I went to see Sicko last night, and I think it’s a work of genius, and funny as hell to boot. I can see why the American health-care industry would be upset about it, though. The film’s message is simple and blatant: “The American for-profit health-care insurance system is catastrophically fucked up, and the socialized insurance systems of Canada, Britain and France are great. Even Cuba’s system is better than ours.”
I can think of a hundred skimped or ignored issues in that message right off the top of my head. (For instance: what’s the percentage of Americans who are actually satisfied with their medical insurance system? What about the really poor or otherwise marginalized people in France and Britain? What about the use of additional “private insurance” services by affluent people in socialized-medicine countries? Aren’t you cherrypicking the worst cases of neglect and greed in the US system in order to dramatize the point? Etc. etc. etc.)
But it’s all irrelevant. Mitigating circumstances and gray areas and both-sides-of-the-story considerations are not Moore’s concern. In the words of another well-known public figure, he doesn’t do nuance. Moore’s great gift and mission as a filmmaker is merely to call attention to “the elephant in the room” in various issues of American culture and politics. He does this by pointing out simple, naive and pervasive errors in popular perception and opposing to them simple and naive counterexamples. He uses his bumbling baseball-capped Everyschlub persona to spell out explicitly the conventional wisdom that we automatically accept, and to give a voice to our surprise when we find it contradicted by reality.
In Sicko, the elephant in the room is the simple fact that For-profit health insurance companies can often increase their profits by denying coverage and/or denying care to people who need them. This tends to subvert the ostensible goal of the health-care industry to supply sick people with the medical services they need.
We as a society have semi-subconsciously accumulated a whole lot of conventional wisdom to avoid seeing this elephant in the room, and Moore skewers piece after piece of it with his faux-naif “comedocumentary” technique. A few examples I remember:
Conventional Wisdom: Our health-care system in America is the best in the world.
Moore: But all these people are going bankrupt due to medical bills and not being able to afford the care they need and getting the runaround from insurance companies and drowning in paperwork when they try to deal with the problem.
CW: Well, it may not be perfect, but it’s better than socialized medicine.
Moore: But all these ordinary people in Canada and Britain and France have socialized medicine and they really like it. They get medical services that they need, it’s paid for with taxes, they can afford to buy their medications, and they don’t have to worry about the costs every time they get sick. They’re appalled at the idea of living with a health-care system like ours.
CW: Whatever. Socialized medicine means communism and control by the government.
Moore: But they don’t think it’s about communism: they think it’s about democracy. They think it’s just simple common sense for citizens of a democratic country to establish one big common risk pool to share the costs and the benefits of universal medical care.
CW: But it sucks for the doctors. They have no freedom to run their practices the way they want to and they have to put up with skimpy government salaries and they lead crappy lives.
Moore: No they don’t. Look at this British doctor with his fancy car and his million-dollar London house and all; he’s happy with his practice. These doctors don’t want to work in a system where they’d have to provide care based on what the patients can afford rather than what they need.
CW: Well, even if socialized medicine has some advantages, it ruins the rest of life. Europeans have to pay such high taxes to support their health care that they can’t afford a decent individual standard of living.
Moore: Sure they can. Look at this middle-class French couple with their house and two cars and two kids, and no debts except for their mortgage. Look at these souvenirs they’ve collected from all their vacations all over the world.
And so on and so on and so on. By the time the movie got to Moore’s Cuba-trip schtick, I was just sitting there helpless with laughter. I said in my previous post that Moore’s a canny propagandist, but what he really is is a brilliant counter-propagandist. He takes all these half-digested, half-conscious, over-simplified notions that we’ve absorbed from commercial and political propaganda and lays them right out on the table. Then he comes back at them with over-simplified contradictory evidence from reality, and stands there looking puzzled and scratching his head at the contradiction.
And the audience laughs at him for being such a naive nebbish, and simultaneously laughs at itself for never having seen the contradiction before. Sure, the picture Moore ends up presenting is over-simplified, distorted, biased, too black-and-white. But boy, is it ever refreshing, in a “by golly, the emperor isn’t wearing anything!” kind of way.
