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The Controversial Director on the Story Behind His New Film “Sicko”

By SARAH BAKER and KATIE ESCHERICH
ABCNews | Nightline
June 13, 2007

Polarizing — that’s one way to describe the work of filmmaker and activist Michael Moore, whose new film, “Sicko,” takes on the U.S. health care system.

“Nightline’s” Terry Moran spent a day with the director in Sacramento, Calif., where Moore teamed with the California Nurses Association to hold a rally at the state capitol.

The nurses wore red “Sicko” T-shirts and cheered for Moore as he criticized America’s health care system.

“I am honored to be able to be here today to be able to join with you in a very important movement that is already taking place all across this country,” he said. “Because the American people are fed up with this broken health care system. And & it’s the nurses who are on the front lines of this war. And it is a war. It’s a war against greed.”

While the group was walking through the state senate chambers, a group of teenagers recognized Moore and immediately swarmed him, shouting things like ‘Oh my God!’ and ‘I love your work!'”

Moore is known for producing films that inspire love and hate, and stir political debate, but he said in some ways he feels like a failure.

“There’s a big part of me that feels like a failure, in the sense that I started out by making a film about General Motors to save my hometown of Flint, Mich., and … Flint today is in far worse shape than when I first made the movie,” Moore said.

“I made [“Bowling for Columbine”] in the hopes that there wouldn’t be anymore school shootings, and look? We’ve gone through another tragic school shooting. & ‘Fahrenheit 9/11’? Bush was re-elected a few months later. You have to understand that there’s a part of me that feels like, geez, when are you going to make a movie that can actually get something done? So I’m hoping that this film, ‘Sicko’ will do just that.”

Health Care’s Haves and Have-Nots

Moore’s hope for the film is that it will inspire change and help find a solution to the massive problems facing the U.S. health care system, and said that making the movie inspired him to change his own life and to take better care of himself. He began to diet and exercise, dropping more than 30 pounds during the course of the film’s production.

Moore hopes that people who see “Sicko” will realize that the current health care system needs an overhaul and will start a “political movement” of change, but he also said that fixing the health care system isn’t strictly a political issue.

“It’s not really a political issue,” Moore said. “I should say, it’s not a partisan issue. It’s political in the sense that our laws make it so that people have a difficult time getting the care they should get. Until those laws change I think we’re going to have this ‘haves and have-nots’ society that we have when it comes to health care.”

Moore believes that the U.S. needs a universal health care system, and tried to drive home that point by comparing the American system to those around the world. That goal brought Moore and his production team to Cuba, and as a result, Moore has run into trouble with the U.S. government because of the trade embargo with that country.

“The mainstream media has done such a good job of telling us how horrible Castro is and whatever the violations are down there,” he said. “I think we all know what the situation is in Cuba. What we don’t know is the other side of the story, and that’s what I try to fill in. … In my movie you see Cubans getting help whenever they get sick, and that is the truth. The U.N. supports that fact. They have an excellent health care system, probably the best in the Third World.”

‘I’m Not a Democrat’

Most people would say that Moore’s films are liberal-leaning, but the director said he doesn’t categorize himself as a Democrat or Republican.

“I’m not a Democrat. I’m not a part of the Democratic Party,” he said. “My wife, she’s the vice chair of the local Democrats up in northern Michigan, where we live. She keeps trying to get me to join. & I have always voted for whoever I thought was the best person.”

Moore was widely criticized for the statement he made at the 2003 Academy Awards, saying, “We live in the time where we have fictitious election results that elect a fictitious president.” Moore now acknowledges that if he had it to do again, he probably should have said it differently, but he takes issue with those who called his actions un-American.

“What’s the crime that I’ve committed here? Because I first stood on an Oscar stage and said I don’t think the president is telling us the truth? That we were being led into war for fictitious reasons? & I can’t think of anything more pro-American than standing up and saying our leader is making a mistake. If you think your leader is making a mistake, you should stand up and say something. It is your duty as an American.”

‘People Are Dying’

In addition to being a filmmaker and an activist, Moore is also a deeply religious man, an Eagle Scout who at one point decided to go to the seminary and become a priest. He said that “Sicko” comes from “a spiritual place.”

“I don’t like putting my religious beliefs out there,” he said. “But I do believe that this film is coming from a very deep place, from a spiritual place in the sense that I believe as a Christian and a Catholic that it is my responsibility to make sure that not only am I covered if something happens to me, but that everyone else is covered. & I belong to the Directors’ Guild. I have a great health plan, and I’m going to get help, but 47 million people aren’t going to get help. There’s something wrong with that. It’s very immoral.”

“Sicko” contends that people are dying because of the flaws of the current system, and Moore places some of the blame for these failures on insurance and pharmaceutical companies.

“There’s no getting around the fact that people are dying in this country as a result of the decisions that get made by these health insurance companies. People are dying in this country because they can’t afford the pharmaceuticals because of the price gauging that takes place. & I don’t think it’s a dirty little secret anymore, I think it’s pretty much out in the open.”

And what does Moore say to people who tell him he should leave the United States if things are so bad?

“I’m here to stay. It’s the country that has to change. I’m not changing. I think there are millions like me who feel the same way,” he said. “We’re Americans, and the most patriotic thing we can do is to work to make this country a better place. Things are going to have to change, because I’m not leaving. We’re going to have to have universal health care for all Americans. I’m not leaving. This war has got to end. I’m not leaving. I’m going to continue my work, to do these things because I believe it is a requirement of me as an American.”

Copyright 2007 ABC News Internet Ventures

By Roger Ray
Springfield News-Leader
Voice of the Day
Published Wednesday, June 6, 2007

In the mid 1970s, the then-largest insurance company in the world, Prudential, added auto and homeowners insurance to its product offerings. The reason given for this move was, are you ready?…. because there was about to be a national health program in the United States that would end the need for health insurance! Prudential wanted to give its agents another product to sell to make up for what they would lose in commissions on health insurance. However, the Carter administration failed to overcome the objections of health care providers and insurance companies and abandoned health care reform.

Twenty years later, the newly installed Clinton administration made health care reform a priority. Insurance premiums had risen by more than 3,000 percent since the Carter administration; clearly, something had to be done before health care bankrupted the American economy. But a multimillion dollar campaign, including shamefully deceptive TV ads, was launched by the insurance industry, and the Clinton reform initiative not only failed but was replaced by a reform that not only further empowered insurance companies but reduced medical services and physician salaries while increasing out of pocket expenses to the insured!

Now, as the presidential election season is heating up, candidates are presenting their plans for how to fix a health care delivery system that is so sick there is a reasonable question as whether to take the patient into the emergency room or just head straight to the graveyard. Interestingly, in 2007, no one seems willing to talk about a universal health care program that cuts insurance companies out of the system. Insurance and pharmaceutical companies have become so powerful that no politician who has even the slightest hope for winning an election will dare to challenge them. Our democracy is not “for sale” because it has already been purchased, and the owners are the for-profit corporations in the health care field. There are three lobbyists for every elected official in Washington, D.C. representing the pharmaceutical companies, which is why any legislation addressing medical services or prescription meds is written by and for insurance and pharmaceutical companies, not the elderly, the ill or the poor.

As a member of the clergy, I approach the issue of health care from the vantage point of concern for the poor and the sick. I am outraged that 47 million Americans are simply priced out of the world of health insurance and tens of millions more do not have adequate coverage.

But beyond the whole issue of compassion and social ethics, the way this nation is operating its health care delivery system is insane from a purely economic viewpoint. We provide free public education, not out of the goodness of our hearts but because we know that we need an educated populace to have a strong society. We build road and bridges, not for the convenience of our citizens but to make our citizens productive. We regulate certain utilities, the food industry, pollution and establish standards for construction, automobiles, and even beauty products, to protect our population from harm and to help keep our society strong and productive. Providing health care is just a part of the social network of services that make the country work. We are already paying more for health care than it would cost to have universal health care. The costs of health insurance make our American manufactured goods too expensive to compete in the world market and the number of workers who are sick, disabled or unable to be creative or innovative in new careers is killing our global competitiveness.

From a perspective of sheer greed, we should provide universal health care so that we can export products rather than jobs. It makes no sense to just demonize the insurance industry because for-profit companies have no motivation for self-regulation. For them, the sky is not the limit. They are interested in patients in the same way that fleas are interested in dogs; that’s just the way capitalism works. For the sake of our country’s economic future and for the sake of our very souls, we must make basic health care available to everyone and at a cost that allows people to still earn a living wage. We must regulate the insurance industry until such time that we can do what every other developed nation in the world has already done: make it unnecessary.

Roger Ray is the senior pastor at National Avenue Christian Church (Disciples of Christ). “From the Left” appears every Wednesday. Coming Tuesday: “From the Right.”

Thomas Walkom
The Star
Jun 09, 2007

Among the glitterati, Michael Moore used to be a hero. Now he is a bum. When Roger and Me, his film on General Motors head Roger Smith and the deindustrialization of America, came out in 1989, he was lauded by reviewers as a breath of fresh air, a 21st-century gonzo journalist. When it was later revealed that the dramatic core of that film, Smith’s refusal to be interviewed by Moore, was untrue, the filmmaker was denounced as dishonest.

Now comes Sicko, Moore’s latest film and a scathing indictment of U.S. health care. The critics are determined not to be taken in again. When the flick showed last month at the Cannes Film Festival, Canadian reviewers blasted Moore for whitewashing this country’s medicare system. At a pre-release showing for reporters this week, there was more muttering about his “manipulative” techniques.

The critics should relax. It’s true that Sicko may not make it in a peer-reviewed academic journal. Caustic and blatantly opinionated, it makes no pretense at even-handedness. It does not delve into what is good about the American health system, of which there is plenty. Its description of universal health care systems, such as Canada’s, is cursory. It is not comprehensive.

It is, rather, a film designed to agitate its audience and make a political point, what in the old days — before propaganda got a bad name — might have been called agitprop.

And it is also fundamentally accurate.

Audiences in Canada, Britain, France and Cuba — the countries Moore visited on his health odyssey — might be bemused by portions of Sicko. In Moore’s Paris, everyone is well-dressed and attractive. In Britain, everyone is polite. In the relatively short Canadian portion, the narrator looks in on a Windsor hospital emergency room and finds no one waiting longer than 45 minutes. To any Canadian who has ever been forced to go to emergency, this would seem unbelievable.

But Moore is not making a film for Canadians or the Brits or the French. He doesn’t delve into Canada’s debate over two-tier medicine. He ignores British controversies about public-private partnerships in health and pays absolutely no attention to French complaints that upfront user charges subvert that country’s medicare system. He doesn’t care about any of this. Nor should he.

Moore is making a film for Americans. And what he is telling his compatriots is very simple and very true: that America’s refusal to embrace some kind of universal health care system makes absolutely no sense.

This is not a novel point. Nor, outside of the U.S., is it even remotely controversial. In Canada, no one except for a few diehards in the right-of-centre Fraser Institute lionizes the U.S. system. Dr. Brian Day, the incoming head of the Canadian Medical Association is a vigorous critic of Canadian medicare. But he touts French or German medicare, not the U.S. model. Ditto Preston Manning, the former Reform party head. He says he wants a two-tier system that would keep the existing universal system.

The reason is simple. Universal public medicare works — which is why every industrial country outside of the U.S. employs some form of it. For those who choose to read the scholarly literature, the evidence is overwhelming. Americans spend more per capita on health than any other nation in the world and get worse results. This is not just Michael Moore talking; it is the Organization of Economic Co-operation and Development. When Moore says Canadians live on average three years longer than Americans, he is correct. When he says infant mortality rates are lower in this country than the U.S. he is right there too.

It’s not just Canada. United Nations figures show that a baby born in Havana has more chance of surviving than one born in New York City. The British live longer than Americans as do the French and Japanese. Is it simply coincidence that all of these countries, save the U.S., have some form of universal public care system?

Nor is there any doubt as to the culprits. Again, the evidence (from the New England Journal of Medicine among others) is overwhelming. Americans waste billions on so-called administration costs attributable to private health insurance companies. As Sicko accurately points out, some of these costs are incurred by insurers doing everything they can to avoid paying benefits to sick policyholders. Moore finds this weird and he is right. Paul Krugman, the Princeton University economist who now writes for The New York Times, makes the same point. But Michael Moore is more entertaining.

So why don’t Americans wise up? Moore looks to vested interests in the U.S., primarily doctors, insurance companies and drug firms. Discount that as paranoia if you wish. But it is all documented in the contemporary press accounts of the bitter debates over Bill Clinton’s failed attempt to bring in universal health care.

Moore also fingers the bizarre strain of anti-communism that still runs through U.S. popular culture. If you think he is kidding, you should read some of the email I get from Americans when I write — in a far more restrained way than Michael Moore — about medicare. A good many Americans do think that medicare (or, as they call it socialized medicine) is a plot against freedom. As Moore says, this view is amplified by the media.

In 2000, a Yale political scientist named Ted Marmor published an article in the academic journal HealthCare Papers that made exactly this point.

Looking at media coverage of flu epidemics in Canada and the U.S., Marmor found that identical events (overcrowded waiting rooms, patients dying on the way to hospital) received entirely different interpretations in the media. If a woman in Los Angeles died from the flu, the blame was placed on the virus. If a similar flu death occurred in Montreal, Canadian medicare took the heat.

Is Sicko worth seeing? I leave it to my colleagues who are more knowledgeable about film to say something intelligent about this. But personally, I get a kick out of Moore. At times, he uses all the Hollywood tricks to wind the audience into his story. At other times, he’s more Brechtian: During the French segment of Sicko, it’s as if he’s saying: “I know this is a cartoon, but look at me doing this cartoon!” As a piece of entertainment, it works.

But I suspect Moore is trying to do more than entertain. He’s trying to whack his fellow Americans on the head and say to them: Hey! Wake up. Why do we run our health system in such an insane way? No one else does.

And in that, he is absolutely right. Good luck to him.

By ROSE ANN DEMORO, CNA/NNOCC Executive Director
LA Daily News
June 6, 2007

MICHAEL Moore’s riveting new film provides a valuable lesson that we can solve the health care crisis without dumping more resources into a too-often heartless, private, insurance-based system.

Lack of insurance is not the trouble in America. The insurance industry itself is the problem.

A Zogby/UPI poll in February found that 42 percent of Americans said their insurer had refused to pay a medical bill. A USA Today/ABC poll in March found one in four Americans had trouble paying for medical care in 2006, although two-thirds of those were insured.

“Sicko” puts human faces on those numbers. Like Donna and Larry Smith, who had to sell their home and move into a cramped room in their daughter’s house when their medical bills became unpayable. Or Laura, the young woman sent a huge bill for her post-accident ambulance trip because it wasn’t “pre-approved.”

Neither story is an aberration. Moore unearths 1971 White House tapes in which President Nixon and John Ehrlichman discussed the pending bill to promote managed care. Ehrlichman reassures Nixon that “all the incentives are toward less medical care … because the less care they give ’em, the more money they make.”

Three decades later, Moore shows the inevitable evolution of this scheme, partly through two industry whistle-blowers who agonize over their role in denying care. “You’re not slipping through the cracks. They made the crack and are sweeping you toward it,” one says.

In an intimate final screening in New York that the California Nurses Association was invited to attend with the real-life stars of “Sicko,” Moore made clear his view on whether the bandages and sealing wax that some politicians and presidential candidates favor can fix this callous system. “We have to eliminate the private insurance companies. They have to go,” Moore said.

Such sentiments may not be widely popular on Capitol Hill. After all, “Sicko” notes, the insurance industry’s “biggest accomplishment might be buying our U.S. Congress.” But beyond Washington, it gets a different reception.

A New York Times/CBS poll this year found that 64 percent said the government should guarantee coverage for all, and 55 percent identified it as the top domestic priority for Congress and the president.

Can it really be done? Moore shows us four ways how – Canada, Britain, France and even Cuba. He could have added every other industrialized country where care “doesn’t depend on your premiums; it depends on your needs.”

Amid the four other countries Moore visited, the U.S. is last or next to last in one health care indicator after another, such as life expectancy, adult mortality and infant-mortality rates, to name three, according to World Health Organization statistics. Only when it comes to per-capita spending are we number one.

Where does the money go? From one-fourth to one-third is siphoned off the top for paperwork and profits for the private insurers, compared with less than 5 percent for Canada or our own Medicare, a publicly run program.

Forcing everyone to buy insurance, as Gov. Arnold Schwarzenegger proposes, or providing tax credits or shifting more government money to the HMOs won’t solve the crisis; it will just reward the insurers for their system of preventing care and make them wealthier.

Put that money back into delivery of care. Set up a system in which everyone is covered, for life, with quality medical care, comprehensive benefits and cost controls.

Sound impossible? Most of those featured in “Sicko” would not have been helped at all by the majority of the limited reforms proposed in Congress or by most of the presidential candidates to date. But we can accomplish that here in California with Sheila Kuehl’s Senate Bill 840 or nationally with House Rule 676 in Congress, both of which would guarantee comprehensive health care for all without relying on the insurance industry.

“Sicko” profiles three Sept. 11, 2001, rescue heroes who have since struggled to obtain needed care. Moore tries to bring them to one place where the U.S. does guarantee universal care: the military base at Guantanamo.

Only when they’re turned away do they go next door to Cuba. “They just wanted some medical attention, the same kind (our government) provides to al-Qaida,” Moore says. For the rescue heroes or the rest of us, is that too much to expect?

Rose Ann DeMoro is executive director of the California Nurses Association.