AFTER ‘SICKO’

Michael Moore’s “Sicko” is an important movie. Not because it is objective. It isn’t. And not because it is fair and totally accurate. It isn’t those, either. It is important because it has found a way to energize the public debate on the future of the American system of health care.

Mr. Moore, striding through the film in his lumpy jacket and baseball cap, makes a case for universal, single-payer health care. He interviews desperate Americans who have felt cheated and mistreated by the American system, and happy customers of government-run health systems in Canada, Britain and France. He notes American postal service, fire protection, water service and libraries – as well as Medicare, Medicaid and the Veterans Health Care Service are all publicly supplied and supported by taxes and asks why not complete health care for everyone.

Most politicians have never given serious consideration to single payer because of the relentless lobbying against it.

Per capita cost in those countries with single payer is about half what Americans pay, and the United States lags behind in basic measures of excellence like life expectancy, infant mortality and childhood obesity.

We continually hear that the United States has the finest health care system in the world, whereas the World Health Organization in 2000 ranked it 37th among all nations, France being the first.

Scare words and propaganda are not the right tools for solving America’s health care crisis. Decision time is here, with 44 to 46 million uninsured and mounting criticism of the present system. An angered public complains of rising costs of health insurance, co-pays, deductibles and threatened loss of benefits. Many doctors complain about the red tape, paperwork and obstruction by insurance clerks. Business, large and small, suffers from the growing cost of health benefits and the burden of an outmoded linkage of health care with employment.

What’s needed is a factual, credible comparison of the present health system in this country with those of, say, Canada, Britain and France. Advocates and opponents of a single-payer plan have both argued their positions extensively.

We have masses of material by Physicians for a National Health Program promoting its goal of a single-payer national insurance plan.

We have ideological pressure groups crying “Socialism!” and the insurance and big drug companies in opposition.

To make a good judgment, we could use an up-to-date comparison of costs, waiting times, measures of excellence, pay of doctors and nurses and other professionals, together with, if possible, an appraisal of public satisfaction and dissatisfaction.

And we need them in a form that almost all Americans can readily understand. A movie, say.