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After tackling the automobile industry in ‘’Roger and Me’’ (1989), the gun laws in ‘’Bowling For Columbine’(2002) and the Bush administration and the Iraq war in ‘’Fahrenheit 9/11’’ (2004), Michael Moore knew exactly where he wanted to head next. Winning an Oscar for Bowling for Columbine and the Palme d’Or for ”Fahrenheit 9/11” had only further fuelled his enthusiasm for unearthing social injustices, as he turned his attention to the US health care system for his latest documentary, ”Sicko”. Dealing in particular with the way in which health insurance is geared to preventing proper care to premium-paying US citizens wherever possible, Moore goes on a mission to show us just how this red-tape riddled system compares to the rest of the world. With his typical blend of humour, reportage and fact-finding, he visits all manner of countries – from North American neighbours Canada to European neighbours Britain and France. As provocative as ever, the film climaxes as he arrives in Cuba, where he takes a group of ordinary US citizens, in dire need of treatment for various ailments, to experience a state-controlled health care service. The results, as so often with Moore, are shocking but never less than thought-provoking.
Q: What do you think people from the US will learn from this documentary?
A: I don’t think the problem is uniquely American. If I were living in your country, I’d be worried about what your government is doing to snip away at the social safety net that you’ve had for many years, taking money away from health care, education, social services…and the film should act as a warning to you. If you have a government that wants to be more American-like, watch this film and take a look at what you get when you have a society that’s structured more like our society. I would be somewhat frightened if I were living under another government watching this, and thinking about how my government keeps talking above privatisation and outsourcing and these sorts of things, and creating a two-tier system – one for the haves and one for the have nots. So I think the film is very relevant outside of America.
Q: Do you not think privatisation will be better?
A: No, I don’t think it’ll be better! In fact, it’s worse. I’ll give you an example from my country. The health insurance companies spend upwards to 25 per cent of their budget on administrative costs – bureaucracy, red tape etc. Our federally funded health program, called Medicare and Medicaid – this is for old people and the poor – their total administrative costs, to run a federal program, is just 3 per cent of their budget. If you ask most Americans, what per cent the government spends to administrate Medicare, they would say, ‘Ah, well, a private industry has to be 25 per cent, so it must be 35 or 45 per cent.’ No, it’s 3 per cent! In Canada, it’s 1.7 per cent; that’s the percentage of their budget that goes on administrative costs. It should have nothing to do with profit – you should never be talking about profit when you’re talking about people’s health, just as you wouldn’t ask, ‘Why isn’t the fire department making a profit?’ or ‘Why isn’t the city water department making a profit?’ These are basic human rights, life and death issues, as is healthcare. And that’s the way that we need to see it in our country.
Q: What about other countries? What experiences did you have in Europe?
A: Well, Norway is the craziest! I thought, ‘If we showed Norway in the movie, nobody will believe this!’ I thought France was already crazy enough, for an American audience to digest what’s available there. So, they’re never going to understand Norway! Seriously! If you have certain illnesses in Norway, you get a week a year at a spa in the Canary Islands, paid for by your health insurance. You have a spa in the Mediterranean, near Turkey I think, and your health insurance pays for you to go there – I can’t tell Americans that! They would think I was making science fiction, so I had to leave Norway out of the movie because it would be too much to take. The Norwegians hire a philosopher…they have a government philosopher. And they have a state oil company, because they don’t let the private oil companies call the shots…it’s the ‘earth belongs to the people’ concept, as the oil comes out of the earth. So they hire a philosopher who makes sure that the oil money is spent in an ethical way and the oil that’s mined in an ethical way! How am I going to explain that to someone in Texas? I am going to put it on the DVD, because I truly think if we have to go anywhere, go to Norway!
Q: Were there any other countries you didn’t make it to?
A: We were on our way to Slovenia, just for comedy, because they and the United States share a similar position on the World Health Organisation chart. We called up the Slovenians, and we did a lot of research with them. Their main complaint in Slovenia is that most of their mail goes to Slovakia! And you can’t get any respect! If you tell people you’re going to Slovenia, they think you’re going to Slovakia!
Q: Does it make you sad, the more you uncover about your own country, or do you remain optimistic?
A: Yes, I remain optimistic. I’m not a cynic. I absolutely believe that people can change. I believe that Americans, as I said in the movie, at our core. We have a good heart and we have a conscience. Sometimes we’re a bit of a slow learner and it takes us a while to figure it out. When I made my speech at the Oscars, that we were being led to war for fictitious reasons and I was booed off the stage, 80 per cent of the American public supported the war and I was in the 20 per cent didn’t. But now, 72 per cent oppose Mr Bush. He has a 28 per cent approval rating, so people came along and people eventually got it. So I’m hopeful for my fellow Americans that they will eventually get it, but it unfortunately takes a while.
Q: Do you not think, though, that insurance companies and pharmaceutical companies have got their claws so far into Capitol Hill, things won’t change?
A: Well, I think this is a bigger fight. This will be harder than stopping the war in Iraq – and we haven’t done that yet – because their financial claws are so deep into our politicians. For crying out loud, the main proponent of universal health care is a senator who is now the number two recipient of health care money. So it’s going to be quite a struggle. And health care in America makes up more than 15 per cent of our GDP, so that’s an industry now that’s larger than just about anything else.
Q: Can you say why you chose Hammersmith Hospital in the UK, because that’s a flagship hospital and part of it is privately funded?
A: We didn’t go to the private part of the hospital. We only went to the public part. It was all NHS that we covered. And we went into more than one British hospital. I was surprised. I’m comparing them to American hospitals. So I was surprised at how nice they were. In fact, my niece was going to school there, north of London, last year and she had what she thought was an appendicitis attack. She went to the hospital and they immediately took care of her, and didn’t charge her anything and she had great care – and that’s what you hear from any American who ends up at a British hospital. I wanted to keep the film about middle class Americans and I wanted to go where the middle class Brits were – and the middle class is at Hammersmith Hospital. So the film is not about the poor. But we went to a homeless shelter out near Shepherd’s Bush. I didn’t put this in the movie but I might put it on the DVD. They were getting acupuncture, they were getting foot massages…I’d never seen anything like it. It felt like I was in Norway! That American woman in the film, who says that about Britain, that is our view of any kind of British system – we think it’s out of a Dickens novel, some poor house! We’re always surprised when we go in and we see just actually how good it is. That doesn’t mean it doesn’t have its flaws or problems. And the French, the British and the Canadian stuff that’s in the films is through my American eyes, and I’m comparing it to America, and I’m not saying they don’t have problems. But those aren’t for me to fix. Trust me, from an American point of view, the Europeans look pretty good. You need to preserve what you have and fight to get back that which you lost.
Q: Do you also have to present it in monetary terms? You visit the British doctor, and see his house and car…
A: Have you ever visited us? That’s the society in which we live. We live in a consumer society. That’s why we’re so in debt. Americans now carry the largest debt they’ve ever carried. Nobody saves any money. It’s down to 1 per cent, for people to save from their income. People, they buy and they go in to huge credit card debt, they re-mortgage their homes to buy more things. And as Tony Benn says in the film, it’s an ingenious system, as the more in debt you are, the more you are enslaved to that particular job or those in power, as you don’t want to rock the boat.
Q: Well, Britain is following you in many ways. After all, the US and the Brits are allies…
A: Well, there wouldn’t be a war in Iraq is it wasn’t for Britain, and Australia, and Italy, and Denmark…and all the other fine members of the Coalition of the Willing. Let’s just say, George Bush…he doesn’t know any better. But Mr. Blair does. Mr Blair isn’t stupid, and he was the enabler of George W. Bush. He provided him cover, so he could go to the American people and create essentially a delusion – or an ‘illusion’, as a kinder person would say – that the world was behind us on this. If Blair hadn’t supported him, if Howard hadn’t supported him, if Berlusconi hadn’t supported him, I don’t know if he would’ve been able to pull it off. The Brits have to ask why they didn’t throw Blair out and take to the streets.
Q: Why do you think this issue of health care isn’t higher up the political agenda in America?
A: All the polls show that this is the number one domestic issue in the upcoming election, with Iraq being the number one international issue. It will be a big issue in this election, and I intend to be a part of that discussion, and I hope that the film prods these candidates towards positions that I’ll hope that they’ll take.
Q: You really use the health system as a jumping off point in Sicko, don’t you?
A: Well, I do in all my films…Fahrenheit 9/11, it used 9/11 as a jumping off point. It was really about Iraq. Bowling for Columbine wasn’t really about the Columbine shooting. It was just the jumping off point to ask, ‘Why do we have a quarter of a billion guns in our homes?’ Just as this movie is really about health care. I mean it is, in the sense that it’s a vehicle that I’m using to get to the larger issues I want to discuss, which is, ‘What is wrong with the American soul?’ and ‘Why are we behaving the way we behave?’ and ‘Why do we treat each other this way?’
Q: When George W. Bush told you, in Fahrenheit 9/11 to “go get a real job”, what went through your mind?
A: I didn’t put this in, but I’d shot a scene where I called my Dad, where it cut from me saying, ‘Dad, do you have an oil company or a baseball team that I could run?’ But I’ve not run into Mr Bush since, and he hasn’t invited me over to dinner.
Q: How about the guy in Sicko who runs the anti-Michael Moore website. You paid his sick wife’s health care bills. Can you talk about that?
A: I called him yesterday, he didn’t pick up, I left a voicemail – and that was on his website 15 minutes later. He responded at first in a very kind and loving way. He was very grateful and thanked me for it, and wished the film well. He woke up this morning, and – being a blogger – had a different feeling!
Q: Don’t you think your film supports Castro’s regime, given you wax lyrical about Cuba?
A: No, I think the film points out that the American government is providing better health care to the Al-Qaeda detainees than to the people who tried to rescue those who were attacked by Al-Qaeda on 9/11. The irony of that, to me, is supreme. That’s what most Americans who see this are going to be thinking – ‘Are you kidding me? How bad is it? We won’t even do this for our own people, but we will take care of the people who attacked us on September 11th?’ In some ways, it’s very Christian to love your enemy, and do good to those who persecute you – I think it’s what the Bible says. But basically, I’m using it as an ironic moment. Had the detainees been held in Spain or Italy or Australia or the Philippines, we would have gone there. It just happened to be in the island of Cuba.
Q: Were you surprised to be under investigation by the US government for going to Cuba?
A: The law says that journalists can go there – you don’t need a licence or form of approval to go – and this is a form of journalism. It’s a non-fiction film and it was rather surprising that we got a letter. I shouldn’t say ‘we’. There were 15 or so of us that went; only one person got a letter! So if its about the law, all 15 would’ve got a letter, because they all came back with a Cuban stamp on their passports. Nobody else gets a letter – only I got singled out.
Q: How moving was that final scene, when you take Americans seeking healthcare to Cuba?
A: As you saw, they were in tears. They couldn’t believe they were getting this kind of help. And we asked to be on a floor where there were Cuban patients. We didn’t want to be treated like a tourist might be treated. We wanted to see what the Cubans get, and see their medical equipment and training – it was an amazing thing to see.
Q: Weren’t you afraid they might just give you the best care, given the cameras were on?
A: Any time you have a camera present, people are on their best behaviour. But after we left, we had to leave a couple of 9/11 workers there for their treatment – Reggie was one of them. She told us this after she came back: ‘After you guys left, after the cameras were off, I just wanted to see if it would be the same if there weren’t cameras.’ She speaks Spanish, do she snuck out of her hospital room, went downstairs and walked into the hospital as if she were a tourist from Puerto Rico who was sick. She said, it was the exact same thing. ‘What is your name? What is your date of birth? Please come this way?’ And that passed the test for her. She wasn’t just being treated well because Michael Moore was there. We heard it from Cubans all over – that’s the sort of care they get. It’s a huge thing priority over there.
Q: Can you define the difference between documentary and propaganda?
A: Propaganda is what those in power use to try and sway the public toward their point of view, oftentimes shading the truth in order to get the desired result. But only those in power are able to use propaganda. If you are not in power, you have to use whatever means you have to try and fight back with the truth. And what I do is I try to show Americans and the world what you’re not going to see on the Evening News. Things that are not going to be brought to you by the corporate media. To me, it’s the corporate media that does the propaganda work. They don’t question the war. They let Bush get away with this. They were cheerleaders for this war. And you have one or two voices out there saying, ‘Hey, something’s wrong here!’ To call that propaganda is Orwellian, when the real propaganda comes from those in power who are enacting suffering on not only our people but the people of Iraq. I’m very careful in my films to make sure every fact I give you is a fact. If I state it as a fact, it is a fact. And on my website, when the film opens, I’ll have all the sources and all the back up for all the facts in the film. The opinions in the film are mine. And you can disagree or agree…the opinions may be right or wrong. I think they’re right, because they’re mine! But they may not be. Your opinion may be right to you. I’m trying to get a debate and a discussion going. But when I tell you that there are 9 million children in the US, that’s a fact. When 18,000 die a year because they don’t have health insurance, that’s a fact. But my belief that we should eliminate the private insurance companies, there should never be profit attached to it, that’s my opinion.
Q: So you don’t think you hold any power with filmmaking?
A: No, I don’t hold power. I can’t create the system that I want to have created. I can’t fix this tomorrow because I don’t hold power, so I’m using an art form to express myself. Primarily, I’m a filmmaker. I’m not a politician. I’m not running for office. I’m not a preacher. If I were those things, that’s what I’d go do. But I’ve chosen to be a filmmaker, so I’m going to focus first of all on making a good movie. I’m going to focus on making an entertaining movie that you’re going to want to see on a Friday night. And that is always my primary thought.
Q: Would you ever run for office?
A: No. I already ran for office. I was one of the youngest people ever elected in the United States, when I was 18, to the board of education in the town where I lived.
Q: There is no confrontation in Sicko, in the way there was in previous works…
A: Well, I’m not going to knock on the door of Charlton Heston, but I think there’s a big confrontation. In this film, I’m confronting the audience – especially the American audience. I’m challenging them to get up out of their seats – and act like the French!
Q: What’s your health insurance like?
A: First of all, I’m a member of three unions – the Director’s Guild, the Writer’s Guild and the Actor’s Guild. So I have three different health plans. Only 9 per cent of the American public – non-public employees – belong to a union. I’m one of the 9 per cent – so I’m in the lucky group. So I won’t have a problem. But getting insurance for this film was very difficult, for my staff and for the production insurance. None of the big insurance companies would give me insurance, because I had to tell them what the film was about – insurance. And no distributor will distribute a movie that doesn’t have insurance. And no theatre will show a movie that isn’t insured, because they have to be on the policy in case they’re sued. So it was amazing. I learned how insurance companies control what we see in the movie theatres, because they have the ultimate say as to what movies get made by whether or not they’ll insure them. So we spent months before we could even begin the film trying to find somebody to insure the film. Eventually, we got a small company in Kansas City in Missouri, run by possibly the only Democrat in the insurance industry!