"I think that one of most notable things was how universal the response was, no matter which city we went to," said Jan Rodolfo, a CNA member and nurse at the Alta Bates Summit Medical Center in Oakland, Calif., who traveled across the country on the bus.
In Los Angeles and Washington, D.C., said Rodolfo, the first five rows of the theater were reserved for nurses, and in New York, the CNA members escorted Moore into the theater and stood with him as he introduced the film. "In every premiere, there were people weeping," she said. "And when the film was over, there were people walking out of the theater, just demanding to know what they could do to change things."
According to the CNA, at least 10,000 nurses have signed up to help in a campaign to win legislation from Congress creating a "single-payer" system that would cut out private insurance companies, and expand a vastly improved Medicare system to cover every person in the country.
"There were huge numbers of nurses, in particular, coming out in the different cities, who had never been involved in unions or health care reform activism before, and who were just beyond excited to be there and wanting to get involved for the first time," Rodolfo said.
The impact of the movie was felt beyond the theaters where the activists turned out.
A movie reviewer in Dallas--the heart of Bush country--described how he emerged from the bathroom after a screening to find that "[t]he entire Sicko audience had somehow formed an impromptu town hall meeting in front of the ladies room...[H]ere these people were, complete strangers from every walk of life, talking excitedly about the movie. It was as if they simply couldn't go home without doing something drastic about what they'd just seen."
The meeting ended, said the reviewer, with an exchange of e-mail addresses and plans to "get together and do something...It was like I was standing there at the birth of a new political movement."
SICKO IS perfectly made to give form to the simmering bitterness with U.S. health care system. Its focus is on the victims of the system--in particular, people who thought they were fully covered, but discovered they really weren't when they needed it.
That's a familiar story--as Moore learned when he made an appeal on YouTube for people to reach him with their "health care horror stories." In the first 24 hours, he got than 3,700 responses. More than 25,000 people had contacted him by the time a week had passed.
People often live through their own health care nightmares without a sense that the system is a source of frustration for millions of other people throughout U.S. society. Sicko is changing that.
Politicians of both parties are alert to the discontent. But their rhetorical flair in sympathizing with victims of the health care system hasn't been matched by action.
The latest mantra among politicians of both parties is "universal health coverage." Republican presidential contender Mitt Romney claims he achieved it with a Massachusetts law passed while he was governor, and Oregon's Democratic Sen. Ron Wyden says this is the goal of his Healthy Americans Act, proposed in Congress late last year.
But in reality, these bipartisan proposals would be a cash cow for the insurance industry--and would worsen the health care crisis facing working people.
In Massachusetts, for example, Romney's "universal coverage" proposal requires all residents to be signed up with a health insurance plan by the beginning of this month, or face a stiff penalty on state income taxes. On the other hand, fines for companies that don't meet requirements for providing health coverage for employees are a drop in the bucket.
The effect of the law will be to undermine the already ailing employer-provided insurance system, while driving the uninsured into stripped-down insurance plans, with high deductibles and out-of-pocket costs--the very plans that Sicko took special aim at.
Instead, Sicko stakes out the case for a real alternative--a single-payer system that eliminates private insurance and covers everyone.
That's created an awkward situation for the leading Democratic presidential candidates, who have put forward health care proposals that, on closer look, have a lot in common with the "universal coverage" shell game. As the Los Angeles Times reported, Hillary Clinton, Barack Obama and John Edwards "all have staked out positions sharply at odds with Moore's approach. But none of them is eager to have that fact dragged into the spotlight."
The liberal Internet network MoveOn.org tried to blur the differences between Moore's call for fundamental change and the Democrats' proposals.
"Several 2008 candidates--John Edwards, Dennis Kucinich, and Barack Obama--have plans to guarantee affordable health care for everyone with a public insurance option," MoveOn said in an e-mail to members. "These are the most forward-thinking proposals ever seen in a presidential race."
But only Kucinich supports single-payer legislation. Edwards' and Obama's plans fall short of "guaranteeing affordable health care for everyone."
As for these being the "most-forward thinking proposals ever seen in a presidential race," Democrat Harry Truman backed a far more radical national health insurance plan in his 1948 presidential campaign, and for decades after, Democrats regularly affirmed their commitment to this goal--though they didn't do much to work toward it.
On its bus tour, the CNA challenged not only Democrats but other unions that have made concessions to the health care industry, rather than commit to a single-payer proposal.
CNA Executive Director Rose Ann DeMoro accused the Service Employees International Union (SEIU) in particular of giving cover to politicians who refuse to support legislation for a single-payer system. "[I]t makes [the politicians] look like they are accomplishing something when in fact they are accomplishing nothing," DeMoro told the Corporate Crime Reporter.
The proposals put forward by Clinton, Edwards and Obama are the product of 30 years of retreat and rightward shifts in official Washington politics.
By contrast, ordinary people are clearly ready for much stronger measures. According to a CNN poll in May, 64 percent of people said they thought the government should "provide a national health insurance program for all Americans, even if this would require higher taxes." A New York Times/CBS poll in February found that six in 10 people were willing to pay higher taxes so that everyone had insurance.
According to the Public Policy Institute of California, its survey found that "by a two-to-one margin, most prefer 'a universal health insurance program in which everyone is covered under a program like Medicare that is run by the government and financed by the taxpayers' nationally to 'the current health insurance system in the United States, in which most people get their health insurance from private employers, but some people have no insurance.'"
As Rodolfo pointed out, "The public in general in the U.S. is ready for some kind of universal health care, but it isn't clear enough about what that needs to look like." If a case isn't made for a genuine alternative, she said, it's easy for people to be pulled toward one of the more "realistic" proposals.
"[M]y sense is that up until this movie came out, you could be Hillary Clinton or Barack Obama or John Edwards--or even Rudolph Giuliani or Mitt Romney--and be out there talking about supporting universal health care, and the folks you're talking to weren't looking for a distinction in terms of what that actually meant," Rodolfo said.
"So my hope now is that any time one of these politicians stands up and advocates for health care reform that would expand the private health insurance industry, people are going to stand up and go, wait a second, the health insurance industry is the problem, not the solution.
"I'm hoping that the movie is going to bring a new consciousness about the role of insurance companies, in particular, as the root of the problem, and it will really refocus things on single-payer."
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THE SINGLE-payer legislation sponsored by Reps. John Conyers and Dennis Kucinich is a stark contrast to the half-measures and concessions to industry floated by other politicians.
Known as HR 676, it would create a comprehensive system under which everyone--all U.S. residents, regardless of immigration status, from cradle to grave--is covered by a single, government-administered health program. The proposal would forbid "a private health insurer to sell health insurance coverage that duplicates the benefits provided" under the government system.
The bill would allow a mix of private and public health care providers, but all private companies would have to convert to not-for-profit status--though over a too-generous 15-year "transition" period.
Estimates of funding for the program are $1.9 trillion a year--to be raised through the already existing Medicare tax on employees and employers, an additional payroll tax on employers (which nevertheless would still pay less per worker for health care than under the current system), and increased taxes on the wealthy and big corporations and banks.
Mainstream politicians claim that a single-payer system is a pipe dream--and that their "universal coverage" proposals are more "realistic."
But the problem, as Sicko makes clear, is built into the fabric of a privatized system. As Nation reviewer Christopher Hayes put it, Sicko shows why "if single-payer is ever going to come to America, it's going to be over the insurance companies' dead bodies."
A single-payer system would be only a first step toward truly rational health care. For example, though the government system would negotiate a better deal on drug prices, pharmaceutical companies would remain private. And in other countries with national health care, any restrictions in coverage have served as the means for private insurers to undermine the state system by "supplementing" it.
But a single-payer system in the U.S. would be a huge advance. Above all, it would establish in the U.S. the principle that exists in other industrialized countries--that health care is a right, guaranteed to everyone. The fundamental priority, as left-wing British Labour Party leader Tony Benn says in Sicko, "is solidarity."
The health care industry won't give in without a sustained struggle--one that organizes health care providers as part of a broader political mobilization to demand change.
It will take more than a movie to win the kind of dramatic change that's needed to begin fixing the American health care system. But this movie--along with the efforts of the activists who greeted viewers outside the theaters with information on how to get involved--could be the first spark of a new movement.
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