In Depth

The 'Sicko' Effect

Criticized But Unbowed, Moore Says His Documentary Put Topic on National Agenda

Documentary filmmaker Michael Moore has been called everything from a seer to a charlatan. Is he a committed truth-teller and professional muckraker, or is he a shameless self-promoter who uses important issues for personal advancement?

Whatever he or his critics claim him to be, the impact of his most recent project, “Sicko,” the Oscar-nominated documentary feature about the U.S. health care system, has been felt throughout the media. Mr. Moore himself has seen the effect his film has had on TV news coverage.

“I think it’s helped a lot of journalists realize there’s a whole other side to this story—the non-corporate side, the side of nurses, the side of working people, the side of people who have no insurance,” Mr. Moore said in a recent telephone conference call with reporters. “Every week I get somebody sending me a video or a story from their local newspaper or TV news station where the local TV reporter has gone out and talked to the local Donna Smith or Julie Pierce or Reggie Cervantes, someone who has had to go through the very same things these ‘Sicko’ participants have gone through.”

Since “Sicko,” there have also been changes in Donna Smith’s, Julie Pierce’s and Reggie Cervantes’ stories. Each of the three women spoke during the conference call, commenting on how “Sicko”—and the TV news coverage the film generated—altered their lives.

“Immediately after ‘Sicko’ opened, there was intense media coverage about the issue of medical health reform. Even Oprah said it would be her issue going into her new season, but that was months ago, and the road to change has been much more rocky and lonely for many of us,” said Ms. Smith. “Medical problems continued as the glare of the spotlight receded. My Cobra benefits expired and I couldn’t get anyone to insure me as a cancer survivor. I joined the ranks of the uninsured for the very first time in my life. If we had single-payer or Medicare-for-all as the law of the land, none of these stories would be happening. Overall, I thank Michael for making the film.”

In “Sicko,” the story involving Ms. Pierce and her husband was tragic; he died because of health insurance neglect.

“‘Sicko’ brought these tragedies to light. It amazes me how many people have not seen ‘Sicko,’ have not heard of ‘Sicko.’ So I went and bought a bunch of DVDs and I keep them with me, so when I’m out and about, I’ll ask people if they’ve seen ‘Sicko’ and if they tell me no, I hand them one because people need to be educated,” she said.

Ms. Pierce does not think TV news is doing enough about the health care issue; she wants more from journalists.

“It angers me that the media, every time a new story comes out of tragedy, of somebody who’s lost their loved ones due to the for-profit health care system, they bring the story to light like it’s the first time they ever heard of something like this in their life. We need to get off the ‘me’ wagon and get on the ‘we’ wagon and make change in this country.”

When asked specifically how “Sicko” influenced the way network news is covering the health care issues facing Americans today, Mr. Moore said, “For so long, especially on television, the journalism surrounding this issue has been, ‘Read the press release by the pharmaceutical company or the health insurance company and act accordingly.’ And so for years now we have been inundated, whether on local TV news or on CNN, with, you know, ‘Tonight’s Health Report’ brought to you by … hmm? Fill in the blank; name the pill. Then the health report is telling us about some great new discovery some pharmaceutical company has made or something that the insurance companies want us to do, and reporters have taken their cues from industry and Wall Street when it comes to reporting about health care issues.”

With that in mind, Vivian Ho, the Baker Institute Chair in Health Economics at Rice University, said, “Many policy experts and critics argued that the film was biased—they felt that the film gave an overly bright picture of health care in Europe and Canada, and that the visit to Cuba by the 9/11 volunteers was ‘over the top.’”

Mr. Moore acknowledged—and defended—the criticism. But today, he thinks things have improved in part because of the criticism.

“It’s very encouraging to me that since ‘Sicko’ and my dustup with Dr. Sanjay Gupta and Wolf Blitzer, I have noticed somewhat of a change where they are now having to talk about this in a different way,” he said. “Dr. Gupta actually did a special on this issue, where it appeared that he lifted whole ideas right out of ‘Sicko’ and made them his own—which, by the way, I’m a huge fan of that kind of plagiarism because I don’t call it plagiarism. It’s the old saying of imitation is the sincerest form of flattery. I hope these people in the media will take these ideas. It’s great to hear Sen. Hillary Clinton in the debates quote statistics from ‘Sicko’—they’re straight out of the movie in terms of our infant mortality rate, in terms of how these other Western countries live one, two, three years longer than we do. So to have these ideas out there, we don’t care about being credited for them or whatever. Just to have moved the ball down the field a bit through this movie has been a good thing.”

Dr. Ho is more skeptical.

“‘Sicko’ had an incredibly large impact when it was first released, but now it seems as though the movie never played,” she said. “However, the problems faced by many of the Americans interviewed in the movie resonated with the general public. I find it interesting that the film was very negative regarding insurance carriers, yet there doesn’t seem to be a great backlash against insurance companies in TV network stories at the moment. Once in a while there is a story about a patient denied essential care due to an insurance company denying coverage (as in former Sen. John Edwards’ campaign), but not any more than before ‘Sicko’ appeared.”

John Pollock, professor at the College of New Jersey and author of “Tilted Mirrors: Media Alignment With Political and Social Change,” told TelevisionWeek that he thinks TV news began seriously targeting health care issues prior to “Sicko.” He points to Magic Johnson’s 1991 announcement that he was HIV-positive as the turning point for media and public opinion alike.

“Magic Johnson’s announcement was the Pandora’s box that generated the changes that led to the daily cable and network television reports of health icons such as CNN’s Dr. Sanjay Gupta, who is more recognizable to some viewers than many of the news anchors themselves.”

Mr. Moore vividly recalled the Blitzer/Gupta incident with CNN, in which he said networks like CNN were “bought” by the insurance companies and the pharmaceutical industry. Today, however, he’s more sanguine about TV news entities, in part because he sincerely believes his film has made a difference.

“If the media would just do their job and report what’s going on right down the block in their own towns every single day…. It’s happening in Boise, it’s happening in Baton Rouge, it’s happening in every little town across America. When I see it happening, it’s just wonderful,” he said. “They take a page right out of the movie. They follow the people through the process. They have a reporter there when someone is on the phone with the insurance company waiting for an hour, going through 17 different people. It does more good to localize and to personalize it than the movie in the movie theaters.”

Rose Ann DeMoro, executive director, California Nurses Association, said the film has resulted in a movement for change, which the network news has reinforced in its health care coverage.

“There’s never been a movement like this: the ‘Sicko’ movement. In the fight for Medicare-for-all, the latest December Yahoo/AP Poll showed that 65% of all Americans support expanding Medicare to all patients,” she said.

“What ‘Sicko’ exposed is that the U.S. national health care policy itself is sick. We can see from the powerful stories on TV news, and the most heroic among us are still hostages to an out-of-control health care system,” she added. “Since ‘Sicko,’ the debate has changed. Government-sponsored health care, like Medicare-for-all, is now on the forefront of the public’s mind. What ‘Sicko’ taught America is that health insurance is not health care. Coverage is not care, because the holes in the coverage are large enough to slip through and die.”

While “Sicko” has not seen the commercial success of “Fahrenheit 9/11”—$24 million in box office compared to $100 million for the latter film—the TV news coverage of the film was invaluable in getting the message of “Sicko” promulgated. Fewer people saw the film in theaters, but the TV news coverage and the imitations “Sicko” inspired have been just as important.

Mr. Moore credits Ms. DeMoro’s organization for keeping the pressure on people to rent “Sicko,” as well as on the broadcast media to stay on the subject.

“The nurses have been at the core of getting people to see this movie. It’s now the third-largest-grossing documentary of all time. And with all the piracy on the Internet, it’s been seen by millions more people. The more people that can see it, the better in helping to explain how they do this in Canada and England and France. It’s really not rocket science," he said. “Since the film came out, I still get dozens of letters every day from people who are being abused by the so-called health care system.”

Mr. Moore added, “It breaks my heart; in fact, I had to stop reading them because it’s so tragic to see so many people whose lives are ruined. Their only crime is that they live in America. If they lived a few hundred miles north in Canada they wouldn’t be writing me these letters. Why Canada and every other civilized country on this planet has been able to figure this out and we haven’t is a disgrace. I know we’re better than that as Americans. I know we’re capable of it. I know we have the money to do it—that’s certainly been proven with $12 billion a month being spent on this war.”

Turning to politics with regard to health care in America, Mr. Moore said, “We find ourselves in this election season with candidates who don’t quite get it. A Republican candidate who truly doesn’t get it, and then two Democrats who I think in their hearts want to get it, but it’s not their heart that are speaking. It’s the wallet in their pocket or purse.”

Mr. Moore has not endorsed any candidate. His interest remains on health care, urging journalists to put out a message on the legislative level to congressional representatives.

“What’s important is that people across the country elect people to Congress who will support [House Resolution] 676,” he said.

HR 676 is a bill now in subcommittee in the House of Representatives to create a new and far more functional single-payer method of paying for medical services while leaving the medical system itself alone and intact.

“If Congress passes 676, the chance of having a President Clinton or President Obama sign that bill is much greater,” Mr. Moore said. “What I’ve learned is that if Congress will take up the fight and the leadership in getting truly universal health care passed in the country, that the Democratic president will not veto that bill. That’s the reality. We wouldn’t think of not having a nationwide education system, we wouldn’t think of not having an interstate highway system. The fact that we don’t have it for health care, I swear to God, 100 years from now we’re going to look pretty silly when they write the history of this era, in a time of extreme wealth and knowledge, that the richest country on earth couldn’t find it within themselves to do this.”

Mr. Moore said, “I’m optimistic and I’ve been buoyed by the change in covering this issue and the reporting. The reporting needs to continue and journalists need to really explain how single-payer works. It’s not just a term; explain it. What it really means when you put it in everyday language for people, it’s such common sense. It’s as simple as saying there should be two handles on the faucet, one should say hot and the other should say cold. That makes great sense.”