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It was easy to read and hear a lot about this one in advance (including a lot of praise by people to had already seen it in advance screenings or through the copies that could be found online), nobody spins the wheels as well as Michael Moore, and this is a talent that is at least half the fun of watching his films: you start watching having the feeling you are sharing information that is important! Or rather: IMPORTANT! And it is, of course. There is no doubt that the happy triangle of education-pension-health is among the greatest worries in people’s life-planning. Whether it becomes overblown competitive (education), non-financable through changing age patterns (pensions) or … in the case of the health system (or rather: the health insurance system), the trouble maker is not so easily identified. It has to do with money, of course, and the costs of … what? Now let’s be honest: not living in the US is a great problem for understanding the system’s and the film’s core point. Apparently, if you live in the US, you are firstly not legally obliged to have health insurance. Let’s say, on a general note, this is rather stupid, as low-income families in particular will under these circumstances choose not to have insurance and safe the money for supposedly more pressing expenditures. The system sets an incentive for getting yourself into trouble, because as soon as illness occurs, you are on the verge of being ruined. So this is a flaw in the system, and it is very hard to understand how it can be, espacielly if the notion the film works on is true that the whole system is dominated by lobbyists of the health insurance companies. These should lobby for compulsory insurance: firstly it means more members, and secondly it means more distribution of risk, meaning more profit despite less monthly membership fees.

While this first point is odd, the second is odder: you have an insurance system that basically works ruthlessly on the basis of ad-hoc approval by people who work for for-profit companies. Emergency or illness and prior approval of treatment by a company representative??? I don’t blame the film for being outraged and polemic about this – if you live in a country where such a system is being commonly accepted by anybody with a voice, then there is plenty of reason to be … not outraged, maybe, but stunned. What really strikes me about this film is how many people / voters apparently take this ridiculously dysfunctional and inhuman health care system they live with for granted. Allow me to be a little bit insulting (and unfairly so, I’m sure): any country with a population slightly more educated about what’s going on in the rest of the world would be out on the streets about such ludicrous processes as pay-as-you-go-medicine, even more ludicrous vocabulary such as "socialist health system" for any system that establishes a solidarity-based risk- and burden-sharing between ill / healthy and poor / rich.

The film is not a bad film, it does what it needs to do for its audience. The problem is that for most audiences outside the US, the film has a completely different point. Americans are supposed to wake up to the facts about their rotten system. Non-Americans just need to stare in incredulity at the fact that the Americans need to be woken up in the first place.

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