Even before its national release this Friday, Michael Moore's "Sicko" has contributed to a renewed debate on the U.S. health care system. The film focuses on Americans who do have health care coverage and shows in painful specifics how insurance and drug companies profit by withholding needed care.
Already the film has provoked elected officials, the media and ordinary people to again consider what America want from our health care system. As I left the New York City theater where the film previewed, a young African-American woman sitting behind me called her friend to ask, "Can you believe it, in France and Cuba people don't pay for health care?"
With "Sicko", Michael Moore has provided an opportunity to make health care a key issue in the 2008 Congressional and Presidential elections. But if progressives want to use this election to ask why the US ranks worse than most other developed nations on longevity, mortality, obesity and other measures of health, they will need to extend the discussion beyond health care.
In fact, most health researchers agree that improvements in health care can make only modest improvements in overall well-being. Every year, the decisions that food, tobacco, alcohol, automobile, and firearms industry executives make about advertising, pricing and opposition to government oversight contribute to hundreds of thousands of preventable deaths and illnesses. In recent decades, chronic diseases such as diabetes, cancer, heart disease and stroke, all associated with the unhealthy behaviors and environments that corporate America promotes, have become the main causes of death. In that same period, and especially since 2000, business interests have radically transformed the role of government, shifting resources from protection of public health to protection of profit.
One consequence has been an epidemic of obesity as the food industry spends billions to persuade Americans to eat and drink more high calorie, low nutrient products. A recent study published in the New England Journal of Medicine predicted that if current trends on obesity (and its consequence diabetes) continue, our children and grandchildren will have shorter life spans than we do.
To avoid this future will require redefining the relationship between business and government. And here "Sicko" offers important lessons for progressives. Moore doesn't waste his precious time with his audience in wonkish prescriptions for health care reform. Rather, he asks basic questions: What do Americans want from their government? Who are we as a people? What lessons can we learn from other countries? By focusing on core values, Moore suggests a way that Americans can discuss these issues that goes beyond sound bites. By showing how profit distorts the health care system's ability to meet people's needs, he encourages people to consider alternatives. By emphasizing democracy as the solution to special interests, he roots the discussion in American ideals.
To expand this discussion to include the most fundamental causes of ill health, we need to ask some other questions: Do American's want to turn over responsibility for their children's health and nutrition to McDonald's, Coke , RJ Reynolds and Budweiser? Do we want to entrust the care of our parents and grandparents to Merck and Pfizer, who promote drugs they know to have lethal side effects? Should Ford and General Motors be able to persuade the Senate to water down auto safety and pollution control regulations that are still weaker than those in Europe and Japan? Do we want a Supreme Court that values corporate profits more highly than public health?
If the answer to these questions is no, then voters will need to elect a new Congress and President in November 2008. Moore's "Sicko" shows that it is possible to engage the American people in considering these questions. By making the well-being of Americans a central issue, progressives can put health on the ballot in 2008.