Michael Moore's scathing, important look at the U.S. healthcare system has plenty to rile the far right -- and a lot more to enrage the larger American public.

By Andrew O'Hehir

Executive Editor

Published May 20, 2007 2:09PM (EDT)

"I know the storm awaits me back in the United States," Michael Moore told a wall-to-wall throng of reporters here after the Saturday morning press premiere of his new film, "Sicko." Then he heaved a deep breath and added, "But this is just so pleasant."

It was indeed another gorgeous, summery morning on the French Riviera, but the real heat was indoors. There wasn't a single empty seat inside the Grand Théâtre Lumière -- which holds more than 2,000 people -- for "Sicko," and dozens of stragglers were locked out on the sidewalk. Moore's screed against the outrageous state of American healthcare was received with uproarious affection, but one might argue that Cannes provided the softest possible crowd. An American left-wing populist, attacking America's profit-motive, private-sector ideology before a roomful of international intellectuals, at least half of them Europeans. May I introduce a new phrase into the Franglais dictionary? C'était un slam-dunk.

"Sicko" does not display Moore at his most cinematically inventive or imaginative. It presents a TV-documentary-style parade of episodes, characters and settings, bouncing from various American cities to Canada, Britain, France and Cuba (and yes, don't worry, we'll get to that). Moore plays a far smaller personal role in this film, appearing only occasionally in his comic-relief role as the clueless buffoon who can't seem to grasp that healthcare in all those other countries is free, or virtually so. When he's eating dinner with a group of Americans living in Paris who begin to list all the things they can have as free or nearly free entitlements -- not just healthcare but an emergency doctor who makes house calls; not just childcare but a part-time in-home nanny -- Moore puts his hands over his ears and begins singing "La la la la la." (If you have kids or any kind of chronic family health problems, your reactions might include weeping in despair, slitting your wrists or booking a one-way ticket.)

Still, there is no mistaking the passion and political intelligence at work in "Sicko." It's both a more finely calibrated film and one with more far-reaching consequences than any he's made before. Moore is trying to rouse Americans to action on an issue most of us agree about, at least superficially. You may know people who will still defend the Iraq war (although they're less and less eager to talk about it). But who do you know who will defend the current method of healthcare delivery, administered by insurance companies whose central task is to minimize cost and maximize shareholder return? Americans of many different political stripes would probably share Moore's conclusions at the press conference: "It's wrong and it's immoral. We have to take the profit motive out of healthcare. It's as simple as that."

"Sicko" purposefully does not focus on the 50 million or so Americans who don't have health insurance, as scandalous as that is, but on the horror stories of middle-class working folks who believed they were adequately covered. There are so many of these they begin to blur into each other: the woman in Los Angeles whose baby was denied treatment at an emergency room outside her HMO network, and died as it was being transferred hours later; the woman in Kansas City whose husband was repeatedly denied various drugs his physician prescribed for kidney cancer, and who in the last stage of life was denied a bone-marrow transplant that could have saved his life; the woman who was told her brain tumor was not a life-threatening illness, and died; the woman who was told her cancer must have been a preexisting condition, and died.

One might respond that anecdotes like these have tremendous emotional power but little analytical rigor, but in this case I think we all know (and fear) that these worst-case outcomes exemplify the system perfectly. Moore interviews two healthcare whistle-blowers, both now plagued with guilt, who explain what should be obvious: The point of the system is to treat as few people as possible as cheaply as possible, and those who get ahead in the healthcare industry are those who find ever more devious ways to deny coverage. (For example, you can now be denied for certain preexisting conditions you didn't know about, on the premise that you should have known about them.)

OK, let's get to the headlines: Yes, in the film Moore travels with a group of ill and injured 9/11 rescue workers (along with several other of his film's protagonists) to Cuba, where they receive free and apparently excellent medical treatment. It's unquestionably another button-pushing Michael Moore stunt, designed to provoke controversy. It's cheap but funny, dubious as evidence but affecting anyway. Moore does not even seem aware of the possibility that the Cubans were shrewd enough to see the propaganda value in this exercise, and put on a dog-and-pony show for his and our benefit. (For that matter, we don't know how much of the visit was planned in advance with Cuban authorities.) All that aside, within the context of the film and the argument Moore is building, Cuba makes as much sense as anywhere else.

Moore begins his foreign odyssey in the film after meeting a 22-year-old Michigan woman who has moved across the Ontario border (not entirely on the up-and-up) because she's been denied treatment for cervical cancer. He wanders around emergency rooms in London, Ontario, and London, England (where he discovers that the cashier's window is for paying patients their travel expenses, not for settling the bill). He zips from one Parisian arrondissement to another with an on-call physician on the night shift. He dines with the aforementioned Americans abroad, who seem dazed and a little guilty about their escape from healthcare hell.

Much of this is played as comedy; Moore corners a young Afro-British couple with a wiggling bundle in the hallway of a London hospital and says cheerfully, "So -- how much they charge you for that baby?" But Moore is trying to push us beyond the universally shared idea that something must be done to the slightly more controversial idea that something has been done, and that all we have to do is appropriate it. Americans have of course been conditioned for generations to believe that socialized medicine is first of all a disaster in its own terms, and secondly, the pathway to totalitarianism.

His portrayal of the Canadian, British and French systems is undoubtedly simplistic , and several Canadian reporters took that up with him at the press conference -- although all of them admitted they wouldn't trade their system for ours. But Moore's overall point is, I think, inarguable: Flawed as they may be, those systems are a hell of a lot more humane and civilized than anything we've got. (Life expectancy is significantly higher, and infant mortality lower, in all of those countries than the United States. Whatever outdated stereotypes you may hold, these days poor people in Britain are statistically healthier than rich people in America.)

Addressing a series of questions from foreign reporters at the press conference, Moore said: "We should do what we always do as Americans, steal the best things you're doing and make them our own. The Canadians do certain things very well. The Brits do certain things very well. The French have the best system in the world, and that's not my opinion. That's how the World Health Organization rates them. None of them is perfect, but it's not my role to make criticisms. It's my role as an American to say, why don't we take the best elements you're doing and blend them together, and call it the American system?"

Moore decided to go to Cuba, as he explains in the film, after learning the peculiar irony that detainees at Guantánamo Bay are entitled to something American citizens are not: free healthcare. In a brief and awkward scene, he tries to bring a fishing boat with his 9/11 refugees aboard into U.S. waters just off the naval base. They are refused entry (Moore is evasive about the details) and then seek treatment at the best hospital in Havana.

"The point of this was not to go to Cuba," Moore said at the press conference. "The point was to go to Guantánamo Bay, to get the 9/11 workers the same medical care we're giving to members of al-Qaida." If the detainees had been at a U.S. base in Spain or Italy or Australia -- all countries with universal healthcare -- he'd have taken his 9/11 workers there instead. In fact, when Moore drops the jokes and political attitudinizing during the Cuba sequence, the pathos of the story makes his point for him: A poor Caribbean island, whatever its ideology, can afford healthcare for everyone while we do not. The only possible conclusion is that our society has chosen not to.

When asked about his potential prosecution for violating U.S. Treasury sanctions against trade with or travel to Cuba, Moore was uncharacteristically sober. "I know a lot of you have written things like, 'How dumb are they?'" he said, "but I don't take this lightly. The Bush administration may try to claim that my footage was obtained illegally. We haven't discussed this possibility yet, but actions could be taken to prevent this film from opening on June 29. I know that sounds crazy to the Americans in the room. I guess it is crazy."

When Americans do get to see "Sicko," Moore says, "They will understand that this was about helping 9/11 rescue workers who've been abandoned by the government. They're not going to focus on Cuba or Fidel Castro or any other nonsense coming out of the Bush White House. They're going to say: 'You're telling me that al-Qaida prisoners get better medical treatment than the people who tried to recover bodies from the wreckage at ground zero?'"

When Moore interviews Tony Benn, a leading figure on the British left, his larger concerns come into focus. Benn argues that for-profit healthcare and the other instruments of the corporate state, like student loans and bottomless credit-card debt, perform a crucial function for that state. They undermine democracy by creating a docile and hardworking population that is addicted to constant debt and an essentially unsustainable lifestyle, that literally cannot afford to quit jobs or take time off, that is more interested in maintaining high incomes than in social or political change. Moore seizes on this insight and makes it a kind of central theme; both in the film and aloud, at the press conference, he wondered whether some essential and unrecognized change has occurred in the American character.

"I hope this film engenders discussion, not just about healthcare, but about why we are the way we are these days," Moore told us. "Where is our soul? Why would we allow 50 million Americans, 9 million of them children, not to have health insurance? Maybe my role as a filmmaker is to go down a road we might be afraid to go down, because it might lead to a dark place."

Moore's last revelation in "Sicko" is sure to be endlessly debated in the right-wing blogosphere that is so obsessed with him (and may be of little interest to ordinary viewers). Some time ago, Jim Kenefick, proprietor of the especially bilious anti-Moore site Moorewatch, almost shut down his site to focus on his wife's worsening illness and escalating healthcare costs. An anonymous donor then sent him $12,000 to cover his wife's bills and keep the site running. (She has apparently recovered.) Now that donor has been revealed and, as Kenefick now says he suspected all along, it turns out to be Michael Moore.

"I want him to know that it was done with all the best intentions," said Moore, adding that he planned to phone Kenefick personally after the press conference. (According to Kenefick's blog, Moore left him a voice-mail message later on Saturday.) "I went back and forth about whether to use that material," Moore went on. "I asked myself, would you be doing this if it weren't in the film? I decided that I would, and I should, and that that's the way I think we should live."

Moore says he began exercising and lost 25 pounds while working on his healthcare film; "I'm actually a fairly skinny person for the Midwest," he quipped. He says he's tried to maintain a lower public profile since "Fahrenheit 9/11" and would like Kenefick and his many other critics to cut him some slack. "You know, I begin to hope that as I enter the discourse with this film, I might get some kind of a break. As far as the accuracy of my movies goes, I think the record speaks for itself. Maybe people will say: He warned us about General Motors, he warned us about school shootings and he warned us about Bush."

* * * * For more coverage of the Cannes Film Festival, click here.

By Andrew O'Hehir

Andrew O'Hehir is executive editor of Salon.

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