It’s nice of course to hear someone say that health care should not be for profit, and to show how the insurance companies, drug companies, and HMOs put their profit-taking ahead of human life. But otherwise the film’s analysis of the health care crisis in the United States is seriously wrong. Moore never mentions the word capitalism, nor does he attack an entire social system based on profit-taking, of which the health care system is just one instance. Moore never attacks capitalism per se, not here, nor in his earlier films. In Roger and Me, for example, he was merely pushing for traditional union demands, a better deal for the working class, not attacking wage-slavery as such (i.e., capitalism).
As regards this film about poor health care in the United States, capitalism would seem to be eliminated as a cause by Moore’s examination of the health care systems in Canada, England, and France, all of which are capitalist societies but which nevertheless have universal free health care. Here is where the film goes badly awry. Moore makes it seem as if the health care systems in those countries are because people there have a different social ethic – they take care of each other – whereas here it’s everyone for themselves.
This is nonsense. That Canada, England, and France have free universal health care is the direct result of the powerful socialist labor movements that existed in those countries. But this is never mentioned in the film. One interviewee in Canada attributed their free health care to the efforts of one man. For England, Moore explains that its National Health Service was established right after World War II. It was one of the first things the English did to pull themselves together and rebuild after the ravages of Nazi Germany’s attacks. There is not even a hint that a powerful socialist labor party had come to power at that time which did much more than establish a National Health Service. It also nationalized huge chunks of the economy, that being the conception of socialism that was dominant at that time (national ownership = socialism).
For France, Moore shows the protest marches that take place whenever the free health system is threatened. Those protest demonstrations he showed were the recent ones, most assuredly, because free health care is increasingly under attack across Europe, as the neoliberal capitalist offense gathers steam there. Europe’s welfare states, wrenched from the ruling class through decades of massive socialist and labor struggles, are starting to be dismantled, as anti-capitalist cultures have been weakened and even destroyed. Moore makes no attempt to explain how the French got free health care to begin with. For that, he would have had to explain that the French have had a strong left, one of the strongest in Europe, ever since the French Revolution, with massive communist, socialist, and labor movements and parties.
All this history is left out of Moore’s film. Well, of course, if you can’t even mention the word capitalism (I’m pretty sure it was not mouthed once by anyone in the film), let alone even acknowledge the massive opposition generated by this death machine, you perforce have to take an ahistorical approach. The Canadian, English, and French just happen to have free health care, as a given, perhaps because they are less selfish, more compassionate people.
Which leads us to Moore’s recommendation for people in the USA: We must become more compassionate, like citizens in Canada, England, and France. The film strongly implies, of course, although it is never explicitly stated, that the insurance companies must be gotten completely out of the health care business (although he did make this very explicit in subsequent interviews on television). But this does not reach the level of a political strategy. Strategy remains on the level of changing our own morality, of remembering that we’re all in this together, that we’re one big family.
Socialism was eliminated as an explanation of anything (even in Cuba) early in the film by Moore’s ridiculing of the fear of “socialized medicine.” You would think this would have had the opposite effect, of establishing that socialized medicine is better. But it didn’t. Socialism can’t be better. So it is just left out. (Although Moore did point out that we have socialized fire departments, postal services, schools, and libraries, so why not health care – not mentioning of course that the postal service is already partially “privatized,” and that libraries and schools are under threat of being so; I guess fire departments are safe for the time being; but garbage collecting has already been turned over to corporations in most cities; and water departments are being sold off.)
What happened is that the central drive of capitalists, to commodify everything in order to make a profit off it, putting profit ahead of life even, got checked in Canada, England, France, and Cuba. It didn’t in the United States, which is the most thoroughly capitalist society in the world. In the absence of strong socialist and labor parties here, corporations simply took over the health care system and turned it into a source of profit. They are doing this all over the world with regard to everything – water systems, education, parks, roads, lights, heating, health care, schools, armies, and even the government itself – everything. This is the neoliberal capitalist offense to destroy everything public and commodify every last thing on earth, even the wind.
A rich moment in the film for me was the newsreel footage showing George Bush signing the Medicare “reform” bill. If ever a scene could illustrate the meaning of the phrase “laughing all the way to the bank,” this is it. He was literally laughing, with glee, and with his usual smirk, but almost with a look of disbelief that they were pulling this scam off. Anyone who thinks that Bush is a dimwit who doesn’t know what he is doing is nuts.
Health care for profit indeed shows in an especially blatant way the insanity, immorality, and criminality of putting profits before people. But this is not at all atypical in a capitalist economy. The oil industry is willing to destroy the earth in order to keep the profits rolling in. Actually, the earth doesn’t even enter into their calculations. The massive, multi-billion dollar food processing industry has no regard at all for people’s health, for whether their products are nutritious or not. The only thing that matters is whether they can be sold. For then the money rolls in. Capitalists as a class have never given a hoot for workplace safety, and have only dealt with the issue when forced to, no matter how many people are dying in their operations. Putting profits before people can almost serve as the very definition of capitalism.
Is Moore aware of all this? Well, he did hint, in vague terms, in his interview with Amy Goodman on Democracy Now!, that the basic underlying problem was that we needed to change our relation to capital. But this is not attacking the profit motive directly, and he avoided saying the word capitalism. Is he a closet socialist who is tailoring his message to what he thinks will fly? Whether he does it on purpose or not, it would surely be better to come straight out and lay down the historically accurate radical analysis. Of course, if he did that, the film probably wouldn’t be opening in corporate owned movie complexes across the country. Doesn’t that just show though how thoroughly radical analyses of our social problems has been excluded from public discourse? But is that a reason for not making them? Will these half-assed, watered-down assessments get us anywhere? I don’t think so.
It reminds me a bit of what has happened to the environmental movement, as succinctly summarized recently by Jeffrey St. Clair and Joshua Frank (Counterpunch, June 29, 2007, “Toward a New Environmental Movement: Kick Out the Corporate Bastards”):
Big green groups are not helping the situation. Their hands are tied by both the large foundations that pay their rent and the Democratic Party to which they are attached at the hip. They long ago gave up on challenging the system. Most groups today are little more than direct mailing outfits who have embraced a sordid neoliberal approach to saving the natural world. The true causes of planetary destruction are never mentioned. Industrial capitalism is not the problem, individuals are. Not the government's inability to enforce its weak regulations. Not big oil companies, or coal fired plants. These neoliberal groups argue ordinary people are to blame for the impending environmental catastrophe, not those who profit from the Earth's destruction.
At least Moore fingers insurance and drug companies, and HMOs. But he doesn’t finger capitalism.
Nothing will change in the United States as regards health care. Capitalists are too solidly entrenched. The entire political apparatus is in their hands. They will never agree to eliminate this huge source of profit for their insurance, drug, and hospital corporations. Moore is just whistling in the wind.