WASHINGTON -- In many respects, Michael Moore's new movie, Sicko, is like a trial for those who oversee healthcare in the United States.
The industry -- doctors, drug makers, hospitals, insurers -- is charged with greed and putting personal interests above patients'. Moore heard from thousands of people who had maddening and heartbreaking brushes with this system.
As chief prosecutor, Moore lets them do most of the talking and weaves their stories into the film with wit, compassion and humor.
But one aspect missing from the film is the defense.
Do not expect to hear anyone speak well of the care they received in the United States.
On the other hand, patients and doctors from Canada, Britain, France and Cuba marvel at their healthcare.
Moore tells viewers there are about 50 million people in the United States without health insurance.
In the last week of June, the Centers for Disease Control and Prevention estimated there were about 43.6 million uninsured people in the country. In March, the Census Bureau put the number at 44.8 million.
Moore noted that about 18,000 people die each year as a result of the lack of health insurance.
That number comes from a January 2004 report from the Institute of Medicine. The report said the uninsured do not get the care they need and are more likely to die prematurely.
Taking on the pharmaceutical industry, Moore says it spent millions of dollars lobbying Congress for a Medicare prescription drug benefit. ''Of course, it was really a bill to hand over $800 billion of our tax dollars to the drug and health insurance industry,'' he said.
MEDICARE DRUG COSTS
Moore is citing the projected cost for the Medicare drug benefit's first 10 years.
Last year, however, Medicare officials told The Associated Press that the projected cost of the benefit through 2015 stood at about $729 billion, a substantial drop compared with original estimates.
Moore also noted that the some of the elderly in the drug program could end up paying more for their prescriptions than they did before.
That is true. But the vast majority do save because of the tens of billions of dollars in annual government subsidies to help cover the cost of their medicine. The Centers for Medicare and Medicaid Services says people save about $1,200 a year on average by participating in the program, called Medicare Part D.
At one point, Moore notes where the United States ranks in terms of healthcare around the world. ''The United States slipped to No. 37 in healthcare around the world, just slightly ahead of Slovenia,'' he said.
That ranking is based on a 2000 report from the World Health Organization that some health analysts viewed as misleading.
Moore does not say that one of the countries he highlighted, Cuba, is ranked 39th, below the United States. Among the others, France is ranked No. 1, the United Kingdom ranked 18th and Canada ranked 30th. He does not give those rankings, either.
The report, based on 1997 data, measured not just the quality of care provided, but how well the countries prevented illness and how fairly the poor, minorities and other special populations are treated.
Moore's film includes security video showing a disoriented elderly woman in a hospital gown and slippers wandering in the gutter of a busy Los Angeles street. Kaiser Permanente Bellflower Medical Center near Los Angeles had discharged her and sent her off in a cab. Eventually, a staff member from the Union Rescue Mission in the city's crime-ridden Skid Row area comes out to help the woman.