SiCKO Builds a Movement
Americans want big changes in our heath care system. And now Michael Moore's great new film, SiCKO is helping to turn a desire for change into a crusade for change. Now breaking box office records in its second week in theaters, SiCKO conveys powerfully emotional stories of Americans trapped in a system controlled by insurance and drug companies that deny care and destroy lives in order to maintain their profits. We walk into the movie house individuals with our particular gripes about the health care system. And we walk out wanting to be part of a national movement for health care for all. For great account of how spontaneous organizing literally occurred in the theater lobby – at a Dallas, Texas suburban cineplex – click here.
So, what kind of movement should we be building? Unlike this weekend's very expensive Live Earth rock and roll extravaganza whose major message (in the face of looming global environmental catastrophe) seemed to be to make personal life changes: "Buy better lightbulbs, unplug your cellphone chargers, and run your tour bus on bio-diesel," the thoughts of people who see Moore's movie turn immediately to institutional and political change.
After seeing Moore's film, most people want to pose a big question to all politicians: Will you work to guarantee health care for all? Not incrementally – one disease at a time, or one group (like kids) and then another group (like their parents) in another program – but through a universal system of health care for all?
Here's a second crucial question we should politicians: Will you pledge to cut the big insurance and drug companies out of a central role in the design of your universal health care plan? This week the Campaign for America's Future joined with MoveOn in a campaign to urge our members to take friends to see SiCKO and then to communicate with all the candidates for president, asking them to reject contributions from big insurance and drug companies. We will publicize the answers.
The good news for those of us who come out of SiCKO inspired to change our health care system: Several of the presidential candidates – Edwards, Obama, and Kucinich – have already pledged not to take contributions from the insurance and drug companies, their pacs and their lobbyists. And each of those Democratic candidates has already put forward a plan to achieve health care for all. Hillary Clinton has announced she will come forward with a plan for universal health care in the coming months – a big step forward from her original posture of just covering kids first. It appears that Clinton's campaign IS taking insurance and drug industry money, but she is under pressure to change that policy – which is the one of the goals of our email campaign. (Click here for info on how to reach her campaign and others.)
This is where two different tendencies in the health care movement diverge. Some people want to understand which of the possible nominees has the best plan – or discuss how we put pressure on him or her to get better. The other reaction – which I've gotten in person and in angry emails – says don't even bother talking about the promising proposals coming from politicians like Edwards and Obama. They are just not as good as Dennis Kucinich's plan (HR 676) which would create one national public (single-payer) health plan for everyone. Michael Moore, although he has generally wisely stayed above the details of specific policy, has given a few interviews dismissing Edwards and Obama as fatally flawed because they preserve a role for private insurers.
Now, there is nothing wrong with unremitting public pressure. If everyone who sees SiCKO is enlisted in the Kucinich campaign – and if everywhere the other candidates go, they are confronted with crowds chanting for single-payer, it could (in theory) convince Obama or Hillary or Edwards to embrace HR 676. Or failing that, if a Democrat gets to the White House anyway, he or she (or the more progressive new Congress) might be forced to support a pure single-payer plan sometime after the election. The debate about health care for all won't be over on election day, it just begins. And everyone should energically raise their voices. Tell the politicians that we want a comprehensive health care plan that covers everyone. And those who think HR 676 is the only way to achieve that goal, should be vociferous – and they will. That kind of democracy in action is good.
But one big problem with "single-payer or nothing" – or Dennis Kucinich or nobody – is that it runs the risk of ignoring potentially important differences between the candidates who actually have a chance to win the nomination – and it takes the pressure off those candidates to try to improve their health care plans if they think that all the "SiCKO voters" are going to give our votes only to Kucinich.
Now, I happen to think that the health care plans put forward by Edwards and Obama represent pretty important proposals – much more understandable than Hillary Clinton's 1993 plan or John Kerry's undecipherable health care proposals in 2004. The prospect of debating Dennis Kucinich before audiences of progressive primary voters probably made Edwards' and Obama's plans somewhat more progressive – but they also got better because some of us paid attention to the details of what they and their advisers were saying – and pushed them in the right direction. (See links below.)
Do the Edwards or Obama plans remove the private health insurance industry from any and all role in expanding health care coverage? No. But both Edwards and Obama create a public program, similar to Medicare, that would play a central role in making sure all Americans have coverage. Here's a description of Obama's plan from David Cutler, one of his key advisers:
If you don't have health insurance through your employer, you will be enrolled into a new, comprehensive public health insurance plan that emphasizes prevention, chronic care management and quality care. This plan will enjoy the great efficiencies we see in public plans like Medicare but, if you still cannot afford it, you will receive a subsidy to pay for it. Of course, you can choose private insurance if you prefer but the private plans will have to compete on a level playing field with the public plan—without the extra payments that tip the scales in favor of private Medicare Advantage plans today.
It ain't pure single payer, and people have a choice of a regulated private insurance, but the plan people are automatically enrolled would end up being a pretty big single-payer public insurance program – like Medicare.
Edwards has a similar public insurance plan, and when he rolled it out for public discussion (well before Obama), he told Tim Russert of Meet the Press: "One of the choices . . . is the government plan. So people who like the idea of a single-payer insurer health plan, that is actually one of the alternatives that people can choose."
We don't know what Hillary Clinton's plan will look like. She could cautiously aim at covering everyone only if she is re-elected for a second term (as she has hinted). And she could aim at achieving that goal incrementally, insuring all poor children first in one program, and middle-class kids in a separate program, and all adults in a separate program. That would be a disappointment. And people who think of themselves as "health care voters" should be letting her know that RIGHT NOW.
In this crucial primary season, some in the movement for health care for all will dismiss the differences between candidates, embracing only Dennis Kucinich and single-payer. But the rest of us, more realistically, should emphasize the most progressive elements of the Edwards and Obama – and Kucinich – proposals, while trying to use them to leverage a better, more progressive plan out of Hillary Clinton.
The single-payer advocates get the diagnosis of what's wrong with American health care correct: the for-profit drug and health insurance industries who profit by denying people care and by manipulating the system. But even if you would like to completely cut these corporate interests out of our basic health care system, it would be real progress to achieve a public health insurance plan like Medicare that covers over half the population. And some of us think there could be a political advantage – and a good reply to the "Harry and Louise" propaganda from the insurance companies – if we can show that people who like their private insurance plans will get to keep things just the way they are.
Michael Moore has generated a lot of very productive emotion by exposing how the insurance industry denies care to people who thought they were covered or keeps sick people from getting insurance. But we all need to get used to another populist attack on the private health insurance industry – but not designed to take them out but to regulate them. You can see it in California, where Arnold Schwarzenegger is trying to cover everyone without a public plan, so he has to try to put strong new restrictions on private insurance companies (who want to participate) to get them to insure all comers – even people with pre-existing conditions – and to do it at affordable premiums.
If any of the leading Democrats – Edwards, Obama, or Clinton – get elected president, we are likely to see two parallel experiments with the insurance industry: displace them as much as possible with the best possible public plan AND regulate the hell out of them to try to get them to change the business model so well described by Hillary Clinton at the Las Vegas health care debate: "Insurance companies make money by spending a lot of money, and employing a lot of people, to avoid insuring you, and then if you're insured, they try to avoid paying for the health care you receive."
Our most important job is to build a strong movement with a clear goal: good health care guaranteed for all. And then we have to explain and re-explain how the business practices of the big health insurance and drug companies actually prevent us from achieving that goal. If we keep up pressure for strong reform and not just weak reform – perhaps we can build a health care system that puts people ahead of profits: the kind of system that – as Michael Moore showed us – the Canadians, the British and the French have enjoyed for decades.
http://commonsense.ourfuture.org/the_great_risk_shift_healthcare_for_all
http://commonsense.ourfuture.org/health_care_for_america
http://commonsense.ourfuture.org/health_care_for_america_blog_roundup
http://commonsense.ourfuture.org/edwards_gives_nod_toward_health_care_for_america
http://commonsense.ourfuture.org/blog_reaction_to_edwards_health_care_plan
http://commonsense.ourfuture.org/the_universal_health_care_debate_is_over
http://commonsense.ourfuture.org/where_the_health_care_debate_is_going
http://commonsense.ourfuture.org/health_care_answers_we_need/
http://commonsense.ourfuture.org/universal_care_getting_right_mix
http://commonsense.ourfuture.org/advisor_describes_obama_health_plan
http://www.tompaine.com/articles/2007/06/04/obamacare_clearing_away_the_fog.php
In November of 1945 only seven months into his term of office President Harry Truman proposed a national health care program. Years later in his autobiography President Truman stated the health care issue was the rock on which his popularity was dashed by the establishment. It has been so every since with any caring public servant who has tried to remedy shameful state of health care maintained by the medical industry to preserve exorbitant levels of profit. I say it is long past the time to eat that fatted pig.
July 9, 2007 9:10 AM | Reply | Permalink
You do realize that the financial services industry as well as the insurance and pharmaceutical industries have a huge disincentive to major change. How much money will a universal plan draw from Wall Street? Insurance companies are significant institutional investors. So are pension funds. Will pension fund admininstrators join all the above to keep from losing portfolio value?
And how will universal medical coverage affect premium income in other areas? If everyone is automatically insured, how will the levels of liability insurance be affected? What about the medical payments portion of auto insurance? Workers' Compensation?
I am an advocate for a Medicare-for-all type basic plan. I also believe that we must be prepared for dealing with the inevitable unintended consequences of change. To do that we must understand what a truly tangled mess the current system is and who all the potential opponents of change are likely to be.
July 9, 2007 10:03 AM | Reply | Permalink
Good points, which suggest a fierce fight, likely behind the scenes, by entrenched finance. We might have passed a point of no return, if too many people are too heavily invested to ever let it change. And I hold little hope of countering the power of concentrated wealth, unless we change campaign financing, or voting, as in instant runoff to allow 3rd parties to avoid the role of spoiler.
Then again, the powers that be make mucho bucks off campaigns, too.
July 9, 2007 10:49 AM | Reply | Permalink
What the public has to do is ignore the establishment’s media monopoly reorganize in new political parties, if the old one refuse to bend, that accept no financing from the insurance/banking and pharmaceutical industries and if will not matter what the entrenched intrests want or do not want. That group of folks have had a far too plush ride up till now and cutting their influence down to a fair representative share based on their numbers will not hurt the country, it in fact make it stronger.
Every step towards a banana republic economy with strong fascist tendencies shortens the life span of this republic while every move towards equality of opportunity and democratic representation (other than in name as is the case more and more of late) strengthens the Republic and lengthens its life. Modern societies can not exist for long without a certain degree of socialism (democratic socialism) due to the destabilization that 17th and 18th forms of economics have inherent in them in cultures with a plethora of urban centers greater than 50,000 in population and a small agricultural class.
The glittering dream that everyone who works hard can become a millionaire, well today with badly inflated fiat dollars a multimillionaire, and keeps crony capitalism in buisness is a damnable lie that does disservice to the greater good including the in the end to lives of the uber rich.
The health and health insurance industries are raping the economy and making the cost of health care more than double what it is in other first world nations while providing decent care to a minority of the population and leaving another one third of the population with little or no health care. Doctors are begin to recognize the big HMO's are harder to get a fee out of than government programs so the opposition to single payer government run insurance is considerably less than it once was from that quarter. We just do not need one more for profit industry between doctors and the public. Like I said earlier it is past time to kill and eat that fatted calf.
As an aside…
What do you expect would happen, given the values currently prevailing in our medical industry, if it suddenly became more profitable to cure cancer than treat is effects until it kills its host?
July 9, 2007 12:47 PM | Reply | Permalink
Three Cheers for Roger Hickey. (On mature reflection, let me change that to 2.98 Cheers).
I love Hickey's work on Campaign for America's Future, and I suppose as long as the my body, bankroll, and the Take Back America Conference itself hold out, I'll show up. I also agree with nearly everything in this post. Having said that, I suppose I better draw attention to the one tiny paragraph which raised a large and bushy eyebrow.
Here's the gripe. The greatest danger to the Progressive Movement, MHO, is that it may fracture along "cause lines". Here, the danger is a fracture between the environmental movement and the health care movement. There is also the danger of a generational fault line between those for whom rock and roll is an effective means of attraction to progressive causes and the generation(s) who are a bit beyond the booty-shaking stage.
Many young people are still convinced of their immortality and they can dance the night away, no problem. For them, maybe the lure into the Progressive Movement is the vision of a Water World future, with global warming turning the world of their mature years into a nightmare. Many older folks (like me) wake up in the morning check to make sure they still have their aches and pains (if not, as an old friend of mine says, then's the time to worry) and are still inhaling and exhaling the right number of times and in the proper sequence, and then start their days, wondering if their health insurance will enable the patching of the thing which which goes awry.
So let's not boost the health folks' position by belittling the young light bulb switchers, o.k.? Besides, all that rocking and rolling has aerobic benifits...and perhaps Universal Health Care ought to subsidize it as cheaper in the long run than couch potatohood.
aMike
July 10, 2007 4:44 AM | Reply | Permalink
Corvid
Agreed, Medicare for all is the way to go. Equally important to understand is that anything short of this, or of a system to get rid of all private health insurers, is horribly, horribly unacceptable.
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That's because you have to consider who and what you're compromising with if you do something less than single-payer or expanded Medicare. Keeping any kind of role for private insurers amounts to a further impramatur for an obscene system that has profited from people's misery and death. Forget the economics for a moment; this is a moral objection, about as crystal clear as you can get.
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And the heart of this is the people involved. Every time a decision is made by an insurance company to exclude someone with a pre-existing condition or to deny needed treatment to a supposedly insured client, it is a morally repugnant act that reflects not just on the system but equally and damningly on all the decision-makers along the line. Every one of them, individually. Responsibility for such heinous acts is not divisible; rather it rests justs as heavily on each and every participating individual as it does on the system. This includes the doctors who acquiesce.
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Remember Nuremburg. We simply cannot keep these people around. Every last trace of private health insurance has to go.
July 10, 2007 8:01 AM | Reply | Permalink
Thanks, Mike. I was getting a little tired of the meme circulating all last week in the MSM about how pointless the entertainment event was, even it it also happened to include some people with a certifiable political role and half a brain, like Gore. The line would always run that the concerts use so much energy themselves.
My first thought was that people don't seem to understand the idea of politics, of organizing and motivating people, or for that matter of advertising. If plain old manipulation of the public isn't important, why has so much of the GOP effort been about smear ads, and why indeed is so much effort going into controlling media spin of this event, even if I'm finding it silly? (Maybe, as Mike says, I'm not its intended audience.)
I could put it down in part to the lazy media effect. Once a line starts, it becomes the story. I could put it down in part to the media's embarrassment with its own milking of celebrities, just as complaining about coverage of Paris Hilton became coverage. I could put it down, too, to the usual success of conservative spin more, I bet, than to reactions from us aging lefties.
But then another aspect occurred to me. It's so very parallel to the complaints against Edwards (or Gore's house). It's in effect the even older GOP meme that anyone who advocates for change is a hypocrite, whereas those who use wealth and power to back wealth and power (and maybe avoid a war and become president) are just dandy.
I suppose that youth political movements always descend into cultural movements, as they did with the 1960s. But there's always a real opportunity along the way.
John
http://www.haberarts.com/
July 10, 2007 8:35 AM | Reply | Permalink
As if every person apparently did not have a fair list of horror stories (and I have a few dozen of my own) I found a new Google gadget that drives the issue home even more.
It is one thing to say that US health care is worse than any socialized country, but quite a bit more scorching to prove it.
By using the most current UN data sets, it is easy to see how we stand in important quality of life criteria. If every congressman had only this image framed over their desk, and people printed copies and handed them out and spread them, the idea that the US system has to be changed would be overwhelming.
If you want to see the story deeper than one image can show it you can go to the source.
July 10, 2007 9:28 AM | Reply | Permalink
Indeed.
a) It's possible to pay attention to more than one topic.
b) There are multiple ways to make progress on a particular topic.
Gore and Moore are both helping to set the stage for major changes. It's a mistake -- and kind of a silly one, at that -- to portray either Live Earth or SiCKO as if they say something profound about the larger efforts they're part of.
July 10, 2007 9:33 AM | Reply | Permalink
Are the big insurance companies the same as the big HMOs? I was thinking they were different sets of companies.
Regardless, it will be a big fight. Single-payer is an even tougher fight, almost certainly unwinnable, so that's why Obama and Edwards are starting out without it. The hope is likely that the public health insurance component of their plans will be the camel's nose under the tent. Of course, the HMOs will realize it and fight tooth and nail.
July 10, 2007 10:29 AM | Reply | Permalink
I have to agree as well. Awareness raising might be the most important part of the environmental movement.
Everyone has now heard about global climate change, and majorities around the world want their governments to do something about it. That didn't happen overnight. Among young people, the pro-environment sentiment is even higher, likely in no small part to events like this one.
I do understand that it's hard, even for a concerned group of people with the best of intentions, to do all that much without government action.
If I have any gripes, it might be that they didn't make fun of Sen. James Inhofe (R-OK) for denying global climate change (and being an idiot). Seriously, if a Dem wins the presidency in 2008, a few Republicans in the Senate may be the only thing standing between us and passing important legislation on the environment.
July 10, 2007 10:53 AM | Reply | Permalink
Yeah, the review by Alessandra Stanley in the New York Times was totally braindead. Some people just don't get it.
I don't know why so many in the media get caught up in irrelevant details so often. She said:
"Carbon-offsetting, the newly fashionable practice of compensating for one’s own carbon emissions by paying into a fund to reduce them elsewhere, may be better than nothing, but to some it sounds too much like rich men paying others to take their place in the draft during the Civil War."
Really? To me, it sounds like a stopgap measure and a second-best solution to be implemented until our gov't, and more specifically the GOP, wakes up and actually does something about global climate change. We shall see whether or not it is too late. But at least now, after these concerts, more people are aware of the problem.
Kids from Atlanta to Peoria to Los Angeles hear about these concerts even when they would never hear about environmental issues otherwise. That's important. Period.
July 10, 2007 11:08 AM | Reply | Permalink
I am concerned that if the insurance are allowed to stay in business, even with the requirement that they have to accept everybody, regardless of prior conditions, they will just find more ingenious ways to avoid paying out for claims. It will be intolerable to them to take a reduction in profits, so they will find another way to make profits. The results may turn out to be a hideous fraud.
July 10, 2007 11:52 AM | Reply | Permalink
Wow. That tool is absolutely fantastic. I can't wait to play with it. Thanks for bringing it to our attention. I'm going to write the folks with the suggestion that a similar tool be made for the United States. The census data sets available on-line, combined with this tool, would be an incredible tool for those interested in social analysis, politics, and history of the U. S. Thanks again.
aMike
July 10, 2007 12:04 PM | Reply | Permalink
Re: Keeping any kind of role for private insurers...
"Medicare for" all would have to have private insurers, unless you want to get rid of Medigap insurance and make people pay out of pocket-- which could easily still bankrupt people with serious conditions
July 10, 2007 12:57 PM | Reply | Permalink
Roger Hickey
Thanks.I believe that SICKO is a piece of Art that comes along rarely that could change a nation for the better.The awesome power of Art!
See my piece of June 20 at on my blog for more of my comments on SICKO
One issue however that Moore hasn't figured out yet is that a treatment oriented "disease care" system is not economically sustainable.
But in time he will come to understand this.
PREVENTION- both individual(health behaviors)and institutional(public health)-will save the day from economic meltdown.
Prevention should be implemented incrementally with fairness and compassion.
Dr. Rick Lippin
Southampton, Pa
http://medicalcrises.blogspot.com
July 10, 2007 3:59 PM | Reply | Permalink
Exactly, corporations are mandated by law to maximize profits, our healthcare cannot afford the middleman. Parallel experiments sound like a workable compromise, but I also fear allowing any private capital to have a voice at this table and it would flex it's muscle and corrupt the system.
Money is too powerful, and universal healthcare is too valued an American dream.
July 10, 2007 5:16 PM | Reply | Permalink
In the name of political realism, the "public option" approach ignores a dominant political dynamic - that is the drive to privatize Medicare and limit public programs to the sickest and least politically powerful. The will to create a truly level-playing field between the public option and private insurance is better spent, in my view, on improving and expanding Medicare for All. In order to win either fight -- public option or HR 676 -- we will need to sufficently villify the private insurance companies. If successful, and SiCKO is hugely successful at doing that, we can't then leave them in a system gamed to enhance their profits as the least insurable get put into a second tier program. The problems of Medicaid, the subsidies to private HMO's under Medicare Advantage and the role of private insurers in Medicare Part D reveal the pitfalls of an incremental public option approach. Strong presidential leadership and a solid Democratic caucus can more likely win the political fight if we fight for a solution that will actually solve the problem - Medicare for All.
July 10, 2007 6:13 PM | Reply | Permalink
If we don't hurry it will have taken almost as long as it took women to achieve the vote. <grin></grin>
aMike
July 10, 2007 7:26 PM | Reply | Permalink
It's one thing to get to vote on universal health care every two or four or six years, but I'd like a target I can shoot at on any given day. One of the facts of American life is that corporations also have a hand in how you are governed, yet they are hardly ever petitioned for redress.
Let's fix that. I wonder if fast, short, and targeted boycotts of big companies are in order? Something along the French system of "instant boycotts" organized by students via their telecom system in the 1980's.
For example, bring WalMart to its knees during a week, while announcing this is done to support universal health care, then switch to GM, or McDonalds, or whatever. You could hold a "health care boycott lottery" from a pool of targets every Sunday, to symbolize the lottery of living without affordable health care. (There's a lot of fun to be had with this idea; imagine the 'width' of a company's wedge on a 'wheel of shame' being proportional to their net profits from the previous year.)
It drove the French government nuts back then, and I'll bet the tactic will get the attention of Corporate America. It may even be necessary to murder/death/kill one or two "corporate entities" along the way to make the point.
The message to take home: "If you are a large company making money at the expense of hardworking Americans, and you value your continued existence, you'd better adjust your attitudes on universal health care."
July 11, 2007 11:31 AM | Reply | Permalink
Re: For example, bring WalMart to its knees during a week, while announcing this is done to support universal health care, then switch to GM, or McDonalds, or whatever.
At least as far as GM goes it's also a victim of the current healthcare system, not a villain. GM actually does provide good health benefits to its employees and should not be boycotted for that reason. But really, I don't see why any company should be blamed for this mess (other than the insurers of course). It's ridiculous to hang health benefits from employment to begin with and it's something we need to get away from.
July 11, 2007 1:57 PM | Reply | Permalink