Ode to the SiCKO Decade and Single-Payer Power

Jul 17, 2017

By Donna Smith, Executive Director – Progressive Democrats of America

When Michael Moore’s documentary film, SiCKO, was released in June 2007, the nation was yet to elect our first African American president, and the Patient Protection and Affordable Care Act (ACA/Obamacare) was yet to be introduced or debated. Taken with the unrealistic notion that somehow SiCKO would awaken millions of people to the suffering embedded in the dysfunctional healthcare system and that those millions of people would mobilize for change, my husband and I immersed ourselves in every way we could to push for truly universal coverage for all Americans through improved and expanded Medicare for all.

A decade later, even as the U.S. Senate prepares to vote on the most Draconian healthcare bill we might possibly imagine, we also see growing and massive support for Medicare for all among Americans not currently in Congress – a strong majority of us support universal coverage offered through the trusted, if imperfect, gold standard of coverage passed 52 years ago this month.

Lest we forget the path to this point, I want my fellow SiCKO subjects and Michael Moore to know that my original, then seemingly unrealistic notions about the potential impact of the film wildly underestimated what we could get done in just 10 short years – or as an old history professor of mine used to say, “What’s a decade between friends?” I can only write from my perspective, but I believe that without the making and the showing of SICKO here and around the world, we’d be way worse off than we are today in terms of the health reform movement.

After SiCKO’s New York City premiere, on July 12, 2007, I received an invitation to testify to the U.S. House Judiciary Committee. On July 17, 2007, I joined a panel of experts to offer testimony about medical debt and personal bankruptcy. I testified on the panel with: Mr. Todd J. Zywicki, George Mason University School of Law, Arlington, VA; Clifford J. White, III, Director, Executive Office for U.S. Trustees, U.S. Department of Justice, Washington, DC; Ms. Elizabeth Warren, Harvard Law School, Cambridge, MA; Mr. Mark Rukavina, Executive Director, The Access Project, Boston, MA; Dr. David U. Himmelstein, Harvard Medical School, Cambridge, MA. There were so many ways I felt inadequate to the task – I was the ultimate outsider, a patient, from the western U.S., and I definitely do not have a doctorate. My knowledge and expertise in the healthcare system comes from decades of experience as an insured American.

The night before I testified, I used the last two $20 bills I had in my pocket to bargain with a cab driver in Georgetown to take me to the Jefferson Memorial and give me half an hour alone there. I took my testimony, folded up in my pocket, so I could practice it in the presence of an American I believed had shared my love of country and my devotion to the ideals of this nation – yet unattained. Though there were a few tourists there at 10 pm on the July 16, 2007, evening, no one seemed to mind that I was reading out loud and pacing back and forth trying to practice not blubbering or getting mad. If you care to read that testimony, you can still CLICK on this link and find it. Interestingly, in the audience that day for the hearing were two single-payer, Medicare for all heroes I was yet to know very well – Marilyn Clement, the late founder and leader of Healthcare-NOW!, and Tim Carpenter, the late founder and leader of Progressive Democrats of America.   There was no way for me to know then, but I had been placed, somehow and some way, in the circles with movement leaders and system experts that would form the basis for the incredible growth and power that exists in the single-payer, Medicare for all movement today. In case you missed it in the witness listing – David Himmelstein is one of the co-founders of Physicians for a National Health Program, PNHP, and then law professor Elizabeth Warren is, well, now a rather well-known senator from Massachusetts. Wow. This SiCKO sister was in rarified air, and I never looked back.

If you ever have an interest in seeing my testimony from that day, I was also fortunate enough to appear on Bill Moyers’ Journal in May of 2009, and the producers of that program were able to find the video of the House Judiciary hearing through the Library of Congress. I stayed in touch with many of the people from that witness panel, and Elizabeth Warren was among those who were most supportive of my efforts even though there was absolutely nothing in it for her to give a damn what a person bankrupted by healthcare costs might have to say. After receiving a copy of my written testimony, this is the message I received from her on July 19, 2007:



Please call me Elizabeth. People who share foxholes should be on a

first name basis.

I’m pushing everywhere I can. I’ve been sending your powerful

testimony to everyone who might be in a position to help, and I’ll

keep writing about it.

It was a brave act of citizenship to testify about something so

painful. With more people like you, I know we can win this fight.


Stay in touch.



Marilyn Clement and Tim Carpenter also reached out to me after the hearing, so I kept writing, and I kept believing that every person we reached with the film or with the message of that hearing would know that there is a better way. Every time someone requested that I speak, I said yes. Most of the time, the request was actually for help to get Michael Moore to speak, and I understood that. But once folks discovered that Michael probably would not and could not go to every meeting or event, people then would invite me.

Early in 2008, I was hired to work for the California Nurses Association, in their communications department, and I read all the patient stories people sent in to the nurses after SiCKO was released. Even though one of my bosses was reluctant, when I would mention that I had been invited to speak on Medicare for all somewhere around the country, he would answer and laugh, “OK, you’ve got your 15 minutes of fame, go ahead. Just make sure you write about it.” And write about it I did. For everyone. More than 500 essays about Medicare for all, one book, and numerous speeches – and most of what I wrote I did on my own time, without pay. My husband was livid sometimes about that. He hated seeing me work 60 or 70 hours a week and then still stay up to write. But I knew that my window for impact was short – or so I thought.

Now bear with me here because I plan to lay this out quickly so everyone may follow. Through Tim Carpenter and PDA, I became co-chair of the national Healthcare NOT Warfare campaign. We promoted John Conyers’ HR676 in the House, and we worked to elect other progressive House members who would also support single-payer. I joined the advisory board of Healthcare-NOW! When the DNC met in 2008 to determine the platform for that election, PDA and Healthcare-NOW! worked together to push a much stronger bit of language in the healthcare plank. John Conyers helped me, and I found a delegate from Chicago to introduce the language. It passed. Shortly afterwards, lots of other groups decided PDA and Healthcare-NOW! might be worth more support, and some new alliances were forged.

As Barrack Obama prepared to take office and Sen. Max Baucus was releasing his white paper on healthcare reform in late 2008, I was working to prove that a person such as myself might just be able to hold her own with the “big boys” in the policy arena. I tagged along to meetings, and I made myself useful in bringing people together from the various groups that were part of my advocacy work in the post SiCKO period. Even though many were stubborn about getting to know each other, I eventually gave in to bringing PDA and Tim Carpenter together with some of those in power with the nurses. This was not an easy link to make as I was not sure if the work PDA was doing around so many issues and candidates would be anything of a fit for those working more pointedly on single-payer via support for HR676. I was also uneasy that PDA only worked on the House side at that time as I believed if we were ever to have a real shot at achieving Medicare for all, we needed to keep pressure on all Congressional members.

By late July 2009, it was my job to make sure the Medicare anniversary being celebrated with a nurses’ rally in DC’s Upper Senate Park would also have all the high-powered Congressional players/speakers in the battle for single-payer. Sen. Sanders was the only real alternative as a Senate voice supporting healthcare justice, and by this time my friend and PDA leader Tim Carpenter was warming to the idea that we had to do work on the Senate side if we would ever really have a chance for single-payer. I was terrified when I got a call from Bernie’s health staffer who said he was not going to make it to speak because of a vote on the Senate floor. I barked reflexively at that staff member, “That is unacceptable. We have 500 nurses and more than 1,000 people in this park waiting to hear Senator Sanders speak. It is not acceptable for him to cancel.” And I hung up my phone. As I was preparing for the brow beating that surely would have followed a Sanders’ speaking cancellation, I saw Sen. Sanders running across the street from the Capital. Literally running. While no one but me knew at the time, I regretted my bluster but was so grateful he had decided to come. He fired up the crowd as only Bernie can do, and so did Tim Carpenter. The advocates then fanned out across the Congressional office buildings to act as citizen lobbyists, and some of the leadership went behind closed doors with Sen. Sanders to discuss strategy. My role in bringing them closer together on single-payer effort with the nurses was working, and I was pleased.

There would then develop some close and powerful friendships among all the leaders from PDA, Healthcare-NOW!, PNHP, and the nurses of CNA and National Nurses United coming together around speaking up for and about Medicare for all throughout the ACA/Obamacare debates and voting period. Condensing the story a bit for readers, those alliances forged and nurtured in the post-SICKO period really did set the stage for PDA’s leadership, Tim Carpenter, Steve Cobble, Jim Hightower, and others to meet with Bernie in the summer and fall of 2013 to begin planting the seeds that would grow into Bernie’s 2016 presidential run as a Democrat, and more broadly the movement that has been bolstered for Medicare for all by Bernie’s candidacy and by the intense need to address the dysfunction of the U.S. healthcare system. Those who have followed Bernie’s incredible movement-building work and those who supported his presidential bid might do well to thank a filmmaker from Flint, MI, who made a film titled SiCKO that set some of the necessary conditions in motion for a more rapid achievement of Medicare for all. The nurses worked tirelessly on Bernie’s behalf, and the nurses have been working for single-payer as powerfully and diligently as any group in the country.

So, while a while back I apologized to Michael Moore for not achieving everything I hoped to in the years since SiCKO was released, I think putting my own life in perspective may be more instructive. Though I may be one of the people who loses coverage under the Trumpublican bill, and if I do lose coverage I will face terrible health consequences and perhaps even death, I can rest assured that due to my involvement in and willingness to tell my story as a part of SiCKO, a chain of seemingly unrelated events came together in a powerful way that has given lift to what I wanted from the beginning – healthcare is a human right. And when this country finally gets to where we must in terms of healthcare justice, I think every one of us will owe a debt of gratitude to Michael Moore and to SiCKO. Happy 10th anniversary, SiCKO extended family.

Finally, a dear friend sent me this last week after telling me that Sen. Elizabeth Warren wanted to share a message with me. Watch her video message HERE. Thank you, Elizabeth. I am so glad you are in the trenches for me now. Dignity heals. Ten years later, dignity still heals.


  1. Paul Devine

    As an person interested in healthcare and retirement reform, I have written a comprehensive proposal which would combine both issues. Under this proposal, all citizens would be covered 100% for all healthcare and retirement would be greatly enhanced. My proposal is quite different from any other proposal in that it includes significant surpluses in both the healthcare and retirement funds well into the future.
    This plan would eliminate Social Security, Medicare, Medicaid, CHIP, TRICARE. and other such benefits in favor of a universal single-payer health plan with interest-vested retirement revenues.
    Should anyone be interest in reviewing this plan, I would be happy to oblige. Written in WORD format, it is simple to understand and is backed-up by mathematical assumptions.

    Paul Devine

  2. jif6360

    Taxpayers now pay for 70 million on Medicaid, 50 million on Medicare, over 20 million public sector workers+their wives and children. This is a low figure (1/2 of the US population). These counts are only going to increase. Read carefully before u have a fit. Here’s a single payer healthcare plan that could get bipartisan support. Share it, start a pole, start a petition. Believe it neither party wants universal health care. Force their hand
    Healthcare Proposal:

    Politicians on both sides of the aisle spend a majority of their time raising money to finance their reelection campaigns. The rest of the time is spent arguing with the opposing party to give the illusion that they are actually attempting to govern. There is one subject that is toxic to both parties and that is Universal Healthcare. With healthcare being 20% of our GDP, this should be the number one issue and the government should be trying to put forth long-term solutions. The Republicans want to simplify the tax code while the Democrats want the rich to pay their fair share. These two issues can be solved with universal healthcare. Whether you’re rich or poor, everybody should pay 10% of their income for universal healthcare without any caps on net income. These funds would be paid into an account similar to SSI or FICA. The only argument left would be the quality of coverage that this would give to all Americans. In my opinion, that coverage should be a $500 deductible with 20 / 80 coverage for up to $10,000, and then the universal healthcare will pay for anything above. In other words, you would never pay more than $2,500 in any given year. This coverage would not cover vision or dental insurance. Insurance companies would now offer supplementary insurance to pay for that 20% (similar to AARP). This supplementary insurance would still promote competition within the market which would keep the quality of coverage high. Public-sector workers would lose nothing if the government would pick up the cost of this supplementary insurance. Private-sector employees who had been covered by their employer would no longer require it and could be given a one-time pay raise to restore the lost value of losing those benefits.

    Let’s do some basic math. We currently have about 90 million people that can’t afford coverage because they are either underemployed or completely out of the work force; indirectly, the government ends up footing the bill when these people have emergency room visits or unpaid doctor bills. We have about 50 million people on welfare, disability and social security. There are approximately 20 million public-sector workers and most of them are married with children. There is an additional element to this equation that is often overlooked. About 20% of our economy is based on government contracts for the private sector. Some examples are road construction and military equipment contracts. These private-sector workers are well-paid and have excellent insurance coverage that is very similar to that of public-sector workers. When you add up all of these disparate groups of people who already have healthcare coverage through the government, we’re really not that far away from universal healthcare as things stand right now.

    At the very least, this proposal should be discussed within the government and then a nationwide referendum should be held so that the people can ultimately decide.

    There are many positive aspects to the plan I just put forth.
    1. Example: If you make $60,000 a year, your insurance would cost $500 per month. Since your employer no longer needs to contribute to your insurance, they could then offer you a one-time pay raise (probably 5 to 10%).
    2. Universal healthcare is inevitable. The foundation for implementing universal healthcare already exists as Medicare.
    3. With Medicare essentially covering everyone, all of the administrative costs would go down considerably.
    4. Businesses would no longer need to worry about insurance costs increasing and could therefore focus on growth.
    5. Our politicians could spend more time trying to reduce prescription drug and medical procedure costs.
    6. The tax code would be simplified thereby reducing government administrative costs for agencies such as the IRS.
    7. A substantial segment of the population doesn’t want to work because they’re afraid of losing their Medicaid insurance. The ones who are actually able to work would now be willing to find jobs because that fear would no longer exist.
    8. This plan would result in a stronger economic environment because there would no longer be mandated insurance costs for employers which would result in the hiring of more employees. This job growth would result in even more people paying into Medicare which makes it easier for everyone to be covered. Medicare would become self-sustaining provided that the government was forbidden from borrowing the funds like they did with social security.
    9. Hospitals would no longer need to inflate costs because the percentage of people who cannot pay their medical bills would decrease significantly.
    10. Keeping deductibles and co-payments would ensure that there would still be competition within the free market.
    11. VA hospitals could join the private sector thereby allowing veterans to go to local hospitals.
    12. This proposal will never be put forth by our government unless the people demand it. Such a bill would detrimentally affect the pocket books of most politicians because they would no longer receive kickbacks from the insurance and pharmaceutical companies.
    Everything I have outlined is just an initial proposal created from my opinions. All of these issues need to be addressed in conjunction with the American people’s input. Note: Obamacare has created an entitlement society. Republicans need to wake up to the reality that this mindset is not going away anytime soon. With this proposal, the people will be paying for their own healthcare and the government will no longer have to borrow trillions of dollars to pay for healthcare. At the very least, this proposal should be discussed within the government and then a nationwide referendum should be held so that the people can ultimately decide.

    Let’s get real. Free healthcare for everybody would cost about 10,000 per person. U can tax the rich to death and your not going to reach that. U could make the government take all the sin taxes (tobacco and alcohol) to help pay for it. You’ll still come up way short. If everyone pays this is possible. We have all these honest politicians to keep corruption in check. Or are we better off trusting the insurance companies.