"Sicko" Vs. A Sick Show

"Sicko" is required viewing, not because it's a contender for the Oscar for Best Picture—though given this year's paltry offerings, anything is possible—but because it is far better than the play now being staged by the White House.

Two days before Michael Moore's documentary on the health care crisis went into wide release Friday, President Bush huddled in the White House with a group of people he later described as "distinguished health care experts." He called it "a really interesting and good discussion," but it's not hard to imagine, once you realize who was in the room, the monotone that passed for robust health care debate in the Oval Office that day.

Included in the visit with Bush were representatives from The Heritage Foundation, whose bona fides on the right are well known, and two lower-profile groups: the Galen Institute, which says it exists to promote free-market health care policies, and the New America Foundation, a "post-partisan, public policy institute" with a center-right-leaning board of directors. Heritage and Galen in particular are committed to doing whatever they can to douse whatever grassroots fire for change is ignited by "Sicko." The Urban Institute—which in May 2006 issued a report [1] with the shocking finding that many of the uninsured find the cost of insurance "too high" and that solutions involve either "expanding eligibility for public insurance or providing subsidies for private insurance coverage"—and the humanitarian group Project Hope rounded out the circle.

If President Bush heard anything that would challenge the policy frames within which he and conservatives in Congress have been operating within on health care, his statement in the Roosevelt Room [2] after the meeting didn't betray it. He appeared totally oblivious to the fact that Moore's movie was stripping Bush's propaganda bare.

To address what's wrong with health care, "our nation has a clear choice," Bush said. "One option is to put more power in the hands of government by expanding federal health care programs and empowering bureaucrats to make medical decisions. The other option is to put more power in the hands of individuals, by making private health insurance more affordable and accessible and empowering people and their doctors to make the decisions that are right for them."

The words, familiar to those who have listened to Bush talk about health care, are eerily similar to a laughably over-the-top scene in "Sicko" in which a young Ronald Reagan, in his pre-politician days, records an album for the American Medical Association's "Operation Coffee Cup" offensive against what the organization called "socialized medicine." Reagan is heard intoning about the dangers of not only government bureaucrats telling patients what care they could and could not receive but those same bureaucrats telling doctors where they could and could not practice. With the backdrop of the "Red scare" for which Reagan was an iconic voice, it was an effective bit of propaganda.

It also set the stage for the false choice, and intellectual dishonesty, inherent in everything Bush has been saying and doing about health care since he has been in office. We are supposed to believe that government-managed health care is inherently evil (but somehow the government-run Veterans' Administration health care system is exempt). But when private insurers ration health care—how else would you characterize the examples of denied essential care in "Sicko" that in some cases led to patient deaths—the conservative think-tankers at Heritage and Galen retreat to blather about "the vibrant free market."

The real choice, as "Sicko" makes clear, is between a radical rethinking about how the nation views health care—as a right of every individual rather than a commodity to be bought and sold—and the perpetuation of a system that impoverishes the many for the profit of the few. There is an army, led by Bush, that wants to put window dressing on a fundamentally dysfunctional system, one that measure after measure [3] shows is leaving Americans with a lower life expectancy and higher infant mortality—but higher costs—than many other developed countries that, yes, "put more power in the hands of government."

Bush is offering a tax deduction—well, OK, he might be willing to compromise and offer a tax credit instead—that people can use to buy the same insurance from the same companies that now operate, as the Economics 101 textbooks say they would, on the principle of providing the least care at the maximum profit.

Some critics are blasting Moore for painting an overly utopian picture of health care in Canada, Great Britain, France and Cuba. But the critics dodge the fundamental difference between health care in those countries and health care in America: the difference in values. In America, while charity is good, the bottom line is each person's health care is their responsibility. You're on your own. In the countries that Moore examines with universal care, health care is a shared responsibility, and the notion that everyone pays into a system that provides for the needs of everyone is not any more questioned than is the concept in America that we all pay for the military and police services that protect us all.

That is the broader discussion that "Sicko" promotes, not just what should we do about the 49 million uninsured in America but what do we do about the overwhelming majority of Americans who have health insurance but do not have health assurance—who could find, as I did recently, that a doctor can prescribe a medical procedure to protect your health, but, to borrow Bush's words, "an insurance bureaucrat can make medical decisions."

So see "Sicko" this week, and since members of Congress are in their states and districts, invite them to accompany you—especially if they think that the nation's medical care ills can be solved by Bush's little tax cut pills.