What is it to be “sick”? According to Merriam-Webster, there are two definitions:

1 : affected with disease or ill health

2 : spiritually or morally unsound or corrupt

This afternoon I viewed “Sicko.” I was one of the many audience members at the theater who applauded at the film’s conclusion. Sicko will serve provoke much-needed discussion regarding the American health care system. Sicko invokes the second definition of “sick” as well. My hope is that Sicko will also provoke desperately needed conversation, as well as substantive changes, to the American political system, where money acts as a virus and where the equivalent of white blood cells–the Media–has long gone into hibernation.

I am not optimistic about any self-instigated change in the American political system, but perhaps Sicko will provoke the media to start digging into the millions of health care injustices in America. These compelling stories are there for the taking. Perhaps these many cases where health care is being unfairly denied to Americans will at least occasionally start showing up on the front pages of America’s newspapers. Before Sicko was released, the undeniable fact that America is having a health care crisis was not considered newsworthy by the corporate media. Nor has any real healthcare conversation occurred in this country since Hillary Clinton was bludgeoned into silence on the issue thanks to more than $100 million spent by healthcare corporations more than 10 years ago.

Our political system is wretchedly sick. Moore makes this clear when he shows us a large room full of members of Congress, complete with little green tags superimposed to show how much money each of them has taken from big healthcare corporations.

Sicko is not just about the uninsured. It is also about those who have insurance. For that reason, this film should be of interest to both the 50 million Americans who don’t have health insurance (18,000 of them die each year because they are uninsured) as well as the quarter of a billion Americans who do have insurance.

Our health care insurance system is horribly sick (again, in the sense that it is spiritually or morally unsound or corrupt). American health care insurance is based upon the idea that you become highly profitable by denying claims to people who deserve reimbursement and who often happen to be dying. They can always go to court, of course. Then, when the jury renders a large judgment against the insurance company, the relatives of the now-dead insured person can enjoy the money. How do those numerous healthcare claims get denied? It’s easy. Doctors hired by the insurance companies stamp their names onto denial letters that are cranked out en masse by insurance company computers.

Keep in mind, that no insurance company executive needs to go around with horns or a pitchfork telling doctors to deny claims that they shouldn’t deny. No one has to tell anyone else to screw the sick people. All the insurance companies need to do is to put the right incentives in place. In Sicko, Moore makes it clear that the insurance companies have implemented carefully crafted schemes along those lines.

As you might expect in a Michael Moore film, you will find some imaginative and effective ways of portraying complicated issues. I don’t want to spoil the film by detailing any of these here. Suffice it to say that you will get your money’s worth if you go to see the movie.

Moore attacks the “socialized medicine” bogeyman with gusto. With some clever use of older video materials and historical political archives, Moore mocks those who would shoot down the idea of socialized medicine as un-American. After all, what’s so bad about socializing a service that should be socialized? For instance, we have socialized firefighters and socialized teachers working in our public schools. As has been well publicized already, Michael Moore spends considerable time exploring the socialized medical systems of Canada, Great Britain and France. Many of the one-on-one interviews Moore conducts with those involved in those “socialize” ecosystems involve Moore at his best.

An interview with a British doctor is entertaining and edifying. Moore carefully points out that in countries with “socialized” medicine, the doctors received bonuses if they can convince their patients to make better health choices such as giving up smoking and reducing their blood pressure. This incentive program contrasts nicely with the scheme by which American insurance companies make money by endangering the health of Americans (through denial of services). One thing and Sicko failed to do is to point out that American citizens really should bear more responsibility for their wretched health. Many of our health issues are brought on by our own shortsighted behavior, including our over eating, our smoking, our excessive drinking and our lack of exercise. Then again, this responsibility comes full circle, because of the conspicuous lack of public health measures in the United States. Americans would be more healthy if they were provoked to be more healthy in dramatic ways. We need to compete with the huge advertising budgets of private corporations peddling their unhealthy goods and services to Americans. We could make some progress if the federal government would fund prime time television announcements concerning public health, using videos created by the best minds of Madison Avenue.

I need to be careful about pointing out where Moore is at his “best.” He is strong with the one-on-one interviews with regular folks. He is strong when he resorts to taunting those who are powerful and uncaring. He makes effective use of statistics (according to CNN, Michael Moore’s facts are checking out quite well). Moore is also strong when he discusses the proper purpose of government. For instance, in one interview it is brought out that there are two ways to control people. You can frighten them or demoralize them. These are tactics that both succeed in keeping people from coming out and voting.

Although it is not specifically presented in Sicko, Michael Moore has issued a three-point Health Care Proposal that would provide free medical care for every resident of the United States. Whether these aims can be accomplished in exactly the way Moore proposes is only a starting point for the discussion. I believe that, at a minimum, there should be a basic level of healthcare guaranteed to every U.S. citizen that is funded by the government. If you break an arm, if the baby has a high fever or if you have chest pains, for instance, it is in the national interest that medical care providers are funded by the government to provide that medical care, no questions asked.

Thorny questions remain as to the extent the government should fund experimental treatment and extremely high-priced end of life treatment. A government that is willing to spend all funds necessary to keep all of the Terry Schaivos of the U.S. “alive” would quickly bankrupt our system (there are as many as 40,000 such “people” in the U.S. at any given time). The huge amount of money spent to maintain even one such person could go far to help many families needing primary or preventive care. Therefore, medical issues are interlaced with moral issues. In the U.S. these issues are interlaced in a contorted and highly politicized way that ignores the plight of the numerous U.S. families desperate for basic medical care for their children.

As much as we might not want to think about it, we do need to allocate our limited budget dollars among many social needs, and medical care is only one of these critical social needs. For instance, medical care tax dollars would necerssarily compete against education dollars. Reasonable people might differ on how to best allocate money to these big ticket items. It is important to note that the Canadian health care system Moore admires in Sicko does not cover all medical expenses. Many Canadians supplement their guaranteed coverage with private insurance.

The point is that we do need to have a frank and national conversation on all of these issues so that there will not be a need to cause acute national embarrassment to our country (in five or ten years) with a film called Sicko II.