July 2, 2007
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Wise Enough to Play the Fool - On Michael Moore’s Sicko

John R. Guthrie

The jester in Shakespeare’s The Twelth Night is characterized as being "wise enough to play the fool." It is generally understood that to be successful in that medieval career track, the King's Fool had to be anything but a fool. And it is in this manner this reviewer views our Falstaffian national jester Michael Moore in Sicko.  This documentary, on the maladies of health care in America, was released day before yesterday.

Sicko is not about those 50 million uninsured Americans, those who “fall through the cracks in the system.” It's about throngs of others, the majority who dutifully pay their insurance premiums, then are denied on one meager pretense or another. This is true even though a health insurance CEO may have a compensation package worth over a billion dollars. And why should our congress people care? They, as elected officials, along with Cheney and Bush, have cradle-to-grave socialized medical care.

Moore’s presentation is leavened by humor, though it can be gallows humor indeed. We find an incredulous Moore traveling to London and asking a couple of Asian descent emerging from the hospital with their newborn, “How much did that baby cost?”

Smiling amusedly, the parents reply, “Nothing!”

He discovers to his “amazement” that physicians in the UK live quite well on their National Health Service Income, and that the young family doctor he interviews appreciates being freed from financial worries so he can use his world class medical education to take care of patients.

Moore condemns the troika made of HMOs, pharmaceutical companies and hospital bureaucracies, all of which contribute megabucks to political campaigns, thus “buying,” not only Tom Delay, but eventually Hillary Rodham Clinton and other liberal icons.

Sicko looks at the roots of HMOs back to Nixon with some magnetic tape revelations that may aggrieve the most inured of us. The film strongly illustrates that private health insurance companies, whatever form they take, are driven by pure greed.

In France, Moore asks a young mother about paid maternity leave, learning to his “amazement” that the cheese eating surrender monkeys,  as we conservatives say, typically receive about six months plus household (like cooking dinner, like doing the dirty nappies) as needed for the working mother.  

Moore visits Canada where his interview subjects explain that they consider the American system “selfish and unthinkable.”

There is the weeping surviving spouse in the U.S. of the father and husband denied appropriate treatment for kidney cancer.

Then there is the man who had to choose which severed finger could be re-attached, the severed middle finger at $60,000 or the ring finger for $12,000.
Ultimately, Moore gathers a group of rescue workers who were damaged to the point of disability by working in the Manhattan ruins of New York following the 9.11. Tragically enough, these “heroes,” like discarded Kleenex, are forgotten. They can’t get crucial care in the U.S. for financial reasons.

With this entourage on a chartered boat, he sails from the Port of Miami, stands offshore in Guantanamo Bay and uses a loud hailer to request medical help; medical care “like the terrorists get” for his 9.11 workers. Needless to say, Moore and his heroes are not welcome. He journeys to Cuba proper. There he finds one of the United State’s best kept secrets; a poor country, one forbidden to U.S. citizens, with a proud and generally happy people who actually share what resources they have. Medical care Cuba provides a greater infant survival rate than in the U.S. and is also exported to the poor around the globe. “We want to export peace, not war,” says one physician.

Enhanced infant survival compared to the U.S. is true of a number of 3rd world countries. The United States ranks just above Slovenia, number 38, in overall quality of health care.

Anecdotal evidence is always suspect, of course. But Sicko is a dramatization, not a scientific paper. It is an art form, in this case the personalization of health care problems through vivid personal stories. The revelation of a greater truth is always a possibility.

Moore eventually asks, “Don't we all have a responsibility to look after the weak and the sick?” Don’t we indeed!

Certainly Sicko may become Moore’s most renowned film. Everyone who has a health concern, or who may ever have one, or who hopes to grow old, would do well to see it.

Dr. John R. Guthrie practiced family medicine in the Smokey Mountain foothills of Appalachia for years. As an adolescent he was a U.S. Marine infantry rifleman and later served as a physician in the U.S. Navy Reserve. He lives in Southern California and is a writer and social activist.


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