Here's a shot I've taken a few times before, usually cursing tourists who mess up my pictures by wearing red. Why doesn't France's supposedly oppressive centralized state outlaw the wearing of red within 500 meters of 2- or 3-star Michelin tourist sites? Look at that jerk in the red jacket on the right - disgusting. And the red-cap guy right in the foreground?*#@!! But the red-cap guy turns out to be such a huge fan of France that he is forgiven.
We saw Michael Moore's film Sicko last night at our local theater in Paris. It's quite a great documentary film, maybe his best since Roger and Me.
It isn't a great film because he gives a balanced and well-rounded portrait of each of his locales. He doesn't - there are other things to say about Cuba and France than you'll see here, and the French audience guffawed at some of the idealizations of France coming from the Americans on camera who lived there. But for the rounded portrait people can do some extra reading.
It also isn't a great film because Moore has a complex deep analysis of how all the pieces of the health care system fit together. He doesn't have that either.
So why is it a great film? Because it goes right to the heart of the core problem and vividly shows its human effects. The core problem is the degradation and denial of health treatment for the sake of saving money. The core effect is that people's lives are diminished and destroyed, or simply ended prematurely.
SPOILER: Moore's trademark stunts here are particularly good because they take "reality" as seen on TV and turn it upside down. So we see his Canadian cousins buying insurance to travel to the United States. This nicely inverts the principle of American superiority that has Americans buying insurance to go to Mexico. We see free universal health care on "American soil" - but not for regular citizens, but for the detainees who are getting it partly so they can be force-fed on their hunger strikes. We see a cashier in a British hospital, but he gives out money to people for transportation home rather than raking money in.
The master stroke involves 9/11 rescue workers who can't get health care for conditions induced by their emergency work in the wake of the destruction of the Twin Towers. Moore rounds a bunch of them up, and they get on boats in Miami harbor and set off on what looks like Gilligan's three hour cruise. They go to Guantanamo and then to Havana. This nicely inverts the principle of American superiority illustrated by the Cuban boat people yearning to be free in the US. The 9/11 rescue workers are reverse boat people heading for the Cuban doctors and medicines no one will give them in the US. END OF SPOILER
Moore's "analysis" is in every frame: if you don't keep market logic out of human essentials, you damage and destory people. Period. That's the analysis. And it is correct.
The other countries - Great Britain, France, Cuba, and of course Canada - are there to show how much better people do when the criterion of care is patient need rather than business revenue. The health outcomes of that philosophy are so much better that that it reminds you of how detached from external reality American business "pragmatism" has become.
The film does include two sequences that suggest the deliberate nature of the less-is-more philosophy (less care for you, more money for me). The first is a conversation between President Richard Nixon and his chief aide John Erlichman on the eve of his announcement of a new health care system in 1971. (See Kaiser Permanente's rebuttal with some supporting documents, Nixon's 1971 "Special Message to the Congress Proposing a National Health Strategy" that followed the taped meeting, and his 1972 "Special Message to Congress on Health Care". See also Sicko's documentation, and the 4th International's dissatisfied review.) The private conversation describes the principle of private enterprise care as less care for more profits. Nixon approves.
The second sequence is Congressional testimony by Dr. Linda Peeno, a former medical reviewer for a large HMO. She said that her decisions to deny care had certainly killed some people, that this had been excellent for her management career, that physicians who denied the most care were directly rewarded with cash bonuses.
It's hard to miss the logic that less care means more profits (and more suffering). The logic is that of the Death Trip I've been blogging about, in which we embrace the principle that is slowly killing us.
Moore asks the great humanist question in the US today: "who are we?" What kind of people are we that we leave people on the sidewalks like trash? Are we monsters? Brainwashed "profits before people" neoliberals walking in lockstep to the obsolete dogmas of the Rupert Murdochs? A people in steady decline and simply afraid - afraid of our own government, as one of the Americans in Paris suggests?
For me the answer appeared in two sequences in France. The first came from a moment when Moore asks a comfortable French couple, so what are your biggest expenses after your mortgage and car payment, and the wife says, "the fish." They then spend some time together, this small French woman and the giant Michigander, peering into her well-stocked fridge. Moore is still wondering what they do with the money they don't spend on $200 office visits and $295 bottles of pills (my own tab for an advance supply of my cholesterol medicine since I was leaving the country and Blue Cross will pay only one month at a time). She says vacations, those are very important. We travel. And she shows Moore tiny bottles of sand she's collected on several continents.
The other sequence involves a French guy in his mid-30s who had moved to the US at 18 but who came back to France when he got cancer. It was all free, he said, and explains how the state-employer partnership assured him 100% of his salary for 3 months of rest and recuperation during his treatments, which he takes in the sun in the south of France. This guy shows Moore pictures of his tanned and smiling self hanging out with friends while the taxpayer foots the bill. Moore expresses surprise, and the guy, with no trace of American defensiveness, says something like, "in three months I went from being a 95 year old man back to this. I had to take care of myself. Now I'm recovered and can carry on, with my life and with my work."
My theory is that French people can expect and demand that everyone pay for everyone's healing as a society because they believe that life is about satisfaction, happiness, pleasure, and well-being. Their food culture is one expression of that, and so is government-funded child care. Another expression is affordable, high-quality health care for all. Life is short, you need to enjoy it, you need to be healthy, so what ELSE, exactly, is it worth spending our money on?
It's this jouissance that the US has lost - the sense of the RIGHT to happiness. We don't expect it for ourselves, so we don't care that the richest companies in the world can take it away from others.
Just a theory, but I do know that the French have much hipper and more beautiful eyeglasses than we do. And their sense of beauty fits together with how much better they treat each other than we do.