6-29-07, 4:17 pm

Sicko Director, Michael Moore 2007.

Delivering his characteristic dark humor and insightful analysis, Michael Moore's latest documentary film Sicko is a searing indictment of the for-profit, insurance-driven health care system.

As Moore notes, the film isn't really about the 50 million people in the richest country in the world who lack any health insurance whatsoever, or about the 18,000 people who die every year in the US because they don't have coverage.

It is about the millions of people who believe they have adequate coverage, but when a health care emergency arises, they find that the insurance company is looking for any excuse to deny their responsibilities in paying for needed care.

Insurance companies have an army of doctors, bureaucrats, and investigators looking for 'pre-existing conditions' or other excuses to deny coverage.

Why do they do this? Are they just nasty people? Maybe. But the real reason is that profit-driven health insurance requires them to cut corners, deny claims, and exclude people most likely to need health insurance – people who are sick or injured – in order to increase profits.

The need to maximize profits means they have to provide payments for as little medical care as possible. Moore interviews doctors and former insurance company bureaucrats who described there role in the process. Insurance company doctors received huge bonuses to deny claims. Corporate bureaucrats found out that the more they saved the company, the higher they were promoted and the fatter their paychecks became. Insurance CEOs have become billionaires.

Meanwhile, people with diseases went untreated or went into debt to pay for expensive treatments. Massive debt, homelessness, and bankruptcy are often caused by debts incurred from medical costs that insurance companies refuse to cover.

And the rest of the world is shocked by how things work here.

Moore traveled to Canada, Britain, France, and Cuba. In each place, he found that myths of poor health care in government-run systems were fabrications. In a Canada he talked with people, even one Conservative Party member, who took pride in the system. It is free and efficient. Patients can go to any hospital anytime to get treatment. The standard myth about long waiting times in Canada is also debunked.

In Britain, Moore spoke with a National Health Service doctor who described how the system there promotes treatment and preventative care. Doctors are paid to convince their patients to make healthy choices, improve their diets, quit smoking, exercise, and to accept treatments that reduce future health risks. On visiting a pharmacy, Moore discovered that no matter the quantity of prescription drugs, consumers pay only about $10, unless they are poor or over the age of 60 and they pay nothing.

In France, a similar quality of care is provided. In each place, the systems are so popular that even the most right-wing politicians won't even try to privatize or do away with them. In contrast to widespread claims by Americans that people in those countries are unhappy with public health care, Moore found that people over there are more generally surprised that Americans aren't more dissatisfied and even angry about having to pay for what should be universal and free.

In each place, the people explained that they felt they had a responsibility to help everyone else in the society when they are sick or injured. That 'we are all in the same boat. And we'll either swim together or we'll sink together.' In each place, the people have longer life expectancy and their health care systems are ranked higher than the US. In America, we're sinking.

The film took and interesting twist when Moore began to think about all of the things in our country that are already 'socialized': schools, libraries, the post office, and emergency services. We rely on and even count fire fighters, the employees of a wholly publicly operated entity, as among our greatest heroes. So how can 'socialized' emergency services be all that bad?

But then we discover that despite all of the talk from a lot of Republican politicians, including Giuliani and Bush, that the fire fighters and emergency workers who responded to the terrorist attacks on 9/11 are our great heroes, some of them are being denied claims for reimbursement for medical costs incurred for their work at Ground Zero.

Moore meets with some of those workers. And here the story takes a surprising turn that will anger you about a system that denies its responsibilities to care for the most vulnerable and tug at your heart strings. I'll let viewers find out for themselves what happens and make their own judgments about whether or not a for-profit health care system is something they want to continue.

But viewers should know that there is a movement for universal care that eliminates greedy insurance companies from the process. In fact, there is a bill (H.R. 676, the US National Health Insurance Act) pending in Congress that would expand the current Medicare system to cover everyone.

Medicare is more efficient; its overhead is about 3% of its total expenditures, compared to ten times that for private insurance companies. Because Medicare isn't profit driven, it would have to equally cover all people for all medical needs. It would cost less than the current private system (well more than $1 trillion annually), and even less than one war in Iraq. You can find out more about that plan by clicking here. Can we afford not to have such a system?

Sicko surely ranks in the top tier of movies this year so far, and is well worth the price of admission.

--Joel Wendland is managing editor of Political Affairs and can be reached at