More than anything else, Harriet Beecher Stowe's "Uncle Tom's Cabin" alerted 19th century Americans to the evil of slavery. Greeting this author to the White House in early Civil War days, President Lincoln is said to have remarked, "So you're the little lady who started this big war!"
Other names are attached historically to great causes. Thomas Paine's fiery "Common Sense" in 1776 inspired the Declaration of Independence. The immigrant Jacob Riis, a New York Times staffer, battled for child labor laws a century ago. Upton Sinclair's "The Jungle" alerted us to a need for meat inspection laws.
Comes now Michael Moore with a documentary film on health care, inelegantly titled "Sicko." It could provide the final push toward a government guarantee of medical protection for every American. If so this social reformer, whose jovial spirit often belies the seriousness of his message, may deserve a place alongside those other heroes. I have a hunch that if every American voter were to sit through "Sicko," no future candidate could be elected president without promising real national health care for all.
Moore's thesis is pretty simple: America's medical costs, roughly $7,000 a year for each of us, constitute the world's highest tab - but the money underwrites a level of care inferior to what patients in numerous other nations enjoy. As a crowning indignity, some 47 million uninsured Americans grovel for whatever health handouts they can find.
We've heard the put-downs, too. Detractors take issue with "Sicko," line by line. Health professionals, the health maintenance organizations and kindred insurance companies - plus the mega-billion-dollar pharmaceutical industry - hover over Moore's every statistic like beady-eyed editors eager to prove him wrong. Whether about Canada, Cuba or countless other venues that Moore praises, the naysayers insist he doesn't tell the full story.
It's easy to imagine history's earlier pathfinders enduring similar dispute - and can't you hear it? Was Harriet Stowe not aware that our slaves enjoy a life span 12 percent longer than the average Negro who was left in Africa? Or - what's Mr. Paine been drinking? The Crown's modest tax makes more sense than dumping good tea into Boston harbor.
Undaunted by apologists for today's profit-conscious U.S. care system, Moore goes after the myth-makers, too. His camera crew finds national health patients in Canada treated promptly, not heading south to buy proper care. (And yes, enjoying a life span that's three years longer than ours.) Are British doctors unhappy? No - Moore finds they're pulling down six-figure salaries. As for French physicians - mon dieu, they're even making house calls.
By contrast, the film depicts American health care as hopelessly tied to HMOs and to insurance companies whose profit margins are fattened by denying legitimate client needs. Several former claims adjusters, possibly conscience-stricken, tell Moore how the system denies money to the ailing - but paying bonuses to bean-counters whose job is to apply the screws.
Moore touches lightly on the industry's free-spending political activity. The formidable drug lobby's medium of persuasion has long been what stock company playwrights of an earlier generation labeled "filthy lucre."
This industry's spokesman on Capitol Hill, the gregarious 64-year-old Billy Joe Tauzin, was elected as a Democratic congressman from Louisiana's Cajun Country in 1980. The Deep South's partisan preference already was shifting to Republican. And when the GOP won House control 14 years later, Tauzin made a deal - he would switch to the new majority party if it pledged to protect seniority status he'd accumulated on the Democratic side of the House Energy and Commerce Committee.
That meant he'd shortly be the committee's chairman. As such, Tauzin was a prime player in amending Medicare rules on prescription drugs. He helped railroad a bill outlandishly compelling the federal government to pay whatever the pharmaceutical firms choose to charge elderly Americans for the same products they sell much cheaper overseas. Along with Speaker Dennis Hastert and House Leader Tom DeLay, Tauzin was part of the cabal that held a House vote open through three predawn hours on Nov. 25, 2003 - the stall time GOP leaders needed to bully a majority into line.
Pill privateers were properly grateful. Tauzin's reward was to hire out to the Pharmaceutical Research and Manufacturers of America, which happily made him Washington's highest-paid lobbyist at a smidgen over $2 million a year. Some House colleagues, needless to say, viewed this as a career advancement.
My question: Which presidential candidate is ready to install Michael Moore as secretary of Health and Human Services?
Van Deerlin represented a San Diego County district in Congress for 18 years.