Michael Moore's latest mockumentary, “Sicko,” is about as subtle as a sledgehammer in bashing our cockamamie healthcare system, and his lens is way too rose-colored in extolling the virtues of a government-run, single-payer alternative. However, his essential point is valid–that dealing with doctors, hospitals and insurers is too often no better than a shell game, and it's a disgrace we cannot summon the political will to fill the life-threatening gaps facing insured and uninsured Americans alike.

Mr. Moore is very clever in his approach. He doesn't focus on the obvious targets–the 45-to-50 million people in this country without any health insurance. Obviously, this crowd, now going bare, would be more likely to back universal health insurance because it is literally better than nothing.

Instead, he tries to scare the life out of those who should feel secure–those with coverage. These are the people whose support will be desperately needed to force any changes in the self-interested status quo.

Mr. Moore depicts the plight of some who have found out that health insurance can sometimes be a game of Russian roulette, in which it's hard to say whether legitimate claims will actually be paid. There is also the looming terror of losing that safety net altogether if one loses their job, or has a serious illness (a pre-existing condition, as the industry labels it).

This was the one area where Mr. Moore really struck a chord. Filing a claim with any health insurer these days has the feel of playing slot machines in a casino, in which you are gambling with your life savings (and possibly your very life). Will all the elements fall exactly into place so the bureaucrat considering your claim won't have the slightest excuse to tell you to take a hike?

Are all your doctors still in your carrier's arbitrary network, or will you be forced to abandon a provider you trust and who knows your condition inside and out, just to accommodate whatever plan you happen to be enrolled in this year? Will the drug your doctor prescribes be on your carrier's formulary? Did you get the necessary pre-approval for a key procedure?

Of course, Mr. Moore goes way overboard in hailing the relative advantages of single-payer systems in other countries. He selects subjects who are thrilled with the quality of their care. The Utopia he pictures provides quite a harsh contrast to the grim reality facing unfortunate Americans left to the not-so-tender mercies of the free market.

However, I could have made a very different film had I followed the same “selective perception” dominating Mr. Moore's script. I would have focused on a dear Canadian friend who complained of severe headaches, dizziness, memory loss and personality changes, yet had to wait months for the MRI that revealed a brain tumor, and months more for the operation that thankfully was still in time to save her life.

I then would have contrasted that with the case of another dear friend here in New York, who had to stop working due to the effects of AIDS on his system, and who couldn't afford to continue his private health coverage. Before he passed away last year, Medicaid financed first-class care for him at one of the city's finest hospitals, along with follow up home services, at no cost to him. Sounds like we must be doing something right.

Does this mean our system is superior to Canada's? Of course not. (Indeed, my Canadian friend–an American who married a Canadian, but is now divorced–remains in Canada in part because with her pre-existing condition, she fears being unable to get any affordable health insurance here in the U.S.) But that doesn't mean Canada's system is the best alternative, either. The lack of grey in Mr. Moore's black and white portrayal is his film's biggest shortcoming.

The fact is we do many things right with our healthcare system. We deliver extraordinary care to the vast majority of Americans, while inventing brilliant diagnostic equipment, treatments and drugs that benefit the rest of the world.

Unfortunately, as Mr. Moore points out, we are also doing way too many things wrong, leaving tens of millions bare, and even those with coverage under the thumb of an often heartless, senseless system.

Mr. Moore excels at spotlighting problems–especially hypocrisy and self-interest. (In his film, he notes that even former healthcare reform crusader Hillary Clinton is taking tons of money from the industry she once sought to tame.) He forces people to face unpleasant facts.

Where Mr. Moore fails is that he always becomes the lightening rod in any debate he inspires, drawing all the fire and attention. The argument becomes more about him–his bias, his skewed technique, his iconic image–than about his subject. The messenger ends up obscuring an important message.

He is often ridiculous in this movie–such as when he pulls a boatload of sick, 9/11 first responders into the waters of Guantanamo Bay, demanding via a bullhorn the same level of care delivered to the “evildoers” imprisoned there. He then somehow strolls into Cuba and gets all his unfortunate charges the top-flight care and medicines reportedly denied them in the USA–at no charge.

(One key point he fails to mention in hailing Cuba's system is that were he a Cuban filmmaker training his critical eye on the shortcomings of Fidel Castro, he would be left to rot in jail, with no cameras allowed.)

Still, bottom line, the problems Mr. Moore spotlights are real, and while the answer might not be a wholesale shift to single-payer as practiced in Canada, Cuba or Europe, we certainly need substantial changes to make sure healthcare is more of a right, rather than the luxury it has become for far too many today.

Can't we have the best of both worlds? What changes could you live with in our healthcare system? If you were Ruler Of The Universe with unlimited power to do good, what would you change first?

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Messenger Obscures The Message

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