Monday, July 16, 2007

Sans Frontières

Saw Michael Moore's new film Sicko yesterday. His films are ones I don't tend to initiate seeing on my own, but if someone suggests watching one I'll tag along. (I only saw Fahrenheit 9/11 because work had a fundraiser at a screening, Bowling for Columbine because someone brought it over to my place to watch, and The Big One because I got outvoted by my three male, fellow unemployed housemates when I suggested Ever After one bored night).

I knew nothing about the health care insurance scene going into Sicko. I know nothing coming out of it.

What I do know more about are experiences some people have had within the health care system. The heartbreaking thing about the film was, of course, the dozens of stories of people who had loved ones die as a result of being denied medical procedures, who had to make terrible decisions in their health care based on cost, and who went into debt just to get medicine they needed.

The problem is, Moore makes these great narrative statements, and then just doesn't back them up. Case in point: a little ways in, Moore asks the question "How did we arrive at this point?" (i.e., where millions of people are uninsured and/or insured but denied much-needed medical coverage). I thought, great! I'll get a crash course in the development of HMOs and the rise of health insurance companies. However, it didn't go there. I still have no idea when or how insurance companies became so central to health care in America.

Moore always has some slightly controversial and sensational ending to his movies. Here, he sails to Guantanamo with 9/11 rescue workers who need health care, and then takes them into Cuba when they're not allowed into the Gitmo detention center. It was pretty awesome. And also depressing.

does tend to over-glamorize the national health care systems in Canada, Britain, France, and Cuba. I realize the point was to show that it's doable, but the overly rosy portraits quickly became irritating. At least admit some of the problems or issues elsewhere; otherwise opponents of single-payer health care will do it for you and effectively take over the debating ground, thus further dichotomizing the issue.

There were a lot of gaps in the film. The pace of it was all right, it just had a lot of holes. Granted, Moore never purports to present a balanced analysis, so Sicko never explores, say, the problems in administering NHS or even suggestions for administering one the U.S.

Achieving universal health care isn't as easy as passing a bill that says everybody will have health coverage. As a policy wonk, this is the exciting part. How do we fund it? What infrastructure will we need to support it? What infrastructure won't we need to support it? Should states get block grants to determine their own implementation systems? And then there's the mobilizing and public education piece. How will the messaging change, depending on audience (doctors, parents, etc.)? There are no right or wrong answers, just answers. That's the cool thing! These are the questions I would have loved to see the film raise. I believe it's doable in the United States. I believe universal health care can be achieved in my lifetime. But I also realize there will be a hell of a lot of appropriations packages to work out, a hell of lot re-organizing and consolidating for administration, and a hell of a lot of public education work to do before any of it can be possible.

One minor quibble I had with the narrative involved a joke about Congress discussing the important of marshmallow peeps instead of passing health care reform. The typical Seattle middle-aged liberal audience laughed uproariously during this scene, but I found myself frowning. One, because as someone who has to read the friggin' congressional summaries on a regular basis, those kinds of frivolous moments on the floor of the House or Senate provide a much-needed brain break. They are infrequent and don't take up that much time. Second, because actually, in the mid-90s, Congress passed a hefty immigration reform package and the Lobbying Disclosure Act, among other huge, far-reaching things. They weren't exactly roasting peeps over a bonfire in the hopper. I understand the point about health care needing to be everyone's priority, but it misrepresents and kind of belittles all the other good and bad legislation that got passed during the same time period. But maybe that's just me getting fed up with Seattle's knee-jerk political audiences who laugh too loudly in all the predictable places.

Thought I might have issue with some of the ways Moore presents issues, I'm still glad he's out there raising them and keeping them in people's minds. Two things I love about his films: he always interviews an ethnically and socioeconomically diverse set of people. I think that always serves him well in illustrating how certain issues affect people across the board. The other thing I always like is how there's always a tie back to his hometown of Flint, MI. As a very proud Emerald City native who frequently raves about my own hometown (minor irritations with fellow residents aside), I totally respect others when they use theirs as a metaphor for American life.

No comments: