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Logo of brjgenpracRCGP homepageJ R Coll Gen Pract at PubMed CentralBJGP at RCGPBJGP at RCGP
Br J Gen Pract. 2007 August 1; 57(541): 677.
PMCID: PMC2099685

Film review

Reviewed by John J Frey

Sicko Written, produced, and directed by  Michael Moore 
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He may be biased but he's right.

That is what my wife remarked as we left a screening of ‘Sicko’, having watched it with a group of health professionals, public health, health policy, and practising doctors. We even saw the transplant surgeons and their spouses coming from the theatre. None seemed surprised at what they saw. How can we be? Doctors have the most intimate experience with the system we ostensibly control. Watching the film, I became angry at ‘them’. However, as a practising physician, I am an obvious co-conspirator. Of course, we don't control the system at all, even if we work as medical directors of insurance companies. The medical director of the insurance company in the film admitted that he doesn't sign most of the letters sent out over his signature, but rather his name was a stamp on a standard procedure for denying payment. It's not his fault, it is the system's.

If no one, then, seems to be in charge of a trillion dollar industry how, then, can so many earn so much profit and others do so badly? That, as they say, is the great mystery. Keeping it a mystery seems to be the full-time job of many people who have trained for the job by operating ponzi schemes or street scams, or running for public office. How else can one explain a system where the federal government, under the ‘freedom of choice’ rubric, allows the system to literally get away with murder? The officials shake their heads sadly and offer the ‘unfortunately, that sometimes happens' excuse often heard in societies where no one takes responsibility. The US health system is a tautology: ‘The system is the fault of all of us therefore none of us is responsible.’ Perfect.

The best parts of ‘Sicko’ were not the finger in the eye, contrived complementary delivery of care by Cuban doctors to three patients suffering from their participation in the 9/11 clean up, or the interview with the articulate old Labour lion Tony Benn. For American viewers, the best part was the interviews with the Canadians. Both the retired Canadian in a golf cart, who proudly admits to being a lifelong Conservative, and Michael Moore's relatives who, presumably, are of a different political persuasion reiterate that no Canadian politician in their right mind would seek to change the egalitarian basis of the Canadian health system. The Canadian approach should be more convincing to Americans than European solutions. We view all of you on that side of the Atlantic as dewy-eyed socialists. But the US health industry persists in vilifying our Northern Neighbouurs as well.

To hear the Conservative gentleman say that the greatest Canadian of all time was Tommy Douglas, the socialist Governor of Saskatchewan who started the Canadian health system, makes the point that the US will never have such a person — or one like Nye Bevan — who did the right thing because it was the right thing. The best we can do is Arnold Schwarzenegger trying to do the right thing in California. But he was born one of those soft-headed Europeans. The current political crop running for the US presidency all express appropriate outrage about our current dysfunctional system but will tiptoe around real change with the gradualism prescription they all propose, in one form or another. Hillary Clinton already blew it once and she wants us to let her try it again.

The folks who should be shocked by ‘Sicko’ are those in the UK who would let the for-profit insurance companies, wrapped in their sheep's clothing, into a country that, for the most part, has done it correctly for over 50 years. Are you nuts?

Meanwhile, do take seriously the point that Moore's Canadian relatives made about never entering the US, even for a day, without health insurance. Neglecting to do so might be dangerous to your health.

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners