The Awful Truth About Sicko

Michael Moynihan’s link-rich review of Sicko in Reason is oh-so worth reading.  Here’s a taste.

Take the case of four-year-old Elias Dillner. In 2004, Dillner’s parents were told by doctors that their son too would benefit from cochlear implants. After being fitted with the first implant, Dillner’s insurance provider said the second operation could not be “prioritized.” The family would have to wait. “We will do anything,” Elias’s mother told reporters, “even if it means that we have to take out a loan for the operation.” Without insurance, the second procedure would likely cost $40,000.

But Dillner’s truculent insurance provider was not Aetna or Kaiser, but the notoriously generous Swedish welfare state, where health care is “free.” And because there is no private clinic in Sweden that could perform the operation, Elias will sit in a queue, hoping, in lieu of privatization, for prioritization. Swedish legislator Robert Uitto said that the Dillner case was unfortunate, but “People shouldn’t, on principle, be allowed to purchase care in the public system.”

Sicko also introduces us to Diane, whose brain tumor operation was initially denied by Horizon BlueCross because it didn’t consider her condition “life threatening.” She eventually received treatment, but “not without battling the insurance companies,” Moore says.

Jack Szmyt found himself in a similar situation. After waiting two months for his initial diagnosis—he too had a brain tumor—Szmyt was told that it would be another month until doctors could start the necessary treatment. Rather than wait in a queue, he borrowed $30,000 from a friend, and flew to a private clinic in Germany. Had he not sought private treatment abroad, his German doctor said, he would likely have died. When contacted by the media, his insurer, again the Swedish government, said it didn’t consider the assigned waiting period “unreasonable.”

But wait, there’s more!

Viewers are taken to London’s Hammersmith Hospital, held up as a shining example of socialized care, where doctors are well-paid and patients well looked after. Moore ambles through the corridors interviewing patients that acclaim the NHS’s ‘free care,’ and express horror at the barbarism of the American system. Indeed, the facility’s “cashier” exists to give money to patients—for travel reimbursements—rather than taking it from them. But as is often the case with Moore’s films, the reality is more complex.

In 2005, London’s Evening Standard reported that Hammersmith Hospital would slash hundreds of jobs; the hospital, the most debt-ridden in Britain, was hemorrhaging money and desperately needed to cut costs. And while the hospital was “downsizing”, Hammersmith’s CEO—yes, even the NHS has an executive class—collected a year-end bonus of close to $20,000. Small beer by American standards, but enough to provoke tabloid headlines in Britain.

Much like the American hospitals Moore excoriates, Hammersmith Hospital, the Evening Standard reported, faced pressure from administrators to limit the number of patients treated in order to cut spending. In a country where the government promises to winnow down queues to 18 weeks, this isn’t an anomalous problem. A recent BBC documentary accused the NHS of using dangerously high doses of radiation on patients “to save time and money.”

After the critical reaction to his previous films, Moore opts for elision over outright falsehood. So when he marvels that a doctor working in the NHS owns an Audi and “million dollar home,” it is hardly in his interest to point out, as The Independent did in January, that “soaring salary levels of doctors are worsening the NHS cash crisis.” And while bitterly lamenting the U.S. system of “wage slavery"—American students, Moore says, are saddled with debt and, thus, “won’t cause [employers] any trouble"—he ignores a recent report from the British Medical Association suggesting that, by their fifth year of medical school, British students “have accumulated an average debt of” $39,000.

None of this will make the slightest difference to Moore’s fans, of course.  They’re not called Moore-ons for nothing.