Director: Michael Moore; Release date: 26 October
Michael Moore's latest film is a call to arms against the US healthcare system - or rather the lack of one. It makes explicit how this profit-driven industry causes insecurity and suffering for millions of Americans, and routinely leads to unnecessary deaths.
US healthcare is funded by private insurance companies with only a fraction of the most vulnerable - children, the elderly and disabled - qualifying for healthcare under Medicaid.
The film opens with a self-employed man attempting to stitch together a deep wound in his own knee. He is one of the 50 million Americans with no health insurance or inadequate cover to fund much needed treatment. Everyday stories like this make for a powerful and shocking film.
Moore's film strips off the layers of a healthcare system which George Bush describes as "the best in the world", and illustrates what a cynical business it is. It's difficult to get insured in the US. Companies reject people who are underweight or overweight, have chronic conditions like asthma or diabetes, or have a mental health diagnosis. A whistleblower from the industry says that "the list could wrap around this building".
Many of those covered by an insurance scheme only discover once they seek medical treatment that the company absolves itself from funding much of it. This has nothing to do with medical need. A woman is denied chemotherapy because the insurance doesn't cover intravenous drugs (the only way to deliver it). A toddler dies in a county general hospital because the company insist she has to wait to be transferred to an "approved hospital" to receive treatment.
A former high-flying doctor in an insurance company, paid to vet claims for treatment, publicly testifies that bonuses and promotion are based on the individual's record in denying medical claims. Any decision to actually pay out for treatment is declared as a "medical loss".
In the event of payment being agreed, yet another layer of people exist to try to recoup it. These are investigators "sent out as though it was a murder case", says one, to find something in the individual's history to discredit them and justify reversal of the decision. This could include a minor ailment years ago, for which they did not seek medical attention but for which others might have.
Moore moves on, via a bizarre and ambiguous comparison with the free healthcare offered at Guantanamo Bay, to comparisons with European healthcare systems. These may be somewhat idealised, but this seems forgivable in the context of the point he is making about the historical differences in approach to healthcare. He highlights the importance of the labour movement in defending the welfare state in Britain and France. He also ridicules, in his usual style, the US propaganda which has likened socialised healthcare to communism.
This is not simply a documentary. It has become a focus for organisation. When it opened in the US nurses' unions leafleted outside cinemas. Sicko has begun to provide a lightning rod for all those who want to fight for universal healthcare. We should use the film in the same way here to intervene in the debate about NHS funding, to oppose the Labour government's creeping privatisation, and to mobilise all those who want to keep the NHS in public hands.