Voices on Sicko:  Review by Holistic Primary Care's Goldman, Plus Comments from Hammerly, Ballard, Diener, O'Connor

Summary: So what do people in the integrated care community think about Sicko, Michael Moore's documentary on the US medical madness? The Integrator invited your comments and reviews - and still does. Eric Goldman, the New York-based editor of Holistic Primary Care was the first to respond, thoughtfully and at length. I attach comments up front from Integrator advisor Milt Hammerly, MD, director of medical operations and integrative medicine for Catholic Health Initiatives, a multi-state health system; Tom Ballard, ND, a clinician with 25 years of practice; Marc Diener, a Hollywood lawyer and activist with the Integrated Healthcare Policy Consortium, and Kathleen O'Connor, journalist and executive director of the citizen's healthcare reform organization Code Blue Now! Then, the main course of Goldman's column, in which he compares Moore's approach to that other major recent documentary, An Inconvenient Truth. Enjoy!

Milt Hammerly, MD

1.    Milt Hammerly, MD: Compelling case for universal healthcare ... but access to what?

"Whether or not you like Michael Moore, his latest movie, Sicko, should be required viewing.  He effectively uses fears, tears, outrage, humor and intellect to make a compelling case for universal access to health care. 

"While it is facile to criticize Sicko as biased (Moore only showcases victims in the USA and satisfied users in Canada, the UK and France) the argument for universal access is still powerful.  Moore implies that the benefits of universal access are only debated and controversial because of lobbying by well-funded special interest groups. 

"Even more controversial is the question of 'access to what?'  If we had univeral access to a sick care system (rather than one that focuses on prevention and wellness) we would not be much better off.  This latter (and probably more important) issue is only touched on peripherally in Michael Moore's movie--maybe he would consider doing a sequel.  I took particular pleasure in the movie's skewering of corrupt insurance companies, politicians and PhRMA but must confess he was overly kind to health care providers (probably because he wants us as allies).  The timing and content of Sicko will definitely ensure some political play.  Admission--$9.00; Popcorn--$5.00; Guantanamo/Cuba stunt--Priceless!"

Tom Ballard, ND

2.   Tom Ballard, ND: Universal access to Coca Cola?

Tom Ballard, ND is a former nurse and sometimes playwright who was a member of the first graduating class of the John Bastyr College of Naturopathic Medicine (now Bastyr University) in 1982.

"Michael Moore’s movie, Sicko, is an example of how far criticism of the medical-industrial-complex has come. While not overtly pro natural medicine, it focuses on a very sick system, and does so in movie houses across the nation.

"(Yet) even 'progressive' media, such as this movie don’t question the medicine, only the way it’s delivered.  His view is kind of like advocating that Coke should be readily available to those less fortunate."

Kathleen O'Connor

3.    Journalist-organizer Kathleen O' Connor: "Fast and loose with the facts ... "

Kathleen O'Connor founded Code Blue Now! after self-funding a competition for quality healthcare reform. Code Blue Now is presently promoting an Opinionaire (take it on their site) with the National Coalition on Health Care which is attempting to provide citizen viewpoints which might help shift the US impasse on health care.

"What a sad waste. Moore is fast and loose with facts. He blames everything on managed care and insurance companies.  He squandered a real opportunity.

"It is the same old partisan divide and preaching to the base. It simply pits the health saving account folks against the single payers once again and we're back to the Hatfields and McCoys when we need to be finding common ground and building consensus."

Marc Diener

4.    Marc Diener, JD:  and the sequel?

Mark Diener is a Hollywood laywer whose passion for integrative care has stirred him to engage a project, in development, related to mind-body and TV/cable. Meantime, he serves as a member of the Steering Committee of the Integrated Healthcare Policy Consortium.

"Saw Sicko yesterday.  Wanted to offer you my take thusly:

"As powerful and provocative as Sicko is, the greater scandal is not about how we pay for healthcare, but rather the nature of those services and why we 'need' them so badly.  Hollywood loves a sequel.  Let’s hope that Moore puts Big Food, Big Pharma and Big Medicine together in his cross-hairs someday."

"Meg and I saw 'the movie' last Sunday....with my mother, no less.

"Lemme preface my comments by saying that in principle, I agree with Moore's basic premise that a single-payor FrancoAngloScandaNadian style national health care system would be a good thing. Or at least not a bad thing. An SPNHCS (Single Payor National Health Care System) is prob'ly the best option for basic coverage of the millions of uninsured people, among whom I proudly count myself. Though by no means a true answer to our health care woes, an SPNHCS would be no worse for patients, practitioners and American businesses than the fustercluck of conflicting corporate interests we now call 'healthcare.' It would prob'ly be a whole lot better on many counts.

"A SPNHCS would, however, be a whole lot worse for the insurance corporations and probably for Big Pharma as well, and that means it's not likely to happen, no matter what Michael Moore says in his movies.

"OK, so 'The Movie' ... It’s a Michael Moore movie, so don’t expect well-reasoned Platonic dialog. Don’t expect a lot of meaningful data, journalistic balance, thorough follow-up, or willingness to admit evidence that does not stay 'on message.' Don’t expect delicate treatment of nuanced issues or acknowledgment of complexity. This is ham-fisted politicking at its best/worst.

"Moore boils the whole health care morass down to a few core themes:

1) Insurance companies are fundamentally evil in that they pretend to care about people but actually care about one thing: making money. 
2) Drug companies are evil because they want to make tons of money off of the products that sick people 'need'.
3) We in the US spend vastly more on HC than any other nation, yet do not show any evidence of being healthier. In fact, it’s quite the opposite.
4) SPNHCSs like in England, France, Canada & Cuba (the countries we visit in the film) are a much nicer and better way to do health care.

"I agree with much of this. The problem is that if you don’t already agree with this, there’s not much in Sicko that’s going to convince you. That’s because Moore goes for shock, outrage, and sob-stories rather than reasoned argument and careful consideration of opposition viewpoints.

	"I agree with much of (Moore's view). The problem is that if you don’t already agree with this, there’s not much in Sicko that’s going to convince you." - Eric Goldman

"It’s interesting to compare Moore's approach to agit-movie with Al Gore's. Both Sicko and Inconvenient Truth try to challenge conventional wisdom, provoke dialog and shake/wake people into personal/political action on complex issues.

"Gore appeals to the mind, providing lotsa science, well-reasoned discourse and a level-headed temperament. The result? A nigh on ironclad argument wrapped in a rather terse and saturnine movie. Kinda like the man himself.

"Moore, on the other hand, tries to push every emotional button he can get his chubby mitts on. Sometimes several at once. He uses datapoints like condiments, sometimes playing them for laughs, but more often just to spice up a conclusion he wants you to swallow as foregone. Facts not supporting that conclusion are simply not mentioned—let’s just call ‘em Inconvenient Truths. The result? A jovial entertaining movie wrapped around an argument that’s got more holes in it than an American flag in Baghdad.

My real issue with Moore’s film is over what he ignores. There’s absolutely no mention of the connection between the chronic illnesses that are killing people and the shit food that they’re eating. There’s no mention of personal responsibility for engendering and maintaining health. There’s no talk at all of holistic/natural medicine as a viable solution.

"In Moore’s vision, people are hapless victims of circumstance, preyed upon by ruthless corporations. Illness is a given, drugs/surgeries/hi-tech interventions are an absolute necessity. The only question is why insurers and pharma companies are so mean and heartless and why someone won’t just give everybody what they need-----like they do in other countries. Moore never really questions the need….and how the “need” is manufactured.

"What’s bankrupting our country is not the 'shit happens' type of illnesses. It’s the chronic lifestyle-related illnesses, the poor-nutrition related illnesses, the poverty-related illnesses, the luxury drugs, and the hopeless but expensive end-of-life intensive care. "Sicko never goes near those topics, which is a gross oversight in a film about what’s wrong with US healthcare." - Eric Goldman

"It’s the classic Lefty Democrat 'spend more' logic. Goes like this: 'Oh, Merck just came out with Wonderol that can cure cancer? Well, by Jove, every man, woman and child in this Great Nation deserves access to Wonderol! It shouldn’t be just for the rich, right? I mean all lives are worth saving, right? So we’ve gotta get Wonderal covered by insurance so everyone can get it, right?' And so it goes….the execs of UnitedHealth Group and Merck go home smiling. Sales of Wonderal skyrocket. Wall Street is happy. Politicos think they’ve done their job caring for the downtrodden. We might soon find out that Wonderal doesn’t really work, or has bad side effects. But that’s okay because by then, more research will have led to Betterol.

"Meanwhile, Corporate America continues dumping cancer-causing toxins in the environment. The food industry continues producing cheap, tasty and poisonous 'branded foods.' And NDs and holistic MDs continue to write books because they can’t make a living in practice.

"Look, I know that illness is a reality, and yes, of course, many people do have genuine needs for medications, surgeries. I know mainstream medicine has saved countless lives. Necessary care should never be denied; payment should never be an issue. But what’s bankrupting our country is not the 'shit happens' type of illnesses. It’s the chronic lifestyle-related illnesses, the poor-nutrition related illnesses, the poverty-related illnesses, the luxury drugs, and the hopeless but expensive end-of-life intensive care. Sicko never goes near those topics, which is a gross oversight in a film about what’s wrong with US healthcare.

The other big problem with Sicko is that it fails to make a very critical distinction between 'Universal Access' (ie. SPNHCS) and 'Universal Coverage.' This will be a very important distinction in the coming years. Whoever gets elected next, they’re probably gonna propose some sort of 'health care reform,' and it will probably be some type of 'universal coverage' plan, meaning that 'Everybody must have health insurance.' Ron Wyden’s already put a bill into Congress to that effect. Wyden’s and other such plans are all variants of HillaryCare.

"What people seem to miss is that these plans are not the same as guaranteed Universal Access through a Euronadian style SPNHCS.

“'Universal Coverage' would create mandates forcing a whole lotta people to buy insurance, thus putting even more money into Big Insurance. And for those who cannot afford coverage themselves, the government would buy it for them. Great! Even more public dollars going into the Managed Coffers. Almost makes a guy wanna vote Republican. Except the Repubs are probably all over this idea too…..after all, more money going into Big Insurance means more money going into the institutional investor sector, which is always good, right? Plus it would take the health care burden off the big employers, which is a good thing, right?

	"The flaw with the Clinton plan, and all variants thereof is that, essentially they try to reform the system while keeping the problem well- ensconced in the center of the reformed system." - Eric Goldman

"The flaw with the Clinton plan, and all variants thereof is that, essentially they try to reform the system while keeping the problem well-ensconced in the center of the reformed system. Instead of getting the wolves out of the henhouse (how one does that, I don’t know), Clinton-style reform simply put more hens in there (cue children’s chorus singing, “Who’s afraid of the big, bad wolf, big bad wolf, big bad wolf?”).

"Michael Moore, being the anti-corporate gadfly he likes to be, ought to be able to see this, and ought to call out the warning loud and clear. But he’s also a Hillary apologist and highly partisan. So he turns a blind eye to what is likely going to be a really bad blunder that will only give us more and more of the same insanity we’ve had for decades. Only now we’ll be forced to have it.

"All that said, Moore makes a pretty good case for national health care, not to mention broad social safety nets in general. He shows clearly that a 'greatest good for the greatest number' ethos in government translates into many collateral benefits for ordinary folks---benefits that lead to an overall higher standard of living for most. He calls these things what they are: Socialism, not to be confused with Communist dictatorship. It has been a long, long time since the 'S' word has been uttered unapologetically in American media. So I applaud him for that.

"Here, in NYC, Sicko generated lots of applause, laughter and firm agreement. But that’s not too surprising, is it? I’d be interested to see it in Peoria!"