Under the weather

Michael Moore explores America's health care system in Sicko. (Alliance Atlantis)

“Who are we?” intones Michael Moore about two-thirds of the way into Sicko, his screed against the bloody mess that is the American health care system. “How did it come to this?”

When posing these questions, Moore’s voice drops to a softer pitch than the guffaw-filled Midwestern twang he generally employs. It’s the voice he pulls out in Bowling for Columbine and Fahrenheit 9/11 when he’s at his most emotional, or, cynics might say, most manipulative. But Sicko isn’t as balk-worthy as Moore’s previous work. Gone are the Broadcast News reaction shots that highlight Moore’s sensitivity (and celebrity), along with the fish-in-a-barrel takedowns of bewildered Charlton Heston types. Although he narrates, Moore himself doesn’t appear for at least the first 20 minutes, when he lumbers toward controversy in his EveryAmerican knee socks and shorts. Sicko is Moore in a — mostly — quieter, contemplative zone, and it’s his most successful film to date. In part, the subject helps: gun control and the Bush administration are inherently scrap-inducing subjects, but it’s hard to find an American who will go to the wall for his health insurance company.

Sicko is a jaw-dropping, sprawling tour of the U.S. health care system that visits France (ranked number one in health care by the World Health Organization), Cuba, Canada and Britain. Every stop underlines the systemic illness down south: private HMOs (Health Maintenance Organizations) make billions while the United States lags far behind other industrial nations in quality of care, life expectancy and infant mortality. Moore doesn’t concentrate on the 50 million Americans — his numbers — who have no insurance whatsoever, although we do meet a guy who accidentally cut off two fingers, and had to choose between reattaching the $12,000 US ring finger or the $60,000 middle finger (he went with the ring finger, being on a budget and all, but man, the middle one might have been useful). Instead, Moore wades into the tragedies of the 250 million who are covered, and still get shafted.

Meet the bleeding masses: There’s the mother who took her extremely feverish 18-month-old daughter to an ER that refused to treat her because the family’s insurance company wouldn’t pay at that particular hospital. The girl died. There’s the insured, retirement-age middle-class couple who face the one-two punch of cancer (hers) and heart failure (his), and then are bankrupted by deductibles and pharmaceutical expenses. They end up living in a basement room in their grown daughter’s house. There’s the widowed nurse who recounts the horrifying tale of her husband’s cancer: after her HMO denied payment for several procedures (“too experimental” is apparently a euphemism for “too expensive”), they finally refused him a last-chance, life-saving bone marrow transplant. And he died.

These are the people who are turned into numbers by a bottom-line business. Moore simply allows them to talk, and their great relief at finally being heard is palpable; the film positively vibrates with emotion. The depth of their sadness is matched by the discomfiture of several health-care-industry workers who recount their own horrors policing the system. One medical officer for an insurance company talks about receiving bonuses for turning away sick people. At a government hearing, a doctor who worked for an insurance company called Humana confesses: “I denied a man an operation and thus caused his death,” then outlines how she was promoted and compensated financially for doing so. This footage is devastating enough without Moore adding Samuel Barber’s portentous Adagio for Strings in the background, but Moore’s phenomenal success has come because he’s an entertainer first, a journalist second. The guy likes to pluck a few heartstrings as he’s tweaking a few noses.

Michael Moore approves of British health care in Sicko. (Alliance Atlantis)

Smartly, Moore slots these upsetting vignettes into a bigger review of contemporary life. Putting aside America’s wealth, why is it that a country of such great charity doesn’t have a health-care system that reflects the day-to-day altruism of its citizens? Moore goes back to Nixon, who unlocked the privatized monster, and quickly sketches out the fact that the health-care industry buys — er, donates to — politicians in power, including one-time reform advocate Hillary Clinton.

Then Moore pulls back from partisan politics and goes wider, connecting the dots between credit card debt, unaffordable child care, lack of maternity leave, a workforce in perpetual fear of losing insurance, and a few other infectious modern conditions. He’s reaching a bit, but the resulting picture — of a populace in the land of the free living as un-free as communists working the fields — is exactly as striking as he hopes it will be. Thus, when Moore asks, “Who are we?” any smug Canadians cuddling their health cards should sober up and take note: the question isn’t only about Americans, but we-the-wealthy-consumerist-debt-ridden-joyless-enslaved-first-world-masses.

Marx would call this state of being “false consciousness,” but Moore is never so fancy-pants, and he buoys his dark message with typical pop flourishes, dropping archival footage and cartoon music here and there. If the methods are a little cutesy and the answers a little simplified — exactly what kind of reforms are we talking about here anyway? — Sicko shows Moore, at 53, as less angry and more heartbroken than he was in 1989, when he went after corporate greed in Roger & Me. Whether he strikes you as a showman charlatan or the last great truth-teller, Moore is unquestionably a patriot; America is his great love, his great obsession, and his great shame.

Suiting this more sombre frame of mind, Moore only engages in a few of his trademark theatricals in Sicko. The old me-me-me Michael Moore rears its head when he brags that he mailed an anti-Michael Moore blogger an anonymous $12,000 cheque to rescue the guy from bankruptcy after his wife fell ill. Tacky.

But the biggest groaner is the stunt in which he takes 9/11 rescue workers, chronically ill and feeling abandoned by their HMOs, to Cuba. Of course, the Cuban doctors dole out hugs and 5-cent inhalers, and whether or not the Cuban government staged the whole thing is glossed over. Still, the point is clear: an embargoed, poor country in the Caribbean seems able to take care of its citizens without bankrupting or killing them — or both — so why can’t America?

In Paris, Moore tools around in a tiny car with a state-paid doctor performing house calls all night. Over dinner, a table of expat Americans describe France as the most “family- friendly” country on earth. Daycare costs a dollar a day, and a public health nurse will visit the home of a new mother and — this is an I-have-a-dream moment for all new parents — do her laundry.

How the French manage to pull off this seeming utopia appeals to Moore’s roots as a union activist. “In America, people are afraid of the government. In France, the government is afraid of the people,” explains one expat. Cut to shots of massive demonstrations that show the extremely stylish, scarf-wearing French people getting what they want. There’s no question that France is the kind of ideal living democracy that America is trying to export, but France is also plagued by xenophobia, and in the midst of reforming the very workforce Moore adores. And where is new conservative President Nicolas Sarkozy looking for models? At the U.S.

Of course, Moore has to keep things simple and fast (despite the scope of the subject, Sicko is tightly edited), so he revs up his cloud of optimism and arrives in Canada. In a hospital waiting room in London, Ont., he finds people who say that here, one waits no longer than 45 minutes for care. Bring an umbrella to protect yourself from a countrywide spit-take during that scene.

But as Moore asked a whining Canadian reporter at Cannes: “Would you trade your health card for mine?” Uh, no thank you. Moore is always better at the macro level than the micro, and in Sicko, he’s trying to humanize the rest of the world for the benefit of his huge American audience. He wants to gently guide his shell-shocked, scarred country toward the notion that universal health care is neither freakish nor threatening, and let them know that a state operating on compassion rather than profits is a reality in other parts of the world (FDR would approve). Sicko becomes not just a film about the inhumanity of the U.S. health-care system, but a film about what makes life worth living. Up here, as we ape America more and more in our culture and our politics, “Who are we?” is a question worth asking, even when it’s shouted across the border by a figure as confounding and infuriating — and imperative — as Michael Moore.

Sicko opens across Canada June 29.

Katrina Onstad writes about the arts for CBC.ca.

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