As agitator-provocateur filmmaker, Moore seems to have calmed down (A function of kinder middle-age Cushier life as a result of success A shrewd eye for the marketplace), bringing a lighter touch and using a more diffuse approach to his subject matter, one more in the vein of “Roger and Me.”
“Sicko,” which is being released in the US by the Weinstein Co. and Lionsgate, may be preaching to the converted, and thus is not going to stir a big controversy since most of the basic facts are known. Commercially, too, “Sicko” lacks the ammunition that “Fahrenheit 9/11” had, which may translate into good but not spectacular box-office.
Unlike his previous two docus, Sicko is more of a folkloristic comedy, in which Moore functions as a contemporary Mark Twain or Will Rogers, a good-natured, wide-eyed American abroad, a voyeuristic tourist who goes from country to country, seeking comparisons and possible solutions to the critical conditions of the U.S. health system-and seemingly perverse and unhappy way of life.
Sicko is less fueled by anger than by bewilderment, disappointment, and frustration that a First World country such as the U.S., the richest and most powerful country on earth, is lagging behind any other country–Cuba and El Salvador included–when it comes to providing care to its citizens, including its designated heroes, such as rescue workers of the 9/11 catastrophe.
Shooting straight-from-the-heart, “Sicko” offers a well-rounded portrait of the crazy, cruel, and discriminatory US health care system, told from the vantage of a cross-section of people facing extraordinary and bizarre challenges in their quest for basic health coverage.
Opening with profiles of several ordinary Americans whose lives have been disrupted, shattered, and in some cases abruptly ended by various health care disasters, “Sicko” makes clear that the crisis doesn’t only affect the 50 million uninsured citizens, but also millions of others, who dutifully pay their premiums only to get strangled by organizational hell, such as insurance pre-approvals. In other words, quite shrewdly, this time around, Moore appeals to–and discusses–the anger and frustrations of mostly middle-class Americans who can afford health insurance but are often caught in a red-tape bureaucracy that’s nothing if not Kafkaesque.
Structurally, “Sicko” is a mess, a combined result of the docu’s broad themes and Moore’s lack of rigorous discipline (Truth to tell, Moore has never been a very good filmmaker). In the docu’s first part, Moore doesn’t appear at all, which is refreshing, but then, as if to compensate for that lack, in the second half, Moore is too much present, practically in every frame, again playing his Capraesque-Chaplinesque “little man,” engaged in David Vs. Goliath battle.
Yet, manipulative and unsubtle as “Sicko” is, and considering that the docu deals with matters of life and death (literally), it offers two hours of light entertainment–and quite a few surprising facts.
While the basic situation that the main villains in the health drama are private, profit-driven insurance companies such as Blue Cross or Kaiser Permanente, is known, some invaluable info comes through interviews with “defectors” and “whistle-blowing” execs and employees of these organizations who no longer work for them.
“Sicko” also reflects the new technologies, with Moore relying heavily on his and other websites. Docu begins with a dozen health horror stories that Moore received from innocent Americans via his blog. It’s through these “mundane” human stories that Moore first grabs attention, such as the tale of an insured man who lost two fingers in an accident and was given a “choice” of which finger to operate on. But it’s really not much of a choice since there’s vast difference in the price tag of the two operations ($12,000 vs. $60,000), and he obviously can’t afford to pay for both.
In its good moments, which are plentiful, “Sicko” puts across its well-taken points and well-documented charges in a characteristically blunt and unbalanced way. But the docu’s scope is too comprehensive, and the film’s middle section is too diffuse, due to the cross-cultural anthropological survey that Moore conducts in three other countries, the neighboring Canada, and then France and the UK.
You could fault the docu for its lack of focus–or lack of depth for that matter. At iuts current shape, “Sicko” seems content to to present general life styles that go beyond issues of health and insurance, such as living conditions, paid vacations, child care, education, and even love and happiness. As a result, at two hours, “Sicko” extends its welcome by at least 20 minutes. Several sections could be trimmed without damaging at all the docu’s integrity or coherence.
Moore details how the American system got into such a mess by going back to the Nixon administration in 1971. He then follows through with the Reagan years and the failure of President Bill Clinton’s effort to legislate a universal health system by appointing First Lady Hilary Clinton as head of the commission. According to Moore, the various agencies of the health industry spent north of $100 million to defeat Clinton’s health care plan, and now maintain four D.C. lobbyists for every member of Congress.
Not surprisingly, the basic explanation for the brutal US system is rooted in the military-industrial complex, summed up in the motto “the business of America is business,” which applies to the insurance companies, drug industries, and the various HMOs. The system favors the rich and powerful, while discriminating against the poor, oppressed and disenfranchised citizens.
There’s a fascinating interview with an old British Parliament member, who puts his finger on democracy and populist voting as the key variables for explaining the roots of the nationalized health care system in UK in 1948. The distinguished, erudite gentleman claims that the interest of the power elite is to keep the masses oppressed, tired, and depressed, so that they will not exercise their right to vote-or to protest, as is the prevalent norm in France, for example.
Whereas in France and the UK, the government is afraid of the people, in the US the opposite situation prevails: The people are afraid of the government, which manipulates the masses through the creation of a culture of fear and paranoia (especially after 9/11).
A funny vignette is set in a London hospital, where Moore interviews a number of doctors about their philosophical and pragmatic approach to their patients. Then, searching for any evidence of a billing department, he finds a cashier sign, where he learns that UK patients who pay for their own transportation to the hospital actually get reimbursed for that cost.
Docu’s most entertaining parts are those which whisked the viewers around the world, with Moore serving as a Will Rogers-like tour guide, visiting countries like Canada, Great Britain, and France, where he talks to doctors, health officials, and a random aggregate of patients seeking help in hospitals and emergency rooms.
Of all the countries surveyed by Moore, France comes across most positively. It is one of the docu’s ironic consequences is that it serves as a forceful propaganda for going to France–for a visit or permanent residence.
Three sequences in Paris are enlightening as well as poignant. In one, Moore has dinner with a group of young American expatriates who praise France’s state-subsidized health and childcare facilities. A young woman claims that it’s unfair that her parents, good, tax-paying citizens, have to go through hell, whereas she benefits from a system by the sheer fact of simply relocating to Paris.
In the other Paris-set scene, Moore brings laughter, when he interviews a married couple and asks questions about income, mortgage, vacations, and food. Moore can’t conceal his amused and bemused response when the French housewife claims that the biggest items on their monthly expense account are “fish and vegetables,” which have gotten pricy over the last couple of year. To make sure that he heard the right thing, he repeats what the woman says.
Moore then joins a government-employed doctor who pays house visits to patients on demand, which stands in diametric opposition to an earlier sequence where an American woman claims that her ambulance costs were not covered because she had failed to seek pre-approval from her company!
Momentum builds up and the film ends on a high note, when Moore gathers a group of 9/11 heroes, male and female rescue fighters (government employees as well as volunteers), all suffering from debilitating illnesses and denied medical attention in the US, for one reason or another. The group arrives in Cuba, where they not only receive attentive medical care and free (or inexpensive) drugs, but also engage in some pleasantly cordial and unexpected diplomacy, when Cuban firefighters arrange for a formal tribute to their 9/11 American counterparts.
The above trip abroad is what made headlines news last week, when it was reported that the US Treasury Department was investigating Moore for possible violations of the US trade embargo restricting travel to Cuba. (In an interview with Moore at Cannes after the screening, he acknowledged that he was under investigation).
Technically speaking, “Sicko” is more skillfully put together than Moore’s previous docus, a possible result of the sharp editing by Geoffrey Richman, Chris Seward, and Dan Swietlik, who worked on the Al Gore-Oscar-winning docu “An Inconvenient Truth.”
Very last image is of Moore, carrying a large basket of dirty laundry in Washington DC, expecting the US government to wash and iron it, a funny reference to an earlier sequence in Paris, in which a middle-class mother is interviewed with her government-appointed nanny, who, among other tasks, washes her laundry, and upon request, would even cook her favorite meal.
Credits
Running time 124 minutes
MPAA rating: PG-13
Weinstein Co./Lionsgate release of Dog Eat Dog Films Production
Screenwriter-director: Michael Moore
Producer: Meghan O’Hara
Editor: Christian Sweitlik, Dan Swietlik, Geoffrey Richman