Sicko looks quickly at the plight of the 50 million Americans who have no health insurance at all, but his real subject is the poor and fragile quality of health insurance most Americans are forced to rely on. In aggregate, the United States may be the richest country in human history, but it's doing a woeful job of protecting the lives of its citizens. We enjoy a shorter life span than most countries in the Western world and have the highest infant mortality rate among developed countries.
To illustrate our poor performance, Moore relates a series of horror stories and introduces us to an array of the system's victims. Even those who think they're covered may find themselves in trouble the very moment they need their insurance. We meet a professional couple who have insurance but fall ill at the same time and end up losing their home when deductibles and co-pays devour their savings. Seriously ill patients are denied treatments that might save them when their insurance companies classify needed procedures as "experimental." A penitent insurance investigator testifies that he once led a research team whose sole mission was to find technical reasons to strip insurance away from those who needed expensive treatments. One such victim of this tactic is a young woman with cancer who loses her insurance because she failed to disclose on her application that she'd once had a yeast infection. A doctor testifies that the insurance company that employed her paid a bonus for finding reasons to deny coverage, a strategy, she decries, that causes people to die who need not.
Except for the insurance and drug companies that earn enormous profits, most everybody knows this is wrong. Sicko reminds us that a decade and half ago the country seemed poised to fix the problem. But then, in Moore's analysis, a combination of Hillary Clinton's arrogant stubbornness and a $100-million-dollar lobbying campaign by the private health care industry left us in our current indefensible situation. Critically, this need not be.
To prove that point, Moore examines the national health care systems in Canada, England, France and even impoverished Cuba. In all four countries, medical care is considered a fundamental human right. Patients pay little or nothing for a physician's services. Doctors make house calls. Drugs are inexpensive. Moreover, Sicko argues, none of the boogeyman terrors of "socialized medicine" are true. Doctors are well paid. Patients can choose their physicians and switch when they are unhappy. Taxes to pay for this kind of universal care are not wrecking national economies.
To close Sicko, Moore pulls the kind of stunt that has become his trademark and makes his enemies foam at the mouth. He gathers three emergency workers who lost their health insurance after becoming sick in the smoke and dust while trying to save people in the 9/11 rubble at the World Trade Center and takes them to Guantanamo to demand the same level of health treatment provided to Al Qaeda prisoners incarcerated there. When, of course, they are turned away, he arranges treatment for them by doctors in Havana. Even a liberal like me arrives at this sequence thinking it too much. It's staged and predictable and proves nothing. Damned if it doesn't work emotionally, though. By the end, I had tears in my eyes.
My Republican friends will dismiss this picture with a mixture of outrage and scorn, will attack Moore as a showboat and a falsifier. They will scoff at me as a bleeding heart for defending the film's many merits. But this I ask in return: Why should this great country be bested by our colleagues in the developed world? Why, as citizens, should we put up with it? We've had lots and lots of people tell us how difficult it would be to build a national health insurance program. But if others can, why can't we? Isn't it time we demand that our leaders get this done? Isn't it time to end the debate between why and why not and move on to the debate over how?