Saturday, June 30, 2007

It's Not Just Corporatized Medicine That's Sick in America


Observations on the Polemics of Michael Moore’s Sicko

In Sicko, Michael Moore polemicizes against the corporate ruler-owners of America today, the advanced and growing state of corruption, greed and malfeasance of what began as what Eisenhower famously described as the “military-industrial complex,” and pleads for the restoration of democracy in the United States, for universal self-governance, for universally shared values of compassion, mercy, reason, fairness, for the restoration of altruism, and for a return of America to the world community.

He takes as his teaching example the case of the thirty-year transformation of medicine as practiced in the United States, from caring for the sick to exploiting the sick for base profit. Through numerous examples in the US and abroad, Sicko demonstrates just how far the American healthcare system, and the underlying ideology (profit, literally by any means) which justifies it, has departed from the global standard of the Hippocratic oath. A parallel development in US healthcare ideology has seen a drifting tendency away from practicing preventive medicine (things like healthy diet and exercise) toward cultivating chronic illnesses, whose symptoms can be treated for handsome profit by prescription drugs. Big Pharma, Moore makes clear, regulates itself today and, along with corporate healthcare, dictates the rules of healthcare service delivery.


At its core, the most radical observation Moore makes in Sicko is how the Orwellian Newspeak of America’s present ruling class has succeeded in demonizing basic human decency, where universal healthcare is equated with a phantasmagorical boogeyman Americans fearfully call “socialism.” Moore playfully, mirthfully turns the lights on to chase the monsters of the darkness away. He counters what is basically a rhetorical and psychological strategy with his own. Intersplicing clips of numerous Cold War-era "all-American values” anti-communist propaganda films, he contrasts this historical group-think against numerous present-day interviews with ordinary citizens, local figures of authority, and Americans, lots of American alien residents, in Canada, Britain, France, and even Cuba. (Since Americans may not live in Cuba, Moore brings a band of ailing US citizens with him to discover the Cuban heathcare system together.)

One on-camera “ga-ga socialistic” Brit turns out to be a committed Tory (conservative). Moore makes his point: the discourse in the United States has slid so far to the right, that even European conservatives now fall in the “extremist left” of the American political landscape. Like a good classroom teacher, Moore repeats the point, contrasting the demonizing anti-Castro propaganda with flesh-and-blood everyday Cubans, the present state of “communistic” medicine in Cuba, and Cuba’s benevolent 40-year tradition of being medical provider to much of the so-called Third World. The impression begins to arise that we are witnessing a Greek comedy unfold, wherein the K Street vilification of universal healthcare more approximates jealous and outraged prostitutes wreaking vengeance because loving wives and lovers and courtesans are stealing their business.

As a polemical documentary, Sicko first states the problem: the present system of managed healthcare is failing to provide healthcare to increasing numbers of Americans. It is predicated on the historically demonstrated flawed logic that capitalism is self-regulating by enlightened self-interest. The system seeks to maximize profits by minimizing services. Unregulated “free market” capitalism is amoral, drawing no ethical or moral distinctions in its single purpose of maximizing profit, of converting anything and anyone into a quantifiable and assessable commodity.

It has become part of a uniquely 21st-century, insane American version of systemic corruption, similar to what Gogol scathingly satirized in his novel Dead Souls. In that novel the protagonist Chichikov maximizes his wealth and social standing through a clever and devious self-serving plan to buy deceased serfs not yet expunged from tax roles. At least Chichikov was buying and selling abstractions, the imaginary remains which created an illusion of living people; corporate medical America magically transforms living, suffering, ailing human beings into mere abstractions of commodities, categorizing them as profit gain or loss, to be developed or dumped as useless inventory.

Sicko
proceeds to a quick historical overview of how things could have come to this. He finds the usual suspects, Tricky Dick Nixon, colluding, as evidenced by his own audiotapes, with Ehrlichman to conspire to defraud the American people with the adoption of the for-profit model now known as Kaiser-Permanente. The Reaganomic counter-revolution of the 1980s accelerated the transformation, and today’s climate of fear, wherein the middle classes are now owned and beholden to the owner-ruler corporate entity, prevents most people not just from resisting or speaking out, but even of allowing themselves to see the truth that lies all about them. Americans have, by and large, been persuaded, through fear and intimidation, to “not see.”

A word about the dithering over the perceived absence of objectivity in documentary filmmaking may be in order here. All narrative requires a point of view, and thus a subjective stance. Objectivity itself is but one point of view. Not all points of view are equally valid or merit equal representation. It has become increasingly fashionable in the American corporate-owned media to label right-wing points of view “objective” and left, liberal, progressive, even centrist points of view as “subjective,” “irrational,” and even “slanderous.” This is an alarming Orwellian development. The persuasion techniques of advertising and public relations, and the rise of “spin” in place of reasoned argument, has so thoroughly saturated American discourse that increasing numbers of Americans are incapable of distinguishing between “fact” and “opinion,” let alone between rational argument (reason) and emotional persuasion (propaganda).

The style of propaganda has become more subtle, no longer the crude, heavy-handed threats of Nazi Germany, Stalinist Soviet Russia, or exceptionalist Manifest Destiny America. Today’s friendly-faced fascisms, from “Jesus loves you (but hates those faggots)” to the specious freedom to choose between 18 types of cola beverages, are no less relentless and perhaps more effective. When all else fails, as Moore points out, a fearful population, despairing and demoralized, will never speak out, let alone act up. Americans are increasingly buried in debt, living in a society that literally sells the American Dream, compelling its consumer citizens into deeper and deeper debt, thus enslaved to the corporations which provide or withhold both the means and the ends – the jobs, the lines of credit, the consumer commodities, and the dream itself.


As the shame and stigma of bankruptcy began losing power, recent legislation has vigorously increased the penalties, and raised the bar making it increasingly difficult for individual consumers to successfully declare bankruptcy, while directing the federal government to bail out corporate bankruptcy through increased taxes. Interesting to note, too, how George W. Bush’s involvement in the great savings and loan crisis in the 1980s has been conveniently forgotten by public memory.


The apparent fact that Moore truly loves his country and agitates for the return of real democracy, in principle, in practice, and in the hearts of his fellow countrymen, makes this film much more radical than most folks want to admit. His rhetorical and psychological strategy is to assume the position of the Greek chorus, repeatedly intoning the moral values of the community, rather like the chorus in Antigone repeatedly reminding Creon to not place himself above laws higher than himself. Today, the Bush White House and all the transformed military-industrial powers it serves see themselves so far above the laws of man and nature, that the catastrophe they are creating and which they blind themselves to, may have already become inevitable.


Moore tells his story, making his points in very broad, comic-book strokes. Sicko is not just and nor just primarily about reforming healthcare in the United States. He speaks in headlines, in part because that is the degenerated level of public discourse in today’s advertising-saturated commercial media. The only counter to the poison may counter-poison. In any event, as the adage goes, desperate times call for desperate measures. This is the most desperate the American Union has been since the Civil War. And it is the most desperate Planet Earth has ever been. And, as Moore quixotically attempts to convey, America is still on Planet Earth and history, even American history, goes back a bit further than the fabulous Fifties and the birth of the Cold War.

Signs of how out of balance and out of control affairs are can be seen in the corporate-owned American media’s reception. Even the most sympathetic reviews of Sicko have tended to take a “balanced” view, quoting corporate insiders’ rebuttals as if the latter were sober and reasonable, rather than mere repetitions of the Big Lie. Instead of addressing the questions Moore raises, the corporate-owned media reaches into its bag of rhetorical tricks: belittling, ad hominem attacks, distracting, misleading, trivializing, and outright dismissing. (“Never mind the man behind the curtain, Dorothy. Look at the pathetic lot of you.”) It’s as if Moore were objecting to Hitler’s concentration camp system, his critics reacting petulantly, reminding us that Uncle Adolf has built a fabulous freeway system, made the trains run on time, and gotten everyone back to work. (“Ohmygawd! It’s, like, you know, so unfaaair!”)


Instead of paying somewhat more in taxes and knowing medical care is always available, as a resource like clean water and reliable public utilities, Americans worry constantly, are forced to choose between medical care and other basic necessities. Moore’s example of the man who, having cut off two fingertips in an accident, was forced to choose which of the fingers to save, based on his ability to pay, apparently, does not sink in. And so Moore goes on cataloging and commenting.


For example, when one critic opines that Moore fails to mention how much the French pay in taxes for their socialized medicine, this critic colludes in the neo-con Big Lie. Europeans may pay more taxes for health care, but they are not at the unregulated mercy of the American “system” (Big Pharma and for-profit healthcare): Moore has just documented, over and over, how more and more Americans, when faced with catastrophic illness, are driven into profound physical and mental distress, bankruptcy, desperation and despair.


Another reviewer trots out quotes from spokespersons for various healthcare corporations to defend “the other side.” Such “fair and balanced” coverage mindlessly repeats the Fox News tactic, of relentless right-wing spin. (And when all else fails, just wear the enemy down.) This is the classic approach: keep the patient too sick to fight back. If they hire a lawyer, well, that’s why corporations have teams of lawyers in their pay. Get more lawyers, if necessary. Hire lobbyists and buy the politicians to serve your purposes as well. As we learned during the AIDS crisis in the 1980s, corporations know if they stall long enough, the sick will simply die and the problem will go away by itself. But higher taxes?! How “communistic”! It is every corporation inalienable right to make as much profit as possible, by any means they deem helpful.


Perhaps the most terrifying example of what we as a society have become lies in Moore’s example of the now common practice of “patient dumping.” Moore puts a human face on this practice and asks the audience, pointblank, is this what we have become? The anecdotal case he follows is of what appears to be a homeless woman, a drug addict, whom the county hospital can no longer afford to treat in its charity ward. The patient has been “released” from the hospital, placed in a taxi, and the driver then literally shoves the patient out of the cab at the doorstep of a skid-row shelter.


The message is clear: the United States harbors an underclass of people it no longer feels the slightest obligation to care for. The underclass are commonly, if but tacitly, judged subhuman. They have already been left to die in the streets, but when the 911 system collects them into the medical treatment system, it slaps a symbolic band-aid on them and spits them out into the street again. I myself had the dubious pleasure of surviving this system with life-threatening AIDS-related conditions in the early 1990s. Seeing it in a movie and living it are two totally different experiences.


The system is a machine gone mad. Moore exposes the underlying system and values, which connect the dots between the now deteriorating medical services to a once comfortably well-off middle class, and points out the direction we are all headed in. Either we all hang together, or we hang separately. The social and economic decline of America could not be spelled out any more clearly. And yet, hardly anyone in America seems to notice still.
#### © 2007 Les Wright

1 comment:

Rich said...

This is the most thoroughly thought out, precise and enlightening essay I have read in a long, long time.
If you haven't seen SICKO (and shame on you if you haven't), then this review/essay is just as insightful.
The question is WHAT DO WE DO? how can we change this out of control machine? This is America. We are the people. Is it too far gone for us non-corporate, non monied people to make a difference or a change?