The premiere of “Sicko” last week in Washington, D.C., brought together an interesting crowd. Though many attendees were liberal, there were some recognizable faces from the other side of the political spectrum, including former Defense Secretary William Cohen (a moderate Republican) and his wife, who were seated two rows in front of me. Given Mrs. Cohen’s far more enthusiastic applause before and after the movie, she is probably the more liberal of the couple. And then there were the foreign dignitaries. According to Michael Moore, the head of the Cuban Mission in Washington (the closest thing there is to an ambassador) was in attendance, no doubt enjoying the propaganda value of the movie for Castro’s system.

Rep. Maxine Waters (D-CA) introduced Michael Moore by telling the audience that she had cleared everything on her schedule so she could be with “the creative genius of our time” and, to great applause, criticized the 2000 Presidential recount whose scuttling of a would-be Gore administration she still finds unconscionable. 

Moore struck a more conciliatory tone in his remarks on stage, saying he hoped “conservative brothers and sisters” could be brought around to his views.

As with his other films, bringing people around to Moore’s personal views is the intent of the movie. And as with Farenheit 9/11, this is a film that many who sympathize with Moore’s politics may nonetheless find hard to admire. Moore’s rhetoric is deployed in furtherance of a number of premises, only one of which is true:

• There are problems in the American healthcare system.
• These problems exist because American healthcare is largely privately run.
• The healthcare systems of Canada, the United Kingdom, France, and Cuba are almost perfect
• These foreign systems are almost perfect because they’re government-run 

Moore labors mightily to get the truth of the first claim somehow to rub off on the others. He thrives on anecdotes: We see specific cases of the misery caused by U.S. healthcare bureaucracy, and hear about better outcomes in, for example, Britain’s National Health Service (NHS). Britons themselves may beg to differ: The Guardian reported in May 2007 that “scores of NHS hospitals across England are failing to protect patients’ dignity and to meet basic standards of cleanliness and care, the government’s health watchdog warned today in its annual check of conditions on the wards.”

As with Farenheit 9/11, this is a film that many who sympathize with Moore’s politics may nonetheless find hard to admire.

Moore might have interviewed victims of British government healthcare—or their survivors, such as relatives of Dunil Almeida, a man whose bowel cancer went undetected for 18 months by the NHS despite his 50—yes, fifty—visits to various government doctors. Almeida sufferered “agonizing stomach pains” and lost a tremendous amount of weight, but his bowel cancer was only diagnosed when he went to Sri Lanka. His widow said “He was even told he was probably imagining the pain.”

In April, The Mail on Sunday reported that “A woman died from multiple organ failure after consulting eight [NHS] doctors who failed to spot she was suffering from septicaemia… They diagnosed her with various conditions, including flu, food poisoning and colic… Her partner said the couple were forced to wait eight hours for a doctor to arrive on the Sunday before Miss Campbell died.”

Also in May of this year, the British Royal National Institute of the Blind reported that:

Moore might have mentioned that, driven by a focus on keeping down costs, the NHS has “refused to approve the drug Erbitux, even though it has been shown to extend the life of head and neck cancer patients by almost two years.” As Daniel Martin writes, “The Government’s rationing watchdog has already turned down a number of cancer drugs, saying they were not ‘cost effective’.”

Tragedy also struck in September of last year, when “a six-year-old boy died after [NHS] doctors failed to diagnose his brain tumour during eight visits to hospital and a health center… Levi Ringer was regularly sent home with tablets for a migraine and one hospital dietician even thought ‘behavior problems’ were to blame and recommended he see a psychiatrist.”

The boy’s mother felt something was seriously wrong with her child, and she pushed doctors to perform a brain scan. She was told there was a three-month wait list for a brain scan, typical of waiting times in a government-run system. Beyond desperate, the mother fought the bureaucracy and pushed to have one sooner: bureaucrats relented and the scan was carried out on the sixth hospital visit. The scan revealed what the mother had long suspected, namely that her son had a serious medical condition: a tumor. By the time the tumor was diagnosed, however, it was too late: the cancer had already spread and the boy, Levi, soon passed away.

Prices may ration care in a private system, but rationing is every bit as real when the government is in charge: remember the long waiting lines outside Soviet stores? In places where the government centrally runs healthcare, the outcome is no different. Some waiting lists in countries with socialized healthcare are stunning: waiting lists for hearing aids for seniors have reached 72 weeks in Edinburgh, Scotland.

Some waiting lists in countries with socialized healthcare are stunning: waiting lists for hearing aids for seniors have reached 72 weeks in Edinburgh, Scotland.

Moore could have included these anecdotes to show that a government-run healthcare system is far from perfect. And he could have shown a balanced picture of how MDs are compensated in a government system. Instead, Moore shows a young British doctor who is well-compensated, with a nice Audi and a nice apartment. No complaints about compensation from him. But why didn’t Moore interview other doctors, or dentists? All he would have had to do was buy a British newspaper. As the Telegraph reported, “NHS dentists are refusing to treat patients with poor teeth because they do not get paid enough to carry out the work… dentists’ leaders said a new [government] contract meant practices were given the same fee for treating people who needed one filling as for people who needed 11.”

Similarly, Canada is singled out for special praise by Moore, and he asks patients in a Canadian waiting room how long they’ve been literally waiting (half an hour or 20 minutes), but failed to show another great anecdote: Canada’s waiting list calculator. It allows you to calculate how long you’ll have to wait for surgeries. The median wait time for open heart surgery in British Columbia is three months, while the wait time for a corneal transplant is 2.5 months.

In Manitoba, Canada, the median wait time for “emergency cardiac surgery” is five days. And in the Canadian city of Winnipeg, the median wait time for cataract surgery is four months. These wait list calculators are all available online, scary illustrators of what happens in government-run healthcare systems.

Moore also holds France up as an ideal. Yet despite income tax rates as high as 71% (including social security contributions) and an enormous public sector, young people, immigrants, and many other Frenchmen are deeply worried about the future. In 2005, “As France declared a state of emergency... to contain violence by enraged youths, Europeans watched with bewilderment and growing alarm at the continued torching of cars, at the destruction of businesses and homes, and at the defiance of police efforts to bring the rampage under control.”

With a government that takes care of everything—Moore makes much of household services provided by the government to new mothers—French society is in crisis. Moore loves the feisty culture of French protests, but for protesters, it’s no laughing matter. In March 2006, a demonstrator in Paris, Philippe Decrulle, told a reporter: “We are here for our children. We are very worried about what will happen to them… My son is 23, and he has no job. That is normal in France.” The French statistics agency, INSEE, reported in June 2006 that 22% of young people are unemployed (defined as looking for a job but unable to find one.)

Moore’s documentary focuses instead on a happy, wealthy couple.  They have an income near 8,000 Euros per month. This couple is hardly representative: 90% of single French people have a disposable income of less than 2,100 Euros per month. 90% of French families with two children have a disposable income of less than 5,300 Euros per month. It would be like interviewing an American couple on the Upper East Side of New York, or in Laguna Beach.

Rep. Waters was more right than she knew when she called Moore a creative genius: The man describes a world that has at best a tenuous link to the real one.

For his documentary, Moore might also have looked at my native country of the Netherlands, a country so ideologically suspicious of profit in healthcare that the healthcare system is almost entirely government run. A study by the University of Amsterdam found that 100 patients per year die of heart failure while they’re on the government waiting list for heart surgery. But that’s only heart surgery: many more cancer patients die as they await treatment. In 2002, the Dutch Health Minister was forced to admit that people die on government waiting lists, and admitted that it often takes five months for patients suffering from head and neck cancer to begin treatment in hospitals, by which point it’s often too late.

Moore makes much of price controls—prescription drugs are cheaper outside of the U.S., and Moore is delighted that British hospitals charge a flat fee for them. But this comes at a price: new drugs are introduced first to American consumers, and many new cancer drugs available to Americans are simply not available to patients in socialized healthcare systems. A report by the Swedish Karolinska Institute, published in the Annals of Oncology, found that the U.S. uptake of lung cancer drug erlotinib is 10 times the European average. The same goes for the uptake of colon cancer drug bevacizumab.

Meanwhile, the uptake of Rituximab in the United States (used to treat non-Hodgkin’s lymphoma) is 4 times that of the E13. The authors report that “nearly half of the observed improvement in the 2-year cancer survival rate between 1992 and 2000 at 50 US cancer centers could be attributed to the use of new cancer drugs,” evidence that America’s advantage over Europe in pharmaceutical R&D is not only a matter of money but also a matter of human lives.

Despite Moore’s burning desire to make people adopt his own views, the editing was not always perfect. One scene in particular was poignant: as the camera panned out from an elite Havana hospital room, it revealed a horizon of abject slums, poverty and misery.

More disturbingly, when Moore went to Cuba to get healthcare for several sick Americans, they became a pawn in Castro’s propaganda machine. Of course the sick American patients Moore brought to Cuba received excellent care from Castro’s system—as the Cuban Mission Head in the audience probably thought, what better PR for Castro than to demonstrate that his system, while producing abject poverty for most people, at least provides good healthcare for the on-camera few? Meanwhile, medical supplies of all kinds are in chronically short supply in Cuba, particularly essentials such as aspirin. Cuban officials blame the U.S. embargo, but in a normal economy, private companies would spring up to fill any shortages of products such as aspirin, medical gloves or syringes—not so in Cuba.

All of this information, all of these anecdotes, could have been included to make for a documentary on different healthcare systems. But Michael Moore was not interested.

Representative Waters was more right than she knew when she called Moore a creative genius: The man describes a world that has at best a tenuous link to the real one. Against all contrary evidence, he claims that “There is no room for the concept of profit when it comes to taking care of people who are sick” and wants to make U.S. healthcare in its entirety a government-run program.

Judging from the tepid response of leading Democrats—almost all of whom support a massive role for the Federal Government in healthcare—to Moore’s proposals, it seems that even his natural allies are skeptical.

Jurgen Reinhoudt is a research assistant at the American Enterprise Institute.

Image credit: Photo by Flickr user farlane