I have been asked to do a review on Michael Moore's new movie "Sicko". It describes, in his usual controversial style, the state of America's health system.

america's doctor?

On of these issues, that many in the civilized world castigate America for, is addressed in this movie. It is the low regard in which human life is held in American society; not enemy life nor alien life, but that of its own citizens at their time of greatest need. The United States is the only OECD country, the only Western nation without a free and universal healthcare system.It is a sad and well known trivial fact, that fully one sixth of all Americans, are unable to afford health insurance, and are therefore living without even the most basic of health services, a consultation with their GPs. In place of universal care, the USA has a system that is based on an insurance, one that in the way of insurance systems in all fields makes a profit by ensuring that as much money comes in through premiums, and as little as possible goes out through claim payments.

This profit motive is well and good when it is cars or houses we are discussing. However, when it comes to health care American style, it is becomes a matter of choosing between life and profit. As one former insurance operative says in the movie, a good doctor is one whose work results in the insurance company spending as little money as possible.

For me the state of the American system was always a distant uninteresting matter, the anecdotes mere tales much like you would expect from a foreign country. They were brought closer home however when in a debate at university I realized that many of my fellows did not consider free universal healthcare to be not just a priority but a necessity for the just government of human society. The me-ism of the modern world it seems, decrees that everyone must pay their way through life. Sharing, and carrying others on the communal back is seen as the creep back of socialism, cheap unrealistic sentimentalism. Free services it is said make people dependent and discourage industry.

Nowhere is this sentiment louder emphasized than in the United States, often even by those most vulnerable to poverty and its effects. I agree to a large degree that the free market is often the best way to go, however as Moore says in the documentary, roads, fire services, schools and a host of other services are publicly provided and none of these have led to the overthrow of capitalism. The provision of these services guards the whole of society against the consequences of lack. If my neighbors' house is on fire and he cannot afford to call a fire engine, is it not unlikely that it will extend to my house and harm me even though I can afford to get help?

new UK parents laugh at the suggestion that hospital should be paid for

Moore starts at high tempo, showing graphic pictures of a man, Adam, who is forced to stitch himself up after an accident as a visit to the hospital would be too costly. He describes the case of Rick, a man who loses the top of two of his fingers in a DIY accident. Uninsured, he is compelled to choose between re-attaching his middle finger and his ring finger, the cost of doing them both being $72,000. He chooses to reattach his middle finger, the cost being a bargain $12,000. There are many other anecdotes, some of them you can see here , affecting both the uninsured and the insured, who Moore says are the main focus of his movie.

He interviews many Americans who have been let down by their insurers, many who have been rejected by insurance companies and many repentant insurance industry insiders and health care officials who reveal that their jobs in a nutshell, are to take care of the pennies, to strive as far as is possible to ensure that their employers never pay out claims. Denied, that is the deadly word that sends 18,000 Americans a year to unnecessarily early graves.

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emergency pay:- even this is not free

The way the system works, those with insurance take out monthly payments, either half matched by their employer or you pay it all yourself. Monthly insurance begins at around $500. This does not however, cover the cost of medicine or any consulting visits to the doctor. Depending on your insurance you pay out of pocket, 20-50%, for the visit. You also can pay for anywhere from 100% of medication on poor coverage to 20% on better insurance. The insurance company decides if you can have the medication needed and if it is covered under your plan. Americans do not walk into hospitals, doctors or pharmacy and get what they want. What treatment they get is not up to the doctor either. It is the Insurance company that determines if treatment is needed, whether operations will be performed and if you will get that medicine you need. And that drug is usually a generic, insurance rarely pays for non-generic drugs. There are also caps on the amount of drugs, for the first three months you may get 80% paid for. Pity if you get worse as the rest is all up to your pocket. Then there is the deductible that must be met before insurance will pay out. All this cover for $500 a month! Oh, and that does not cover ambulance costs. In the movie, the case is visited, of a woman whose insurance company refused to pay for her ambulance because she did not clear with them prior to purchase the request of the ambulance service. That she was unconscious did not matter at all, like your traditional insurance company, the priority was to deny all claims.

It is a moving documentary, personal, probing, well narrated and thought provoking. From American suburbs, to the hospitals of Canada, France and the UK, it contrasts the path to provide health to everyone against the desire to ceding control over countless lives to the aggressive desire to save money. With rising costs, the poor and increasingly even the middle class postpone healthcare until they can do it no more. Still, Emergency Rooms are full of queues, and patients may have to wait long in guerneys before they get proper medical attention.

Ultimately, in his classic style Michael Moore does cut a few corners, and push the envelope, which is as polemicists do. There is perhaps much Moore emphasis on the overall message than on the specifics. This has given his foes an easy time, dismissing his movie and the salient facts it exposes. In his defence, it must be said that Michael Moore has had his greatest success, not in producing scientific reports, but in provoking discussion. Already there seems to be a growing movement both in the right and left of American politics to set things right, and that in itself will give rise to a healthier America.

Here is a link to the movie for download from Veoh. Michael Moore says he does not mind (you have to register and download Veoh Player, so spread this movie around as much as you can. Humanity over profit, and example perhaps? What model would be best for Kenya? We have a population most of whom cannot afford insurance or private care. At the same time though, many public hospitals are in no way equipped to adequately cater for the needs of the public.