Sicko Studies

Look for the latest documentary from self-described gadfly Michael Moore to make the rounds of American college campuses in the not-so-distant future. From Roger & Me to Fahrenheit 9-11, college administrators and professors have routinely made Moore’s cinematic output available to students, either for their extracurricular edification or, not infrequently, as required viewing.

Over that same time period, a cottage industry has emerged with web sites exclusively devoted to fact-checking the rotund one. Moore’s latest film promises plenty of grist for both the academic and the blogging mill.

His video muckraking follows a pattern; into a sandwich of facts, he crams truths, half-truths and often outright distortions. Moore’s expose’ of American health care does not depart from this approach.

He leads with horror stories of families denied medical treatment that will be instantly recognizable to those of us who have covered, or in any way experienced, managed care in the United States. He winds up with a plea to give Americans the same high-quality health care that prisoners of the war on terror get at Gitmo. (The juxtaposing of indignities suffered by survivors of the 9-11 attacks with the elegance of the medical care that Al-Qaeda plotters receive in an American prison offers an odd coda to Moore’s Fahrenheit 9-11, which attacked the U. S. war effort in Iraq.)

In between, Moore promotes the countries that have the health care systems he admires most, namely—Great Britain, Canada and Cuba. “British physicians simply do less of nearly everything—perform fewer surgeries, prescribe fewer medications, and order fewer x-rays,” University of San Francisco professors Thomas Bodenheimer and Kevin Brumbach write.

Ezra Klein quotes the professors in an article he wrote earlier this year for The American Prospect. As for Canada, Klein notes that “The downside of a single-payer system in the Canadian style is that it constructs a system with a high floor and a low ceiling.”

“If you don’t like the government’s health care options, there’s no real alternative,” Klein explains. No free-market conservative, Klein, then a writing fellow at The Prospect, is a big fan of French health care.

He is not, though, unlike Moore, enamored of Cuba’s health care. Similarly, he recognizes that the Health Maintenance Organizations in America— or in their modern guise, Health Management Organizations, but HMOs either way— are not, as Moore would have it, capitalist tools.

“HMOs are a product of government, not of the free market,” Klein said in a debate last summer on Capitol Hill that was sponsored by the libertarian Cato Institute. Indeed, HMOs are protected from lawsuits by a federal statute called the Employment Retirement Income Security Act, or ERISA.

Additionally, HMOs derive a good chunk of their business from government programs and employees. Thus, we find Medicare HMOs for the elderly, Medicaid HMOs for the poor and exclusive contracts managed-care companies have been awarded to provide health care for public school teachers and other civil servants.

Back to Moore, if this latest movie of his was a springboard for discussion in classrooms and lecture halls, its inclusion in college curricula might be understandable. Unfortunately, his work is usually presented as a true-or-false test, with Moore and his faculty fan clubs arriving at the same answers.

Malcolm A. Kline is the executive director of Accuracy in Academia.