Michael Moore's Imperfect Diagnosis

Director Michael Moore appears on the stage at a gala during Toronto International Film Festival, Sept. 8, 2006.
AP Photo/Chitose Suzuki
This column was written by Jonathan Cohn.

The warnings went out in a 2004 company newsletter: Watch out for "a scruffy guy in a baseball cap." The scruffy guy was Michael Moore, and the company was pharmaceutical giant GlaxoSmithKline, whose executives had gotten wind of Moore's new project: a documentary about the health care system called "Sicko." The executives figured it was only a matter of time before Moore showed up on their doorstep, camera in hand — if he hadn't already. "We have six business centers nationwide," a Glaxo official confided to the Los Angeles Times, "all of which report sightings."

Earlier this month, when I got my first glimpse of "Sicko," I felt similar trepidation, though for rather different reasons. My bias in watching Moore's film is that, in the broad sense, I agree with him. I've been writing about the flaws of the U.S. health care system, and the need for universal health insurance, for nearly a decade now. (And, yes, I recently wrote a book with almost the exact same title as Moore's movie — "Sick" — although I'm pretty sure I thought of it first.) But Moore has not always been the most intellectually rigorous storyteller — or, for liberals, the most useful ally. "Fahrenheit 9/11," Moore's attack on the Bush administration and the Iraq war, may be wildly popular among Bush-haters and the most financially successful documentary ever. But a lot of people think it also ended up helping Bush win reelection, by trading in unsubstantiated conspiracy theories and firing up the Republican base. As Jon Feltheimer, the CEO of Lion's Gate Films, told Vanity Fair, "I've been told a number of times [by Republicans], 'Isn't it great what you've done for the party?'"

As "Sicko" rolled, it did little to allay my fears. I spotted plenty of intellectual dishonesties and arguments without context — enough, surely, to keep right-wing truth squads (and some left-wing ones) busy for weeks. Moore also couldn't help but stick in unrelated jabs about the Bush administration's efforts to fight terrorism and insisted on hyping Cuba's medical system — an awfully poor way to counter the generations-old slander that universal health care is tantamount to "socialized medicine."

Still, by the time the final credits ran, it was hard to get too worked up about all of that. Because, beyond all the grandstanding and political theater, the movie actually made a compelling argument about what's wrong with U.S. health care and how to fix it. "Sicko" got a lot of the little things wrong. But it got most of the big things right.

When Moore was filming "Sicko," he frequently told people that he was filming a comedy about the 45 million Americans who don't have health insurance — people who represent the most glaring failure of U.S. health care. And, in fact, the opening sequence of his movie portrays two people in precisely that situation — one of whom is Rick, who accidentally sawed off the tops of two fingers while working at home. With no insurance to pay the bill and limited funds at his disposal, he has to choose whether to have the hospital reattach his middle finger for $60,000 or his ring finger for $12,000. (He chooses the ring finger.)

But, as Moore quickly explains, uninsured Americans aren't the primary subject of his film. Instead, he announces to the backdrop of 1950s music and newsreel footage, he's chosen to focus on the rest of America, the people who do have insurance and the hardship many of them go through anyway. He does so primarily by telling the stories of hapless victims, deftly weaving farce and tragedy. We hear both from a woman who gets stuck with an ambulance bill because she didn't clear the charge with her insurer before losing consciousness during a car accident, and from the widow of Tracy Pierce, who died after his insurer denied a potentially life-saving bone-marrow transplant for his kidney cancer.

Moore isn't aiming for balance: Officials defending the health care industry don't get any airtime. Instead, Moore gives us the views of former insiders turned whistleblowers — like Linda Peeno, former medical director at the HMO Humana. Peeno stopped working there in the late '80s after becoming disgusted with pressure to deny coverage — including for a heart transplant for a man who otherwise might have lived. Moore also introduces viewers to Lee Einer, whose job at a major insurance carrier (Moore doesn't say which) was to pore over insurance applications retroactively, focusing on people with large claims in order to find evidence that they had hidden previous conditions. As Einer explains, it was widely understood that intent to mislead was irrelevant; the companies just wanted excuses to avoid paying bills. (To illustrate what this means in practice, Moore also tells the story of a woman whose carrier pulled coverage after an operation, because on her application she didn't mention a past yeast infection.)