This week alongside all the usual horror movies that get shown for Halloween, another ‘horror’ movie opened on cinema screens here in the UK – Sicko, the new film from Michael Moore.

First off, if your usual choice of cinema snack is a hot dog, particularly with ketchup, I’d seriously suggest something else for going to see this film. The opening sequence is an internet video of an American, who not having health insurance, decides to sew up a gash in his own knee. This gets followed up by a guy who, having cut the tops off two of his fingers with a table saw and again not having health insurance is told that it will cost $12,000 to reattach one finger, and $60,000 to attach the other – he opts for the $12,000 finger and the other one gets binned… But then it transpires that the film is not actually primarily going to be about people without health insurance, the main topic of the film is the people who have health insurance and can’t get treated either!

By way of comparison during the movie, Moore compares the situation in the USA with other countries in the world. The USA is pretty well unique in that it spends a larger proportion of it’s resources that anywhere else on healthcare, but according to a WHO report ranks only 37th. The choices of comparison though are interesting, starting with Canada – a system with which Beth is of course familiar, moving on to the UK with which I grew up, then taking in France, and finally finishing off with Cuba.

Perhaps the first comment I think both Beth and myself would make is that the film does portray both the Canadian and British health systems in a universally positive light. Certainly there is no talk of the multitude of stories about the British NHS in the press. Having said that, when you compare it to some of the horror stories from people in the US you realise that the basic fact that in the UK you’re not generally going be landed with a bill for a hospital stay, or visiting your doctor you realise that Moore is really showing basic principles, and is focusing on the core message, which is that all these other places manage to have affordable, accessible medical care for their people, but the US can’t.

I guess as we’re within the system, we probably become a bit blasé about the fact that when we can just go and see our GP, or even get taken to hospital in an ambulance without having to worry about the cost.

When Moore was putting the film together, he put out a request on his website for any healthcare stories and in return got tens of thousands of replies. Amongst those featured are a couple where the husband had multiple heart attacks and then the wife went down with cancer. Although they had medical insurance, they still had to pay an excess on each claim, and that ultimately has resulted in them having to sell their house. There are also people who on being rushed unconscious to a hospital after a car accident received a bill for the ambulance because she didn’t pre-clear the journey with her insurance company. There were also a number of examples of people whose treatment was denied by the medical insurers for a variety of reasons including technicalities over the initial medical forms. There were several people featured whose relatives had died – in one case a child with a seizure who having been rushed to the closest hospital was refused treatment because it wasn’t on the approved list from the insurance company. By the time the child was transferred to an approved hospital she was dead.

The finale of the film looks at the problems that some of the volunteer workers clearing up after the September 11th attacks have suffered – initially the government only agreed to fund medical treatment for those on the government payroll. Even though there is now a fund to support these volunteers the programme showed several who are suffering particularly breathing problems after working on the site, and who are struggling to make ends meet. From there, the film highlighted the level of care that is being given to inmates in Guantanamo Bay, and then went on to show the medical services that the average Cuban receives.

Certainly Moore could be accused of portraying the US system largely negatively, alongside a strongly positive portrayal of the Canadian, British, French and Cuban health systems. But even if you watch the film knowing that, and being aware of some of the issues in the other systems shown, you cannot fail to be shocked and disturbed by the state of healthcare in the USA. It also serves as a salutary lesson for whenever someone over here argues for how great a privately funded medical system would be in the UK – staff in parts of the US health companies are given bonuses for saving money for their employer by denying treatment. Walking out of the film, for all it’s problems, you do feel rather glad that we have the NHS. Having said that, once you’ve seen some the benefits the French get compared to the UK it’s enough to make you want to up sticks and move there!