Monday, July 16, 2007

Review: SiCKO + Charles on Harry Potter + Baldwin Hills

The other day, C and I went to see Academy Award-winning documentary filmmaker Michael Moore's new cinematic polemic, SiCKO. Having seen all of Moore's major documentaries--from 1989's Roger and Me to the pre-2004 election jawdropper Fahrenheit 911--I already possessed a strong idea of how Moore was going to present his argument formally and thematically, yet I was eager to see specifically what he devised. Despite the occasionally shopworn feel of Moore's shtick, SiCKO is a compelling and at times wrenching film; it's also a necessary addition to the public discourse both about our health care system and about our democracy more broadly. It succeeds in showing, with convincing accuracy (according to several independent reviews I've read), how abysmal--which is putting it mildly--the American private health care system is for those who have health care, but who aren't among the rich or well-covered by government health care plans. Moore very well could have focused on the 50 million or so who have no health care, a population larger than Spain, Canada or Australia, but instead, he looked at the system that the current administration, our Congress, and the insurance and pharmaceutical industry, along with right-wing ideologues and far too many "centrists" not directly attached to any of these institutions, are so determined to keep in place. Moore shows repeatedly how the US's intricate profit-driven health system, whose specific origins he locates at one point in a deal Richard Nixon cooked up after chatting with Edgar Kaiser of the Kaiser Permanente HMO conglomerate, and the decisions such a system entails, conflict, horribly in so many cases, with the ostensible goals of the medical profession and of a self-sustaining, healthy and caring society. Whether it's denying sick patients service because they're "out of network" (somtimes resulting in the patients' death), or trying to game and con and fend them off with the hope that they'll die before they figure out what's going on, or hiding options with the aim that they won't be used, or dumping ill people on the street to save money and then lying about doing so, Moore portrays the ethical rot, duplicity and inhumanity that are endemic, all in the name of funneling more dollars into corporate health care titans', shareholders' and their Congressional lackeys' pockets.

Using his typical set pieces, Moore contrasts the American system with those in Canada, the UK, France, and, to the consternation of those on the right and a number of mainstream media critics, Cuba, to show that in wealthy peer countries, as well as in the small, extremely poor, Caribbean nation, people not only receive equal or better treatment than our far more costly, often inadequate offerings, but pay little to nothing in direct fees, either for treatment or for medicine. In the case of Canada or Britain, the often decried waiting periods, Moore suggests, are no longer than many patients experience in the US, and in the case of France, which has one of the best health care systems in the world, the added benefits are so extensive that they may lead some to book a one-way ticket for Paris when they leave the theater. Moore does engage in a stunt when he takes several former 9/11 responders to the gates of Guantánamo Naval Base to see if he can get the same free, allegedly excellent treatment for them as the prisoners interned there, but this bit ends quickly and doesn't detract from the overall film; instead, it poses the absurd question of why people who have been (falsely in far too many cases) been deemed by W to be "the worst of the worst" terrorists we face are receiving medical care superior not only to "heroes," but to millions of Americans.

There was little in terms of the film's content, both horror stories and the positive aspects of the foreign health care systems, that I wasn't already familiar with, save the extent of France's social benefits, which verged at points on the fantastic--someone to do your laundry while you're out on maternity leave? That didn't blunt the cumulative effect of seeing so much easily preventable suffering and inhumanity. Why should citizens (or anyone) living in the richest country on earth have to choose which finger to have reattached or plead to have an ill child seen by a competent physician or lose their home and become penniless because of an illness? Why should 50 million people have almost no options whatsoever? Moore's film ultimately underlines how unconscionable and untenable our current system is, and how radically it needs to be changed. A fully funded single-payer system that emphasized prevention, and in which people could also purchase private care, seems to be the best option. But we can't have anything like it if we keep allowing our representatives to enable disastrous policies like the Iraq War.

In terms of specific criticisms, I wish that Moore had featured the experiences of people living medium-sized cities and rural areas in the foreign countries he visited. London and Paris are national capitals, and Toronto is Canada's largest city (though he did venture out to London, Ontario), but what would sorts of services and amenities would be available to people in Blackpool, Toulon, or Saskatoon? In terms of Cuba, would the kinds of excellent, free service Moore's troop received be an option for any non-Cuban? And what about in the even poorer parts of the country outside the capital city, Havana? I also wish he'd featured a few more comparison-style charts to make some of his points as clear as possible, and even incorporated a short debate between a proponent of our current broken system and someone who was advocating something better, fairer and more humane. Finally, Moore presented no solutions--except through implication--and the fact remains that each of the competing foreign systems he cites has its pros and cons, the major con being the kinds of higher taxes that a portion of this country's opinion makers congenitally rail against. (Unless, of course, they're paid by the lower middle and working classes.) Those critiques aside, SiCKO is one of the more powerful rhetorical weapons in the battle to improve our health care system; it will not be simple, because the opponents have both the money and the power, but it must and eventually will be done.

Addendum: Princeton economist and New York Times columnist Paul Krugman once again clearly lays out the problems today.


I'm going to confess that I have not finished even one of J. K. Rowling's Harry Potter books. I attempted to read the first one some years after C, who's read all of them, was starting on the fourth or fifth one, but I think I just wasn't in the right mood or mode. Though I rarely read young adult fiction, the narrative itself was enjoyable enough. But I only made minimal progress before putting it down and picking up--who knows what? A large percentage--a majority?--of my students have read all of them, however, so I consider my having not finished even the first to be a bit of a lacuna. (A year and half ago I completed Susanna Clarke's huge and deeply magical Jonathan Strange and Mr. Norrell, and earlier this month I finished Philip Pullman's superb His Dark Materials trilogy, which several students had been touting, earlier this month, but neither Clarke's magicians nor Pullman's "new Eve" Lyra Belacqua is the beloved teen wizard Harry Potter.) I still, however, believe that Rowling's series is a major achievement, and one of these days, I will get around to it (just as I will read more of Proust's A la recherche du temps perdu beyond Swann's Way (A Côté Chez Swann), for example). Everyone I know who has read the books rhapsodizes about them--well, everyone except my former prof Harold Bloom, who went into extreme contrarian mode about the texts, though he exacted no damage to Rowling.

Bloom, it appears, is not alone. As the fifth installment of the film series (most of which I've seen and enjoyed) dominates box offices and the seventh and final (?) volume is set to appear this upcoming week, Washington Post critic Ron Charles issues a note of dissent, entitled "Harry Potter and the Death of Reading." He has tired of the novels and is glad that his daughter has too. He also sounds off about the saddening state--well, for writers, readers and lovers of the literary arts--of the blockbuster book business in this country, lamenting that the series have hardly succeeded in cultivating reading, not only among children, as various people have claimed since the first volume appeared, but among the series' many adult readers.

To quote Charles:

In "The Long Tail," Wired editor Chris Anderson suggested that new methods of distribution would shatter the grip of blockbusters. Niche markets would evolve and thrive as never before, creating a long, vital line of products from small producers who never could have profited in the past. It's a cheering notion, but alas, the big head still pretty much overrules the long tail. Like the basilisk that terrorized students at Hogwarts in Book II, "Harry Potter" and a few other much-hyped books devour everyone's attention, leaving most readers paralyzed in praise, apparently incapable of reading much else.

According to a study by Alan Sorensen at Stanford University, "In 1994, over 70 percent of total fiction sales were accounted for by a mere five authors." There's not much reason to think that things have changed. As Albert Greco of the Institute for Publishing Research puts it: "People who read fiction want to read hits written by known authors who are there year after year."

So we're experiencing the literary equivalent of a loss of biodiversity. All those people carrying around an 800-page novel looks like a great thing for American literacy, but it's as ominous as a Forbidden Forest with only one species of tree. Since Harry Potter first Apparated into our lives a decade ago, the number of stand-alone book sections in major metropolitan newspapers has decreased by half -- silencing critical voices that once helped a wide variety of authors around the country get noticed.

That's only a snippet; do check out the entire article.

Update: Audiologo, in the comments section, pointed out this Motoko Rich NY Times piece about Harry Potter's limited effect on children's reading.


After years of drifting by mostly on toxic videos, Comic View, a handful of films, recycled news, infomercials, and a few series (like College Hill), Black Entertainment Television (BET), now part of the Viacom behemoth, is set to introduce a host of new shows, according to its entertainment president, filmmaker Reginald Hudlin. (One that has yet to appear, Hot Ghetto Mess, is already provoking a media firestorm, with sponsors pulling out and critics decrying what they see as yet another opportunity for negative stereotypes and portrayals.) We caught one of the first offerings, Baldwin Hills, a new reality show set in Los Angeles's eponymous, upper-middle-class Black neighborhood. For whatever reason--skimming, rather than reading the New York Times article, most likely--I thought the show was going to be a dramatic series covering a wide range of characters, but in fact it focuses on a cohort of very attractive teenagers and young adults primarily from Baldwin Hills, along with one or two from the nearby, rougher neighborhood of Crenshaw, whose lives intersect with the Baldwin Hillites. The young people's parents make brief appearances, but the emphasis is on the 18-to-20 somethings.

All of the participants, who fill out the usual reality show "types," are appealing, have good heads on their shoulders (to trot out that tiresome cliché) and, as far as I can tell, none appears headed for the kinds of violence-laden drama that has become a feature of College Hill. We see generous dollops of real bourginess (one young woman, Garnette, I automatically labeled a future head of Jack and Jill), but given the usual representations of Black people, particularly Black youth, on TV, I'm not complaining. What I most liked about the show, which I may or may not watch again, is how self-conscious everyone--except actress Vanessa Bell Calloway, mother of one of the young women--is before the camera. These young folks, as much as they've grown up in a media-saturated environment, still make it clear, through awkward pauses, self-monitored statements, and so on, that they know the world is watching. And as young Black middle and upper-middle-class people, no matter how much they refer to "pimping" (which one character, thankfully, described as a negative thing) or sass back at their parents (and there's a surprising, at least for me, amount of that), they still are aware of the need to act like they have home trainingand good sense. I.e., respectable. Everything changes, but at least among these denizens of Baldwin Hills, less so than the media might lead us to believe.


  1. John, Charles comments touches on some of the issues raised in Motoko Rich's NYT article, Potter has limited effect on reading habits. I will admit I've read each successive installment, as well as the Pullman trilogy. The latter collection is definitely much more complex, better written, with more richly drawn characters, and, with WWII-impacted British sensibility, doesn't pull punches with the horrors that can befall children. That last element, along with its solid footing in literary fiction, may be why the Pullman series hasn't caught on like gangbusters in the U.S. It certainly has none of the (pseudo-British) dry witted, tongue-in-cheek approach to serious issues found in the Lemony Snickett books. I haven't seen any BET shows in a long while (I've been forgoing cable), but have looked at the Hot Ghetto Mess website where some of the Hot Ghetto Mess of the Month photos actually left me speechless. If the young adults on Baldwin Hills have taken a look at that site, plus been inculcated with years of reality TV formula, then it's not surprising they're self-conscious; one of them is due to be cast as the "unstable drama king/queen". Since "black" is often portrayed as synonymous with that title already, wouldn't that be like being cast as the absolute monarch of instability? And really, who wants that title? Thanks for reminding me of the Peskine show. I read about it at Code Z (formerly Electric Skin), but had forgotten to make plans to go.

  2. Audiologo, I did see Rich's article, but since it was focusing primarily on children's reading, I didn't blog about it, but I will add it as an update. I haven't read the Snickett books, but I know they're also very popular. Pullman's books strike me as perhaps too philosophical for some readers (and too advanced for a number of young adults--I think of the children I taught some years ago), though that may change if the movie starring Kidman and Daniel Craig is a success. Still, all three of books present formidable challenges in terms of the content, not just in terms of children's mortality, but also in terms of the overt critique of Christianity and power relations.

    I'm not sure if the Baldwinhillites have seen Hot Ghetto Mess, but it's clear that they do possess a certain level of propriety as well as a wariness--or at least consciousness--that they're being broadcast to a wide array of people, and--perhaps I'm reading too much in here, though given what I've seen of the parents, I doubt it--they have not only the race's, but their CLASS's reputation to...uphold? At least not sully in the way that that other show, and far too many on TV (which as you note, do always have to find a black "unstable drama king/queen" (or several), have done. (Real World, beginning with Kevin Powell's derangement during its first season and continuing on through today, comes immediately to mind.) Does that make sense? The politics of black upper middle-class racial respectability are not dead, at least among this crowd.

  3. John, as a healthcare executive and Canadian citizen, this is definitely my pet peeve and soapbox. Watching Sicko against the backdrop of the current US healthcare crisis was definitely not a pleasurable feeling. I applaud the fact that Moore brings back healthcare as a major focus in the public debate and he's essentially on point with his analysis of the issues (his polemic style however, remains an acquired taste...)

    However, his implied solution(s) and the portrayal of other nations' healthcare systems as superior, is more counterproductive than helpful. I can assure you that Canadian healthcare is in as much of a crisis as the US', for different reasons and with different results. The fact remains that - as individuals - receiving our "bang for our buck" is as much an elusive concept as it is for Americans.

    As buzz phrases like "single payer", "socialized medicine", and "universal healthcare" get tossed around without proper definition or context, what is needed is a comprehensive "apples with apples" comparison of various jurisdictions, how they fund healthcare, how it is delivered to its citizens, and what the major issues in these approaches are. As much as Moore touts Canada, France, and even Cuba as virtuous models, the fact is that all systems struggle with exploding costs and sustainability.

    In the end, US healthcare is a result of societal priorities. Much like gun laws and tax allocation, the US laws reflect what Americans value most: individual versus societal benefit; personal gain over communal well-being. Before solutions from foreign countries are proposed, healthcare needs to consider how much US society as a whole would have to change for alternate solutions to gain ground. As painful as the current US healthcare crisis is, I believe the actual pain inflection point has not yet been reached.

    Just think about it: why is it that, for example, the auto and home insurance industry is much more tightly regulated, transparent and consumer-focused? nobody challenges that everyone who drives a car requires insurance. At the same time, consumers drive prices down by being able to comparison-shop for the cheapest rates and the best service.

    What and who is preventing consumer-focus, price transparency and healthy competition to happen in the US healthcare industry? How can healthcare be put back into the hands of patients? The answer lies not in looking abroad, but in looking at what works at home and and what won't.

  4. Zun, your points are excellent. I agree that we haven't yet reached the terminus at which people will begin demanding changes to the health care system at threat of revolt, but we're getting there. One of the reasons I wish that Moore had explored foreign systems outside the national capitals--or asked more questions about Cuba's treatment of foreign patients--is that I felt we might have seen more complications in the smooth narrative that Moore presents. Or maybe not. But I can easily imagine--and in the case of Britain, am quite aware of--some of the crises other wealthy nations' national health care systems are facing. The fact remains, however, that the US system is the costliest and yet it not only doesn't cover everyone, but badly covers quite a few people who do have health care insurance. One recourse that so many turn to in arguing this fact is personal anecdotes, but system-wide studies have shown that the US health care system is in bad shape, and it needs to be not just restructured, but rethought and rebuilt, sooner rather than later. Perhaps foreign systems are not the model to follow, but they may offer some guides--I'm not an American exceptionalist and I don't believe that this country has the answers to all its problems, even if only we who live here are the ones who can implement them.

  5. John, excellent observations with which I fully concur. I totally agree that the state of healthcare is a shameful scar for the US. How can the wealthiest nation on this earth spend more than any other industrialized country on healthcare with such poor coverage and outcomes for its citizens?

    Unfortunately, healthcare is not widely seen as a basic human right but is more and more becoming a service commodity for those who can afford it. The "fix", as badly as it is needed, cannot come from a humanitarian or fairness perspective. This has never worked and will never fly in the US. Ask any American about universal coverage and you will more often than not hear "why should I pay for some loser's healthcare when I can barely affors my own?" The fact that, once everyone contributes into a single pot, costs for individuals will actually come down is darn near incomprehensible to most.

    The answer will be an economic one: Healthcare needs to be restructured so as many people as possible can lead healthy productive lives (i.e. contribute to economic output versus being sick), employers' crushing financial burden is lifted, healthcare providers can deliver efficient services and the US economy as a whole can stay competitive globally. When GM spends $1000 per car on employee healthcare versus Toyota's $100 per car, the math ain't about healthcare it's about economic viability.

    The problem with US healthcare is that SOME stakeholders benefit hugely from this status quo, and those players keep lobbying hard to keep this current system alive.

    Deep down, I really wish it were about true fairness and patient-focus. I believe a certain moral obligation should be at the core of any serious discussion. But I'm also a pragmatist.

    I'm sure we can fill a whole evening on this topic :)

  6. OK, I won't even go into the intersection between healthcare, race and poverty here. Sliding off my soapbox...