Michael Moore Trains Eye on Health Care

Michael Moore i i

On June 11, Michael Moore discussed a federal investigation into his trip to Cuba to film scenes for the movie. Andrew Walker/Getty Images hide caption

itoggle caption Andrew Walker/Getty Images
Michael Moore

On June 11, Michael Moore discussed a federal investigation into his trip to Cuba to film scenes for the movie.

Andrew Walker/Getty Images

NPR Fact-Checks 'Sicko'

Director Michael Moore's latest documentary, Sicko, is an indictment of the U.S. health care system. Melissa Block sizes up Sicko — as entertainment and expose — with film critic Bob Mondello and science correspondent Joanne Silberner.

It seems as if Michael Moore is everywhere at once these days as he promotes Sicko, a film that finds plenty of fault with the U.S. health care industry while praising systems in place in France, Canada and even Cuba.

Madeleine Brand spent a few minutes with Moore at the posh Four Seasons Hotel in Los Angeles, hours before he moved on to attend a premiere on Skid Row, which has become known as a location for so-called "patient dumping" by local hospitals. (The text version of the interview has been edited for clarity.)

What's it like, this junket here in the Four Seasons?

Well, the first thing I had to do is get them to take down the poster of the movie that they always have in these interviews — the TV interviews, you know they put up a big poster of the movie behind you like it's an ad. This should be news. I mean, it should be a discussion with news people. Why are they participating in an advertising things?

But that's what this is — a junket.

I guess that's what it usually is. But I'd rather have an intelligent conversation about the issues that I raise here.

Is there any compromise from the no insurance company, single payer health-care system you demand in Sicko?

Sure. Like, I'd be willing to leave 12 million Americans off the rolls, uninsured. You know, what's 12 million? Right? We're a big country. No, obviously I'm kidding. There is no compromise. Some things, there is no compromise. Would you be willing to accept a compromise of letting some women vote, but not others? Or some African Americans having civil rights but not others? No. Some things there is no compromise. Some issues are black and white and this is one of them.

Single payer is the only way to go when it comes to health insurance?

That you should not have a private, profit-making insurance company in the middle between the doctor and the patient. That is crazy. The doctor should be able to decide what the patient needs and then perform the procedure. And the patient should not have to worry about whether or not they can afford it — just as if your house was on fire, you shouldn't have to worry about whether or not you can afford to have the fire department put it out.

You made Bowling for Columbine, basically advocating for gun control. [Then] Fahrenheit 9/11. In both cases, what you wanted — gun control and a change in leadership at the White House — didn't happen. Are you thinking that in this case ... you'll have made a very popular movie ... but that in the end nothing really happens in terms of public policy?

The film [Bowling for Columbine] wasn't so much a plea for gun control as it was a plea for Americans to ask themselves why they feel a need to have a quarter-billion guns in our homes. And why when we have these guns do we use them on each other, when it doesn't happen in other countries? In Fahrenheit 9/11 I proposed the possibility that we were being led to war for false reasons. Now, three years later, 70 percent of the country is against the war. You know, somebody had to get the ball rolling here. Somebody had to say it first. So I was willing to take that risk, and I said it. And I got booed off the Oscar stage for saying it. I knew at that time that once people had the information — they'll come along. They'll do the right thing.

So you feel optimistic in this case that they will?

Oh, absolutely. If anything, I don't have to convince the American public that we have a broken health-care system. I think the majority of Americans since they have to go through that health-care system, already know it.

You're known for your kind of guerrilla tactics and confronting people ... Now that you're so well known ... is it impossible for you to do that any more? Do you miss doing that?

It is hard to get into places. You're right, it is. On the other hand, I've also found that because I'm known I get stories from everyday people that otherwise I would never have learned about these things. But they know that I'm the one who's going to stand up and say something — do something, maybe — and so they reach me through the Internet, whatever, and so I get a lot of great stories that way that otherwise I wouldn't get them.

Did you get this idea from people writing into you?

Oh yeah. Oh yeah. Most of the people — the Americans in the movie — are stories that we heard about, people wrote to us about. You know, before the Internet, how would I have ever learned of those stories? We would have had to rely on the media to do its job. (Laughs) There's a scary thought.

Do you consider yourself a journalist?

Yeah, I think of what I do as a work of journalism. It's more like the op-ed page, though. These are my opinions. My point of view. The opinions are mine and I let you make up your own mind.

Do you want to move to France?

No, I want France to move here. I want the French thinking to be our thinking. I like their way of thinking. We have a lot to be grateful to the French for. You know, they helped us with our revolution. We might not have beaten the British without the French help. They gave us that beautiful statue that sits in the harbor in New York City. And they invented sex. We should be grateful to them for that. Before the French it was just procreation. Then they came along and made it interesting.

Moore's 'Sicko' Lands Blows on U.S. Health Care

Michael Moore in doctors' scrubs.
TWC

Review by Bob Mondello

  

Moore's tactics are as provocative as always — a trip to Guantanamo, for instance, to demand that three ailing Ground Zero rescue workers get the same free health care the U.S. government affords suspected terrorists. There's plenty of grandstanding, most of it very funny. And in this instance, all that sizzle is selling the steak.

A Snapshot of Health Care in America

  

Michael Moore's new movie Sicko details problems in the U.S. health care system. At one point, he asks, plaintively, "Who are we?" He's asking how is it that Americans, as a people, are supporting the current system.

  

Get a by the numbers look at "who we are," including the numbers of uninsured in America, and how U.S. spending on health care ranks with other countries.

NPR Interview with Moore

  

NPR's Madeleine Brand interviews Michael Moore before a premiere of Sicko on Skid Row in Los Angeles, a notorious location for so-called "patient dumping" by local hospitals. Moore says he believes his movie will motivate Americans to fix the health-care system.

Director Michael Moore has found critical and popular success with documentaries that blend comedy and pathos to attack powerful interest groups. But those films are nearly always challenged as misleading. His latest work, Sicko, is an indictment of the U.S. health care system, highlighting insurance horror stories and profiling countries with universal health care.

Melissa Block sizes up Sicko — as entertainment and expose — with film critic Bob Mondello and science correspondent Joanne Silberner, who covers the health industry for NPR.

Melissa Block: Michael Moore does what he does quite well, which is to mix tragedy and comedy, back to back.

BOB MONDELLO: At the very beginning, he starts out with a whole bunch of horror stories; they're absolutely grim, and you look at people who are deprived of care because they can't afford it. And he does a lot of clever things to make the reasons for this funny. For instance, he uses the Star Wars theme, and he shows all of the various reasons you can be denied coverage by your insurance company, rolling away on the screen — it's thousands of them. Then Moore starts suggesting that there are other places where health care works better, for instance, Canada, Britain and France, and even — this is the shocking one — Cuba. As he shows other systems, I think it is a very persuasively put-together picture of the health care problem, and it's also very, very funny.

I wonder if there is a moment in this movie that you thought worked especially well?

MONDELLO: The sequence when he goes to Britain. He talks to the people at the National Health Service hospital about the cost of the care they're getting. And you can see that as soon as he mentions money, their brows furrow, and they can't get their head around the questions. They have almost literally never thought about money and medicine in the same breath. I think that is so telling, because I know when I go to a doctor or to a hospital, it is almost the first thing I'm thinking of — "Oh my God, how much is this going to cost?"

Let's talk about some of the medical cases Michael Moore describes in this film. At the very beginning, there is one about an American man who loses the ends of two of his fingers in an accident with an electric saw. He did not have insurance. The man must choose between having his middle finger reattached for $60,000, or his ring finger for $12,000. The man chooses his ring finger. How can a man be put into the position of making that choice?

JOANNE SILBERNER: [In the U.S.,] the hospital doesn't have to give him care unless it's lifesaving care, and his life wasn't threatened by the loss of two digits. So the hospital was within its rights to say, "We can reattach your two digits, but it's going to cost you." The irony is that if he had insurance, the insurance company would have paid far less than $12,000 or $60,000. The insurers can negotiate rates with hospitals that individuals can't.

There are also a number of times in the movie where we hear from people who either work or used to work inside the health care system, either turning down applicants for insurance, denying claims...

SILBERNER: He had an insurance company employee who started crying when she described what she had to do in terms of talking with people who called in.

Moore contrasts the U.S. system with the systems in France, Britain and Cuba, where care is free. He claims there's no waiting, and you can choose your own doctor. And in France, he says, there are doctors who make house calls in the middle of the night. How accurate are those claims?

SILBERNER: I think some of the things that those countries are willing to pay for are things that we Americans would not be willing to pay for. There was also the remarkable revelation that in France, when you're a new mother, a government employee will come to your house and maybe even do your laundry and make you soup. That's not going to go over well in this country.

What about the notion that long lines for health care in other countries are a myth?

SILBERNER: Moore didn't really look at the other side of that. What happens in each of these countries is that they get near to crisis situations, where there are lines — this has happened in Canada, too. And then the government, under pressure, puts more money into the system, and the lines go away. But then they come back. It's a cyclical thing; those lines come and go.

One thing did bother me with presenting Cuba as a paragon of health care, while showing the 9/11 workers who couldn't get care in this country: Moore didn't point out that, on that famous chart where the U.S. comes out 37th in health care, Cuba comes out 39th. So I'm not sure that was the best comparison for him to make.

MONDELLO: On the other hand, that is not necessarily something we should be terribly proud of — being 37th in a chart where France is No. 1.

One of the things he does that's very clever is to try to destroy the myth that socialized medicine is so terrifying. When you see what is probably the most impressive hospital I've ever seen, in Cuba, and it looks like a gigantic Hyatt hotel, it's simply not what you were picturing. We were joking when we came out of the film that it was probably the only MRI machine in all of Cuba, and it may very well have been. But the fact of the matter is that it was there and it was able to help a patient. The rooms there did not look decrepit and old, which is kind of what I expected.

SILBERNER: I think there's an issue of expectations. What do the Cubans expect? What do the French expect? What do the British expect? We expect to be able to get drugs like a recently approved drug for cancer that adds 13 days to life at a cost of $4,000 a month. I don't think people would expect that in France or Germany or Cuba. Thirteen days of added life with some side effects for $4,000 a month? We want it, and they don't. When we stop wanting things like that, I think we can move ahead.

In this movie, Moore advocates eliminating insurance companies entirely and going to a single-payer, government-funded system. This is not what any of the mainstream candidates this year are talking about.

SILBERNER: No, they're talking about various packages that would make insurance more affordable, give a little more government assistance, and in some cases, create a bit more regulation. They are talking about incremental changes, and this comes from the experience of '93 and '94, when attempts to change the system got nothing changed.

MONDELLO: We've had a lot of pictures recently about Iraq, and we had An Inconvenient Truth last year about climate change. These movies are not going to change policy. But it certainly does change the debate. If you think about the way the administration talked about climate change prior to An Inconvenient Truth, and the way it's talking about it now, I think it's clear that there was a major shift. I'm not sure if the movie is responsible for that, but certainly it changed the way the media dealt with it. It was a very persuasive case. And I think this will be a very persuasive case for a lot of people, too.

This transcript has been edited for length and clarity and may include portions of the conversation not broadcast on NPR.

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