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June 22, 2007

SiCKO Review

Over at The Prospect:

whether government-run medicine really kills, or in fact just turns our nurses into a cadre of propagandists in stilettos, is actually a bit beside the point. Contrary to its billing, Sicko is not a movie about health care policy. It does not spend time examining inefficiencies, or incentive structures, or public-private hybrids. It does not offer a methodologically rigorous cross-national comparison of health care systems. (Its portrayal of Cuba is, indeed, absurdly rosy.) That's not its point.

Its point, of course, is to arouse passion, to force debate, and on that, it succeeds. A few hours before, I'd been on Larry Kudlow's TV show, ostensibly to discuss health care and Moore's new movie. "I hate it," barked Kudlow. "Michael Moore's movie Sicko calls for socialized medicine." He hadn't seen it, of course, but felt perfectly comfortable assuming, and judging, its arguments.

The film is more radical, and more troubling, than he'd even imagined. Moore's movie is only superficially about health care. It uses the subject -- and also sick days, and vacations, and child care, and maternal support policies -- as a way to critique unthinking American exceptionalism, to challenge the tautology that states that the way we do things is the best way to do things because … it's the way we do things.

Read the rest.

June 22, 2007 | Permalink


Yeah, that's kind of what I thought it would be.

Posted by: weboy | Jun 22, 2007 10:42:47 AM

nice review. i was getting a sense of that big picture catching up on amy goodman's coverage of the film the last week or so.

Posted by: dex | Jun 22, 2007 11:27:06 AM

What is 'polemic'?
Is that..accurate? --
However 'inaccurate' may be the polemic itself.

Posted by: has_te | Jun 22, 2007 11:27:42 AM

Yer amazin'..
Read that and never once DID see that 'Katrina' word.

Forbearance, indeed!

Posted by: has_te | Jun 22, 2007 11:37:22 AM

"This is not a movie of arguments, but of examples -- of practices Moore thinks more humane, and more in accordance with his countrymen's preferences."

You mean Canada, right?

Posted by: Alex | Jun 22, 2007 11:39:02 AM

That's the way all his movies are. Bowling for Columbine wasn't an anti gun movie as people claimed- it was a movie about how Americans let our fears control us. I saw that movie, and while on one level I didn't always agree with everything he said, I did agree with his point about the power of fear in America. It's a point that I feel he kind of stole from this book that talked about how American irrational fears have too much of influence on what we do.

Posted by: akaison | Jun 22, 2007 11:43:48 AM

Yakov Smirnov! Heh heh heh.

Posted by: SP | Jun 22, 2007 11:51:46 AM

...barked Kudlow...

One could riff for a good while on how apt this analogy is as a description.

Good review. The movie may do some good on getting folks to think about how much we accept as conventional that is really morally evil.

On the other hand, instead of actually, you know, discussing health care policy as a set of rational choices we could make, we'll likely end up with the media conversation being about whether Moore's movie was 'accurate'.

The Republicans have perfected the art of launching flares from a low-flowing helicopter in a battle zone to distract the heat-seeking missiles. So we'll argue about Moore instead of the uninsured, underinsured, and those financially and medically raped by a profit-directed medical 'system'.

Posted by: JimPortlandOR | Jun 22, 2007 11:58:40 AM

But I don't think any approach will matter with regard to the GOP dog and pony act

Posted by: akaison | Jun 22, 2007 12:38:52 PM

The Republicans have perfected the art of launching flares from a low-flowing helicopter in a battle zone to distract the heat-seeking missiles. So we'll argue about Moore instead of the uninsured, underinsured, and those financially and medically raped by a profit-directed medical 'system'.

Yes but as you indicate, this is SOP for the GOP and its media camp followers. Hence the "Ezra Klein hates free markets" meme. All that can be done is to refuse to play. Ezra has provided a template for how that may be done. He states forthrightly that Moore's vision is a radical one. He defends Moore's right as a creative artist to articulate that vision. He recognizes that what Moore is engaged in is political theater rather than journalism. He uses this position as a springboard to address the substantive issues.

Contrast this with the squealing avoidance exhibited by so many in the face of Rightwing attacks on Farenheit 9/11. How many supposed Liberals and Progressives responded by spewing ritualized denunciations of Moore in order to claim credibility for their own criticisms? Too many.

Such folks don't seem to grasp that by accepting the peculiar notion that they are obligated to appologize for Michael Moore's opinions and theatrics that they are validating the GOP's ad hominem strategy.

Here's a counter meme. Michael Moore has an absolute right to express himself as he chooses and the only one fit to answer for him is ... Michael Moore. If you want to argue the mechanics of his film, get Moore on the horn. If you want to discuss the issues of US health care as raised by the comparisons made in the film, then perhaps we can have a debate.

Of course this will only work if "liberals" and "progressives" cease taking the GOP rhetorical bait out of a misguided lust for "respectability".

Posted by: W.B. Reeves | Jun 22, 2007 12:57:23 PM

Based on Ezra's description, it sounds like Moore is following the standard strategy of health care reformers: Focus on the weaknesses of the U.S. health care system and ignore its strengths. Focus on the strengths of alternative systems and ignore their weaknesses. At least Ezra admits that Moore's portrayal of Cuba is "absurdly rosy." I wonder if, during the sequence showing Brits enjoying their "free" health care, Moore mentioned that they do in fact pay for it through taxes. Or that 850,000 of them are waiting for admission to National Health Service hospitals. Or that delays for colon cancer treatment are so long that 20% of the cases considered curable at the time of diagnosis are incurable by the time of treatment.

Posted by: JasonR | Jun 22, 2007 2:05:23 PM

I see nothing wrong with liberals complaining about the defects of Moore's work as both art and polemic, if the complaints are accurate. If Moore's work calls more attention to him and his methods than to the issues, that may actually be due to defects in his approach rather than to defects in the critics.

Posted by: Sanpete | Jun 22, 2007 2:08:23 PM

If this were isolate to Moore Sanpete- you might have a point because aestheticall you are right. The problem of course is that this tactic of trying to appear like the 'reasonable' liberal isn't limited to Moore's films. It is in the background of most debates in this country. The "crazy loony left." Part of the reason I say some of what I say in diaries and comments here is related to this reality- that we don't even recognize anymore how much of our thinking is built of being defensive.

Posted by: akaison | Jun 22, 2007 2:40:36 PM

Akaison, one of the cheesier tactics used to derail discussion is to ignore the actual arguments made and to subtitute invented, easily rebuted arguments in their place.

For example, no one suggested that it would be "wrong" for liberals to criticize Michael Moore or his films. What was suggested, was that it would be foolish to enable the hijacking of the health care debate in favor of a "debate" over the flaws of Michael Moore and his films. Particularly foolish when such enabling is the product of a vain desire for "respectability" as defined by the opposition.

Liberals and Progressives have no obligation whatever to answer for Michael Moore's opinions or how he expresses them. The sooner they get over playing Pavlov's Dog to the GOP's bell ringers on this score, the better.

Posted by: W.B. Reeves | Jun 22, 2007 3:24:32 PM

The amazing thing to me, as a person who lived during the 50s, is how we've slid down all the major indices from number one to number fifteen or number twenty. Having lots of shiny cars does not mean we're a highly developed society.

Some of this corrects itself naturally, as when we learn that, yes, lots of people come here, but, guess what, a lot of people also go home because here isn't as great as they thought it would be.

But it's absurd, and absurdly expensive, to think our medical system can't be improved. That's money that could be spent on other problems we know we have.

In the post-colonial era we're colonizing ourselves- and attaining third-world status in the process.

Posted by: serial catowner | Jun 22, 2007 3:41:33 PM

To explain for anyone having trouble getting the point, there has been nothing foolish about liberal criticism of Moore's work. Further, there's no good reason to think that the criticism is a response to reaction on the Right, but it doesn't really matter. And though there's no good evidence that this happens much, if a liberal were to criticize Moore in a valid way to build credibility with the Right, that doesn't seem especially foolish either; might help.

As I said, it may be that Moore's methods are the main reason discussions of his work tend to be more about him and his methods than about the ostensible topics of his films. Many liberals give the Right way too much credit for controlling things.

Posted by: Sanpete | Jun 22, 2007 3:53:15 PM

Sanpete considering your thinking is pretty much all defined defensive thinking and posturing in terms of the right- I don't expect you to understand the larger point made by WB.

Posted by: akaison | Jun 22, 2007 3:59:12 PM

Akaison, you don't support the premises of your remark, as usual. Good luck.

Posted by: Sanpete | Jun 22, 2007 4:03:50 PM

WB- I don't see that happening. I regularly read the creator of even this blog argue with extreme rightwinger when most the public supports him on healtcare. Yet, what audience does he write to? What audience were the Democrats responding to when they caved on the Iraqi funding? What audience did they apy attention to on the bankrupty bill? This goes on and on.

Posted by: akaison | Jun 22, 2007 4:04:28 PM

What audience were the Democrats responding to when they caved on the Iraqi funding? What audience did they apy attention to on the bankrupty bill? This goes on and on.

Indeed. What audience are those who complain about Clinton being divisive responding to?

Posted by: Sanpete | Jun 22, 2007 4:14:40 PM

I find the premise of, "Well, of course what he shows isn't accurate, but that's okay because his heart is in the right place" to be more than a little problematic. It undermines any attempt to hold others accountable to the truth if you openly wink at lies in the service of causes you agree with.

Posted by: Michael B Sullivan | Jun 22, 2007 4:40:05 PM

The amazing thing to me, as a person who lived during the 50s, is how we've slid down all the major indices from number one to number fifteen or number twenty.

Please list these indices, and tell me where I can find this information.

Posted by: JasonR | Jun 22, 2007 4:45:36 PM

From the review:

Intercepting two new parents as they exit an English hospital, he asks, "How much did they charge you for that baby?" "This isn't America," they laughingly reply.

The US healthcare system is the butt of jokes. Holiday-makers learn about it when they're told to carry a minimum of $5m in travel health coverage for that trip to Disney World. When the Tories did their health policy review a few years ago, they sent MPs to lots of countries to see what they could learn from alternative systems. One country was notably missing from their itinerary: perhaps they didn't want to pay the extra £100 or so for the travel policy.

Faux-naifs like JasonR act as if the current system in the US is one that Americans would choose to have, if it were served up as one of a set of options, rather than one they are forced into by the corporate grip on legislators.

So it would be good if JasonR would state his preference explicitly, in words along the lines of 'Given all possible alternatives, I choose a system dominated by coverage that is tied to my employer, that penalises me for pre-existing conditions, and which routinely denies reimbursement as a means of securing profits.'

Posted by: pseudonymous in nc | Jun 22, 2007 5:26:43 PM

It was a beautiful review. Last sentence was poetry. Am convinced there's a whole lot more power in that "reminding America" approach than many give credit.

As for all the grumbling (elsewhere) about the lukewarm Democratic response, I think the critique is tactically misplaced, though I hope it doesn't stop. If this film gets wide viewing, the center shifts. It probably doesn't shift all the way to eliminating the commercial insurance industry, but it make reforming it a heck of a lot easier. If the "far-left" is calling for single payer, and the "moderates" just want to completely revamp the system, implement national insurance reform, eliminate the employer mandate, and offer a guaranteed basic coverage package to all -- well, that is still considerable progress!

The best thing the left can do for an Edwards, Obama, or Hillary health care plan, is to say it doesn't go far enough (whatever "it" happens to be.) If we get to the point where anything short of throwing out the entire system is considered a "moderate" position - we might actually get something done after '08!

Posted by: mdale | Jun 22, 2007 5:36:08 PM

Akaison, Nothing will change unless sufficient pressure is generated to force a change. The new technologies have opened up new possibilities for organizing that kind of pressure but there certainly are no guarantees. The fact is that both of the Parties are elite institutions, far more concerned with directing popular sentiment away from any challenge to the status quo than enabling it.

Under the circumstances, laying the foundation for that sort of challenge has to be the first order of business. Only the fear of a real social/political dislocation is likely to inspire a change of course among the elites. It's the only thing that has ever accomplished such a political sea change.

I don't pretend to have all the answers as to how this can be accomplished. Of this much I'm convinced though. It won't be done without fiercely contending every inch of the terrain in public discourse and debate. The collapse of the Left became a foregone conclusion the moment it gave in to the notion that it could abstain from the existing discourse by retreating into a tidier one of its own design.

Social/political change is never a pristine process. It's messy, disruptive and sometimes quite ugly. However, the alternative is to leave the field entirely to the elite strata and their sycophants with their counsels of complacency and despair.

Those of us who hanker for a vision of the future that isn't held hostage by a relative handful of economic and political power brokers, must, first and foremost, speak at every opportunity and in every forum we can. We must speak clearly, plainly and without apology.

Speaking is not enough of course. To succeed we must build a powerful, articulate and active constituency for change. In this we can expect little to no help from the Democratic Party establishment and the entrenched interest that sign their checks. This because such a movement would, of necessity, exceed the limits of electoral politics.

Can it be done? Not if we don't attempt it. The first step in such an attempt is the continuous articulation of the demand for change. Power has never conceded anything without such a demand. It never has and it never will.

Posted by: W.B. Reeves | Jun 22, 2007 5:48:18 PM

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