Sicko’s reel change

Where does entertainment end and activism begin? When asked in relation to the documentary Sicko, those two threads are so entwined the question can't be answered.

Before director Michael Moore shot a single frame of Sicko, activist groups he'd reached out to were supplying him with the stories of people who'd fallen victim to this country's health care system. The same is true of staffers for Detroit Congressman John Conyers, who has introduced a bill that seeks to create a single-payer (read government-run) universal health care system for America.

And when the movie debuted, the same people who assisted Moore and his producers with research were waiting to capitalize on public interest in the film. Activist groups, such as the 40,000-member Health-Care Now, have been using the movie as a rallying point to recruit thousands of new members and, in turn, gin up support for Conyers' bill.

Activists also turned out to cheer when Conyers and Moore appeared at a Washington, D.C., press conference held in conjunction with a screening of the film. Conyers sang the praises of Sicko — "I believe that the release of Sicko is one of the most important developments in our public debate since the Clintons tried to pass universal health care legislation in 1994," said the congressman — and Moore endorsed Conyers' H.R. 676

To the cynical, it can all be seen as a simple matter of mutual back-scratching. To which supporters of reform reply, "So what?"

"Sicko has given a huge boost to organizing efforts," says Chuck Idelson, spokesman for the California Nurses Association. Throughout the country, members of the CNA and the affiliated National Nurses Organizing Committee are handing out leaflets urging support of a national single-payer health plan. Idelson says, "This has given a massive infusion into renewing the debate about what constitutes genuine health care reform."

Moore makes no pretense of objectivity — the lack of which has been one of the major criticisms of the film. Forget about any attempt to portray differing sides in the debate over how to fix a system that virtually everyone agrees is in need of repair.

In a statement issued last month, the senior vice president of the Pharmaceutical Research and Manufacturers of America, Ken Johnson, called Moore's film a "biased, one-sided attack."

"Michael Moore is a very talented filmmaker, but a review of America's health care system should be balanced, thoughtful and well-researched to pin down what works and what needs to be improved," said Johnson. "Unfortunately, you won't get that from Michael Moore."

Neither does Moore explore problems associated with the single-payer government programs that exist elsewhere. Instead, Moore depicts the problems found in our system with heart-wrenching stories — an older couple forced to live with their adult children because they've been left bankrupt by medical bills, the woman dumped by a hospital outside a homeless shelter, the 9/11 rescue workers neglected by the system after they developed debilitating respiratory problems — and offers what he believes is the best solution: a national health care system of the sort used by every other industrialized nation. Then he goes a step further, urging his audience to get off its collective ass and get politically active to make that change happen.

Stowe, Carson and Moore

Works of art have raised consciousness and helped to spark change before. Harriet Beecher Stowe's novel Uncle Tom's Cabin played a major role in growing the antislavery movement throughout the North in 1850s America. A century later, Rachel Carson's nonfiction book Silent Spring ignited the modern environmental movement. Oscar-winning documentary filmmaker Terry Sanders recalls how the fictional movie The China Syndrome — released just before the real-life drama at Pennsylvania's Three Mile Island plant in 1979 — contributed to the national backlash against nuclear power. More recently, the documentary An Inconvenient Truth placed the problem of global warming front and center; the Climate Project, a grassroots educational effort associated with the documentary, trains activists to further educate people in their communities about the dangers of climate change.

But it is hard finding an exact corollary to Sicko. The San Francisco Chronicle last month described Moore and his film as being "the centerpiece of a campaign that melds activism, policy, politics and Hollywood into a media force like no other widely released film." Variety, which covers the entertainment industry, described Moore's Capitol Hill appearance with Conyers as a "textbook illustration of how politics and showbiz can be perfect bedfellows." Moore called upon the dozen or so Democratic lawmakers present to "remove the profit motive from health care" and the legislators responded by urging "people to go see the film ... and then in turn press their elected representatives to support H.R. 676."

"We know that the for-profit motive is going to prevent all those benefiting from this as a business to resist a universal national health care plan," says Conyers. "We understand this won't be a cakewalk. Those who are [receiving] the huge profits and salaries and bonuses they now enjoy won't give them up because it's the right thing to do. We're going to have to fight for every inch of territory we get."

On the other hand, says Conyers, having a $14,000 hospital bill land in your mailbox is a pretty strong incentive for motivating grassroots activism.

No one doubts that the industry will again pull out all stops if reform efforts show signs of becoming law. During the last go-round, the Health Insurance Association of America mounted a $30 million campaign promoting alternatives to the Clinton proposal, a campaign that included the incredibly effective "Harry and Louise" television ads. What gives reformers hope now is that, as the situation has grown steadily worse over the past 14 years, the political landscape is changing.

Fact & friction

"MYTH No. 1: Americans have the best medical care in the world.

"FACT: We have the most health care, but not the best. The United States ranks 37th in health care performance, behind countries like France, Italy and Colombia, yet we spend more money on health care than any of them."

That bit of myth-busting isn't a quote from Sicko, but instead comes from a corporation that previously felt the sting of being caught in Moore's viewfinder: General Motors.

GM and Moore aren't exactly allies now, but the fact that the automaker has printed up a pamphlet titled Health Care 101 to decry the problems plaguing America's health care system is significant. So too is the fact that the booklet is being distributed by people who are allied with Moore in a campaign to reform this system that Americans increasing realize they can neither afford nor tolerate.

The group that passes out GM's pamphlet is called the Michigan Universal Health Care Access Network, or MichUHCAN. Its members have been working to transform the health care system since 1990. And the group, like other organizations across the country with the same goal, is using Sicko as an organizing tool. Go to its Web site (michuhcan.com) and you'll see bannered across the top this message: "Welcome Sicko Fans — If you're as sick as we are of our critically ill health care system — Join us!"

Is it delusional to think that the Big Three could not only agree on the problem, but join groups such as MichUHCAN in pushing for a comprehensive solution?

In a recent issue of the online magazine Slate, columnist Timothy Noah noted that of all the victims portrayed in Sicko, "one significant victim of market-based health-care system is left out: market capitalism itself."

"I refer not to health insurers, nor to the health-maintenance organizations, nor to for-profit hospitals," wrote Noah, "but rather to the businesses outside the health-care sector that are saddled with the growing cost of providing health insurance to their employees. This obligation puts American companies at a disadvantage with respect to foreign competitors whose governments provide health care. The most obvious victim, ironically, is a company Moore knows very well: General Motors. Because of health-care obligations, the automaker that Moore pilloried in his first film, Roger and Me, is fighting for its life."

Noah goes on to imagine Moore approaching GM Chairman Rick Waggoner and offering him a deal, saying, "Rick ... I know there's bad blood between your company and me, but let's let bygones be bygones. You want GM to be in business five years from now. I want the government to guarantee decent health care. Join me in demanding national health care in the United States, just like they have in Britain, France and Canada."

"Sure, Wagoner might refuse," concludes Noah. "But then what would he tell his stockholders?"

The bottom line is that the lack of a national health care plan is an impediment for American corporations competing in the global marketplace, and that sooner or later the economic imperatives of the situation will eventually force them to support the type of system being advocated in Sicko.

It's been widely reported that providing health care coverage to its workers and retirees adds between $1,100 to $1,500 to the cost of every car GM produces. Why would the automaker be opposed to a national health care plan such as the one Conyers is proposing? We called GM to find out, but couldn't get a straight answer, with a spokeswoman telling us that the company isn't going to "give a position one way or another" on a national health plan.

"It's not a black-and-white issue," says Michelle Bunker, manager of healthcare communications for GM. "The health care system is extremely complex, and there's not one single solution. We just want a health care system that would improve service and quality and safety."

Hal Stack, director of the Labor Studies Center at Wayne State, says the U.S. automakers are most likely being held back by an ingrained opposition to expanding the scope of government.

Their continued reluctance to embrace a single-payer plan is an example of "ideology trumping self-interest," says Stack.

It wasn't that long ago that the opposite could be said of the unions themselves, which were allowing perceived self-interest to take precedence over what should have been a driving principle. Stack explains that, in the years after World War II, America's big unions chose to gain medical coverage for their members at the bargaining table rather than seeking any kind of universal, government-run program.

The thinking, explains Stack, was that a union's ability to obtain higher quality of care for its members would encourage others to join so that they too could enjoy those same benefits. It was referred to as the "union premium."

"In hindsight, that was profoundly mistaken," says Stack.

What happened instead, he explains, is that union premium provided corporate America an "incentive to avoid or destroy unions in order to avoid paying that premium."

But unions by and large have come to see things differently. As they declined in power, and the cost of providing health care coverage put industry at a disadvantage to foreign competition, union members have been forced to accept paying higher and higher health care costs.

"The reality is that at every bargaining table, whether it is in the public sector or the private sector, the issue of paying for health care isn't just the elephant in the room, it's the tyrannosaurus rex," says Stack. "It makes every negotiation difficult."

Unions, increasingly, are now seeing that the best way to deal with the issue is to create a single-payer national plan. The UAW endorsed H.R. 676 one year ago. The AFL-CIO endorsed a single-payer approach to health reform in March. More recently, Leo Gerard, international vice president of the United Steel Workers union, weighed in on Sicko and the importance of the movie to reform efforts.

"We all know from our bargaining experiences how crucial it is to get health care off the table," wrote Gerard in an opinion piece about Sicko. A national plan, he contended, "would eliminate much of the contentiousness in negotiations and make it much easier for American companies to compete in the global economy against nations that already provide national health care ..."

"Make no mistake. Moore's film advances our cause," added Gerard in urging his members to drum up support for the movie. "The more popular the film, the more clear it will be to politicians that this issue must be addressed."

It's about time

Sicko is hitting at an opportune point, says Marjorie Mitchell, president of MichUHCAN. Defeat of the Clinton health care reform plan and the subsequent loss of a lawsuit MichUHCAN brought against the state of Michigan in an attempt to force it to provide universal health care were setbacks for the group, but organizers never lost faith that change would eventually come.

The way Mitchell sees it, the longer the current system continues on, as is, the more support for an overhaul will grow.

That realization appears to be taking hold in a big way. The most recent Gallup Poll on the issue found that 69 percent of Americans think the government is responsible for ensuring all Americans have health coverage. And in February, a New York Times/CBS poll found that "affordable health care is at the top of the public's domestic agenda." The poll, which had a margin of error of plus or minus 3 percentage points, revealed that Americans "across party lines" were willing to make some sacrifice to guarantee everyone has access to health insurance. Sixty percent said they'd pay higher taxes to realize that goal, and "nearly two-thirds said the federal government should guarantee health insurance for all Americans." Asked whether they'd prefer the current system or a national insurance program, "38 percent said they preferred the current system, while 47 percent preferred a government-run approach."

What's hitting home for the middle class — in home after home after home — is just how much this isn't someone else's problem, says Mitchell. That point is hammered in Sicko, which focuses not on the problems of the uninsured, but rather the horror stories of blue-collar types who learned the hard way how precarious the current system is, even for those who are covered.

Particularly upsetting, says MichUHCAN staffer Valerie Przywara is the number of people who receive health insurance through their job but, if they become so ill they can't keep working, lose coverage.

"I just think that's wrong," says Przywara, who worked as a psychologist for 30 years before recently joining MichUHCAN as its sole paid staff member. "Linking having a job and health care makes no sense. The irrational cruelty of people being ill and losing their health care compelled me to act."

MichUHCAN is currently working with a coalition that includes unions, businesses and grassroots activists to lay the groundwork for a planned ballot measure that would be put before voters in November 2008. Instead of outlining a specific approach, the group will seek voter approval of a mandate that will "guarantee that no resident of Michigan lacks continuous, comprehensive and affordable" health insurance coverage. To accomplish that, they will also seek creation of a "sustainable and equitable" financing system that allows universal access to health care, mental health care, dental care and prescription drugs.

"Clearly, single-payer is probably the most efficient," says Mitchell, "but we're not saying it has to be a single-payer system."

"We're organizing around a set of principles rather than a specific financing system," adds Przywara.

The group is among many across the country that had volunteers out distributing literature at theaters showing Sicko. The Michigan group is affiliated with a national organization that has a presence in 34 states. The thinking is that, in the absence of a comprehensive national plan, "the states need to be laboratories of change."

Others, meanwhile, are out building support for Conyers' H.R. 676. Among the groups taking part in that effort is nonprofit Physicians for a National Health Program. Dr. Quentin Young, the group's national campaign organizer and a physician for 55 years, compares the effort to the civil rights movement and the antiwar movement during the Vietnam era. The way he sees it, a decisive shift toward fundamental reform is underway, being driven by the fact that the "consequences of the current system are so horrid.

"This is a very significant struggle that affects everybody one way or another," he says.

And that's the thing. Sicko isn't creating opposition to the current system. The widespread discontent — among workers, employers and health care providers — is already present. What Sicko is doing is staking out what Moore believes to be the solution to this mess in an attempt to galvanize support for reform. And he's doing so in time to make a national single-payer health plan is a significant part of the debate as the 2008 presidential elections approach.

As MichUHCAN's Marjorie Mitchell says, "Nice timing, Michael."