It was impossible for me to watch Roger Weisberg’s health care documentary, Critical Condition, without thinking about the current economic crisis. While much of the turmoil this week has focused on the collapse of several major banks and insurance companies, John McCain published a little-noticed article in Contingencies, the magazine of the American Academy of Actuaries, in which he argued that “Opening up the health insurance market to more vigorous nationwide competition, as we have done over the last decade in banking, would provide more choices of innovative products less burdened by the worst excesses of state-based regulation” (credit goes to Paul Krugman for calling attention to it). We’ve all seen how deregulation worked for the banking industry this week, but McCain’s comments merely echo a more general cynicism about the role of government in protecting its citizen against the excesses of Wall Street and the health care industry.
But rather than engaging specifically with health care policy, Weisberg deliberately underplays the righteous indignation and policy wonkery (although the film quietly argues for a more humane health care system), choosing instead to place a human face on the health care crisis by introducing us to four uninsured Americans who are dealing with potentially fatal illnesses or with chronic health problems. All of them are employed, taxpaying citizens who contribute to the system. But they are among the 47 million U.S. citizens who do not have health insurance, and they are all faced with overwhelming medicals bills, sometimes ranging into the hundreds of thousands of dollars. In the case of Joe Stornaiuolo, a charming former doorman who develops cirrhosis and deals with diabetes, a lack of insurance turns a treatable condition into a potentially fatal one when he cannot afford the medication to regulate his condition. Joe’s story alone refutes the claim of McCain adviser, John Goodman, who has asserted that because of the availability of emergency rooms, there are essentially no uninsured Americans.
Equally compelling and, in some cases, heartbreaking are the film’s other three stories: Karen Dove, a property manager from Austin, Texas, develops ovarian cancer and faces chemotherapy while uninsured, leading her to consider divrcing her husband of thirty years if it will reduce their financial burden. Hector Cardenas is forced to have his foot amputated after complications related to diabetes but loses his insurance when he exhausts his sick days at his job as a warehouse manager, which also leads to him losing his meager benefits. Carlos Benitez, who works as a chef, also has a painful degenerative back condition that could be treated with surgery, but without insurance the operation would cost over $100,000. Carlos considers getting the surgery in Mexico, which would cost $40,000, allowing the film to point out that thousands of Americans cross the border every year to get cheaper medical treatment.
I’ll admit that I found some aspects of Critical Condition a little frustrating. The transitions between stories, which were punctuated by a generic Muzak-type score, felt disruptive to me, taking away from the film’s contemplative, observational style, and I think that material could have been delivered more effectively as a voice-over, perhaps, but that is the smallest of quibbles. To my mind, what counts is the fact that Weisberg genuinely allows us to get to know the families involved, to see these four uninsured people in their daily lives, often over the course of a couple of years.
Much like Michael Moore’s Sicko, Critical Condition reminds us of the absurd choices people are forced to make in order to preserve their health. Get a paper divorce to reduce medical costs? Cross the border to get surgery at a significantly reduced cost? Take expensive pills or fall behind on your mortgage? While Critical Condition lacks the historical grounding that I found valuable in Moore’s film (the history of HMOs, in particular), the film illustrates the degree to which so many health insurance organizations place profit over care, while also illustrating the fact that in the long run, we end paying more when people don’t have adequate access to health care, not merely financially but morally as well.
Update: Critical Condition will be broadcast September 30 at 9 PM as a part of PBS’s POV series.