Sicko

Sicko
Sicko theatrical poster
Directed by	Michael Moore
Written by	Michael Moore
Produced by	Michael Moore
Starring	Michael Moore
Distributed by	The Weinstein Company Lionsgate (theatrical)
Release dates	June 29, 2007
Languages	English, French, Spanish

For other uses, see Sicko (disambiguation).

Sicko (or SiCKO) is a documentary film by director Michael Moore, released in the United States and Canada on June 29th, 2007. It investigates the United States health care system with a focus on for-profit health insurance and the pharmaceutical industry. The film contrasts the U.S. system with Canada's single-payer system and other universal health care systems, including those in France, England and Cuba.

On April 19, 2007, Moore announced on his website that Sicko had been selected for the 2007 Cannes Film Festival where it had its world premiere on May 19, 2007; he also announced the North American release date. Moore's film had an early premiere the week before its North American release in Washington D.C..

Synopsis

Sicko deals with the problems of the American for-profit health insurance and pharmaceutical industries. Its main message is that publicly-funded health care is a better model than the present US health-care system because the present system is designed to maximize profit by minimizing the care delivered to patients.

At one point in the film Moore says: "And the United States slipped to 37 in health care around the world, just slightly ahead of Slovenia."

U.S. health-care system

Anecdotes of people denied care

The movie begins with the retelling of the stories of people who were denied health care, either because they did not have health insurance or because the insurance companies denied their request for coverage for a particular ailment, due to specious reasons. (On February 3, 2006, Moore requested, via his blog, that people send "Health Care Horror Stories" in an effort to share his view on the health care industry.)

The examples shown include:

• Doug Noe's insurance provider, Cigna Healthcare, approved a cochlear ear implant for only the left ear of Noe's toddler daughter, Annette, who was born with an acute hearing disability. Cigna argued that a two-ear operation was "experimental." (After Noe alerted Cigna that Moore was making a movie about the US Healthcare system, and that Noe's case would be featured in it, Noe was contacted by Cigna, and they agreed to approve the second implant. This occurred before Moore had actually heard of Noe's case, so Noe acted independently of Moore.)

• A woman gets stuck with the ambulance bill after a car accident because she didn't clear the charge with her insurer before requesting the ambulance; the accident had immediately rendered her unconscious and unable to request approval.

• Also shown is the widow of Tracy Pierce, who died from kidney cancer after his insurer denied numerous treatments recommended by his doctor, including a possibly life-saving bone-marrow transplant.

• Homeless patients, still in hospital gowns and some with IV tubes in their arms, were abandoned at homeless shelters by Los Angeles hospitals after they had received some medical treatment. (In May 2007, Kaiser Permanente, a large nonprofit health insurer, settled criminal and civil lawsuits by agreeing to establish new rules for discharging homeless patients. They paid $55,000 in fines, covered the city attorney’s investigative costs; and agreed to spend $500,000 on the homeless for follow-up care and other services.) Mike Huffman is seen in the film describing the dumping of a woman at the Union Rescue Mission in Los Angeles' Skid Row.

• One woman's insurance provider denied coverage after an operation, because she didn't mention a minor previous yeast infection on her application; they retroactively cancelled her coverage on that basis.

• Rick accidentally sawed off the tops of his middle and ring fingers on one hand while working at home. He had no insurance and limited funds at his disposal, so he was asked by the hospital to choose whether to have the hospital reattach the end of his middle finger for $60,000 or the end of his ring finger for $12,000. (He chose the ring finger, "being the hopeless romantic he is".)

• Accounts of four fully-insured American women being denied crucial specialist referrals, diagnostic and therapeutic procedures. Two of the women died of cancer as a result, and one eventually sued her HMO after the diagnosis of her brain tumour in Japan (her American HMO told her the tumour doesn't exist). A footage of the director of her HMO testifying is shown.

Accounts from inside insurance companies

Some repentent former employees of insurance companies are also interviewed, and describe dubious practices of their former employers, such as considering the best doctor in their employ to be the one who could deny the most treatments.

One scene shows a clip of Congressional testimony given in 1996. Dr. Linda Peeno, a former medical reviewer for the health insurer Humana, said her job was to save money for the company. "I denied a man a necessary operation", she testified, referring to a decision she made in 1987. (Her testimony "has been widely recounted over the years," according to a news article in The New York Times. A spokesman for Humana said the case Peeno referred to had involved whether a man had coverage that would pay for a heart transplant, and Peeno correctly found the insurance didn't cover the procedure.)

The film also interviews Lee Einer, whose job at a major insurance carrier (not identified in the film) was to examine insurance applications retroactively. Einer was to peruse large claims in order to find evidence that the applicants had hidden previous conditions. Einer says it was irrelevant whether or not the applicant intended to mislead, the companies just wanted excuses to avoid paying the claims. Even if they had a previous condition that had never before been treated, many states have a "prudent person" rule that states that if it is a symptom for which a prudent person would have sought a diagnosis, then what that symptom indicated counts as a pre-existing condition.

Origin of HMO

The film pointed to a critical event in 1971 with Edgar Kaiser, the son of the founder of one of the first big health maintenance organizations, Kaiser Permanente. He went to see John Ehrlichman, a top aide to President Richard Nixon, to lobby the Nixon White House to pass legislation that would expand HMOs and would give the current system Americans use today.

While showing black and white still photos of Nixon meeting with Ehrlichman in the Oval Office, the film played the taped conversation between Nixon and Ehrlichman, recorded February 17, 1971, including the following portion:

Ehrlichman: “We have now narrowed down the vice-president's problems on this thing to one issue, and that is whether we should include these Health Maintenance Organizations like Edgar Kaiser's Permanente thing."

President Nixon: "Now let me ask you... You know I'm not too keen on any of these damn medical programs."

Ehrlichman: "This is a private enterprise one."

President Nixon: "Well, that appeals to me."

Ehrlishman: "Edgar Kaiser is running his Permanente deal for profit. And the reason that he can … the reason he can do it … I had Edgar Kaiser come in … talk to me about this and I went into it in some depth. All the incentives are toward less medical care, because … the less care they give them, the more money they make.”

President Nixon: “Fine.”

Ehrlichman: [Unclear] “… and the incentives run the right way.”

President Nixon: “Not bad.”

The film then shows Nixon the very next day giving a public announcement:

I want America to have the finest health care in the world. And I want every American to have that care when he needs it.

Washington lobbyists and politicians

The movie also describes the connection between lobby groups such as PhRMA, the largest and most powerful lobbyist block in Washington D.C., and political groups. Moore says that Hillary Clinton, who once championed the Clinton health care plan, is the Senate's second-highest recipient of campaign donations from the health care industry. Moore said that Clinton's friend Harvey Weinstein, whose company provided financing for the film, asked him to remove the scene but Moore refused. Moore said that he had donated to Clinton's first Senate campaign but has since become disillusioned with her.

Health-care systems elsewhere

In the film, Moore states that the United States is the only industrialized nation that does not offer free basic health care to all of its citizens. The American system is compared to those of Canada, the United Kingdom and France, which have universal health care for their citizens.

In Canada, Moore speaks to his relatives and other Canadians about their health care system. He is then told about the contribution to the Canadian health system by Tommy Douglas, who was voted the Greatest Canadian in 2004. Moore then goes to a Canadian public hospital to interview a microsurgeon and people in the Emergency waiting room.

In the United Kingdom, Moore discovers that all pharmaceuticals are subsidized, so only a maximum of ₤6.65 (approx. US$10) is charged (free of charge if younger than 16 and older than 60). When in an NHS hospital, Moore attempts to find about about British patients' in-hospital expenses, only to be told laughingly that there is no out-of-pocket payment. He eventually finds a counter labeled "Cashier", only to learn that low-income patients actually receive money there to reimburse their trip to the hospital. This segment also includes interviews with British former Member of Parliament Tony Benn, a NHS general practitioner and an American woman residing in Great Britain.

In France, Moore interviews the head of O&G Department of a French hospital, and then a group of Americans living in France. He also rides along with a 24-hour French house-call medical service SOS Médecins in which a doctor makes visits to patients' homes, taking dispatch calls like a taxi driver. Moore further learns that French government provides social services so far as to provide day care for $1 a day and do laundry for new mothers, as part of their job of providing neonatal support. He then interviews the local middle class to find out about the impact on their life due to heavier taxation to fund the universal health care system.

Moore features several pundits arguing against the other national systems, calling them “socialist takeover”. With the backdrop of 1950s-style anti-communist propaganda ("Red Nightmare"), Moore plays a portion of a record distributed by the American Medical Association in the 1960s, narrated by Ronald Reagan, who warns that universal health care could lead to communism. Moore then features people in the film to counter-argue that universal health care is democratic. He then shows images of American police, fire service, postal service, public education and community libraries, and argues that these services are also "socialized" but none of them has led to communism.

Moore then interviews those who volunteered as rescue workers after the World Trade Center 9/11 attacks; these volunteers had subsequently developed physical and psychological maladies, including respiratory disease and PTSD, and were denied government funds to care for their ailments. Since the U.S. government has touted the medical care provided for the alleged enemy combatants detained at the U.S. Guantanamo Bay detainment camp, Moore assembles the 9/11 rescue workers and one of the people seen earlier in the movie, and any others who need medical care that they cannot get in the U.S. They sail from Miami for Cuba on three speedboats. After a journey that is mostly not shown (due to "prohibition by Homeland Security laws"), the group arrives at the entrance channel to Gitmo. Moore asks for access with a megaphone, pleading for treatment for 9/11 heroes that equals the treatment the "evildoers" are getting, but no response is given. Moore finally gives up when a siren is blown from the base.

The group then moves on to Havana, where they can buy medicine for very cheap price and receives free medical treatment they would otherwise not be able to afford. The volunteers are hospitalized there and receive treatment, having only to provide their names and birth date. Moore asked the doctors to provide them only the same level of care they would give to Cuban citizens, however, being that Moore was at a tourist hospital he received similar care to other medical tourists. He also interviews pediatrician Dr. Aleida Guevara, the daughter of Che Guevara (Guevara was a medic himself).

Although trip participants signed confidentiality agreements prohibiting them from talking about the trip, some did say that the trip was a success, with The New York Post quoting John Feal, head of the Fealgood Foundation that raises money for 9/11 first responders, that “From what I hear through the grapevine those people who went [to Cuba with Moore] are utterly happy."

In the film's finale, Moore provides an example of "taking care of each other, no matter the differences". When he found out that the biggest anti-Moore website, MooreWatch, would have to close because its webmaster Jim Kenefick needed the money to pay for his wife's medical treatment, he sent a check for US $12,000. Moore says that he does not want the health care system to trump the first amendment. The audience is shown a "thank you" letter posted by the host, calling Moore his "Guardian Angel" (written while he was still unaware of Moore being the donor), while continuing to criticize Moore on his website.

Release

On May 19, 2007 more than 2,000 people applauded loudly after the film's first Cannes screening at the packed Grand Theatre Lumiere, the main festival auditorium.

The North American premiere of Sicko was held in London, Ontario at the Silver City movie theatre at Masonville Place on June 8 2007, with Moore himself in attendance. Sicko features patients from the London, Ontario area.

Reception

Critical response

Sicko at the Cannes Film Festival receiving a standing ovation

The movie has received overwhelming positive reviews from film critics, including a 91% fresh rating on Rotten Tomatoes, a composite score of 74/100 on Metacritic, and an 8.5/10 on IMDb. Following early viewings at the Cannes Film Festival, Variety described Sicko as "an affecting and entertaining dissection of the American health care industry", concluding it should play well internationally. Moore has nonetheless been quoted as saying, "I know the storm awaits me back in the United States."

In an early review a week before the premiere, Richard Roeper and Michael Phillips (the latter filling in for Roger Ebert) gave Moore's film two thumbs up.

Roger Friedman of Fox News called the film a "brilliant and uplifting new documentary" and praised Moore for the way in which he lets "very articulate average Americans tell their personal horror stories at the hands of insurance companies" and "criticizes both Democrats and Republicans for their inaction and in some cases their willingness to be bribed by pharmaceutical companies and insurance carriers."

British film magazine Empire commented that "Sicko is the film that truly reveals Moore as an auteur."

The New Yorker's David Denby disagrees, writing: "After the early tales of the [U.S. Health Care] system's failure, “Sicko” becomes feeble, even inane.". In a review published in both the The New Yorker and Reason Magazine, Michael Moynihan calls the film "touching, naïve and maddeningly mendacious, a clumsy piece of agitprop that will likely have little lasting effect on the health care debate". Michael Phillips, who reviewed the film for the Chicago Tribune, wrote, "You don't have to be a conservative to take issue with the way Moore apples-to-oranges so many economic comparisons in his movie, or the way he relies on the easy comment. "Everywhere else, [people] seem to take care of each other," Moore says late in the film. Everywhere else?"

Box Office

Sicko made $4.5 million on its opening weekend. In only 441 theaters, it took in an average of $10,204 per theater, the second highest average gross of the weekend.

As of July 9, Sicko has grossed $11.5 million in the United States, which already makes it the eighth-highest grossing documentary of all time.

Legal controversy

Piracy

Although the film was released on June 29 2007, a copy was leaked onto the Internet in early to mid June 2007. Moore, who previously stated his support for Internet downloading, denies leaking the video himself and an investigation has been held as to the source of the Internet leak. When asked about the leak, Moore said:

"I'm just happy that people get to see my movies...I'm not a big supporter of copyright laws in this country...I don't understand filmmakers...who oppose sharing, having their work being shared by people, because it only increases your fanbase...I've always been happy in the past when teenagers have downloaded pirated copies of my movies...They've been downloading them and they've been sharing them, and I think that's great." [5]

Treasury Department probe

In a May 2, 2007 letter, the Office of Foreign Assets Control informed Moore that he was the subject of a civil investigation stemming from the filmmaker's March trip to Cuba. In the letter to Moore, a Treasury official noted that the department had no record of Moore obtaining a license that authorized him to "engage in travel-related transactions involving Cuba," alleging that Moore violated the United States embargo against Cuba. A duplicate master copy of the film is being held in Canada in case American authorities attempt to seize the film as part of the criminal investigation against Moore that arose from taking American 9/11 rescue workers to Cuba for medical treatment. Moore has said that if any trip to Cuba is for journalism reasons, the U.S. allows it. He also added that SiCKO is a non-fiction film and for journalism. Moore states that his intentions were to travel to the US Naval base in Guantanamo Bay. Upon Moore's arrival to Guantanamo Bay a siren was sounded and Moore decided to turn around for safety.

Responses to film

WBAI Radio, part of the Pacifica Radio Network, reported that SiCKO was revitalizing the debate for universal health care within the United States, calling the film "adrenaline for healthcare activists". It named individuals and entities ranging from U.S. Congressman John Conyers, Jr., to the California Nurses Association. It reported that the latter "began traveling the country to leaflet moviegoers as SiCKO opens in theaters to support a 'single-payer' health care system." Additionally, Michael Moore, who was interviewed, reported that he had tried to enter the New York Stock Exchange to advocate for stockholder divestiture from health insurance companies but was prevented from entering. Moore called his film his most "subversive" film to date, saying it was his strongest critique yet about the economic system of the U.S.

Health care industry professionals are responding to depictions of their organizations. In a letter to the Wall Street Journal, Robert S. Bell, M.D., President and CEO of University Health Network, Toronto, said that while Moore "exaggerated the performance of the Canadian health system," it provides universal coverage of a similar quality to that enjoyed by only some Americans. Michael Moore posted a leaked memo from a Blue Cross employee about the likely consequences of the film. The memo expresses concern that the movie misleadingly turns people against Blue Cross by linking it to abuses by for-profit HMO's.

Soundtrack

Many songs, instrumental and otherwise, exist on this film's soundtrack. They are:

• "I'm Alone Without You," Written and Performed by The Nightwatchman (aka Tom Morello)
• Aquarela do Brasil by Ary Barroso (in reference to Terry Gilliam's film, Brazil)
• "Baseball" (from the film, In the Bedroom), Written by Thomas Newman
• "Loverly Spring" (from the film, Lemony Snicket's A Series of Unfortunate Events), Written by Thomas Newman
• "Rejected," Written by Danny Winn, Performed by Danny Winn and the Earthlings
• "Star Wars Main Title Theme," Written and Performed by John Williams (as John T. Williams)
• "Secret Pint," Written by Stuart Braithwaite, Performed by Mogwai (band)
• "Adagio for Strings," Composed by Samuel Barber, Performed by Brno Philharmonic Orchestra
• "I'll Take You There," Written by Alvertis Isbell, Performed by The Staple Singers
• "Sabre Dance," Composed by Aram Khachaturian, Performed by Brno Philharmonic Orchestra
• "The Bad Beginning" (from the film, Lemony Snicket's A Series of Unfortunate Events), Written by Thomas Newman
• "Chez Olaf" (from the film, Lemony Snicket's A Series of Unfortunate Events), Written by Thomas Newman
• "(I've Got a) Golden Ticket" (from the film, Willy Wonka & the Chocolate Factory), Written by Leslie Bricusse and Anthony Newley, Performed by Jack Albertson and Peter Ostrum
• "Christmas Eve Montage" (from the film, The Nightmare Before Christmas), Written by Danny Elfman
• "Street Fighting Man," Written by Mick Jagger and Keith Richards, Performed by The Rolling Stones
• "Lucy" (from the film, Little Children), Written by Thomas Newman
• "The Baudelaire Orphans" (from the film, Lemony Snicket's A Series of Unfortunate Events), Written by Thomas Newman
• "L'amour est bleu," Written by Pierre Cour and André Popp, Performed by Vicky Leandros and Claude Denjean
• "Le temps des cerises," Performed by Charles Trenet
• "The 59th Street Bridge Song (Feelin' Groovy)," Written by Paul Simon, Performed by Nana Mouskouri
• "Una Musica Brutal," Written by Phillippe Mauric Cohen Solal, Eduardo Anibal Makaraoff, and Christoph Hermann Mueller, Performed by Gotan Project
• "Je t'aime... moi non plus," Written by Serge Gainsbourg, Performed by Serge Gainsbourg and Jane Birkin
• "Beam," Written by John Powell, Performed by Hans Zimmer
• "Can't Sleep #2" (from the film, In the Bedroom), Written by Thomas Newman
• "I'll See You in C-U-B-A," Written by Irving Berlin, Performed by the Austin Lounge Lizards
• "Ice Skating" (from the film, Abandon), Written by Clint Mansell
• "Ring" (from the film, The Astronaut Farmer), Performed by Suart Matthewman
• "Don't Be Shy," Written and Performed by Cat Stevens (as Yusuf Islam)
• "Ce monde absurde," Written by Steve Barri and P.F. Sloan, Performed by Claude François

See also

• The Death of Mr. Lăzărescu
• Healthcare in the United States
• Healthcare in Canada
• Canadian and American health care systems compared
• Healthcare in Cuba
• Category:Healthcare in France
• Category:Healthcare in the United Kingdom

External links

• Sicko Official movie site
• Sicko at IMDb
• Sicko at Rotten Tomatoes