A Killing Machine

This is a review of Michael Moore’s film ‘Sicko’. 

It’s no exaggeration to say that the US health industry is a killing machine. Michael Moore’s latest film, ‘Sicko’, is an expose of the reality of a private system based on health insurance. It tells stories that ordinary Americans told him when he asked for them on his web site. He received over 25,000 of them.

Anybody who reads reports of life in the USA knows that more than 40 million Americans are without health insurance. The lack of it can kill them. But what Moore’s film concentrates on is the people considered to be the lucky ones; those with health insurance. He takes us through a series of horror stories which are harrowing watching. They expose the barbarism and hypocrisy of a ‘health’ system which is the most expensive and wasteful anywhere in the world. Behind each individual tragedy, which commonly ends in needless death, lies a perverse system in which the purpose of the industry is not to make sick people well, but make as much profit as possible, even at the cost of denying people treatment.

The health insurance industry which pays the bills for medical treatment in the private hospitals, uses all its resources and ingenuity to find any reason for denying treatment to people with health insurance. So perverse is the system that it sets up incentives for staff whose rate of refusal (of treatment) is highest. Personal financial gain, and career advancement, is greater, the higher your level of refusal. It’s almost as if you have a bonus system for killing people!

We see a film of one senior doctor of an health insurance company, spilling the means about how she made her way up the hierarchy because of a high refusal rate. Being a good doctor was measured by refusing sick people treatment. Pre-existing orders not mentioned on their forms (however trivial), or any other reason is used to deny treatment. The film takes introduces us to the families of people who die because they were denied treatment, sometimes the individuals themselves. One black woman’s daughter died because in a state of panic she took her to the ‘wrong’ hospital which refused to treat her.

Moore contrasts the barbarism of the US system with forms of socialised medicine in Canada, France, Britain and Cuba. If the picture he paints is somewhat rosy (given the attacks on socialised medicine which are taking place in the first three of those countries), he is nevertheless trying to make the contrast to an American audience.

It is a little irritating that he shows us how well a GP is doing financially under the NHS, especially at a time when the big increases for GP’s take place in the midst of a financial crisis for many hospitals.

Tony Benn is interviewed on the British NHS, and reads a leaflet produced by the British government in 1948, to explain the new service. Benn says that if anybody tried to privatise it in Britain “there would be a revolution”. Undoubtedly the NHS, despite all its faults, has been revered by the majority of the British population. However, after 10 years of a New Labour government the very foundations of the NHS are being destroyed by the introduction of a ‘health market’ modelled in some respects on the US system. Indeed some of the health care companies mentioned in the film have been invited to Britain to take over parts of the NHS.

In the USA today the cost of health insurance continues to rise and company after company are forcing their workers to increase their contributions to health insurance and/or cutting provision. Some of the corporations are even asking the state to take the problems off of their hands. But the ‘reforms’ being offered by Republicans or Democrats are based on the continued domination of the health insurance industry.

Moore picks up on the sad story of that great heroine Hilary Roddam Clinton who tried to introduce universal health care at the beginning of the first term of her husband’s administration. This effort was gunned down by a well finance campaign by the health industry giants and the politicians who are in their pockets (and have their pockets lined by health company contributions). Today, with her eye on the great prize of the White House she is in the pay of the very people who defeated her Bill.

One group of people highlighted by the film are selfless people (part-time fire-fighters and nurses) who helped out in the rescue and clear-up operation after the collapse of the Twin Towers in September 2001. Unlike people employed by the local authority, these people have been denied any assistance with their dire medical conditions induced by their efforts. Moore derides the US set up by counter-posing the free medical treatment the detainees at Guantanamo Bay receive to the circumstances of Americans. He takes this group of people to receive treatment in Cuba. This will no doubt be derided as a stunt. His detractors will say that the Cubans were bound to use it as a propaganda opportunity. However, what cannot be denied is the fact that a country as comparatively poor as Cuba (and in the face of the economic boycott of the most powerful country on earth) provides a health service which is recognised as a beacon for socialised medicine around the world. We see people who help out health centres for nothing. One woman whose unpaid work gives her great satisfaction has to fight off the complaints of her husband for not cooking his meals when he wants them. Let him cook himself she laughs.

In the USA Moore’s film is being used as a campaigning tool for those struggling for universal healthcare. It could likewise be used here to drive home the message that socialised medicine should be defended against all those who want to reduce it to a ‘competitive market’.

Sitting watching the film I could not help thinking of ta recent speech by Gordon Brown lauding the “common values” which Britain apparently shares with the USA. Gandhi’s famous comment also came to mind. Asked what he thought of “western civilisation” he said he thought it would be a good idea.

In the richest country in the world the pursuit of profit is placed above human life itself. In Britain, prior to the formation of the NHS you could die because you could not afford to pay to see a doctor. Whilst the current government has dared not abandon the concept of free treatment at the point of delivery, they have opened up the NHS to market conditions (albeit not based on the health insurance model) which are progressively transforming NHS Trusts into businesses in which ‘the bottom line’ more and more intrudes into decisions on medical care. Private health companies have been paid a guaranteed amount of money even when they are not carrying out the amount of operations they have been contracted to do. At the same time NHS Trusts have been paid less than they should be because they have carried out ‘too much’ work.

The Brown government would no doubt deny that they would ever abandon the principle of care free at the point of use. However, the market system they have introduced has created a crisis in which many local hospitals or health centres have been closed, supposedly to create a more efficient service. But in New Labour’ market system, efficiency is measured not by the impact on the health of the population but by the balance sheet. There is already a campaign directed at even deeper ‘reforms’ of the NHS which would abandon the principles on which it was founded.

Moore’s film, although directed at a US audience should be used by campaigners in Britain to hold up the vision of a possible future for us here, unless the ‘reforms’ and the market-system are reversed, and the profit motive is driven out of the NHS. The trades unions in particular have a responsibility to stop equivocating and denounce the government’s ‘reforms’ as leading to the destruction of the NHS as a national service. The film should be shown widely to our members and to a wider audience. It is an important campaigning tool which could be used to develop a debate throughout the unions and with service users to warn people of what is taking place and to build campaigns directed at driving out the profit motive and the market system from the NHS.

To read ‘Sicko’ Factual Backup visit: http://www.michaelmoore.com/sicko/checkup/

Also worth a visit: http://www.calnurse.org/ California Nurses Association