Medicine At Gunpoint: The Sicko Crowd's Deadly Rx For America

Part I

Michael Moore has described his new film Sicko as a "
comedy," but there's nothing funny about it. With its radical prescription for the takeover of all of American health care by the federal government, it's more like a tragedy -- a very dark tragedy that is guaranteed to lead to an unhappy ending.

Sicko, which took in an estimated $4.5 million during its opening weekend while garnering 91% positive critical reviews so far, is emerging as an unlikely catalyst for the headiest of agendas: the establishment of socialized medicine in the United States in the form of single payer universal health care. Such a wholesale paradigm shift in an area that comprises one-sixth of the nation's economy is extremely dangerous, more than anything else facing the American people today with the possible exception of another major terrorist attack. If they are enacted, Moore's and his compadres' prescriptions for American health care are sure to be deadly, not only to our individual health but to our freedom, our autonomy, and our very way of life.

The term "universal health care," reminiscent of Orwellian Newspeak, is an attempt to give a more palatable name to a concept Americans have always rejected: government-run or completely socialized medicine. Some proponents argue on behalf of health care reform "light," in which all residents are forced by law to pay for, and to prove on demand that they have, conventional medical insurance offered by private companies closely regulated by the state. Such a mandate just went into effect statewide in Massachusetts on July 1, 2007. Others advocate "single payer," in which private insurance companies, and the desire and ability of people to pay for their own care including out of their own pockets, are outlawed, replaced by a socialist government bureaucracy that provides a uniform ("one size fits all"), tightly regulated, and limited number of treatment options for everyone.

Moore and the millions of people like him who believe in socialized medicine usually deny that what they are proposing for the United States is in fact socialized medicine. Finally, in a live interview on Larry King Live on CNN on June 29, 2007, Moore used the "S" word. The set up was a brief question near the end of the program from a woman on the "King cam" who said she was concerned about soldiers coming home from Iraq and Afghanistan, and if their medical needs would be met-after which this exchanged occurred:
Moore: Oh boy, this is going to be a big problem.

King: They're covered, though, they're all, aren't they-

Moore: They're covered, but-well, they're covered, yes. The VA is actually-it's a good system of socialized medicine-

King: That's what it is.

Moore: That's what it is.
It was telling that Moore smiled broadly when he said the Veterans Administration was "a good system of socialized medicine."

Sicko's success at breaking through and capturing a lot of the public's attention and imagination, even before anyone had actually seen the film, is emblematic of Michael Moore's unprecedented visibility and influence, in both the popular entertainment culture and, not incidentally, at the highest levels of national politics. In 2004, Moore got a seat of honor at the Democratic National Convention, sitting in a box right next to former President Jimmy and Rosalynn Carter after which Moore commented that Carter "said to me, 'I can't think of anyone I would rather have sit with me tonight than you.'"

In terms of box office receipts, Moore is the most successful documentary film maker in history and he's been anointed with the usual totems of critical acclaim including an Academy Award and a Palme d'Or from the Cannes Film Festival. Yet, Moore is the kind of player who, if he didn't exist, would most likely have been invented by the system. In other words, his talent and the quality of his work are not accurate predictors of his mega success.

That success is no accident. The $148 million generated at American box offices by Moore's four earlier documentaries, and the prospects that this new one, Sicko, will continue to rake in the cash, as well, are due to their all being closely in sync with the increasingly leftward tilt of the American mainstream, particularly the media and all of the interlocked nanny state special interests. These and other stakeholders are coalescing around the enormous potential of Sicko, the latest example of Moore's pro-statist agitprop.

Paradigm Shifter

The lead up to Sicko's June 29 national roll out was a genuine phenomenon. Prior to its opening, with only a small number of reviews actually published, Sicko had already become the most hyped, and written about, movie of 2007, and possibly of the past decade. (Sorry Al Gore and Angelina Jolie, but you're yesterday's news.) The publicity campaign and its effects amounted to a uniquely intense domestic display of sensory shock and awe-and included thousands of gaga news stories (and not just cloned wire service copies, but unique articles, many with local angles), intense television and radio coverage, numerous politicians jumping into the act, and scores of thousands of red shirted radical health care professionals, Moore's armies of the night, holding benefit Sicko screenings around the country on behalf of their demands for universal health care. It's hard not to see all of this as a psycho-social tsunami of major proportions presaging a potentially significant paradigm shift, one that is emblematic of an ominous new zeitgeist or meme that is making what was once unthinkable (socialized medicine in the U.S.) appear to be inevitable-while taking the American popular culture of dependency and entitlements to an entirely new level.

In recent years Moore's whimsical, semi-bumbling, aging post-punk persona, first on display in his "documentary" Roger & Me (1989), has morphed into an extremely disciplined, hard core, propaganda-spewing fellow traveler (it's an arcane term, I know, but please look it up-it applies perfectly to Moore). This is especially evident when Moore is plying his self-aggrandizing act off the big screen in numerous increasingly mainstream welcoming venues around America. His career arc into radical politics calls to mind another popular American icon, TV personality and former comedienne Rosie O'Donnell.

Fifteen years ago Moore couldn't have gotten away with going to Cuba and fictionalizing that authoritarian hell hole as a  modern, compassionate, and efficient health care paradise. Today, he not only made the trip, his depiction of Cuba (using a classic Potemkin Village stage set) as the best model for us is being taken seriously by a gaggle of leading opinion makers. That's Cuba, where the unelected authoritarian Castro dictatorship, soon to mark its fiftieth year in power, still summarily jails, tortures, and often murders people it doesn't like, according to PBS[1] and numerous other credible sources.

As
I wrote in my first take on Sicko, Moore focused his narrative on a limited number of issues, mostly involving the insurance industry and the woes of people who fell through the safety net even with insurance. (In 2004, Moore reportedly said that he would take on the pharmaceutical industry in his next film, which became Sicko,  but "Big Pharma" is barely mentioned in Sicko's final cut.) Moore brings the Sicko story to life with highly selective and emotional anecdotes featuring sympathetic Americans who have complaints about the way they were treated, and he tops everything off with more vignettes of the alleged superiority of medical care and medical care delivery, if not life itself, in France and Cuba.

These themes, and the participants, were chosen very carefully to ensure maximum resonance, but Moore consistently twists and manipulates the story. Numerous bloggers (several examples here, here, and here) and writers on the Internet, many of them with extensive experience in the health care field, are currently engaged in correcting the voluminous record of misstatements, obfuscations, distortions, omissions, and outright lies in Sicko. (One example: The film's coup de grace, where Moore takes several sick Americans-9/11 "first responder" rescue workers!-to Cuba for "free" treatment was not a spontaneous act after they had been turned away from getting help at the U.S. enemy combatant prison, Camp Delta, at Guantanamo Bay, Cuba. Rather, it is now being pointed out that Moore had made plans to go to Havana and film there all along.)

The striking images of ailing 9/11 workers crying out for help, their unsuccessful approach by small boat to the notorious Guantanamo Bay American prison (the modern day Devil's Island in many people's minds), and finally the workers getting medical treatment in Havana present a devilish combination that, if nothing else, earns Sicko a prominent place in the top tier of the motion picture propaganda hall of fame.

Individual scenes or points of contention aside, however, in a broader sense Moore completely ignores the issue of how deeply intertwined health care is with freedom-perhaps because the curtailment of liberty and freedom lies at the core of everything that Moore is proposing.
 
Mark Steyn said it well recently in National Review Online:
"Socialized health care is the single biggest factor in transforming the relationship of the individual to the state. In fact, once it's introduced it becomes very hard to have genuinely conservative government-certainly, not genuinely small government. . .  In Continental cabinets (and in Canada) the Defense ministry is somewhere you pass through en route to a really important portfolio like Health. Election campaigns become devoted to competing pledges about 'fixing' health care, even though by definition it never can be."
Adding further context, Eric Novack, M.D., a Board Certified Orthopedic Surgeon in Arizona, had this to say recently at The Health Care Blog:
"Single-payer advocates speak in broad generalities of fairness and justice and risk pools-which sounds great to the public, but is short on actual policy implementation. . . To learn about the details of single-payer advocates, you actually need to read the legislation they are promoting. Here's the basics: unelected bureaucrats are given complete control over budgets that far exceed individual state spending (i.e. in Arizona, the single-payer plan would give a 9 member unelected group complete control over a budget [$30 billion] nearly 3 times the size of the entire state budget [about $11 billion]. . . Patients are explicitly banned from paying, with their own money, for any treatment, test or service, that has not been authorized by the faceless bureaucracy. In other words, it is Medicaid for all."
But that analysis is still at the level of budgets and numbers, which can seem remote from our everyday experiences as people, patients, or "medical consumers." When single payer universal health care begins to impact you in your doctor's office, however-and that will happen sooner than later if Moore and his ilk have their way-it will be time to be really scared.

EMRs/EBM = Totalitarian Medicine

It's a seriously underreported fact, but universal health care, especially the single payer variety favored by Moore, relies on the two "E's"-EMRs (Electronic Medical Records) and EBM (Evidence Based Medicine).

In the complex matrix of government and large private interests that determines how American medicine is delivered today, the reality of EMRs is the easier of the two to understand. If EMRs are adopted, everyone in the country will, by law, be given a unique number, or "identifier," which will follow the individual from cradle to grave. The identifier, a de facto national ID, will be the key to unlock a treasure trove-a life's worth of the most private and intimate data having to do with the complete history of a person's health status and his medical care. Every American's doctor visits, every medical test and diagnosis. . . every single drug and treatment prescribed, surgery performed, sexual problem reported, incident of depression or mental illness or illegal drug use suspected or confirmed-everything!-would by law have to be recorded digitally and warehoused in government data banks forever, for the purpose of unknown numbers and kinds of current and future uses, many of the latter not even foreseen yet.

The American Association of Physicians and Surgeons (AAPS) explains "To be distinguished from a customized digital personal health record (PHR) that a patient controls, the EMR is standardized, interoperable, and controlled by the System." Privacy will clearly be a thing of the past if EMRs become standard, especially under a government-run system.

Technology is advancing at a quickening pace in this area, and is helping to drive a plethora of questionable privacy-busting implementations. On June 25, 2007, for example, according to news accounts, the American Medical Association, which has supported universal health care since 2001, "adopted a policy [link is to a Word doc file]. . stating that [implantable human RFID tags or biochips, a.k.a. "spychips"] can improve the 'safety and efficiency of patient care' by helping to identify patients and enabling secure access to clinical information."

Since it will be impossible to opt out of universal health care once it's passed into law, an important corollary to the improved identification of citizens via their EMRs is the enhanced ability, and the necessity, of tracking everyone to make sure that they are in full compliance with the new mandates. In California, which is moving ahead with legislation that will require all residents to participate in state-run universal health care, we have been given some insights into how the system of enforcement is projected to work. "The [Gov. Arnold] Schwarzenegger administration," according to the Los Angeles Times (April 11, 2007), is "consider(ing) putting teeth in its plan to require coverage for all. . .  People who refuse to obtain health insurance could be tracked down by the state or a private contractor, enrolled in a plan and fined until they pay their premiums. . . The proposal to locate people without insurance would use state or private databases and target those who lacked coverage for 60 days or more." A Schwarzenegger advisor commented approvingly, "You're going to have some people who are bad actors, and that's where you need some sort of tracking system."

To be continued.

Peter Barry Chowka, a former advisor to the NIH, is a widely published investigative journalist and medical-political analyst who specializes in reporting on the politics of health care and innovative therapies. His Web site is http://chowka.com/.


[1]     On the PBS Web site is a transcript of the 2005 American Experience documentary "Fidel Castro." If you search the page using the keyword "thirst," it will take you to several paragraphs with eyewitnesses' descriptions of the deadly brutality in Cuba's political prisons.
Part I

Michael Moore has described his new film Sicko as a "
comedy," but there's nothing funny about it. With its radical prescription for the takeover of all of American health care by the federal government, it's more like a tragedy -- a very dark tragedy that is guaranteed to lead to an unhappy ending.

Sicko, which took in an estimated $4.5 million during its opening weekend while garnering 91% positive critical reviews so far, is emerging as an unlikely catalyst for the headiest of agendas: the establishment of socialized medicine in the United States in the form of single payer universal health care. Such a wholesale paradigm shift in an area that comprises one-sixth of the nation's economy is extremely dangerous, more than anything else facing the American people today with the possible exception of another major terrorist attack. If they are enacted, Moore's and his compadres' prescriptions for American health care are sure to be deadly, not only to our individual health but to our freedom, our autonomy, and our very way of life.

The term "universal health care," reminiscent of Orwellian Newspeak, is an attempt to give a more palatable name to a concept Americans have always rejected: government-run or completely socialized medicine. Some proponents argue on behalf of health care reform "light," in which all residents are forced by law to pay for, and to prove on demand that they have, conventional medical insurance offered by private companies closely regulated by the state. Such a mandate just went into effect statewide in Massachusetts on July 1, 2007. Others advocate "single payer," in which private insurance companies, and the desire and ability of people to pay for their own care including out of their own pockets, are outlawed, replaced by a socialist government bureaucracy that provides a uniform ("one size fits all"), tightly regulated, and limited number of treatment options for everyone.

Moore and the millions of people like him who believe in socialized medicine usually deny that what they are proposing for the United States is in fact socialized medicine. Finally, in a live interview on Larry King Live on CNN on June 29, 2007, Moore used the "S" word. The set up was a brief question near the end of the program from a woman on the "King cam" who said she was concerned about soldiers coming home from Iraq and Afghanistan, and if their medical needs would be met-after which this exchanged occurred:
Moore: Oh boy, this is going to be a big problem.

King: They're covered, though, they're all, aren't they-

Moore: They're covered, but-well, they're covered, yes. The VA is actually-it's a good system of socialized medicine-

King: That's what it is.

Moore: That's what it is.
It was telling that Moore smiled broadly when he said the Veterans Administration was "a good system of socialized medicine."

Sicko's success at breaking through and capturing a lot of the public's attention and imagination, even before anyone had actually seen the film, is emblematic of Michael Moore's unprecedented visibility and influence, in both the popular entertainment culture and, not incidentally, at the highest levels of national politics. In 2004, Moore got a seat of honor at the Democratic National Convention, sitting in a box right next to former President Jimmy and Rosalynn Carter after which Moore commented that Carter "said to me, 'I can't think of anyone I would rather have sit with me tonight than you.'"

In terms of box office receipts, Moore is the most successful documentary film maker in history and he's been anointed with the usual totems of critical acclaim including an Academy Award and a Palme d'Or from the Cannes Film Festival. Yet, Moore is the kind of player who, if he didn't exist, would most likely have been invented by the system. In other words, his talent and the quality of his work are not accurate predictors of his mega success.

That success is no accident. The $148 million generated at American box offices by Moore's four earlier documentaries, and the prospects that this new one, Sicko, will continue to rake in the cash, as well, are due to their all being closely in sync with the increasingly leftward tilt of the American mainstream, particularly the media and all of the interlocked nanny state special interests. These and other stakeholders are coalescing around the enormous potential of Sicko, the latest example of Moore's pro-statist agitprop.

Paradigm Shifter

The lead up to Sicko's June 29 national roll out was a genuine phenomenon. Prior to its opening, with only a small number of reviews actually published, Sicko had already become the most hyped, and written about, movie of 2007, and possibly of the past decade. (Sorry Al Gore and Angelina Jolie, but you're yesterday's news.) The publicity campaign and its effects amounted to a uniquely intense domestic display of sensory shock and awe-and included thousands of gaga news stories (and not just cloned wire service copies, but unique articles, many with local angles), intense television and radio coverage, numerous politicians jumping into the act, and scores of thousands of red shirted radical health care professionals, Moore's armies of the night, holding benefit Sicko screenings around the country on behalf of their demands for universal health care. It's hard not to see all of this as a psycho-social tsunami of major proportions presaging a potentially significant paradigm shift, one that is emblematic of an ominous new zeitgeist or meme that is making what was once unthinkable (socialized medicine in the U.S.) appear to be inevitable-while taking the American popular culture of dependency and entitlements to an entirely new level.

In recent years Moore's whimsical, semi-bumbling, aging post-punk persona, first on display in his "documentary" Roger & Me (1989), has morphed into an extremely disciplined, hard core, propaganda-spewing fellow traveler (it's an arcane term, I know, but please look it up-it applies perfectly to Moore). This is especially evident when Moore is plying his self-aggrandizing act off the big screen in numerous increasingly mainstream welcoming venues around America. His career arc into radical politics calls to mind another popular American icon, TV personality and former comedienne Rosie O'Donnell.

Fifteen years ago Moore couldn't have gotten away with going to Cuba and fictionalizing that authoritarian hell hole as a  modern, compassionate, and efficient health care paradise. Today, he not only made the trip, his depiction of Cuba (using a classic Potemkin Village stage set) as the best model for us is being taken seriously by a gaggle of leading opinion makers. That's Cuba, where the unelected authoritarian Castro dictatorship, soon to mark its fiftieth year in power, still summarily jails, tortures, and often murders people it doesn't like, according to PBS[1] and numerous other credible sources.

As
I wrote in my first take on Sicko, Moore focused his narrative on a limited number of issues, mostly involving the insurance industry and the woes of people who fell through the safety net even with insurance. (In 2004, Moore reportedly said that he would take on the pharmaceutical industry in his next film, which became Sicko,  but "Big Pharma" is barely mentioned in Sicko's final cut.) Moore brings the Sicko story to life with highly selective and emotional anecdotes featuring sympathetic Americans who have complaints about the way they were treated, and he tops everything off with more vignettes of the alleged superiority of medical care and medical care delivery, if not life itself, in France and Cuba.

These themes, and the participants, were chosen very carefully to ensure maximum resonance, but Moore consistently twists and manipulates the story. Numerous bloggers (several examples here, here, and here) and writers on the Internet, many of them with extensive experience in the health care field, are currently engaged in correcting the voluminous record of misstatements, obfuscations, distortions, omissions, and outright lies in Sicko. (One example: The film's coup de grace, where Moore takes several sick Americans-9/11 "first responder" rescue workers!-to Cuba for "free" treatment was not a spontaneous act after they had been turned away from getting help at the U.S. enemy combatant prison, Camp Delta, at Guantanamo Bay, Cuba. Rather, it is now being pointed out that Moore had made plans to go to Havana and film there all along.)

The striking images of ailing 9/11 workers crying out for help, their unsuccessful approach by small boat to the notorious Guantanamo Bay American prison (the modern day Devil's Island in many people's minds), and finally the workers getting medical treatment in Havana present a devilish combination that, if nothing else, earns Sicko a prominent place in the top tier of the motion picture propaganda hall of fame.

Individual scenes or points of contention aside, however, in a broader sense Moore completely ignores the issue of how deeply intertwined health care is with freedom-perhaps because the curtailment of liberty and freedom lies at the core of everything that Moore is proposing.
 
Mark Steyn said it well recently in National Review Online:
"Socialized health care is the single biggest factor in transforming the relationship of the individual to the state. In fact, once it's introduced it becomes very hard to have genuinely conservative government-certainly, not genuinely small government. . .  In Continental cabinets (and in Canada) the Defense ministry is somewhere you pass through en route to a really important portfolio like Health. Election campaigns become devoted to competing pledges about 'fixing' health care, even though by definition it never can be."
Adding further context, Eric Novack, M.D., a Board Certified Orthopedic Surgeon in Arizona, had this to say recently at The Health Care Blog:
"Single-payer advocates speak in broad generalities of fairness and justice and risk pools-which sounds great to the public, but is short on actual policy implementation. . . To learn about the details of single-payer advocates, you actually need to read the legislation they are promoting. Here's the basics: unelected bureaucrats are given complete control over budgets that far exceed individual state spending (i.e. in Arizona, the single-payer plan would give a 9 member unelected group complete control over a budget [$30 billion] nearly 3 times the size of the entire state budget [about $11 billion]. . . Patients are explicitly banned from paying, with their own money, for any treatment, test or service, that has not been authorized by the faceless bureaucracy. In other words, it is Medicaid for all."
But that analysis is still at the level of budgets and numbers, which can seem remote from our everyday experiences as people, patients, or "medical consumers." When single payer universal health care begins to impact you in your doctor's office, however-and that will happen sooner than later if Moore and his ilk have their way-it will be time to be really scared.

EMRs/EBM = Totalitarian Medicine

It's a seriously underreported fact, but universal health care, especially the single payer variety favored by Moore, relies on the two "E's"-EMRs (Electronic Medical Records) and EBM (Evidence Based Medicine).

In the complex matrix of government and large private interests that determines how American medicine is delivered today, the reality of EMRs is the easier of the two to understand. If EMRs are adopted, everyone in the country will, by law, be given a unique number, or "identifier," which will follow the individual from cradle to grave. The identifier, a de facto national ID, will be the key to unlock a treasure trove-a life's worth of the most private and intimate data having to do with the complete history of a person's health status and his medical care. Every American's doctor visits, every medical test and diagnosis. . . every single drug and treatment prescribed, surgery performed, sexual problem reported, incident of depression or mental illness or illegal drug use suspected or confirmed-everything!-would by law have to be recorded digitally and warehoused in government data banks forever, for the purpose of unknown numbers and kinds of current and future uses, many of the latter not even foreseen yet.

The American Association of Physicians and Surgeons (AAPS) explains "To be distinguished from a customized digital personal health record (PHR) that a patient controls, the EMR is standardized, interoperable, and controlled by the System." Privacy will clearly be a thing of the past if EMRs become standard, especially under a government-run system.

Technology is advancing at a quickening pace in this area, and is helping to drive a plethora of questionable privacy-busting implementations. On June 25, 2007, for example, according to news accounts, the American Medical Association, which has supported universal health care since 2001, "adopted a policy [link is to a Word doc file]. . stating that [implantable human RFID tags or biochips, a.k.a. "spychips"] can improve the 'safety and efficiency of patient care' by helping to identify patients and enabling secure access to clinical information."

Since it will be impossible to opt out of universal health care once it's passed into law, an important corollary to the improved identification of citizens via their EMRs is the enhanced ability, and the necessity, of tracking everyone to make sure that they are in full compliance with the new mandates. In California, which is moving ahead with legislation that will require all residents to participate in state-run universal health care, we have been given some insights into how the system of enforcement is projected to work. "The [Gov. Arnold] Schwarzenegger administration," according to the Los Angeles Times (April 11, 2007), is "consider(ing) putting teeth in its plan to require coverage for all. . .  People who refuse to obtain health insurance could be tracked down by the state or a private contractor, enrolled in a plan and fined until they pay their premiums. . . The proposal to locate people without insurance would use state or private databases and target those who lacked coverage for 60 days or more." A Schwarzenegger advisor commented approvingly, "You're going to have some people who are bad actors, and that's where you need some sort of tracking system."

To be continued.

Peter Barry Chowka, a former advisor to the NIH, is a widely published investigative journalist and medical-political analyst who specializes in reporting on the politics of health care and innovative therapies. His Web site is http://chowka.com/.


[1]     On the PBS Web site is a transcript of the 2005 American Experience documentary "Fidel Castro." If you search the page using the keyword "thirst," it will take you to several paragraphs with eyewitnesses' descriptions of the deadly brutality in Cuba's political prisons.