Michael Moore stands on the deck of a small boat he's motored from Florida to Cuba, the sea stretching behind him. Framed by his stalwart-looking passengers, three 9/11 rescue workers suffering an array of health ailments, he puts bullhorn to mouth as the camera cuts to a watchtower on Guantanamo Bay. Moore pleads, "They just want some medical attention, the same kind that al-Qaida is getting. They don't want any more than you're giving the evildoers, just the same."
It's one of several slow-motion-gonzo moments in SiCKO, Moore's documentary on the business of U.S. medical insurance. The bullhorn and faraway prison camp form an apt embellishment, as Moore stands opposed not only to the institutional neglect of ailing patients but also (once again) to the Bush administration. His impatience with the government's ongoing ineptitude, ignorance and iniquity — expressed most vociferously in Fahrenheit 9/11 — here finds a mini-perfect storm. Preceded by shots of orange-jump-suited detainees at Gitmo playing soccer inside their cages and a tour of the hospital unit showing operating room, ample medicines and doctors in white coats, the scene takes a poke at the war on terror alongside border anxieties and military posturing.
Turned away from the rocky-beached, barbed-wired camp, Moore takes his passengers on to Cuba, where they find clean white facilities, attentive doctors and affordable medicines. It is this scene that has reportedly inspired the U.S. Treasury Department to investigate "possible violations of the U.S. trade embargo restricting travel to Cuba" and, incidentally, provide free publicity for the film. The quite literally feel-good sequence closes with a tribute to the U.S. rescue workers by firefighters in Havana, a scene where tearful embraces are augmented by the fact that one of the U.S. workers, medical technician Reggie Servantes (currently suffering from "pulmonary and bronchial problems," according to the team of Cuban doctors who examine her), speaks Spanish. "Mi hermanos," they agree, all rescue workers a global family. Really, if only the U.S. might learn not only to get along with its neighbors, but also take them as models for good behavior, the world would be a better place.
This would be the most reductive point to take away from SiCKO, which, like Moore's previous documentaries, mounts a righteously angry, alternately sentimental, blowhardy, often effective argument. He uses anecdotal evidence and occasional numbers to make the case that U.S. health insurance companies, in the words of one e-mailer to Moore, "flat suck." The focus on the broken system appeals directly to "those of you who are living the American Dream." If you're like Larry and Donna, a two-career couple who put six children through college, you will be bankrupted if you depend on insurance companies when your health gives out. It's a neat bit of timing that on the very day they arrive at their daughter's doorstep (they've lost their house), their son-in-law, a "contractor," is leaving for work "out of town." When asked why daddy's going to Iraq, a tearful child answers, "To do some plumbing."
Such coincidence grants Moore's film a narrative structure with a familiar political point: The crises facing regular citizens are connected, as well as ongoing. And most insistently, the crises have to do with class. Again taking up the cause of the working-class victims and heroes he's made his focus since Roger & Me, Moore offers up some familiar villains. The first versions of medical profiteering trace back to the Nixon administration, specifically a 1971 conversation between John Erlichmann and the president (courtesy of the White House tapes) concerning Edgar Kaiser's proposal that health insurance could make money — lots of it. The film includes brief digs at Ronald Reagan (who appears to have been a paid spokesperson for the industry, before he was president) and "little lady" Hilary Clinton, who famously fought back, for a minute. But, after a slew of white men decried her plan for "socialist medicine" (and protestors burned her in effigy), she now appears to have accepted enough financing from lobbyists that she'll never again propose anything like "universal health care."
She's hardly the only figure with such association. As the film shows congresspeople making their way to a stage show with the president, each is followed by a little green dollar amount, indicating the campaign monies they've accepted from health insurance and drug company lobbyists (Bush, unsurprisingly, is followed by a gigantic number). Cute as well as accusatory, the bit connects fear and money by way of politics. It's an incisive analysis in its way, more nuanced than the most obvious conclusion, that congresspeople are greedy, conformist or categorically unthoughtful. Here the system, recounted by victims as well as former workers within it, looks dismal and dishonest.
By contrast, the film's examples of resistance are sympathetic, tragic and sometimes fierce. A 22-year-old cancer patient marries a Canadian so she can afford treatment by crossing the Detroit River periodically. While she notes that she's telling "little white lies," Moore again makes the broader point: "Yes, what Adrienne was doing was illegal. But we're Americans. We go into other countries when we need to." Looking at street surveillance tape of an impoverished patient being dumped by hospital employees onto Skid Row, he submits that a nation might be judged both by how it treats "those who are worst off" and those it deems its "best," that is, the 9/11 heroes.
While it articulates all kinds of individual rage at these consistent failures, the film's most effective moment is also self-congratulatory. Denied coverage for his daughter's treatment, a man writes Cigna ("without my permission," notes Moore), announcing that Michael Moore is making a movie about health care. "Have you ever been in a film before?" he writes, at which point the company calls to reverse the denial. If a movie not even made yet had such effect, maybe SiCKO will inspire someone else, somewhere, to make a right decision.
This article appears in Jun 27 – Jul 3, 2007.