In 1991, the American Nurses Association published its Nursing Agenda for Health Care Reform, which gained the support of 76 nursing and healthcare organizations. It called for a radical change in healthcare delivery based on providing care in communities, schools, and the workplace and promoting a balance of health and illness services.
In 1993, President Bill Clinton appointed Hillary Clinton to head the country’s task force for healthcare reform, and nursing was a prominent voice influencing the task force’s deliberations. Later that year, the Health Security Act was introduced in Congress, but it failed to pass. Partisan politics and special-interests groups ended that attempt to ensure health care for all citizens.
Today, 14 years later, we’re no closer to having a healthcare system that provides universal coverage, and 47 million uninsured Americans live day to day, hoping they won’t encounter the U.S. healthcare system. But today, there’s also a buzz in health care about Michael Moore’s new film SiCKO.
Actually, the film doesn’t focus on the plight of the nation’s uninsured. It focuses on Americans who have insurance but who suddenly may find they will not be receiving their benefits. SiCKO takes us into the lives of everyday people struggling with life-threatening conditions and the consequences of payments denied by their insurance companies. The film also takes us into Canada, the United Kingdom, France, and even Cuba, where health care is universal.
As SiCKO shows, the U.S. system forces some people to choose between financial hardship and decreased quality of life—and sometimes death. And in the world’s richest industrialized nation, Michael Moore thinks we should rise up and support universal health care.
Moore posts his “Prescription for Change” on his Web site. He advocates free universal health care for life for all U.S. residents, the abolishment of health insurance companies, and public regulation of all pharmaceutical companies. He also suggests that people write to their U.S. representatives to support House of Representatives Bill 676. This bill, introduced in 2003, is the U.S. National Health Insurance Act, or Expanded and Improved Medicare for All Act. Its purpose is to expand and improve Medicare coverage to provide comprehensive health insurance coverage for all U.S. residents.
But access to affordable health care for all has been elusive in America, even though other industrialized countries have and maintain national health insurance, socialized healthcare delivery systems, and other “free” government-funded programs for its residents—all its residents. Moore wants to move the boomer generation from complacency to action. After all, the boomers may find themselves in the same unfortunate situation as some of the people in the film—thinking they are covered for services but denied payment by the stroke of a pen.
So what can we do to improve access to affordable health care in the United States? Help friends, family, and others navigate the healthcare maze and get answers to questions about insurance coverage, financial aid, and out-of-pocket expenses. Pay careful attention to the plans being proposed by presidential candidates during the primary elections and be an informed voter. Health care promises to be one of the top two issues in the 2008 elections. Whether or not you agree with Michael Moore’s prescription, you can speak up on behalf of the underinsured and uninsured.
SiCKO has been called a documentary, and the facts are extensively referenced on Moore’s website. The film has also been called alarmist, provocative, and misleading. Whatever your point of view, the film does tell some poignant stories of everyday people, and it does raise ideas and issues that should be on the minds of all healthcare providers and partners in the industry, including insurance carriers, pharmaceutical companies, and advocacy groups.
In 1787, Thomas Jefferson wrote, “Without health, there is no happiness.” In our pursuit of happiness, we should have a healthcare system that eliminates the need to choose between health and poverty.

Pamela F. Cipriano, PhD, RN, FAAN
Editor-in-Chief