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SiCKO Film Review: Titicut II

September 17, 2018

This was written on request for, and rejected by, DOTmed News, June 25, 2007. It was believed that my review would be offensive to some current or potential clients, and I was not given the opportunity to redo it. At least it was written while on the clock.

Intro (this would have shown before the article was clicked on):
Michael Moore’s SiCKO may be the most important health documentary since Titicut Follies, if even a tenth of the reform that film brought about comes to pass.

Body (the article as it would have appeared once clicked on):
In 1967, Frederick Wiseman made a documentary called Titicut Follies. The title referred to a variety show performed by the patients, but the real follies depicted were the harsh and inhumane conditions at a mental hospital in Bridgewater, Massachusetts. The film’s existence led to a great deal of reform within the health care industry, though the film itself was banned from viewing by all but specialists until 1992, when PBS brought the great shame of Bridgewater before the community at large. Even before it was banned, Wiseman was forced by the Supreme Court to state that “Changes and improvements have been made at the Bridgewater Mental Facility since 1966,” which he presented on a card preceded by another card stating that the Supreme Court required him to include the next card.

Similarly, Michael Moore is now in legal trouble related to the climax of his new film, SiCKO. Through the course of the film, he demonstrates that the current health care system rewards thieves, maimers, and murderers while true heroes are left to rot, unable to pay their bills. The culmination of this fact is that inmates at Guantanamo Bay get free state-of-the-art medical service. When he brings a load of 9/11 rescuers with health problems to Gitmo, their presence on what is legally U.S. soil is ignored, so he takes them to Havana Hospital and asks them to get the same care an average Cuban would get, which is all free and better than they could get in the States. For this humane act, Moore is facing federal charges, for little reason other than, as argued in the film, that the U.S. government dislikes Castro, while in Canada, Tommy Douglas, who began the socialized medicine system, is regarded as the most important Canadian of all time. If Moore is able to bring about a tenth of the reforms in the health care system that Wiseman, who ultimately regarded his freshman film as ineffective and trying too hard, brought about, we will all be much healthier.

Is Humana Humane?

Moore has selected a much bigger target than Wiseman did in choosing a single facility, and in doing so, his argument is necessarily diffused over a broad spectrum. The most heinous organization presented in the film is Humana, in which the doctors themselves were given quotas of patients to turn down, and given bonuses for turning down more patients. Linda Pino, who rose to the highest position and eventually resigned in disgust, testifying before Congress to the fact in material from C-Span 2 in addition to being interviewed directly by Moore. The film makes clear at the beginning that the film is not about people without insurance, as it details horror stories of an uninsured man who lost two fingertips in a woodworking accident and could afford to have only one replaced, such horrors are carried out more indirectly on those “living the American dream” with health insurance.

Moore’s principal argument in the film is that socialized medicine is as necessary as a socialized fire department, police department, post office, schools, and libraries — all essentials that should not have a market price, even though the postal service is certainly supplemented by one. The case against socialized medicine is presented by clips from Red Nightmare, one of the most ludicrous propaganda films ever made, and by a vinyl record made by Ronald Reagan. The reasons they despise socialized medicine are all the things we have with HMOs — inability to choose a doctor, one-size-fits-all care, etc.

Public Enemy #1 — Richard Nixon and Kaiser Permanente

Moore traces the origins of the current health system to March 17, 1971. Nixon is shown in black and white footage saying “I like that” to a private health care plan offered to him by Kaiser Permanente that makes more money the fewer people it serves, then shown looking brazen on television the next day, calling it a plan for “all Americans.” Rush Limbaugh used to present a treatise on taxing the poor because they contribute the least to society, but, according to his book, The Way Things Ought to Be, would append it saying that “only those in Rio Linda,” his favorite target of a place of low intelligence, would take it seriously, but Moore asks us if this is much different from what is going on with HMOs.

Throughout the film, Moore visits other countries in the free world with socialized medicine, saving the strongest praise for France, where the taxes are extremely high, but where the average citizen’s purchasing power is much higher than in the U.S, and the government even provides people to wash citizens’ clothing free of charge. The doctors in these other countries are appalled by a system that would force a man to choose which finger he keeps and which is buried in a landfill. In contrast to the inaptly-named Humana, at NHS a very wealthy doctor tells him that “the better we do for our patients, the more we get paid.” Who could argue with such a system, save perhaps a minority of people with a great deal to lose? Indeed, in such countries, pre-existing conditions cause doctors to take especial care, rather than eliminating care entirely. Moore shows that some insurance companies claim transient, minor health conditions from coughs to yeast infections for dismissal of charges on pre-existing grounds.

War of Words and Magic Bullets

Moore indirectly cites and utilizes the “magic bullet” psychological theory that films such as Red Nightmare were made based on — that the message goes directly to the receiving person and is accepted as true. “Cuba is where Lucifer is. That’s what we’ve been told for over 40 years,” for example. Editing back and forth from Red Nightmare to a Soviet musical featured in the documentary East Side Story is used to show American socialism by other names in the name of socialized medicine. Moore probably does not expect us to take his message as a magic bullet, but his detractors argue that he manipulates his material to have such an effect. Certainly, the scope of the topic requires omissions, but what he did use brought in a great deal of applause in the Upper West Side audience with whom I viewed the film.

Who loses? Based on what is shown in Moore’s film, only the drug and insurance companies have anything to lose from such a plan. With the state paying for everything, doctors in England and France have plenty and live lifestyles as lavish or more so as American doctors. Although medical equipment manufacturers and dealers were not directly dealt with, being subsidized with state funds appears to be something that would benefit such people as well. The spending cap for UK patients on medicine, no matter what the quantity, is £6.55, roughly $10 U.S., and the cashier at the hospital pays out transportation expenses and collects no money. Moore includes the story of a little girl named Mychelle who dies because her mother could not provide her with car transportation to a Kaiser Permanente hospital, since her local hospital could not treat her under her insurance policy. Moore argues that this is tantamount to murder.

He presents a take on Americans faking common-law marriages in order to get free medical care from Canada that echoes the morality expressed by Charles Chaplin’s final speech in Monsieur Verdoux — echoed by Moore as, “We’re Americans. We go into other countries when we need to, and it’s allowed.” This section of the film does strain his argument a bit-he depicts American news footage discussing how long Canadians have to wait for bypass surgeries with people simply waiting at clinics where such procedures are not done emphasizing how brief their wait time actually is. This raises a red flag, but it is also an inevitability given the sheer number of facilities that he, unlike Wiseman, is taking on.

Human Values or Monetary Values?

Moore presents a lesson in the form of former British parliament member Tony Benn, who tells how that National Health Service formed out of a desire to help one’s fellow citizens in the years following World War II, after the British had been experiencing the equivalent losses of 9/11 on a daily basis. Rather than go after “potential” threats far and wide, “If you can find money to kill people,” says Benn, “you can find money to help people.” Bush, not unexpectedly, is readily brought up to blame. At one point, Moore uses the technique of sound advance, placing much of Bush’s voiceover on an image of a dog looking in a window of the previous interviewees. Noted early in the film is that Bush’s Medicare act supposedly to help seniors got its fourteen largest Congressional backers positions at health insurance companies for which they resigned their government posts. Even in dealing with those affected most directly by 9/11, New York Governor George Pataki is shown giving a speech at Ground Zero listing restriction after restriction leveled against the health benefits to 9/11 workers and calling it “fair,” which Moore presents as being limited only to those employed by the state.

Moore places a large emphasis on values. He begins subtly by positioning Kelly Malles, an employee in an HMO call center who breaks into tears about how much of a “bitch” she is on the telephone in order to stave off the emotions associated with denying people in need, in front of a nativity scene. Subtle references toward civic and religious values are culminated in images of community rebuilding after storms and enormous search parties to find lost children, asking what makes medical care any different from these. One of Moore’s biggest detractors would have been forced to shut down his hate page because of his wife’s medical bills, so Moore sent him an anonymous check. Unfortunately, noting as such in the film gives him the effect of self-aggrandizing for which he is already accused.

Moore’s bullet may not be magic, but it is an important volley giving the government and the insurance companies a great deal to answer for. A core argument not to be overlooked in Moore’s film is that the American government keeps the U.S. in fear and apathy, while in other free countries, the government is afraid of the people, and responds to mass protests to avoid revolution. The purpose of the Second Amendment was to protect against a corrupt government, not to defend fearmongering. In the words of Mary Shelley, “it is by words that the world’s great fight, now in these civilized times, is carried on.” Insurance companies have been challenged to their right to exist, but should be glad that the people’s current defender is a Michael Moore, but prudent, lest their actions give rise to a Tyler Durden.

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