FEEL IT IN YOUR BONES

Michael's Moore's Sicko is not a movie. It's an experience. And a shared one at that. For instance, the loud laughter and smirk of every person in the theater directed at President's Bush statement about "Too many OBGYNs cannot practice their...love of women" underlines the humour as well as common understanding of dismal reality that's endemic in many aspects of the running of this country today.

Moore does a really great job in depicting the inadequacies of the health care system in the US. There have been many reviews from diverse quarters about the remarkable accuracy and comprehensiveness of his documentary. Of course, he cherry-picks a little, but who does not? I also have a slight objection about dismissing some of his narrations and examples as anecdotal, because in some cases, even a single story really strikes deep at some outrageous aspects of the US healthcare system, like the story of the man who had to pay 60,000$ for attaching one of his fingers, or like the woman who could not get coverage after she was knocked out in a car accident because the driver of the ambulance carrying her to hospital was not "pre-approved".

The list of qualifiers in insurance company plans is daunting indeed, and more often than not one finds out only after being in a serious accident or having a serious health issue that he or she was not covered. Some aspects of standard insurance plans are galling in the simplest ways; for example, why does my university health insurance plan not cover dental and opthalmological treatments? Aren't these organs an important part of my body? And why should the dentist charge my friend 600$ just for a dental examination? Doesn't this start to feel a little insulting after a while? Sometimes sheer numbers speak a lot, and while one is accomodating about differences in costs, some of the costs for relatively simple treatments in the US are astronomical and unbelievable indeed.

Moore also documents well-known aspects of health care systems in France, Britain, and Canada. While one can debate about advances or sophisticated treatments, it is surely true that simple operations and therapies are cheap or many times free in these countries. Moore also interviews people about other things that should matter in daily lives; like being on extended paid leave when one is sick, or generally having an extended leave period every year, like they have in France. In this context, Bill Maher's superb article about how many Americans have a knee-jerk reflex reaction against everything French comes to mind. As Moore asks, why is there so much instinctive anti-French sentiment in the US? Is it because the government is afraid that Americans may actually like the French?

Another knee-jerk reaction that many Americans, and increasingly people in other parts of the world have, is against everything government. Sometimes the very suggestion that perhaps a service could be handled by the government or that government could put controls on some aspect of private ownership is greeted by denouncing that action- and that person- as "socialist". This is a very dangerous path to tread, because no system is perfect, no matter how good it is. One of the things I loved about the movie was that Moore makes us aware of the many good and essential services that the government already runs in the US, and in the other parts of the world; education, law and order, firefighting, and the postal service to name a few. And privatisation is certainly not necessarily the answer to having these efficient services. Economist Kaushik Basu for example has recounted how, as an answer to private players such as FedEx, the US postal service reinvented and modernised itself to stay efficient and competitive. There is no doubt that these federal US services, without private interference, are some of the best in the world, and nobody ever seems to want to delegate firefighting to the private sector, so that they can first take a look to see if the homeowners whose house is on fire are "pre-approved" to have the fire put out. The point is that government works pretty well in many countries and is essential in some large-scale services, and it is also a truism that specific individuals and administrations have botched up the working of government. Here the people too are to blame, because they just don't demand more transperancy and accountability from the government. To denounce government in a single punch line is to neglect many aspects of current federal systems, and to believe that one system will really solve all our problems. We need to always keep a watch on government to ensure that they don't interefere too much in our lives, but then we also need to keep a watch on private corporations with certain regulatory frameworks, unless of course people are going to again shout "Socalist". In general, both governments and corporations need to be afraid of the people, a scenario seldom seen.

If there is one filmmaker who can make a significant point with the most outrageous technique, it's Moore. This is apparent when he takes a bunch of 9/11 rescure workers first to Guantanomo, where Al-Qaeda operatives are getting fine health-care, and then to Cuba where these workers get actually treated for very low cost. This has been cited again as cherry-picking; I am sure not everyone will always receive the finest health-care in Cuba, but Moore wants to make the general point here about the escalating costs of similar treatments in the US, a point that is right on target.

Part of the problem of course is the lobbying by corporations that goes on in Washington, which Moore recounts. Most prominent are the oil, pharmaceutical, food, and healthcare lobbies (not to separately mention the corn lobby). This is a tricky problem, because not having lobbying also does not help. But the original function of lobbyists was to serve as a mediator of information and understanding between government and corporations. This role largely seems to have been abandoned, and lobbyists are now paid massive amounts by corporations to essentially sell their corporation to the government. The simple lure of fantastic amounts of money is usually sufficent to sway opinions, and bills, orchestrated by powerful forces in the government.

Interestingly, the problem is not with corporations per se, if you want to look at it that way. Corporations' goal is to maximise profit, that's just how they work. One can in fact, in this context, criticise the government for not having enough regulatory controls to make sure that they don't add gratuitous qualifiers for putting someone on their insurance plan. It seems that only in a healthy relationship between government and the private sector can the health care problem be well-addressed. Unlike Moore, I don't think that insurance companies should be completely eliminated as the middle man between doctors and patients; the world has just become too complex a place for that. But it is also ridiculous that a doctor first needs to call insurance company and talk to them to make sure the patient is "pre-approved" for treating even a simple ailment such as a broken bone.

The healthcare situation, and its solution, are maddeningly complex. Wisely, Moore does not suggest solutions, except more government participation. But he still does a very important job, because millions of Americans are confused and distraught about their health care situation and options, and it would bode well to become aware of the acute problem America faces in this respect, which becomes apparent especially when compared to other developed nations. Moore also does a fine job of dispelling the myth that free or cheap healthcare is necessarily of poor quality, and that government doctors have poor lifestyles. Also, the quality of healthcare in the US itself is sometimes overrated, as I myself have heard from relatives and friends.

In the end, the problem is larger. Healthcare is a problem that would very likely be solved by a fruitful alliance of government and the private sector (but admittedly not the Bush government). To perceive such a solution, it is very important to get rid of biases, both in favour of laissez faire capitalism as well as towards massive government involvement. Now is a good time to get rid of catchall catchphrases such as "Government is the problem" or "Government is the solution". It is important, especially in a capitalist country like the US, to teach the beneficial role that government plays, especially in schools. Americans and other people need to stop slapping on labels on policies and individuals. The slightest government controls have to be stopped getting labeled as socialist and inherently detrimental. Making profit by itself is of course not bad (saying that is rightly construed as socialism) but realising that profit-making compels corporations to act a certain way and makes it necessary for all of us- not just government- to make sure that they don't wriggle out of compromises by lobbying and casually paying huge fines, is something essential.

Michael Moore's film can be seen as a comedy. But at the end, perhaps half of the people in the theater had a tear in their eye. Maybe they also were simply asking "Why should I pay five thousand bucks to make sure that me or my child gets good treatment in a simple emergency? Why should I have to suffer a massive financial loss just because some old condition that I had which should not have mattered, suddenly made me ineligible for insurance? Why could I not suffer an injury and simply walk into a hospital and then walk out a few days later with a feeling of actually having been cared for, rather than a feeling of having been financially appraised, evaluated, and summarily asked to pay a large amount of money because I did not read some fine print sometime? In additon to the trauma of my accident, do I deserve this additional mental trauma?". It was likely that every person in the theater had one or more of these questions, either because of their own experience or that of someone close to them.

Whether you believe in government action or more corporate solutions, one thing is for sure; there are fundamental problems with the health care system in the United States. There is a large discrepancy in this situation, and the way that everyone thinks the US is and should be. This issue goes beyond partisan politics. Until it's resolved, I, and many others like me, will believe in God just for hoping that we never fall seriously ill in the US.