But is this true?

Moore transports us to Canada, England and France and interviews patients and caregivers. Compared to what we get in the US, it looks good indeed. Moore asks “what is stopping the US from taking the things that each of these countries do right, and don’ t do the things they do wrongly.”

Bush and some Republicans Co. tout “Family Values.” Having to work two and three jobs at minimal wage, high-cost, or no medical care, and with little time off to spend with family is far from family values.

Linda Peeno, an insurance executive, became disgusted with ”the dirty work of managed care” and testified before Congress that she had saved her company $500,000 by denying claims. Running a successful, for-profit HMO means less care/ fewer tests/ cheaper medications and greater profits.

Why is this a surprise? The purpose of a corporation is to make money. The only way to do that is to charge more or provide less service. We learn that there are four times as many lobbyists as there are members of Congress, and that just covers those that report their connections. The Insurance and pharmaceutical corporations anted up some $800-plus million in support of George W. Bush. Do we think they will stop now? The major presidential politicians have been showered with money from the HMOs and the pharmaceutical industry. If they want our support and votes, they need to understand our demand for an end to this expensive and broken medical system.

Can we afford it? Perhaps the clearest answer came from Britain’s Tony Benn, a former Member of Parliament. He said they figured if Britain was able to “find money to kill people during W.W.II, they could find money to help people.” This was in 1948 at a time when 42,000 civilians had been killed during the war and Britain was in dire financial shape. The health care system was not established as a charity. It serves all citizens, rich or poor.

Benn pointed out that those in debt become hopeless. The hopeless don’t become involved in politics and don’t vote. Keeping people frightened of loosing a job, of their neighbors and the world at large, they become demoralized. Many turn to drugs, alcohol, and pills to ease their hopelessness and psychological pain.

Poor, frightened, and demoralized debtors — those too afraid of loosing a job to complain or resist — are a boon to employers. Cancellation of pension plans and drop in union membership is a direct link to poor health. That loss of solidarity in numbers, makes it easier for employers to say: “take it or leave it.”

The Republican Party touted Family Values. In the US, lack of medical care often requires that both parents work. But that is not all. Asked why France has not only excellent universal medical care but also government supported day care for children, education through college, minimum of 5-weeks paid vacation, 35 hour work week, and help for new mothers, the answer was “the government if afraid of the people — they march in the streets.” In the US, the people are afraid of the government. If Homeland Security could not find a man whose name they knew, with drug-resistant tuberculosis, why the drumbeat message of war on terror? Is there any greater terror than learning that you, your child, you mate has terminal cancer?

A society is judged by how it treats the weakest, the most vulnerable, those worst off. Is there hope for universal single-payer health care in the US? If we can tax ourselves to support firefighting, libraries, police, post offices and school, why should we not tax ourselves and support health care for all?

Some politicians support universal single-payer health care, but until we stop the corporate control of medicine, and their flow of money to politicians who make decisions, it will not change unless we the citizens demand it. Physician groups, nurses and unions are joining in solidarity for health care, with support from a few politicians. Can we wrest medical care from corporations, and demand tax-supported medical care, for everyone, rich and poor?

Moore ends the film and points out we are all in the same boat — we will sink or swim together. “Be good to each other,” he says, “The word is WE, not ME.”

Janette D. Sherman, M. D.
July 21, 2007