"You just vomited up your stomach? Okay, just fill out these forms..."

Michael Moore, preeminent provocateur of the documentary film world is back with Sicko. This time he’s taking aim at the managed healthcare system of the U.S. The film serves as a powerful indictment of the insurance companies and those who in essence aid and abet them. He points out the patent insanity of the whole thing and it made me wonder why I hadn’t really thought about any of it before.

Of course, the dire statistic about 50MM Americans lacking insurance is trotted out, but as he says at the beginning, the movie isn’t about them, it’s about us—the people with health insurance.

Moore ’s main argument is that the insurance companies need to be removed from the system completely, because a profit-motive has no place in determining how to treat the sick. Those who adopt a pro-privatization stance argue that competition/profit-driven models create an overall more efficient system. But as Moore points out, how exactly do you generate profits in the health care industry? Why denial of service of course!

The less health care you provide, the more money you make. So you have an industry where the health care professionals are rewarded for providing less care. When I say rewarded, I mean straight-up financial compensation for having a high claim-rejection record. I have to say, despite how obvious it seems, I’d never really thought about the ghastly arithmetic involved. I always thought, well we pay out the arse, but we have the best doctors and hospitals that money can afford. Well I suppose we do, if you’re “money”. I don’t count myself in that group. I have always had pretty decent health insurance I suppose. I’ve worked for the state of Michigan and New York and a couple of Fortune 500 companies. The thing is, I’ve never really had to test how good that coverage actually is.

The movie provides many painful anecdotes about people who did test out their coverage only to find it severely inadequate. There’s the 22-year old denied treatment for cervical cancer, because her HMO says she’s too young to have developed that kind of cancer. Then you have the woman who lost her young daughter, because the insurance company would not pay to give her emergency treatment, insisting she be taken to a neighboring hospital even as her condition rapidly deteriorated in the “out-of-network” hospital. It makes you wonder if these are even people who run these organizations. HAL 9000 had more humanity.

The politics involved are just nauseating. I'll save that for another post entitled "Pissing in the Hurricane."

Moore spends a great deal of time showing us what health care is like in other Western countries such as Canada, France and England—all of which have universal health care. The contrast is infuriating even if Moore uses somewhat idealized images of these systems.

Journalists from some of those countries with universal health care have blasted Moore for being loosey-goosey with the facts. They argue that their systems are not utopian health care paradises. They point to long waits in the ER present in their own countries. Well, I don’t know about anybody else, but when a family member or myself has had to receive emergency care, we waited for hours in the ER insurance or not. The difference is when you leave the ER in Canada , you don’t get billed for it. Nuh-uh, the naysayers cry, “what about taxes?” WTF about’em? When I look at my paycheck, I get a percentage deducted for health care expenses already. Now add in all the co-pays and deductibles and tell me how this is different?

There are four huge impediments that prevent a universal health care system from getting off the ground: a.) the insurance companies; b.) politicians the insurance companies own; c.) doctors that benefit financially from privatization and d.) the over-worked/under-educated American populace.

Moore ’s film aims to stir the fourth group into action. He certainly gives them enough gas to light the torches.

In the Q&A after the film, Moore said that his film is meant to raise the question: “Who are we as Americans. What have we become. What has happened to our soul?” I think (and I am not a cynic but a realist) we’re going where we’ve always gone: for the money. What in our past would lead anyone to think Americans have ever prized anything above financial gain? The country’s very economic foundation was literally built on the backs of slaves. Prior to the emergence of unions, individuals like Henry Ford amassed Croesus-like fortunes working the common man nearly to death. Our foreign policy has often been based on what is best for the American bottom line as opposed to what would create a better world (See: Shah , Iran). We want our history to be “Ma and Pa Kent” as opposed to Jim Crow.

/End rant.

As far as America goes, the brochure has always been nicer than what actually awaits you when you get here. We’re better at making our $#!t smell like peaches than any nation on the planet.

It’s damn tough to get us to stop drinking the Kool-Aid.

So until then, the American people will continue to bend over so that the insurance companies can continue to use our collective @$$es as one big ATM machine. And that thing in their hands ain’t no debit card.

If America really is blessed, then I guess God is the invisible hand. Makes perfect sense, really.

DVD Pick of the Week for You to Love with a Gentle but Firm Hand

As I get older, I find myself more and more fascinated with history. Military history and religious history are by far my favorite subjects. Between the two, you get a fairly comprehensive look at how the world around you has come into being. Errol Morris’s The Fog of War offers an insider’s candid ruminations on some of the most important military conflicts in modern history.

Robert S. McNamara was not only the Secretary of Defense under JFK and LBJ, but also served in the military during WWII. In the film, he sits down with Morris for an interview that begins with the conflict in Japan during WWII and talks in-depth about the mistakes the U.S. made in the Vietnam War.

When I saw the film in the theater years ago, the first major revelation that McNamara made (at least for me) was about the dropping of the atomic bombs on Japan. He implicitly says that we were wrong to drop those bombs. The country, he explains, had been firebombed to oblivion. The Japanese cities of the time were built mostly from wood. Relentless firebombing runs decimated vast swaths of the urban landscape and inflicted casualty rates of 50-90% (according to McNamara) in the civilian population.

Yet the U.S. still decided to drop two experimental atomic devices that instantly claimed 120,000 civilian lives and led to 100,000 more eventual deaths due to radiation poisoning. Yes, the Japanese imperial government was impossibly proud, but prior to Hiroshima and Nagasaki the Japanese infrastructure had been nearly obliterated. It was only a matter of time.

The real reason we dropped the bombs? Well, as they always say, “follow the money.” The Manhattan Project cost an estimated 2 billion dollars (roughly 23B in today’s dollars). For that amount of money, a few mushroom clouds in the desert just don’t cut it. Also we did it to show Russia and China that the U.S. had ascended to “biggest dog on the block”-status.

In a moral vacuum, what we did makes perfect sense. What bothers me is how the decision to drop the bombs has always been painted as this grave but necessary maneuver that saved the lives of countless U.S. troops who would have presumably been forced to embark on a ground invasion. To quote Sgt. Al Powell from the greatest movie ever: “Wake up and smell what you shoveling!”

But enough about that.

The film also talks about how and why we failed in Vietnam. The parallels to Iraq are obvious and you just wish that someone would have forced the current administration to watch this film about five times.

So go rent this movie, because it’s good for you to see how the military works and how smart people end up making really bad decisions.

Craig Ehlo Is Not Walking Through That Door

See? This is what happens when you go places you don't belong. Spurs in 3.5.

Seriously though, things just look really bad for the East. It's like there is an even distribution of superstars, but the majority of the "not-quite-superstars" all ended up in the West. The Spurs, Suns, Mavs, Jazz, Nuggets and arguably the Rockets are better than pretty much every team in the East. The Heat are way too old, the Pistons are a bunch of slackers and the Cavs are just not a good team. Only Chicago and Orlando show enough promise to not only challenge for the title, but do so for a good stretch of years into the future. We're the basketball equivalent of the National League.

Joe Dumars, we need you now more than ever.

Movie Pick of the Week

Judd Apatow is moving in on "must-see" status fairly quickly. I found this movie more consistently funny than The 40-year Old Virgin. It's the type of movie you might see twice, because you were laughing too hard and loud to hear all the jokes the first time. I only saw one trailer for this and it didn't look that funny, but I kept hearing good pre-release notices on the movie. Having watched it, I don't think you could make a general audience trailer that would make somebody want to go see this film.

I expect word-of-mouth to be great. It's long, but for me it honestly never feels padded and doesn't lose steam. Like most movies it follows its genre conventions in an almost desultory way, but I didn't care because it was so funny almost all the way through.

I would like to see Apatow learn to write women better. Paul Rudd's wife is a shrill, castrating, humorless brow-beater (seriously, would a woman say that her husband playing fantasy league baseball is worse than him having an affair?). Catherine Heigl is a bit of a cipher. We get enough of Seth Rogen's character to understand why someone might find him endearing after a while, but with Heigl, there just isn't much there. Yeah, she's pretty, but after that? What's frustrating about it is that she is at times likeable and you just wish you would have gotten more of what makes a character like hers decide to be with this guy who is somehow an utterly charmless charmer.

Enough of that though. The movie made me laugh. A lot. A whole lot. I'll be seeing it again. Just to hear Paul Rudd say, "Roads? Where we're going, we don't need roads." again is worth $10.50.

What Now?

"I once scored four touchdowns in a high school football game." - Al Bundy. Yes, Detroit fans, we've reached our Al Bundy moment. The window has been emphatically slammed shut by none other than Mr. James and his rag-tag bunch of cast-offs.

Where do we go from here? First off, get rid of 'Sheed. He's an embarassment, a liability, and a nutcase. How do you let yourself get tossed in one of the most important games of your career, thus ensuring not only that your team's chances of winning diminish greatly, but that you'll also hurt them by being suspended should you win the game?

Next, the Chauncey question. To re-sign or not to re-sign? Hell, that's tough. He's 31, but one of the top five PGs in the game right now. What options do we have? Bibby? No defense. Mo Williams? Not sold on yet. J-Kidd? Too risky. The only hold-up is that Chaunce is going to ask for something like 60 over 4 and there is no way in hell Joe should pull the trigger on that. But there are more than enough desperate teams in the league that will. I'd hate to have to make that call. Then again, I bet the Mavs wish they had.

Then you've got the question of Flip Saunders. I don't think you have much of a choice here either. Who's out there for a veteran team? Carlisle? Bridge is burnt and submerged under sewage. Brown? The previous times infinity. Chuck Daly? Hey, Riley's still in the game! Yeah, well since Flip has a guaranteed contract, I don't think we'll be seeing a change at the helm anytime soon. This isn't necessarily bad, because I think with Rasheed gone, it'll be much easier to get a hold over the team. And let's be real: the Pistons won 64 games last year, the highest total in team history. Clearly Flip is doing something right. When he first started he was praised for opening up the offense. I hope we can keep that trend going.

The bottom line is the Pistons need new blood. Build around Tayshaun. Get a few more good years out of Chaunce and Rip. Get a great post player (I didn't really realize how much we missed Ben Wallace until I watched Ilgauskas abuse us on the offensive boards). Get a consistent scorer who can create his own shot. Get fracking motivated about winning. The insouciance of this team since they won the title has been galling. They need to stop reading the press-clippings and start earning the right to wear those dumb arse "championship belts" Rasheed and Ben used to wear.

I think this quote from Chauncey sums up the Pistons over the past couple of years:

"I don’t see the situation as being that bad," he said. "It’s 2-2, these are the Eastern Conference finals. We have three games left — two of them at our place."

Yeah, funny how that worked out.

P.S. - In order for the Cavs to earn my respect, they need to take two games off of San Antonio. If they can do that, I will admit that they are a decent team. Until then, they still suck. They are the real-life equivalent of Michael J. Fox's basketball team from Teen Wolf.