Louis Proyect: The Unrepentant Marxist

August 28, 2007

Sicko

Filed under: Film,health and fitness — louisproyect @ 1:19 pm

As art and as political commentary, “Sicko” marks a giant leap forward for Michael Moore. Dispensing with a lot of the customary gimmicks of his previous films–including trademark confrontations with greedy corporate heads on their own turf–it focuses more on the stories of individuals who have been victimized in one fashion or another by the lack of decent health care in the richest country in the world. By using their misfortune as a means of exposing a system built on naked profiteering, he will open the minds of millions of Americans to a new way of thinking. The emphasis throughout the film is on the need for collective action and working-class solidarity, a clear challenge to the way of doing business as usual in capitalist America.

The film begins with a look at the consequences of being uninsured in the US. Moore introduces us to a worker who loses two fingers to a band-saw. After being rushed to the hospital with the two severed fingers, he learns that they have a rate schedule based on the type of finger that needs to be reattached. His index finger will cost $12,000 but the ring finger will be $60,000. Since the man describes himself both as a sentimentalist and of limited means, he decided to go for the ring finger since it was a reminder of his wedding vows.

But after reviewing several other examples of the calamities that await the uninsured, Moore explains that his film is focused on what happens to those who do have health insurance from some of the most powerful and profitable corporations in the US, including Cigna, Aetna, and Blue Cross/Blue Shield. Since they are under enormous pressure to show the maximum return on stockholders’ investments, they find it necessary to deny payment on claims for major medical procedures like cancer surgery. The insurance companies will typically go through the application forms of the claimants looking for “pre-existing” conditions that have nothing to do with the illness for which they are being treated. One woman discovers that her $12,000 claim for surgery was turned down because she had a yeast infection 20 years earlier. This is like refusing to pay for the cost of a heart transplant because somebody had been treated for insomnia in the past.

Insurance companies will also refuse to pay for many life-saving procedures that they deem as “experimental” and hence not reimbursable. In a heart-wrenching segment, we meet a white woman from Missouri employed as a nurse whose African-American husband was suffering from kidney cancer. A specialist told them that a bone marrow transplant from a suitable donor would probably save his life. After it was determined that his younger brother was a perfect match, they sought approval from her insurer to go ahead with the procedure. Even though (or perhaps because) her health plan administrators were doctors at the hospital that employed her, they turned her down because the procedure was “experimental”. In a meeting with the administrators, she accused them of having a double standard. If it was their mate who needed help, they would approve. She also accused them of bigotry because she was married to a Black. They, of course, denied this. If there is anything that “Sicko” reveals, it is the utter incapability of the rich and the powerful to see themselves as others less privileged do.

The answer to these problems is obvious. You need to take the profit motive out of the health care system. Moore is very good at refuting rightwing opponents of “socialized medicine,” who would regard government participation in health care as the first step toward a communist America. He reaches deep into the film archives of the 1950s to show excerpts from anti-Communist documentaries that are hilarious to watch today. We see three men sitting at a lunch counter who share a single spoon, the consequence apparently of government rationing. There is footage as well of old Soviet-era films, including young people doing calisthenics (horror of horrors) as well as a snippet from a musical commemorating hearty peasants meeting their wheat quota. As a connoisseur of Soviet-era kitsch, I recognized it immediately as a performance of Dimitri Shostakovich’s proletarian oratorio “Song of the Forest,” a marvelous work despite the clunky libretto.

Next on Moore’s itinerary is a visit to the countries that are so demonized in the American media as poster children for the ills of government meddling in health care: Canada, Great Britain and France. The net effect of his interviews with citizens in each country is to debunk the claims of the free marketers. When he sits down with a couple of elderly Canadian relatives, he learns that even if they are making a brief visit down to Michigan to see members of the Moore family, they take out temporary health insurance at the local Sears department store. Why? They know that an accident on US soil can cost them thousands of dollars.

They refer Michael Moore to a friend of theirs, an elderly man who took a golf vacation in Florida several years earlier. While swinging a club, he snapped a tendon in his arm and was forced to go to a local hospital where he learned that it would cost $25,000 to repair. He cut his vacation short and flew back to Canada immediately where the surgery was free. While driving around on a golf cart with the man, Moore presses him with all the usual charges against the Canadian system. Isn’t the medical care second-rate? Don’t you have to wait forever to see a doctor? The bemused golf player says not at all. Using the trump card of the US conservative ideologists, Moore leans forward and asks him if he isn’t worried that it will lead to socialism. The man says that he is a member of the Conservative Party in Canada himself and that he doesn’t regard health care as a matter of politics at all. It just makes common sense to make health care available to everybody for free. He adds that Tommy Douglas, the father of the Canadian health care system, was voted the greatest Canadian in the country’s history in a 2004 poll.

It is worth mentioning, although the film does not, that Douglas was a founder of the New Democratic Party. If there is any obvious political message in the film, it is the need to back Labor or Social Democratic parties. Without ever really getting to the heart of how the capitalist system operates, Moore is quite open about the need to back working-class initiatives of the kind that have led to programs like national health insurance. In an interview with long time leftwing British Labour Party leader Tony Benn, the case is made for democracy which involves the working people using the ballot to press for reforms that is in its own class interests. “Sicko” makes an essential point that a Labour Party victory after WWII was instrumental in establishing socialized medicine even though the country was devastated economically at the time. If Great Britain could accomplish this, there is no excuse for the US not to. All that is missing is the political will.

To drive home the point about the economics of health care, the finale of “Sicko” involves a boat trip to Cuba with three emergency medical technicians (EMT) who developed chronic illnesses after volunteering to work at the WTC site following 9/11. They have respiratory illness, post-traumatic stress disorder and other ailments that remain undiagnosed and untreated. After showing video clips of Republican politicians assuring their critics that al Qaeda suspects were getting top-notch medical treatment at the Guantanamo naval base in Cuba, Moore–resorting to the kind of guerrilla theater that made him famous–approaches the base in a boat with his sick EMT workers. Picking up a bullhorn, he asks the guards if they can come into the base to get the same kind of free and excellent health care that the terrorists were receiving. After a siren goes off, they beat a hasty retreat.

The final moments of the film are deeply moving as we see the EMT workers being cared for by Cuban medical personnel in next door Havana, where it costs nothing to see a doctor and where health indicators match those in G8 nations. For Moore to portray Cuba in such a light takes a lot of guts given the anti-Communist hysteria in the US found in both parties. Recently Barack Obama urged an end to a ban on visits and remittances to Cuba by Cuban-Americans, a relatively modest proposal that is backed by many in the expatriate community. To show that she is more reliable than Obama when it comes to defending American imperialist interests US in the region, her opponent Hillary Clinton stated that “Until it is clear what type of policies might come with a new government, we cannot talk about changes in the U.S. policies toward Cuba.”

In what amounts to a relatively minor flaw in the documentary, the Clintons are shown in a more positive light than they deserve. Moore represents them as caving in to rightwing pressure when they put forward a health care plan after taking over the White House. In reality, the Clinton health care plan had very little in common with Canadian single payer or British socialized medicine. The bill was a Byzantine proposal that required employers to provide health insurance coverage to their employees through health maintenance organizations (HMOs). This was a typical Clinton maneuver, putting forward an idealistic-sounding reform that was essentially toothless. When the health insurance industry, the American Medical Association and the Republic Party unleashed a ferocious attack on this palliative measure, the Clintons folded like a cheap suitcase. President Clinton did rediscover his spine, however, when it came to pushing through NAFTA and throwing single mothers off of welfare.

Critics on the left have attacked “Sicko” for not being more explicitly critical of the capitalist system. To the contrary, the film is a 113 minute assault on the profit motive. Perhaps they expected Moore to include an interview with a member of the World Socialist Website on the labor theory of value and the tendency of the rate of profit to decline. Fortunately, Moore understands how to reach people with the very same kind of ideas without putting them to sleep.

If anything, the main criticism that can be made is that Moore is not consistent enough when it comes to defending the social democratic principles that politicians like Tommy Douglas and Tony Benn represent. As a Democratic Party loyalist, Moore must surely understand that no Presidential candidate will ever challenge the health insurance industry. While Hillary Clinton is an obvious puppet of the industry (the film records that she is the second largest recipient of health insurance industry donations), Obama is almost as bad. In a May 29 article titled “Obama Channels Hillary on Health Care,” Time Magazine summed up his health plan as follows:

“Obama’s plan contains many of the features of the failed health care proposal pushed more than a decade ago by his rival, Hillary Clinton, that went down in flames in 1994, including its most controversial element: a legal mandate that employers provide coverage for their workers, or pay a percentage of their payroll into a fund for the uninsured.”

Ultimately, a government health plan in the US will require a break from the two-party system, something that Michael Moore is probably not ready to do. This will require a mighty upsurge from the American grass roots that will result in 1960s type protests or in electoral initiatives to the left of the DP–or a combination of the two. So far, “Sicko” has generated nearly $25 million in ticket sales, which represents roughly about 2.5 million people in the seats. Seeing and hearing wild support for the message of the film last night at the New York Cineplex I attended gives me a strong sense that the tide is turning in favor of the massive social change that will produce the reforms that “Sicko” advocates. Whatever Michael Moore’s ideology, he will have played a critical role in making this happen.

12 Comments »

  1. I did think that Moore might have mentioned that, given the torture the Guantanamo prisoners have suffered, they surely needed good medical care.

    Michael Yates

    Comment by Michael Yates — August 28, 2007 @ 1:51 pm

  2. Some left fora were indeed critical of this film, but in the long-term project of educating Americans about their own best interests and how they will never be met in the current political system, Moore’s film should have a major impact.

    The most affective parts of the film for me were the visits with normal people in Canada, England and France, showing a socialist approach to delivering service as not at all threatening or utopian. The beginning of the film, featuring the sad stories of people denied healthcare, made me uneasy, as it began to feel like propaganda. And the final part, where Moore transports sufferers from the after-effects of 9-11, to Cuba for treatment, stopping at Guantanamo along the way, lost focus and integrity by attempting to include two highly charged issues not related to the real subject. The scenes inside Cuba, though, were beautiful.

    Comment by plato's cave — August 28, 2007 @ 1:52 pm

  3. I haven’t seen the film but I’m surprised anyone on the left critized it for not being “left enough.” After Moore begged Nader not to run it’s clear what the limits of Moore’s politics are, so people should stop expecting him to be the second coming of Lenin or Eisenstein.

    Comment by Binh — August 28, 2007 @ 3:14 pm

  4. Michael Moore has limitations in his politics but he’s a great propagandist who probably reaches more working class people than anyone on the Left I can think of. His lack of knowledge only really shows when covering issues beyond the US (understandably). Hence the problem I have with the interview with Tony Benn here in Britain. Benn is a charismatic aging Left reformist but his view of political realities is sadly dated. The Labour Party he argues workers should vote for to get reforms through is not the one that brought in the NHS. On the contrary, it’s the very party trying it’s best to undermine the National Health Service. It’s now New Labour, a pro-big business neo-liberal party, as are the other two main political parties here. New Labour health policy is designed to allow the increasing privatisation of healthcare e.g not building hospitals through public funding but PFI schemes. As a consequence of New Labour policies, local battles are going on all over the country defending the National Health Service against funding deficiences, ward closures and redundancies. At the national political level New Labour only retained it’s parliamentary majority in 2005 because most workers still loathe the Tory Party even more. As a consequence of this, there is no large-scale national political alternative at the moment – there are local councillors scattered around the country who are either explicitly socialist or in local community or pro-NHS groups which are Left-ish. Two possibilities exist – Respect, created by the SWP out of the Stop the War initiative. This has George Galloway as a Member of Parliament and quite a few local councilllors in a few places. It’s main drawback though is that it has dispensed with class politics and has an almost complete orientation to Muslims of all classes in particular areas. The other possibility is the CWI-backed Campaign for a New Workers Party. This is an explicitly socialist formation but not revolutionary. It has around 3,000 signatories nationally but it has not taken off to the extent first hoped for, largely due to an underestimation of how low the level of class struggle/consciousness still is. Having said that, the CNWP still remains the best hope for national Left-wing working class political representation. Hopefully, this will complement an increasing role for bodies such as the National Shop Stewards Network, set up by trade union militants within the last year.

    Comment by Doug — August 28, 2007 @ 4:29 pm

  5. Perhaps I ought to clarify my comments in referring to the issue of working class political representation. I wasn’t referring to Britain as a whole, just in England and Wales. The political landscape in Scotland is entirely different and the issue of nationalism is a core one that comrades there have to address. The key role of the SNP in the devolved parliament and the acrimonious split in the Scottish Socialist Party have created immense problems.

    Comment by Doug — August 28, 2007 @ 6:55 pm

  6. Excellent commentary, Louis. You have very well grasped the political essence of the movie, as well as the transformed cinematic techniques which Moore chose to employ when taking on this issue. It’s one of great personal interest to millions of people in the United States of America. SiCKO aims at a broad public in the United States, and it’s still in theatrical release. More than that, it has succeeded in generating public discussion of health-care provision (and exclusion!) as an issue facing the people of the United States.

    The sickness of infantile leftism is one of our greatest problems in the United States. You remember that old saying about “Those who can, do. Those who can’t, teach.” Sometimes that applies to people on the political left. The criticism which passes for political commentary on the left in the United States is all-too-frequently an unfortunate mix of smug self-satisfaction and ignorant boorishness.

    The grossest example of this was the campaign waged against Moore for FAHRENHEIT 9/11 incredibly describing it as “pro-war” which was carried out by THE MILITANT some years ago. In fact, all of the left attacked MOORE rather than using his comments to attack the evils he was describing and the “official story” which was put out about the September 11th attacks on the people of the United States.

    Some people think that criticizing is the most important thing anyone can do. It’s all but a justification for the existence of some groups and individuals. You very well criticized this posture as exemplified by the ISO and SA. Thanks for those.

    Moore’s SiCKO is exactly as you say it is, a 113-minute assault on the private profit system in health care in the United States. It’s more and more apparent that the real purpose of the entire insurance system is essentially to decide that who does NOT get whatever medical procedure or medication. Oh, yes, one other aspect not widely commented on was his linkage of the current situation to anti-Communism and the Cold War, which has been part of the cultural landscape of the United States almost the whole time since 1917. Moore is a long more politically left than he at first appears.

    Best wishes,

    Walter Lippmann
    Los Angeles, California

    Comment by Walter Lippmann — August 29, 2007 @ 2:45 am

  7. This is Louis Proyect at his best!

    I believe that a translation into Spanish would do marvels in Latin America, particularly in those countries where the national health system was ravaged by the insurance companies and the pharmaceutical laboratories, such as mine, Argentina.

    There is an ongoing struggle here against this development (which began in Argentina in 1966 and reached its highest degree of depravation under Menem, during the 90s), and it will not be easy because many unions -including many very combative unions- have been induced to take the US American system as a Panacea for their own members within the general destruction of the public health system.

    Comment by NĂ©stor Gorojovsky — August 29, 2007 @ 6:11 am

  8. Compliments to Walter Lippman, again! The critical compulsion and defensiveness of the left, especially the strict or theoretical left, is understandable, since it has been an embattled minority for so long. However, there is always a flavor of elitism in it, an “I know more than you” quality. I hear the same tone in the talk of some environmentalist and global warming activists.

    Leftists have to do two things at once, which tug against each other: speak to the real interests of the largest number of people, and at the same time point out the traps of reform within the system. As you say, Michael is doing the first far better than most of us on the “critical” fringe.

    Comment by plato's cave — August 29, 2007 @ 2:54 pm

  9. roger i love michael moore exactly for being such a successful propagandist; marxism often neglects the importance of media & design for the propagation of its messages. colonel would say that i am stalinist because i think so, but this has nothing to do with stalinism, it’s pure necessity. to reach critical mass we have to use the mediatic weapons of the ruler.

    Comment by parodycenter — September 3, 2007 @ 3:37 am

  10. I haven’t watched the movie yet. But I will soon. At least he draws good discussion to the topic and stimulate discussion regardless how left he is or is not.

    Comment by crashahelmet — May 15, 2008 @ 9:32 pm

  11. It’s interesting you see so much involvement of Moore himself in his movies. He heavily involves into the movies, seldom do directors make into the screen and he makes his face seen everywhere in posters in the film interviewing people etc

    Comment by Pat — May 18, 2008 @ 10:18 pm

  12. I think Michael Moore is incredible. The films he’s involved with usually have some kind of shock value and I love the fact that he isn’t afraid to get people talking about serious, controversial subjects.

    Comment by Melinda's Fitness Blog — December 8, 2009 @ 8:36 pm


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