Sicko: Making of Michael Moore’s Docu

Cannes Film Fest 2007–Sicko had its origin almost a decade ago, when Michael Moore shot a segment for the premiere episode of his 1999 TV show THE AWFUL TRUTH about Chris Donahue, a dying man battling his insurance company over a pancreas transplant. The story detailed how Donahue made seven years of payments to health care provider Humana, only to be denied coverage for the life-saving operationthat is, until Moore intervened by proposing a mock funeral and the company relented to avoid a total PR disaster. After the back-to-back success of his Academy Award-winning BOWLING FOR COLUMBINE and the top-grossing documentary FAHRENHEIT 9/11, Moore is returning to the American health care crisis, this time flaring it up for the big screen.

The film is about health care, and it isnt, says Moore. As with all my films, I take a subject and use it as a vehicle to address larger issues and bigger ideas. In this case, Im trying to answer a larger question: why are we, the largest western industrialized country, without free universal health coverage for everyone Why us What is it about us

As word spread of Moores latest film concept, the U.S. corporations whose massive profits come from health care began having aneurisms. Ken Johnson, senior vice president of the Pharmaceutical Researchers & Manufacturers of America trade group told a journalist that industry executives were freaking out and pulling their hair out.

Indeed, Big Pharma went on lockdown. Michael Alerts were sent out to company employees working for at least six major drug companies, warning them to watch out for Moore and his film crews. We ran a story in our online newspaper saying Moore is embarking on a documentary and if you see a scruffy guy in a baseball cap, youll know who it is, a Pfizer spokesman told the L.A. Times. Late last year, CNBC reporter Mike Huckman noted the level of paranoia was extreme when he covered a drug companys analyst conference, questioning the reason for the high anxiety as The Michael Moore Effect.

Using the Website

Yet, from the very start of his project, Moore was always just as interested in honoring the victims our health care system as in unmasking its villains. In February 2006, he issued a call on his website, asking readers and fans to send in their personal health care horror stories. His message read, in part, If you’d like me to know what you’ve been through with your insurance company, or what it’s been like to have no insurance at all, or how the hospitals and doctors wouldn’t treat you (or if they did, how they sent you into poverty trying to pay their crazy bills) …if you have been abused in any way by this sick, greedy, grubby system and it has caused you or your loved ones great sorrow and pain, let me know. Nothing could have prepared him for the response a deluge of more than 25,000 e-mails in just the first week.

A close friend told cancer survivor Donna Smith about Moores website request, and since Smith had enjoyed Fahrenheit 9/11 she thought shed check it out. I fired off a quick, curt e-mail, just around two or three paragraphs, and didnt think anything would come of it or that anyone would care, says Smith, the wife of a cardiac patient who moved into their daughters home after insurance costs devastated them financially. I was venting in that e-mail, it was just sheer frustration. But I was also hoping, against all odds, that somebody would hear from those of us who played by the rules and made it a priority to pay their premiumsand yet were still going under. To have someone like Michael listen and expose a problem that millions of Americans are facing every day gave us a dignity we havent had for years.

Axis of Evil

Early on during production, Moore made an important decisionto focus on one particular area of health care rather than covering the unwieldy issue from every conceivable angle.

We had our own Axis of Evil: the pharmaceutical industry, the hospital business, and the insurance carriers, says OHara. While major pharmaceutical firms are profit-obsessed corporations that bankroll Washington politicians and often lie about their research and development costs, the filmmakers viewed prescription drugs as a necessary evil that may ultimately help patients. The same can be said for hospitals-though they, like Pharma, should be regulated and run more efficiently, people obviously need them.

Such allowances, however, couldnt be made for private insurancea completely unnecessary factor when it comes to health care, says OHara. To make his point even more emphatic, Moore decided not to concentrate his efforts on the 45 million Americans who lacked medical insurance, but instead on the majority who are covered and were denied benefits or became strangled with ridiculous bureaucratic red tape.

The stories speak for themselves. But behind the stories lies the question of how insurance companies literally can get away with murder. Scores of industry insiders and whistleblowers contacted Moore, eager to share their stories on the record about how insurance companies make billions in profits by keeping needed benefits away from those patients who deserved them. I was told I was not denying care, I was denying payment, went one familiar refrain.

This Is a Comedy

Fortunately, when the medical madness got too heavy or too dreary around Moores offices, a healthy dose of humor would help lighten things up. A large sign stating This Is A Comedy was posted near the entrance to remind sleep-deprived staffers that laughter is the best medicine. Even a sad little houseplant that wilted in a corner office for weeks provided comic relief when someone hung a note on it that said This Plant Needs Health Care.

Shooting first began across the United States, with crews sent out to shoot various patients stories region by regionfor instance, a West Coast jaunt took the production to Los Angeles and San Francisco, a Texas whirlwind included shoots in Houston, Austin, Brownsville, McAllen and Dallas, while another Southern trek filmed people across Florida and elsewhere. To demonstrate how US health care has become so acutely diseased compared to much of the civilized world, the crew visited several other countries including France, England and Canada. In the end, between 150 and 200 unique stories were documented over more than 130 days of shootingcompared to a mere 38 days of filming on FAHRENHEIT 9/11. More than 500 hours of film were eventually shotthe most ever exposed by Moore for a single movie project.

When Moore and his crew returned from shooting, the real surgery began: editing those hundreds of hours of interviews and other footage into a movie. Joining Moore again in the cutting room was FAHRENHEIT 9/11 editor Chris Seward, along with new team members Dan Swietlik (winner of an ACE Award for his work on AN INCONVENIENT TRUTH) and Geoffrey Richman (GOD GREW TIRED OF US, MURDERBALL).

Ultimately, believes Moore, SiCKO will not only expose a failing system and offer solid alternatives, but also show his growth as a filmmaker. BOWLING FOR COLUMBINE was not ROGER & ME, and this is not FAHRENHEIT 9/11, he says. When people go to the movies they expect something that will make them laugh or cry or think. They want something fresh and new, and Im not interested in doing the same thing over again. I think some people will be surprised by the tome of this film.”

I knew this would be a challenge, he concludes. Theres not one character or one company to hate in SiCKO, theres no single antagonist like Roger Smith or Charlton Hestonits an entire system. Both the audience and I have to work a little harder with this film because its not so black and white. Lets face it: me marching up the steps to the CEOs headquarters for the umpteenth time isnt very interesting. Its not that I wouldnt do that again, but with SiCKO I wanted to get through a whole film without having to bang on the door of power. I dont want the audience going out into the lobby saying Gee, Mike really kicked some ass. They have to kick the ass themselves. This situation is only going to end when everyone stands up and says, Enough!