Transcript - 6.29.07
BRANCACCIO: Welcome to NOW.
There's an early scene in Michael Moore's new film "Sicko" where a guy sits in his living room with a needle and thread not doing embroidery but sewing up a nasty gash in his knee. The guy's one of the tens of millions of Americans with no health care coverage. But Moore's film isn't really about the uninsured...it's about the terrifying things that can happen to people with coverage in a healthcare system that can leave people bankrupt, sicker, or in some cases dead.
Like all of Moore's films, from "Roger & Me," "Bowling for Columbine," to "Fahrenheit 9-11," "Sicko" is going to raise the temperatures of audiences, critics, and politicians. The controversial filmmaker sees it as an opening salvo in what might become the policy knock down, drag out of the decade: what to do about America's broken health care system.
MOORE: Thank you for having me here.
BRANCACCIO: So, how did this work? You put out an all-point bulletin, an APB on the internet, "Send Michael Moore your health care stories?"
BRANCACCIO: And what'd you get?
MOORE: I got too many of 'em.
MOORE: I got over 25,000 letters from people telling me things that, you know, I—I thought, you know, I—I thought I would hear, you know, some pretty bad stuff, and I'm—certainly from people that don't have insurance. What surprised me—were the letters I received from people who were fully covered, as they say.
BRANCACCIO: But not so fully covered in the end?
MOORE: Not so fully covered. Because—the insurance industry—as it turns out, doesn't really like to pay all those claims. Because—if they pay all those claims, they don't make as much money.
BRANCACCIO: Well, look what happened to this woman.
MOORE V.O.: Laura Bernam was in a 45 mile-an-hour head-on collision that knocked her out cold. Paramedics got her out of the car and into an ambulance for a trip to the hospital.
BERNAM: I get a bill from my insurance company telling me that the ambulance ride was not gonna be paid for because it wasn't pre-approved.
I don't know exactly when I was supposed to pre-approve it. You know, like after I gained consciousness in the car, before I got in the ambulance, or I should have grabbed my cell phone off of the street and called while I was in the ambulance, or, I mean, this is just crazy.
BRANCACCIO: Was that representative of the kinda things that you got in?
MOORE: Yes. And that's a minor. That's a minor one. Fairly small medical bill. And actually, you know, the—the insurance companies, they've done their own statistical—research.
And they know that if they just send zero, like denied, won't pay any of it, to a certain number of people—a certain percentage of those won't complain, won't contest it, and then will just go ahead and pay it themselves.
BRANCACCIO: Then in the movie, you have Dr. Linda Peeno. And she used to have a big-time job at an insurance company. You have footage of her testifying, essentially coming clean.
PEENO: I am here primarily today to make a public confession. In the Spring of 1987 as a physician I denied a man a necessary operation that would have saved his life and thus caused his death. No person and no group has held me accountable for this. Because in fact what I did was I saved a company a half a million dollars for this.
BRANCACCIO: Essentially, she's saying that she killed someone with—
MOORE: That's right.
BRANCACCIO: —one of these denials of insurance.
MOORE: That's right. She and other doctors who work for insurance companies—know when they mark "denied" on the claim—they are essentially perhaps writing somebody's death warrant. And they're rewarded for that.
They're rewarded —she told us that the—the doctor at the insurance company who denied the most claims at the end of the year—got like a Christmas bonus. And - and to say something, if I can, on behalf of the insurance industry —the law requires them - it's their fiduciary responsibility to maximize profits for their shareholders.
Well, how do they—how do they maximize profits for the insurance company? Try not to pay out claims. I mean, it's basically—you know what insurance is. It's Vegas. The house always has to win. And—and so, they're playing an odds game, they're playing a risk/ratio game. And—and they're trying to figure out how is it that we can win out and keep most of the money that we have coming in.
BRANCACCIO: You chose to focus on insurance companies. You don't choose to go after doctors. You don't choose to go after trial lawyers. Why the focus on the insurance companies?
MOORE: The insurance companies are in the way. They are in between the doctor and the patient. A doctor should be able to decide what a patient needs and then prescribe that, whatever that is necessary, whether some procedure, whether it's an operation, whether it's a prescription or whatever.
And so often, doctors have to go and get permission from the HMO before they ev—before they can do their job. So, in other words, the doctor's office is calling somebody in a cubicle somewhere maybe 1,000 miles away to get permission where—to do something that's right there in their office.
It—it really—makes no sense. And it gets in the way of better health for all of us.
BRANCACCIO: We asked—the insurance trade association for a reaction to "Sicko." And they did send a statement. The American's Health Insurance Plans, A-HIP in Washington, and I expected it to say, you know, Michael Moore is a jerk. It doesn't actually say this. Here's what the short statement says.
BRANCACCIO: Quote "We need a uniquely American solution in which the public and private sectors work together to make sure that everyone has high-quality, affordable health care"
Now, we'll talk about that in a second, but they're sayin', "Yeah, you know, there is something to talk about with this health insurance business."
MOORE: They're being very smart about this. In part, because they know which way the wind is blowing. They know that the American people are—are really fed up—with the current state of our health care system. And they can't defend it.
So, you're actually going to hear them say in the coming weeks and months, "Well, we support health care for everyone. We believe all Americans should have health insurance. And in fact, we would like the government to mandate that you buy that insurance from us."
BRANCACCIO: But that doesn't satisfy you. You want these insurers pulled out...
MOORE: No. They have to be—they have to be out. They can't—they can't—there's—you can never be talking about profit when you're talking about people's health. It's a life and death issue. You would not talk about it with the fire department. You wouldn't say, "Well, you know, the fire department this year—didn't post a very big profit," you know.
You wouldn't have the—the fire hall saying, "You know, that house fire over on the other side there, you know, if we go over and put that fire out, no, no, it's gonna affect our bottom line." You—I mean, we wouldn't allow that kind of conversation with our police, with our fire. We shouldn't allow it either with health care. Because it is a life and death issue.
And profit has to be removed from it. We're number 37 in the world according to the World Health Organization, when it comes to health care.
BRANCACCIO: Just ahead of who?
MOORE: Just ahead of Slovenia.
BRANCACCIO: In terms of health care—
MOORE: Yes, yes.
MOORE: They're nippin' at our heels too, by the way. You know, I mean, we're laughing about this. But—but we're also—
BRANCACCIO: We're—we're laughing 'cause we're not sick today.
MOORE: Right. And—and—as Americans, because we know we live in the wealthiest country on earth—I don't think we should really be number 37.
BRANCACCIO: So, you go across borders to take a look at other ways of doing these things. You go up to Canada what do you find?
MOORE: I find a—a system—that covers everyone—where no one is left behind in the true sense—of that term and—where people are very satisfied—with their health care. And we went to—a waiting room in a hospital, 'cause I'd heard about these long waits, you know, in Canada for things.
And—and the longest I could find anybody waiting there, it was 45 minutes. Now—the Canadian government will admit that with certain things, they have—some people do have a bit of a wait. With elective surgery, things that aren't life and death issues, there is an average four-week wait in Canada. There's a four-week wait to see a specialist.
The larger issue for me in looking at Canada isn't so much the particulars of the health care system. It's how they view themselves as a people, as a society.
They believe that there's this pie, and that they have a system where you have to share the pie. But everyone shares the pie. And sometimes when you share a pie, you have to wait for your slice. And sometimes you get the first slice, and sometimes you get the third slice and sometimes you get the last slice. And you have to wait for that slice. But the important thing is that in Canada, everybody gets a slice. That's not true in this country.
There's a number of people that get their slice. And there's a whole buncha people begging for the crumbs. And—and that is, I think, the significant difference between these other countries and us. They see themselves structured—with the—with the idea, the concept of "we." And we —operate more from the "me," every man for himself. Pull yourself up by your bootstraps.
We have got to start seeing that we're all in the same boat, that we sink or swim together. And if we allow—we allow too many people to fall outta that boat—that boat isn't going to make it. And that is the primary thing I'm trying to say in this film.
BRANCACCIO: You go to Britain and you hear some of this as well. In fact, you're going through a British hospital. And you're looking for a place where you pay the bill.
MOORE: So this is where people come to pay their bill when they're done staying in the hospital?
Attendant 2: This is the NHS hospital so you don't pay the bill.
MOORE: Why does it say cashier here if people don't have to pay a bill?
HOSPITAL WORKER: Those who have reduced means get their travel expenses reimbursed.
MOORE V.O.: So in British hospitals instead of money going into the cashier's window, money comes out.
BRANCACCIO: So, the man gives you money, the patient, on your way out?
MOORE: That's right. When we saw this, it was like, "No way." It was like—it was like—no, it had to be another explanation. There wasn't. That is the way that they see it there.
They figure, you know, you're checkin' outta the hospital. Last thing you—you should have to worry about is the taxi ride or the train ride home. And so, they give you money—so that you can get home okay.
BRANCACCIO: But here's the thing, Michael, if you spend any time in Britain, I've spent some time in Britain. There's some wonderful health care to be had in the British National Health Care system, on the NHS. But you pick up the paper and it's full of stories of places where the government-run health care system falls short. I was just reading "The Guardian."
The big story a few weeks ago about the 61-year-old lady goes in, she has severe arthritis, to a hospital in the middle of the night. They give her some pain killers, but they tell her to leave. She has to spend the night in the parking lot in a British hospital because she didn't have the money to get home.
MOORE: But every system is gonna have—a—people that fall between those cracks.
It's—the different is, is that they—they try to set up a system there that—where they believe everybody should be covered, and they're gonna do their best—to do that. You can find these anecdotal stories of people like that, but that's—ultimately, that's not the case if you talk to most British citizens.
And you've been around Europeans. They smoke a lot more than we do. I think they drink a lot more than we do. And yet they live longer. Now, how—why is that? It's because if you don't have to worry about paying to see a doctor, the first sign of illness, or a lump or something, you're going right there. You go right there to the doctor. And that's why they're able to catch a lot of things earlier than we do.
Because we have 47 million that don't have insurance, so they put off going to the doctor for as long as possible, sometimes then exacerbating the illness or the disease to the point where then it's too late to—to save them or cure them. And that brings our life expectancy rate down.
What I would suggest is instead of saying, "Oh, the Canadians have that problem with their system, or the British have that problem with their system," well then, let's not do the things they do wrong. You know? We're Americans, why don't we take the one thing the Canadians do right, the one thing the Brits do right, the one thing the French do right, put it all into one big pot, the melting pot, and create our own American system?
I mean, we've had enough time to study all these other systems. They do a hell of a lot of things right. Let's just do those things. And we know what they do wrong, let's not do those things. That, to me, just makes basic common sense.
BRANCACCIO: If the French come up with a decent wine, we're sometimes liable to sample it. Maybe we should—borrow policy ideas, is what you're saying.
MOORE: When it comes to our own health you'd think, you know, man, there's 24 other countries that have got maybe a better idea than us, and—and they seem to be a lot healthier than we are. Why don't we just stop and take a look at that and maybe borrow some of their—some of their great ideas?
BRANCACCIO: There is, though, when we talk about healthcare in the United States, really around the world, a real political conundrum here. If we're indeed as miserable as the stories that you show in the film suggest, why aren't we rising up and clamoring for change?
MOORE: We're not big on the rising up part in this country. Again, because I think it's that individual thing. It's about the "Me Society." You know, we don't operate, again, in the "We." Which is odd, when you think about it, because the very first American word is "We." "We the people." They didn't write down, "Me the people."
It says, "We the people." Yet "we" don't seem to all get together and say—you know, I mean 70 percent is against—of the people are against the war right now yet the war continues. The majority of Americans—want this healthcare system fixed, and yet nothing really happens.
BRANCACCIO: But you also hear a famous member of Britain's Labor party talk about when people are insecure in different ways it prevents them from speaking out.
MOORE: When you have people shackled with debt—college loans, things that they don't pay for in many of these other countries—day care costs, which is subsidized in other countries—and healthcare, you add all this up—it's very hard for people to find a way to take the time to get involved politically, to protest. And in many cases are afraid to do that, because if they are to get out of line and say something they shouldn't say—they may not have that job, and they need that job, especially if it has health insurance. And—it really—it really, I think, paralyzes us. So if you're French, you know, and you don't like what's going on at work and you wanna say something about it, you never have to have this thought in your head which Americans have often, "I can't afford to lose this job because I can't afford to lose the benefits."
"I can't lose the benefits." You know, that—that sentence is not spoken anywhere else in the Western world. "I can't lose the benefits." Because, the benefits in those countries are human rights. So, you can decide. If you don't like that job, you can quit.
BRANCACCIO: Well, you gotta pay for some of this stuff.
MOORE: Well, you gotta pay for it, of course. And they pay from—they pay—they pay more in taxes over there, and, you know, I don't hear them complaining about it as much as we do. We pay—we pay less than they do. And I was wondering why is that? And I—after spending some time over there it became clear to me, the reason they don't complain as much about their taxes is because they actually see a tangible result.
They pay their taxes, and they actually see things. The kid's goin' to college for free. Their—the—there's no medical bills. Daycare is fairly cheap. So they actually see a day-in, day-out, what do we see in this country? We can't get even get a pothole fixed.
BRANCACCIO: But some of this is such a paradox. I mean, you—you get a nice review in "The New York Times," "The Los Angeles Times," but the New Jersey paper said something mean. A number of things about the film.
you know, "He—he praises dental care in Britain," the newspaper writes, "But, you know, what about the stereotype about British smiles?" "He praises the conditions in France, but look how the students are always taking to the streets complaining. How good could it really be?"
MOORE: Well, first of all, the reason it is so good in France is because the people do take to the streets. I interview this American woman who lives in Paris, and she says, you know, "The difference between here and in America is that in France the government is afraid of the people. In the States the people are afraid of the government."
The only reason she said that things work in France, or that—or that people get these great benefits, it's not because government is trying to be nice or the corporations in France are more lovable than the ones here, it's because they're afraid that the people will just shut the place down. And when you have—when the people, "The People," the—the majority of the people carry that big club of democracy in their hands, it forces those in power to do the right thing, because ultimately they really don't wanna do the right thing whether they're French or American or wherever.
BRANCACCIO: I was just reading "The New York Times" this week, they did a—a poll with, among others, CBS, and it found that by a margin of 47 to 38 percent Americans seem to support not just universal healthcare, but the idea of the government providing it.
MOORE: The people are way ahead of the politicians on this issue. I'm—I'm surprised that the Democratic candidates running for president have taken such lame—positions on healthcare.
BRANCACCIO: Is that how you regard it?
BRANCACCIO: Well you do have people like Obama and Senator Hilary Clinton, for instance, talking about the need to—bring healthcare to more people.
MOORE: They're talking about it. And I believe their heart is in the right place. But, they also take huge contributions from the healthcare industry. I mean, Senator Clinton, from the first—quarter reports has taken over $800,000 in contributions. Senator Obama—is, I think, somewhere around a half-a-million dollars in contributions from the healthcare industry. So, their proposals—well Mrs. Clinton hasn't really put forth a specific proposal—
BRANCACCIO: But Obama has.
MOORE: And he has, and—and many parts of his proposal are good. But, the biggest problem with it—is that it doesn't guarantee coverage for all Americans. And we shouldn't support any program that doesn't say, "Every single American—has a right—and has to be covered—with healthcare."
BRANCACCIO: Those people in the United States who feel secure in their healthcare coverage don't want change.
MOORE: Well, they're only secure because they haven't been faced with a major illness yet, or something happened. Wait till something happens. I'm telling ya, the—there are so many stories. And—this is why all the nurses groups, I don't know if you've been paying attention at all the organizing that the nurses have been doing lately. Because they're on the front lines of all this.
BRANCACCIO: Well, especially out in California, the nurses union. There's a woman by the name of Rose Anne De Moro that's actually quite supportive of your film.
MOORE: Yes. Well, they see this. They're on the front lines everyday. They're in the hospital—in fact, she told me—from the California Nurses Association, that—that my film is actually a G-rated version of what they see day-in and day-out. It's much worse than what I've portrayed.
BRANCACCIO: I sat through it with a big thing of popcorn. But—there are moments where you do stop eating.
MOORE: Right. Yeah. But, that's why there's a lot of humor in the film too to alleviate the sadness that exists in parts of the film. And—and I do that in—in most of my films because, you know, I'm—I'm a big believer that when people leave the theatre that they not leave full of despair because I think that paralyses you. I want—I want you to leave agitated, angry—wanting to do something. Or you could just go home and, you know, have sex.
BRANCACCIO: Always—always—more fun than watching a healthcare documentary, I might add.
BRANCACCIO: Well I mean—there's some funny parts of the film, you—you take what starts out as a very serious premise, some first responders to 9/11 who responded to that disaster just out that window, really, are not getting the healthcare coverage—that they need.
MOORE: That's right.
BRANCACCIO: And—so they pile on a boat, and you take 'em down to, where?
MOORE: I take 'em down to —one place on American soil that has free, universal health coverage, full medical, dental, eye care—mental health, nutrition counseling—a place called Guantanamo Bay, our naval station there.
BRANCACCIO: You try to get into the Guantanamo prison there, at the end of the film.
MICHAEL MOORE: Yes.
BRANCACCIO: With these people.
MOORE: Because I learned that the—healthcare we're giving to detainees there—the people that we are accusing of—for plotting 9/11—you can get the list actually from—Congress. It's—you know, they have the list of how many teeth cleanings they've done, how many colonoscopies.
BRANCACCIO: Well, I've walked through those medical facilities—
MOORE: That's right.
BRANCACCIO: —with cameras from NOW, and I'm here to tell you, they look fine to my layman's eyes.
MOORE: Yes. And—and they're getting a lot better care—than many, many Americans. And I thought, "Well, isn't this ironic—that—that these 9/11 rescue workers who aren't getting the care that they should be getting—are sitting here suffering in New York City, and down there in Guantanamo Bay we're taking care of the—of the detainees." Which, we should do. I mean, I'm not opposed to that either. So I figured, why don't we just—get on a boat and—do a reverse flotilla thing
MOORE: Permission to enter. I have three 9/11 rescue workers. They just want some medical attention, the same kind that the evildoers are getting. Hello?
BRANCACCIO: So, our audience is on the edge of their seats. With these people, these Americans, these heroes who needed healthcare, did they let you into Guantanamo Prison for healthcare for 'em?
MOORE: You—you want me to give away—what happens at the end of the movie?
BRANCACCIO: Ah, they'll have to go see the movie.
MOORE: Yeah —I mean, at least leave a little bit—to the imagination here.
BRANCACCIO: Alright. Well, Michael Moore, "Sicko" opened nationwide this weekend. Thank you very much.
MOORE: Thank you.
BRANCACCIO: ...You can find out more about America's health care crisis and the movie "Sicko" over on out website...PBS.org is the place for that.
And next week on NOW: More of our own coverage on the healthcare crisis in America. A political standoff over the future of a government program that's left millions of kids without affordable health care.
And that's it for NOW.
From New York, I'm David Brancaccio. We'll see you next week.