By The River

I went last night to see "Sicko," the new documentary by Michael Moore. It's Moore's first documentary since "Fahrenheit 911," which came out in the summer of 2004. The main screening room at the Midtown Cinema in Harrisburg had a few empty seats, but not many. It wasn't like "Fahrenheit 911," when the line reached out the door and down to the end of the block. George W. Bush and the Iraq War can obviously draw bigger crowds than the sad state of American health care, but I suspect word of mouth will soon be delivering full houses for "Sicko" as well.

This is a revolutionary movie. The genius of Michael Moore is to both show the horror stories and the promised land. By now you may have heard about the American man who lost the tips of two fingers in a table saw accident, and was told by doctors (he had no insurance) that it would cost $60,000 to have his middle finger sewn back on, but "only" $12,000 for the ring finger. He chose the cheaper option and the tip of his middle finger ended up as medical waste in a landfill. Later, Moore talks to a Canadian who had five fingers reattached in 24-hour operation involving four surgeons that didn't cost him a dime.

Then there's the nurse in Colorado whose husband needed a life-saving bone marrow transplant to save him from kidney cancer. His doctors rated the chance of success as high. But her insurance plan--administered by her own employer--called it "experimental" and refused to pay. Even a personal appeal to the hospital board of trustees failed to sway them. He died. Moore interviews former insurance company employees who talk about bonuses linked to denied claims. One doctor is shown telling Congress how she let a man die to save her employer, his insurance company, $500,000. It won her a big promotion, but she was haunted to the point where you wondered if she would walk out of the hearing room and put a pistol in her mouth.

The promised land portrayed by Moore is the single-payer, government-run health care systems of Canada, Great Britain, France, and Cuba. This part of the film will be eye-opening to many Americans, who more likely than not have heard only the self-serving criticisms of these systems by people with a stake in the big-money American plan. Moore shows Canadians, British, French--and American expatriates living in those countries--and Cubans quite happy with their national systems. They can't imagine living in America and having to pay for health care.

Moore should have addressed the taxation issue. Canadians and Europeans do pay higher taxes to finance that free health care, but not nearly as high as you've been led to believe. In Britain (I did a story on this recently for the Patriot-News), the national income tax rate for the middle class is the same or less than it is here. The difference is a national sales tax of about 17 percent. In return, they pay nothing for doctor visits or hospital stays, and about $10 for any prescription. I suspect that many Americans would accept higher sales taxes if they got free healthcare in return. And by the way, Canadians, British, French, and Cubans have longer lifespans than Americans.

I also think he was much too kind to Sen. Hillary Clinton and the failure of the Clinton Administration's attempts to create a national health care plan in 1993. That plan would have been more like the German system, and would not have eliminated private insurance companies from the picture, but it would have insured everyone and eliminated by law many of insurance company practices that bankrupt or kill people. I'm reading Carl Bernstein's new biography of Sen. Clinton, "A Woman in Charge," and he places much of the blame for the utter failure of that effort on her. At least she tried, and showed great personal courage in doing so, but many mistakes were made.

It is one thing to present horror stories, but quite another to show convincingly that it doesn't have to be that way. I hope "Sicko" makes it onto HBO so it can get an even wider audience. I'm not certain if a national single payer system can be created here without some great national calamity like the Great Depression to clear the field for radical action. With at least a third of Americans convinced that gay marriage and immigration are greater threats than lousy healthcare, it will be no small task.