July 02, 2007

Musing about "SICKo"

Michael Moore, like Woody Allen, inspires a lot of envy among reviewers and other creative artists who wonder how these two can so inerrantly and consistently put successful movies up on the screen, and so they draw more than their fair share of ad hominem attacks. For example, Woody's amorous oddities are portrayed as pedophilia and Moore's critics are quick to note how fat and slovenly he is. It is true that Moore is grossly fat and dresses like a slob, and there is an irony to his appraisal of the American healthcare system, since it seems that a great deal of America's health woes can be traced to the epidemic of obesity, with its concomitant high incidence of diabetes, heart disease, failing leg joints and other problems. These are problems he never mentions in his film.

Nevertheless, "SICKo" is a superb movie. Moore has learned to avoid some of the annoying tricks and tropes of his earlier documentaries, such as the quick-cut collages, statistical inaccuracies (e.g., comparing total murders in Canada to the U.S. in "Bowling for Columbine," despite the great difference in population) and conspiracy-theory deadends. These habits set him up for easy refutation and a perhaps deserved reputation for doing agit-prop as opposed to documentaries. Contrariwise, I don't think there is a refutation to "SICKo." As the title of his film suggests, America's healthcare system is a sick joke. It is the ultimate expression of our end-point devolution from cohesive society to Darwinist nightmare. American citizens face awful decisions on an everyday basis, whether insured or uninsured, such as Moore's opening sequence about a woodworker who had to choose between reattaching his middle finger for $60,000 or his ring finger for $12,000; lacking insurance, his middle finger was thrown into an Oregon landfill. In an evenhanded, unforced, let-the-facts-speak-for-themselves way, Moore asks ironic questions of hospitals and healthcare workers in Canada, Great Britain, France and finally Cuba. "Where do people pay after they stay at the hospital?" "Where is the admissions office to see if my insurance will cover this emergency visit?" In one hilarious moment, he finds the "Cashier" window at an English hospital, only to learn that the office dispenses money to patients so they can take a cab ride home.

In the most celebrated sequence of the movie, his trip to Cuba by flotilla of small boats to seek care for 9-11 rescue workers who could not get coverage for their lung and PTSD problems in the U.S., his crew of patients are first told they cannot receive the care given to the "evildoers" at Guantanamo Bay, so they travel instead to Havana, where all of them are given compassionate, first-rate treatment by Cuban doctors and therapists, for free and apparently with few questions asked. A lung patient is given an inhalant drug which costs 5 cents in Cuba and $120 in the U.S. One's empathic state at this point is such is that all you care about is that these ravaged, miserable souls (one rescue worker had worn his teeth to stumps with PTSD grinding; he was given a full set of new teeth) finally found someone in the medical profession to take care of them.

Then in an immediate and heartbreaking transition to Los Angeles, we are witness, by video camera, to the practice of USC Hospital's dumping of mentally deranged homeless at the rescue mission in South Central L.A. Cutting off the identifying plastic bracelets, hospitals in the area simply buy a one-way cab ride to the shelter for the indigent, insane, uninsured detritus who can't pay for confinement, with instructions to the cab driver to dump them on the sidewalk. Two countries, two systems.

Some criticism has come Moore's way, of course, about his failure to prescribe a specific remedy. This is ironic, indeed. I am not sure, from the somber tone of this movie, that Moore really means to suggest a solution. He is more like a pathologist doing an autopsy. At one point he overvoices a question which had occurred by the same moment to most audience members: is this who we really are? I thought about this question as I left the theatre. I think maybe this question had already been answered by the Katrina debacle. America's reaction to that tragedy was to treat the victims as a TV show. There was great wringing of hands, for a while, about the displacement of hundreds of thousands of people whose lives were ruined, about all the helpless who drowned or died on the streets. We got over it pretty fast. Probably three-quarters of a million people have died in Iraq because of the American invasion, but we have no official policy of counting them and snipe at people (Johns Hopkins researchers, e.g.) who do. There is no "national conversation" about that, and the official candidates for President consider such a disquieting datum unacceptable in polite debate.

So we're not going to have a national healthcare service in this country. We have Medicare for the elderly, a flawed system which tries to co-exist with the health-for-profit system it's integrated into, but it's headed for a fiscal brick wall along with Social Security. No money is going to be pried loose from the $1 trillion allocation of the discretionary budget given over to war, armaments and intelligence. No serious presidential candidate running in 2008 is proposing universal care, in the sense all other Western industrial democracies already possess, and such a plan, if proposed, would never get through Congress. The flip-point for Social Security and Medicare, when they go red in the middle of the next decade, will ensure that calls for a national health service are labeled unrealistic and unaffordable, while America's "defense" needs are greater than ever, since so many young Muslim men have access to fertilizer and C-4 explosives.

Moore's movie has the quiet, respectful tone of a requiem, or of a grave prognosis made on the basis of a symptom that finally spells the end, despite all heroic efforts to reverse the course of the disease. Let his detractors say what they will, it is a masterwork.


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