2007, Movie, PG-13, 123 mins


Professional gadfly Michael Moore's first film since the incendiary FAHRENHEIT 9/11 (2004) takes on the American health-care system and makes the enraging, bombastic case that it's sicker than any patient.

This being a Michael Moore film, the filmmaker is as enraging as the subject: His belligerent court-jester shtick wears thin fast and undermines the segments on universal health-care systems in Canada, the U.K., France and Cuba. Every roll of the eyes, every mock-incredulous question, every hyperbolic expression of disbelief that other countries offer their citizens, rich and poor, comprehensive access to doctors and medication without driving them to despair and financial ruin is precious and grating. Worse are his relentlessly sunny depictions of systems that may serve more people more effectively than the cobbled-together U.S. tangle of employment-based and private insurance, Medicare and Medicaid, but they're not perfect, and failing to say so leaves him open to damning criticism. But when Moore gets down to history, the fury is all about the facts, starting with the Nixon-era handover of health-care administration to businessmen like Edgar Kaiser, whose Kaiser Permanente is now the single largest health insurance entity in the U.S. Moore traces the ramifications through cutesy charts and graphs, archival footage, and sometimes wrenching personal testimony: the Michigan woman with cervical cancer who crosses into Canada for care after being denied insurance reimbursement because she was "too young to have cervical cancer." The medical director whose conscience drove her to testify before Congress that she was rewarded by her employer, Humana, for doing "the dirty work of managed care": saving money by arbitrarily denying treatment. The horror stories include those of people refused potentially lifesaving procedures and the shocked frustration of 9/11 volunteers told that their subsequent illnesses were their problem because they weren't working on the toxic Trade Center site in an "official" capacity.

None of Moore's conclusions are new: that American health care focuses on expensive machinery, profitable pills and cures rather than prevention. That in a prosperous, peaceful nation founded on the notion of government by and for the people, all the people should have access to regular medical treatment. That turning over to businessmen the complex jobs of promoting good health practices and treating the sick favors money over care. That since the 1950s, discussion of a single-payer, tax-funded system administered by the federal government has been demonized by lobbyists for the American Medical Association, pharmaceutical companies and high-tech medical equipment businesses, who use red-scare tactics that equate universal health care with communism. That the choice offered by free-market medicine is no choice if you can't afford it. But by the time Moore loads three boats with chronically ill Americans and takes them to impoverished, communist Cuba, where they're offered compassionate care at minimal cost, it's hard not be moved by the shambles the American medical establishment has helped make of their vulnerable lives. leave a comment --Maitland McDonagh

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