SICKO – Reality and Rhetoric

Law_Politics2.jpgAs Michael Moore ventures deeper and deeper into politics, his film-making abilities are getting better and better. I enjoyed Sicko for its slick cinematography and the powerful use of disturbing images and stories. Since its release in June 29, 2007, it is clear that it will be overwhelmingly successful at the box-office, and is sure to do well across the world markets for anti-Americana. And for once, I am convinced anti-Moore critics are temporarily on the back seat.

However as far as Sicko’s message is concerned, looking beyond the scathing sarcasm and criticism of the health insurance industry its time for everyone to ask themselves a few basic questions.

Does the concept of socialized medicine have any relevance in the 21st century? Isn’t it as outdated as McCarthyism or Bolshevism? Simply stated, if you want to bring down the cost of healthcare, does it make sense to pay to exorbitant sums to the middleman, and then reward him for denying it to as many as possible? Well that is at the heart of the matter — universal healthcare in America cannot possibly co-exist with the insurance industry. The whole concept of free healthcare for everyone is so alien in this world of managed healthcare, that the mere mention of the word “reform” or “subsidized drugs” would bring healthcare stocks crashing down on Wall Street.

Despite the fact that nearly all other “capitalist” economies have deliberately kept healthcare out of the profit-sector, the question is a purely political one. The main point that Sicko raises is not about the 50 million Americans who do not have health insurance (as it is no different from homelessness or drug addiction to the lawmakers), but how having a middleman (the insurance industry) stands in the way of delivering it in a humanitarian spirit that medicine has been traditionally required under oath… And Sicko cleverly picks out those few aberrant instances where this has resulted in a complete breakdown in humaneness. Like the scene where the elderly woman was dumped from the hospital into the street by a taxi (is the driver any less inhuman for accepting such a passenger?) or being turned down for surgery for failing to disclose a past yeast infection.

Healthcare costs will continue spiraling, as Humana’s success on Wall Street is an affirmation that capitalism works in the US. But unless people see the glaring irony that the success of the healthcare industry (a.k.a. richer middlemen) and healthy Americans are antithetical, the debate on Universal Healthcare will continue.

But is there really any serious ground for debate on an issue that is obviously nonsensical to debate about? Its time to look beyond the rhetoric, deep within ourselves.

  • It’s simply not true that other capitalist economies have kept health care out of the for-profit sector: Michael Moore simply mis-represents what’s happening in other countriesl. Only Canada has a complete government monopoly on hospital and physicians’ services, and it is crumbling under the weight of a 2005 Canadian Supreme Court decision that the government monopoly violates Canadians’ civil rights. Shortly after the release of SiCKO, BUPA, Britain’s largest private insurer, sold its hospitals to a private equity partnership. In France, private hospitals compete against public ones for publicly insured patients. Read the Wall Street Journal last week for a feature on Holland’s reforms allowing more private insurance choices in order to reduce waiting times for treatment.

    Nor is most U.S health care for-profit: about 85% of U.S. private hospitals are non-profit, including the examples in SiCKO. Most of the U.S. insurers attacked in SiCKO are non-profit. Michael Moore simply chooses not to know what he is talking about.

    I will be speaking on a panel following a film screening of SiCKO and other movies in Los Angeles on September 27 at a free event. Please register at and join us!

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Sudip Ghosh, MD

Sudip Ghosh, MD, is a surgeon at the University of Manchester, UK and a medical writer.

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