Out of Frame: Sicko
Michael Moore is a loudmouth. His films tend towards the brash, arrogant, and inelegant, usually leaving subtlety and nuance to smaller personalities. He has a flair for public spectacle and complete lack of shame that would make P.T. Barnum proud. But say what you like about Michael Moore, he's no dummy. He just plays one in the movies.
Sicko, Moore's examination of the state of America's health care, may be his smartest film. It follows on the heels of the polarizing Fahrenheit 9/11, which, objectively speaking, was probably his weakest: an angry polemic that preached exclusively to the choir, confirming everything the Left already believed, and solidifying the Right's hatred of him. Moore's passion and anger got in the way of making an effective film. Fahrenheit's weakness was that Moore's politics were the only thing on display. Sicko, in sharp contrast, makes the political personal. Moore's smartest move is to let his subjects make his points for him.
The film, which screened at a preview in D.C. last night, begins with a number of stories of misadventures in American health care that are extraordinary in their inhumanity. Extraordinary, but sadly not surprising. We're now used to them. Most center on HMOs tap-dancing around technicalities and bending the definition of "pre-existing condition" in order to deny care, usually with devastating consequences. Moore reins in his tendency towards sarcastic humor through much of this section, allowing the victims' sadness to carry the film. It's an uncharacteristically measured start.
The film picks up steam, and Moore hits his stride, as he gives a brief history lesson on the rise of the HMO system. Moore may be a loudmouth. He may be clever at editing a sequence in a slightly underhanded way to achieve his goal. But he knows when to shut up and just let things play out. In a revealing sequence from the Nixon tapes, the President is being briefed on Edgar Kaiser's health care model. His adviser states quite plainly that it's a for-profit model, and that what makes it so effective is that it seeks to make money by treating patients as little as possible. The very next day, Nixon makes a speech telling his fellow Americans about an amazing new idea in health care. It's simple and unadorned, one of the most memorable moments in the film, and says a great deal. It's a mark of maturity on Moore's part to leave his stamp off of the sequence.
As the film develops, Moore does some traveling. He talks to patients and providers in Canada, England and France, dispelling myths about long waits for care, substandard technology, and doctors underpaid on government payrolls. While his "Aw, shucks" Midwestern disbelief wears a little thin, it serves to make his point: what people in these countries believe to be basic human rights is absolutely foreign to us. When the only cashier's window in the entire hospital is devoted to giving patients money rather than taking it from them, or when doctors are offered financial incentives to care for their patients more effectively (rather than incentives based on how many claims they can plausibly deny) something just seems turned upside down in our heads. Does he pick and choose just the positives? Absolutely. But this is a position paper, not a newspaper article. As Orson Welles pointed out in F for Fake, truth is always measured by degrees in filmmaking, and always through the filmmaker's lens and cuts.
There are the usual political pot shots. But they are much fewer and farther between than usual, and directed at both sides of the aisle. He reserves special disappointment for Hillary Clinton as a former potential savior of American health care who now receives more money from the health lobby than nearly any other elected official. Moore is smart enough to realize that polarization distracts from his message, and so he lines up Conservative Party Canadians and no less than Margaret Thatcher to lend their support to the idea of government sponsored health care.
The filmmaker's tendency towards stunts is also scaled back. The much publicized transport of 9/11 workers to Cuba to receive treatment is the only real "stunt," and that sequence comes off as moving and is difficult to criticize when the workers have tears in their eyes because they're finally getting the care they've been consistently denied at home. There is none of Moore's usual grandstanding, the uncomfortable guerilla tactics at the doors of squirrely corporate executives to throw their transgressions in their faces.
Moore depoliticizes the issue by humanizing it. Again and again, Sicko shows doctors, patients, and public officials from other countries who cannot understand how anyone could deny someone the best care available simply because they can't pay for it. They wonder how those needing medical attention can be seen purely as a vehicle for profit. They laugh at the very idea. As we watch the sickening sight of an elderly woman being dropped off curbside at a shelter by a hospital (with a hospital official admitting this is routine practice), he asks who we are as a nation that this is acceptable to us. Wondering what makes those other countries different, he concludes that, "They live in a world of 'we', not 'me'." It's a brutal assessment to close what is really an emotionally brutal film. Brutal, but not hopeless. Moore has dropped the polemic in favor of a plea: for us to care about each other a little more. And he's couched that plea in the most effective film he's made.
Sicko opens nationwide on June 29.