Government

Will single-payer buzz from "SiCKO" last?

Supporters hope Michael Moore's latest movie will sway public opinion. The AMA and others counter that government-run health care isn't the right solution.

By Doug Trapp — Posted July 23, 2007

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Michael Moore's latest film, "SiCKO," has energized single-payer supporters and drawn attention to their cause. But what, if any, long-term effect the movie will have on the national debate on universal health care system reform is up for debate.

Moore created a buzz on Capitol Hill before "SiCKO" opened on June 29. He grabbed headlines with a rally, a crowded June 20 news conference with Democratic supporters, and two special screenings of his movie: one for lawmakers and one for health care lobbyists. Moore bought a full-page newspaper ad inviting 900 lobbyists to the screening, but only 11 showed up. The viewing for lawmakers, however, was better attended.

Organized labor, led largely by nurses unions, and single-payer advocates used the film as a vehicle to try to sway public opinion by "making moviegoers into health care activists." Their nationwide "Scrubs for SiCKO" campaign on opening night featured nurses in red scrubs designed by Moore, "From SiCKO to Sanity" flyers and an invitation to join the single-payer movement.

The film grossed $11.5 million in its first two weeks, finishing ninth in box office totals. But it opened in only about 10% of the screens occupied by an average summer blockbuster, then expanded to nearly 20% in its second week, according to Rotten Tomatoes, a popular Web site that tracks the film industry. About 91% of media reviews in the site's unofficial tally were positive.

The film was powerful, said Robert Blendon, ScD, a professor of health policy and political analysis at the Harvard School of Public Health. But with many Americans cynical about their government, "SiCKO" still won't create a tidal wave of support for a government-run single payer health system, he said.

"What I think it will contribute to is a sense that it's wrong that we don't have some way of requiring or guaranteeing that people have some basic insurance coverage," Dr. Blendon said.

Peter Clarke, PhD, a professor of preventive medicine and communication at the University of Southern California, said the film won't change the health reform debate in a lasting way, partly because Moore is stereotyped easily by detractors.

In the film, Moore unapologetically targets the profits and influence of the health insurance and drug industries while questioning the profit motive of the American public-private system. He challenges the country's inability to provide basic, affordable health care to everyone the way other countries do. The movie mentions the American Medical Association as a longstanding opponent to socialized medicine.

The AMA is working to increase access to health care and is worried about corporations putting profits before patients, said AMA Board of Trustees Chair Edward L. Langston, MD.

"We disagree, however, that the only solution is to give up and turn our health care system over to the government under a single-payer system," Dr. Langston said. The AMA, as a member of the Health Coverage Coalition for the Uninsured, supports tax credits to help low-income families and individuals buy health insurance, among other reforms.

Rep. John Conyers (D, Mich.) hosted Moore at the Capitol Hill news conference for both "SiCKO" and the United States National Health Insurance Act, which would expand Medicare to cover everyone. The measure, which Conyers introduced, has 75 co-sponsors, all Democrats.

Moore was joined by 32 lawmakers, including Conyers, plus a few dozen members of the California Nurses Assn., which backs single-payer legislation in California. It's the only state where the Legislature passed a single-payer bill, but Gov. Arnold Schwarzenegger vetoed the measure last fall.

With only one presidential candidate supporting single-payer health care -- Rep. Dennis Kucinich (D, Ohio) -- the odds are against the issue gaining traction. It takes the power of a newly elected president for such legislation to succeed, Dr. Blendon said.

Still, single-payer supporters are in a better position today than several months ago when the subject wasn't mentioned as an option for health system reform, said Quentin Young, MD, president of Physicians for a National Health Program. "In recent months, before the movie, even, we moved up to the next higher stage. We were no longer irrelevant, we were the less-desirable alternative," Dr. Young said.

Fairness an issue in "SiCKO"

"SiCKO," like his previous documentaries, includes Moore's sense of theatrics. He takes three 9/11 volunteer rescue workers from New York City to Guantanamo Bay, Cuba, in search of treatment for their various illnesses. Moore says they should be eligible for the same health care as terrorism detainees.

"SiCKO" also showcases horror stories, including an insured couple who went bankrupt because of expenses from multiple episodes of cancer and heart attacks.

Many critics pointed out the film's lack of balance in discussing health care in the U.S. compared with Britain, France and Cuba. Moore solicited through a Web site thousands of complaints from Americans about their health plans but limited his examination of other countries' nationalized health care to anecdotal encounters, such as a dinner with Americans living in France.

"There's no question he did not in any way try to talk about the problems that are faced in those systems and the complaints that citizens have. They are major political issues -- they have been in Britain and Canada -- about waiting times," Dr. Blendon said.

John Goodman, PhD, president of the National Center for Policy Analysis, a nonprofit research institute that promotes private-sector alternatives to government regulation, didn't expect Moore to be fair.

"Since the whole purpose of the film is to compare the worst features of American health care with the best features of health care in Britain, Canada, France and even Cuba (!) who can complain about a few errors here and there?" he wrote on his blog.

Moore, at the Capitol Hill news event, said there are many myths about other countries' health care systems. "Yes, they have their flaws. All human systems do. But ask a Canadian if they would trade their national health care card for your HMO card. You won't find a Canadian willing to do that. Or a Brit or anyone from Ireland or from France."

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ADDITIONAL INFORMATION

Moore movies

  • "SiCKO" (2007)
  • "Fahrenheit 911" (2004)
  • "Bowling for Columbine," Best Documentary Oscar winner, (2002)
  • "The Big One" (1997)
  • "Canadian Bacon" (1995)
  • "Roger & Me" (1989)

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