All this could be yours, Moore says: a socialist utopia based on mercy, equality and government penetration of John Holmesian proportions. And it does look like bliss when compared to the American cruel-world mentality of tormented, avaricious alienation, the same mentality that prompted Ronald Reagan to undertake his mercenary managed care reforms, and now means you may have to choose which finger you'd like reattached after one of those pesky table-saw accidents. We don't rip the system because we're too afraid — of losing our jobs, of changing our lives, of unseating the States as richest nation in the world — and this is why the system keeps ripping us a new one, day in and day out. It's easy to bend a frightened sheep over a barrel.

Americans are so entrenched in this fear that we refuse to believe there might be a viable alternative, says Sicko, and are hasty to criticize any example of another way to live. Many US conservatives insist, for instance, that in Canadian emergency rooms, people routinely die on benches waiting for care. Sicko weakly implies, based on anecdotal evidence from four or five Canadians, that they do not — implying as an aside that even if they do, at least they don't have to pay for the privilege. In this corner we have the many insured Americans who pay out the nose for health coverage only to pay out the ass when their providers deem critical treatments "too experimental" (an unquestionably effective bone-marrow transplant) or "not medically necessary" (removal of a brain tumor.)

Oh, for shame, America, says Moore. You whinge on April 15 but glut yourself with consumer garbage. And look how well you could have it! A self-styled conservative in (surprise!) Canada is so charmingly naïve in his aphorisms: "The more fortunate should help the less fortunate." (And you're not a socialist, sir? Ridiculous! This is how liberal they grow them north of the tree line?) Attractive American expats in France sip wine and natter glowingly of the luxuries of free house calls, government laundresses and all the extra money they have to spend on holidays. An eloquent and charismatic Old Labour curmudgeon reminds us, "If you can find money to kill people, you can find money to help people." Oh, shame, America. Shame on us so hard.

Well, pardon me for playing to type, but Moore's socialist utopia is all so fucking bourgeois.

There's a reason that the only poor people Moore allows in his documentary are Americans. Here is the question Moore doesn't bother to address, which I suspect is because it is not funny, and he has no canned answers for it: Sicko shows how many people fall through the cracks of the managed-care system. What about the people who fall through the cracks of universal health care systems? Where does the corrupt, pharm-slut congressional majority come up with these bogeyman tales of people dying in waiting rooms or waiting years for an operation?

Moore is satisfied and self-satisfied to ask a very few Canadian, British and French patients, "How long do you usually have to wait to be seen?" They say "about 10 minutes" or "it's a very efficient system" and even if they constitute a representative sample, it would still be interesting to look at instances in which universal health care fails.

Conventional wisdom, religion and our hearts tell us that it's true: Disposable income and the stuff you get with it will never make you happy, but security and confidence sure can.

But all of the French, English and Canadian persons he interviews are at least upper-middle-class by American standards. Note that no Cubans, except for doctors at what appears to be a health-IKEA in Havana, are interviewed in Sicko; even these interactions barely count as interviews. While Moore's website provides some evidence for his unsettling claim that Cubans are healthier than Americans, the poll's findings look neither particularly credible nor at all applicable to health care in America.

How does the NHS affect the United Kingdom's many poor and unemployed? Does the French Republic pay for doctor house calls and twice-weekly nanny visits to residents of its Arab ghettoes and bidonvilles?

Furthermore: Does accessibility of medicine really imply a healthier populace? Cubans tell him there are hospitals, clinics and pharmacies everywhere in Havana. (This is also true of Mexico, and it's a good thing, because having a stroll in any Mexican city can give you primary symptoms of COPD.) In Cuba as in Colorado, many people can't afford their prescriptions — even though an inhaler that sells for $120 in Denver costs about a nickel at a Havana pharmacy. An American woman can make an illegal trip to that pharmacy and sneak home in tears of joy; she can finally afford to breathe. But the average Cuban lives on about ten dollars a month. The buck is merely passed to Castro.

The poorest Briton lives, on average, three years longer than the wealthiest American. That's just a statistic Moore mentions, with no evidence whatsoever that the British poor live healthier or happier lives than the American wealthy. We see that an NHS general practitioner is able to drive an Audi, live well in a comfortable home and enjoy (one) flat-screen television. And proud we are of him.

But by my reckoning, being poor is a shit prospect wherever you go. I say, of course a person who nets $100,000 American yearly and gets free health care, cheap education and a nice long holiday is happier than an American who nets $100,000 a year and gets free nothing and two weeks if he's lucky. But what about those who net $10,000 a year — or $100 a year? Moore includes indigent Americans in his documentary and excludes poor people from other countries. It's a glaring omission, and it makes a viewer wonder.

I've never had health insurance, and one of the strongest points of Sicko is that it makes it look like I'm sure not missing much; even the insured are often denied coverage for critical surgeries and daily medical needs, so why throw my money away? Like millions of Americans, I do OK by eating right and availing myself of every over-the-counter palliative remedy I can afford. Besides, I doubt the most comprehensive insurance policy available in America would cover all the medications and treatments I need (birth control, Accutane, Thorazine and/or frontal lobotomy), although in UHC countries I could get them for a pittance. Moore's vision should look like heaven to me.

I once had to pay $300 in one-dollar bills for an emergency-room visit. I had developed a persistent, howling cough and high, steady fever. I was hallucinating, hacking up blood, unable to eat and praying in my sleep for death. After three days of this, bed rest and ibuprofen, I called a nurse's hotline. I was told to call for an ambulance immediately.

At the time, I was working as a waitress and between checking accounts. If I were smart I would have taken a taxi. Nonetheless, I called, and an ambulance arrived swiftly. The EMT barely spoke to me after advising that I "try to take deep breaths." They didn't even turn on the cool sirens! But they did take me to a large hospital on Chicago's north side, where I was told that a doctor "could not" see me until I paid at least 75 percent of the ambulance fee. I gave the cashier every last single I'd picked up on the past few shifts, asked for her to bill me the rest then parked my uninsured ass in a chair, coughed convulsively through the two-hour wait to see an intern and went in to be examined.

I described my symptoms — hardly necessary — and the intern took my temperature, in what was to be her sole method of diagnosis. Between my racking bouts of tussis, she kindly informed me that I had a viral upper respiratory infection, or chest cold, advised that I purchase some Claritin from the nearby Walgreen's, and sent me on my way. I wasn't able to pay rent that month, the loratadine didn't work and I never did find out what was actually wrong with me, but my fever eventually went down.

In this ludicrous, humiliating experience, I was easily among the lucky ones. For one thing, I lived. For another, I had the money. For a third, though there is no polite way to say that I got fucked, I only got fucked to the tune of a few hundred dollars (not including what I was later billed for the "consultation.") That's less than a tenth of what the average American spends on health care every year. (That was, praise Allah, my only medical incident in 2003. Otherwise, I might have had to retune my dry-pasta budget, or ditch my apartment.)

In the cast of the entire farce, the only medical practitioner who seemed concerned that I might be seriously ill was the nurse I'd initially called. Like the EMT, the cashier and the intern, she had heard my noisy, incessant cough and my description of the symptoms. Unlike the intern, who smiled condescendingly as I clutched at my ribs, she had not seen 105.2 on the thermometer she'd just taken out of my mouth. What was unique about the nurse on the phone? For one thing, she had no interest in my financial status, because it was understood that I didn't have to pay her. Again, Moore should look great on this count: When you subtract money from medicine, the result is better care, smarter decisions and healthier people.

But Moore has no idea how to do this and makes no suggestions besides a few wistful recollections of the 1993 Clinton health care plan proposal, some exquisite potshots at particularly venal Republicans and the tawdry old call to write our Congressperson.

This is not satisfactory. We who have weathered gross insurance-or-lack-thereof-related indignities know that the system isn't working for us. Hell, we know that it may well be working better under Castro. We feel deeply for the characters in Sicko. We may resent just as deeply the extent to which we identify with them. We certainly want to believe that one day we too could luxuriate in the French joie de vivre, the smiling experience of an English patient, a warm Canadian poutine of affordable pharmaceuticals. The director is content to point his lens at the victims (here) and the victors (there), but he has no idea how to fight the war. Sicko is thoroughly entertaining, selectively informative and inspirational in parts, and Moore has the balls to match his body type. Still, the familiar feeling of having been cheated came over me as the film's credits began to roll. When else had I been told to seek a cure that wouldn't work? Moore's holey vision of universal health care will be no more effective for the United States of America than Claritin was for my cough.

— Eve Adams (ultimaluz at gmail dot com)