Michael Moore, our current resident agent provocateur and gadfly is at it again, and this time he really hits you where it hurts– in the pocketbook. His bright searchlight of investigation casts it glare on the health care industry, and more specifically on the health insurance and HMO juggernaut. I have to tell you that even if only a minority of what is said in this docu-drama is true, it confirms most of our suspicions that we are being had by our insurance companies and health care providers. It is of course always possible to complain about the odd injustice when someone falls between the cracks. But Moore is dealing not with the abuses of the system but rather its inherent and systemic problems.

When you peel away the shiny veneer of the health care industry and discover that ‘managed care’ has as its main goal the making of money and thereby the limiting of care, even to those who most need it, then the situation is grave indeed. Moore takes various of those folks who were involved in the rescue efforts in NY at ground zero, and not merely chronicles their on going health woes– losing jobs, losing homes, losing faith in the American way, but he takes these folks on a journey to Gitmo in Cuba and eventually to a hospital in Havana where they get much better and very much cheaper help for what ails them than they had been able to get in America. Shameful. Call this demagoguery if you like, but it makes the point. Our system is screwed up.

Some of the more devastating revelations of this docu-drama are: 1) we owe to Tricky Dick in collusion with Mr. Kaiser (of Kaiser Permanente fame) in 1971 the rise of the HMO for profit scheme. The White House Tapes do not lie when they tell us that the specific goal of the new health care system was to make money, and minimize care when it was not profitable to give care. So much for the hypocratic oath; 2) Moore documents how every single major Western nation except the US has a universal health care system of some sort which has not bankrupted the nation, nor prevented doctors from making a good living, nor caused rampant anti-democracy notions. Indeed he documents how universal health care was a natural outgrowth of democracy not socialism, a natural effort after WWII in Europe to do a better job as a society of looking after all its citizens, because the cries of many, including the least and the last in society were finally being heard, and their votes were making a difference. 3) One of the more telling remarks was that in European democracies the government is afraid of the power of the people and listens to their protests and legitimate cries for health care, whereas in the U.S. the people are afraid of the government, of it becoming too controlling and the like, and this then inhibits even legitimate national programs like the Postal Service, or Public Libraries, or Police and Firefighters or interstate roads and highways being adequately funded. It is this same fear of ‘big brother’ that has made a universal health care system a hard sell in America, whilst by and large it is a runaway success in Canada. It is just heartbreaking to hear some of the stories of people refused treatment who either die, or remain maimed or become homeless because the cost of their health care either prevented them from getting treatment or alternately bankrupted them when they got treatment anyway.

The film is under two hours, but it has more of a clear flow and direction than Moore’s previous films. It uses the same montage kind of approach, allowing people to tell their personal stories and allowing that in itself to generate the pathos of the movie. We watch a man sow up his own wound caused by a work accident because he has no health insurance. We see a woman dumped in front of the Salvation Army, having been put in a taxi and sent there by a hospital who decided not to complete treating this woman who needed antibiotics and stitches for a head wound. We see a woman lose her daughter because in her panic she took her to the nearest hospital which refused her care, even though the mother herself worked for a hospital in town. Care was refused because it was an ‘out of network’ hospital closer to where her daughter became ill that she had first taken her child. We hear the testimony before Congress of a woman who was in health care management and was promoted time and again because she ‘saved’ the health care provider so much money by refusing care to patients in need. And the beat goes on. We see Americans driving across the border to Canada because they can’t afford their heart medicine, their cancer treatment, their surgeries in the U.S.

Some 50 million Americans today are without any kind of health care or health insurance. I mean None. Of the 250 million insured, most have health insurance which has so many exclusions for pre-existing conditions, or just recurring conditions that the insurance does not help them when they most need it. It’s a national scandal to say the least. And then we are regaled with those who lobby our Congressmen and Senators for the health care industry– giving out enormous pay offs to both Republicans and Democrats so the health care industry and its pharmaceutical allies can keep making huge profits.

Some of this comes pretty close to home for me. The cost of my cholesterol and blood pressure medicine (both hereditary issues in my case) are very steep and are not covered by my health insurance. Some days you just ask– what good is it, this whole system? It doesn’t even work well for those who can afford to pay for health insurance.

Say what you will about Michael Moore, love him or hate him, he knows how to make us think about what needs to be changed about our society. Certainly the health care industry would be a good place to start. When you realize that the Great Physician himself could not have afforded health care in this system, and would have been censured by the AMA for practicing medicine without their approval, you realize something is wrong with this picture. To say the least.