Sunday, June 24, 2007

Sicko

The new Michael Moore film, Sicko, is (IMHO) terrific. No doubt it contains some inaccuracies and misleading cuts (like his other films) but its overall argument is irrefutable: There is something clearly wrong with our health-care system in light of the better outcomes achieved for less money by other industrialized (and even some not so industrialized) countries. Moore's film also has the virtue of unapologetically touting a single-payer system, rather than one of the satisficing hybrids currently being proposed by Democratic Presidential candidates (although those proposals are certainly better than the status quo). He rightly describes opposition to "socialized medicine" as simple red baiting. As a practical matter, those who note that our politics won't yet embrace a universal single payer system may be right, but that's no reason not to discuss it.

The film's principal didactic flaw is its failure to explain why the U.S. system is such a disaster (although the point could be inferred by astute viewers): because so much of our health care dollar goes to administrative costs that take the form of insurance companies trying to deny coverage; a system in which everyone is covered can spend nearly every dollar on actual medical care; moreover, it does not give people incentives to skimp on preventive care which ends up costing more in the long run. Moore presents choice examples of the cruelty of the private insurance system but few good stories of its perversity.

Meanwhile, as has been widely reported, Moore is being investigated for violating the Cuba travel ban (although he says his application for permission under the exception for journalists was ignored). The travel ban is, in my view, bad policy, but not unconstitutional. However, a government decision not to process Moore's application, or a government decision to prosecute Moore, based on hostility to the content of Moore's views, would pretty clearly be a First Amendment violation. It would also be great publicity for the film, as Mark Twain surely would have noted.