All of these people are about to get on a boat headed for MISCHIEF
Sickness comes in a variety of forms, and while some of them involve frighteningly topographical rashes or other easily identifiable symptoms, some are so subtle and pervasive that you can x-ray, MRI, PET scan, centrifuge and insert any number of uncomfortable 'scopes into a patient and still be presented with all sorts of non-random yet frustratingly incomplete data. A diagnosis can remain just out of reach until a person of uncommon vision and clarity looks holistically at the pieces that have presented themselves and makes a confident decision about what it is that actually needs treatment. And once that diagnosis has been made, any other interpretation of the facts seems absurd, and the person that made them is hailed as the banisher of the ridiculous relics of benighted thinking. Sicko is the story of one such diagnosis and the often reviled man who presents this analysis in a clear, easy to digest form, which, although it may be abrasive in spots, is indisputably correct. The patient in this case is health care in the U.S. and that man, my friends is House, M.D. Wait, I mean Michael Moore.
The sickness that has befallen the United States, is indeed, to borrow a phrase used by our current president in a clip contained in the film, "uniquely American," as there appears to be no other country in the world with a health care system remotely like ours. The most effective diagnosis comes from the inside, and in my understanding of the concept, there is no one more American than Michael Moore (Fahrenheit 911, Bowling for Columbine, etc.). Moore is only possible because of the best qualities of the United States (freedom of speech, mobility between class, cheap and easily available French Fries) but is only a necessary because of the worst manifestations of the values of the United States (the limited scope of acceptable public debate, increasing stratification between classes, cheap and easily available French Fries). He is the ultimate American private citizen, using the circumstances afforded to him by success in the capitalist system in order to address what he sees are the inefficiencies in that system.
While it may be fashionable for self-styled "liberals" to bash Moore for use of "excessive" rhetoric, his jeremiads are a necessary corrective to the prevailing scope of public discourse, ill-advised boat jaunts to restricted areas (Cuba, in this case) notwithstanding. Moore is, to put it bluntly, an American Hero, and the only thing that I can think to fault him for in the execution of Sicko is the timing of the release. The issues brought up by the film are far too important and far-reaching to be relegated to the dog days of the summer, and are sure to be fading from public consciousness by the time the dog-eat-dog days of the upcoming presidential primary season rolls around.
As far as the structure of the film goes, Moore has shifted his documentary format a little this time around. Yeah, he drags around a couple of symbolic cripples like always, but largely absent are the camera ambushes of the previous films, which often made me cringe when they ended up verging too far into "Curb Your Enthusiasm" brand of the humor of embarrassment, which can do a disservice to the message trying to be delivered (and anyway, Borat has that shit locked down now). Instead, Moore fashions himself as a bemused or concerned Gulliver, travelling to a series of alien lands and reporting back his findings, usually voiced by someone other than the filmmaker. The situations of both common, everyday U.S. citizens who have managed health care, and the citizens of the various countries Moore visits that have government provided health care seem absurd. The crucial difference is that most of the U.S. examples tragically absurd, like an unfunny Kafka story, while the foreigners' stories seem like wish-fulfillment of a very unrealistic yet forward-thinking 8 year old who yearns not for limitless candy but for free Albuterol, and what's more, gets it, with a unlimited number of wishes to spare.
This wish-fulfillment fantasy, unspeakable in the U.S. for so long, is taken for granted by the citizens of Canada, of the U.K., of France, of um, Cuba. These countries with which the U.S. has so much in common are so alien in this aspect of the society that there are several communication breakdowns when Moore asks a simple question like "where do you go to pay?" But underneath the practicalities of "socialized" medicine are worrisome questions about values, and what the absence of universal health care says about the values of the society that denies it.
Moore wisely more or less elides this issue, choosing to instead frame the question of values for the viewer to decide herself. And that's what Sicko is about - frame-making - an opportunity to shift the debate and transform the way we speak in public about values, without sounding shrill or condescending. Moore does an excellent job of offering points of entry for everyone along the U.S. political spectrum, precisely because the issue he is tackling, and the values that it manifests, are so universal and pervasive. I hope that the inclusion of the Cuban holiday, and some humorously and irrefutably damning audio evidence from two of Conservatism's shining stars: Richard Nixon (jumpstarting HMOs) and Ronald Reagan (an exclusive track from an LP he cut to defend the nation against creeping Socialism), doesn't cloud the issues, and that when the election cycle kicks up this fall, we are talking seriously about health care reform. I hope that this is a debate that all Americans can join, and a good place to start would be heading to the multiplex to catch Sicko