Many would slate the NHS and to a point, I would too. But what seems to be ignored is the fact that every UK working man and woman contributes to the compulsary NHS insurance. People come here from all over the world on 'health holidays', cannot even speak English and still manage to get treatment whilst not paying a penny towards it!
While the NHS ideal is a good one, it's been abused by many who can get away with it time and time again!
The simple answer is to use the ID card system, a card that is merely a 'key' to your information on any given system that already exist. ALl that is on the card is information that proves the card belongs to you, photograph, retinal scan and/or figerprints. Swipe the card through the NHS system scanner and the system will tell the operator if you have paid your National Health Insurance contributions to entitle you to care.

S.J.Hamblin, Bacup, Lancashire

i think our NHS is great - i recently cut my hand and on a sunday went to hospital was Xrayed within half an hour and was out within an hour and a half with bandages all fixed. No fees and the hospital was brand new clean and friendly. For all of its weaknesses i would not swap the NHS for any other system.

Chris, Coventry, West Midlands

Moore's movies are time and again proven to contain falsehoods.Why yoy people choose to waste money on this self serving idiot is beyond me?

Me

Rob, Crimora, Virginia

I'm an American and I believe we should have universal health care. It's rediculous that our Americans would put people on the streets and not treat them due to their lack of money. Also, lets just say over in Europe that it takes a month or two to get a surgery, people would rather know they have a chance and are going to get the surgery they need and be cured, than be denied the surgery because of insurance and positively die fdue to it. And for the peolpe that spend their life saving and come to America to speed up the surgery still loose. Yes, they are going to live and recieved the surgery faster but now they have no money. All their life and what they worked for is gone in a matter of moments. America needs Universal Health Care !!!

Ashlee, St.Petersburg, Florida

Im from the UK, our heath service is great, our heath service always treats patients the same regardless if they have money or not its all about equality . And for waiting know one waits rearly waits here its a myth everyone is treated the same, for such a rich country your government treats you very poorly. Look how you treat the poor by kicking then out of Hospital to die, because they have no money to pay the bill thats terrible, that would never happen here.

Lee Madeley , Skipton , England

Dr Evie Wallace: I challenge you to provide examples in the US where parents have had to watch their children die because they couldn't afford an operation.

Then I would challenge you to explain why the UK press reports so many patients who die before receiving operations because of the long waiting times.

I'd bet there are a lot more examples of the latter than the former.

Just today the UK press reported the story of an elderly man who used his life savings to get an operation rather than wait for the NHS, which had postponed his surgery again and again.

That certainly doesn't happen over here. But it does in Canada, where provinces publish waiting periods for services on-line. that's what would befall Americans were they to adopt your system.

You see, making a scarce service free makes it even scarcer.

As for the lady who says people shouldn't make a profit off the misfortunes of others, please tell that to your mechanic when your car needs repair work.

Anna Keppa, Boston, MA

I have cancer and can not afford my cancer care, BUT, do not kill me by mandating national health care. <p>

Universal health care is the worst thing that could happen to me. <p>

I am intelligent enough and honest enough to admit that it would be great to make other people pay for my care, but it WOULD GET ME KILLED. <p>

The universal care does not work - it would KILL ME.

M algore, nyc,

Government screws up most things it manages. The free market serves most people's needs better. Most of the problems with health care in the Western world are the result of government meddling.

The best solution would be for people to take most of the money they pay in health insurance and put it in vouchers for health care. A small amount would be paid for health insurance for catastrophic illness. Individuals should be free to spend their health voucher dollars in the way they see benefits them most. This would eliminate all the insurance and government bureaucrats now stepping between doctor and patient who subtract value from health care.

Patients should be able to pay their doctors directly from their vouchers. This will lower doctor's overhead with respect to insurance paperwork and increase the price sensitivity of patients. No more $100 bandaids. They might buy insurance that follows them from job to job, so as to pay wholesale prices instead of retail.

Steve Gregg, Washington, DC, USA

The problems with the NHS are, in part, to do with this governments attempts to move AWAY from a socialized health system. Contracting out cleaning to firms who are in it for profit has directly led to dirtier hospitals. Bringing in ill thought through schemes more suited to supermarket management has also had disastrous consequences.

Having said that, the fashion for NHS bashing from people like Marrin is getting rather tiresome. I have been extremely satisfied with my treatment by the NHS. I have no problems seeing a doctor when I want and I have access to an excellent out of hours service.

As for Moore. Sicko is a polemic not a documentary and should be judged on that basis.

mike power, Aberdeen,

I don't recognise the NHS as described in this article.

My mother is very seriously ill, we have had home visits from her GP yesterday (stayed over an hour talking to mum about her condition, giving treatment), another visit today followed by a visit from the district nurse. The doctor is returning tomorrow. All mum's special dietary needs, special equipment as well as medication are delivered here, free of charge, on the NHS.

I - who am not ill and live in a different NHS region - can always see a practice GP on the day I call.

There are serious problems with the NHS, of course, as there are with practically every health service in the world but I wouldn't swap it for the insurance-based system of the US (which I have also experienced). I'd love to know what Mum's health insurance and prescription costs would be under such a system.

Gillian Walker, Chorley, UK

Every situation involving social care will attract self serving
humans whos agenda is biased because of their own need for attention. People are attracted to such an agenda due to
its emotional component. It's not easy to change peoples minds when they have fallen into the spell of emotional attachment to such an emotionally biased presentation such as Michael Moores. The antidote has to be based on
discrediting the emotional approach with an emphasis on
the human experiences found in the various health care venues. An honest but human approach should have an appeal to people in general. Michael Moore has to be
undercut and left without any defense. The person to do
this should have a strong appeal with people in general.
and should not attack Mr. Moore directly because this would excite his supporters to a defense of him..
Social issues have to be approached with proven facts
and objective power. The antidote to illusion is reality.
Who can and will do this? Let them step forward.--

Doug Rosbury, Salt Lake City, Utah.,U.S.A.

...And that's why we ranked as 40th, BEHIND Cuba and Morroco (not that there's anything wrong with being ranked in... something...behind these countries) as far as quality and cost of Health Care - Preventive health care. (google it)

The thing is, being as one-sided and subjective as Moore is, he knows his country well and knows that sometimes, drastic measures are justified - you have to paint a over-rosey picture in order to sway people and get them to QUESTION their beliefs.
In other words, he's being manipulative for a good reason.

Also, propaganda and mass-targeting-journalism has been ever present in the American culture for quite some time now - meaning, he's just using the same weapons that everybody else (big corporations (including government and religion)) is using.

Haris, Chicago , IL

Simply put... the American healthcare system is superior to socialist systems in every way possible. The areas that are performing the worst are the ones that are under government control (Medicare, Medicaid, VA Hospitals). Those who want to socialize our system need to understand that the only goal of the politicians is to control an ever larger portion of our money. Need proof? All the liberal politicians continually talk about raising taxes to increase revenue to fund more socialized programs when anyone who pays attention knows that every time taxes are raised, revenues go DOWN! Why would they do this? Well, the answer is simple. For the same reason they want to take control of the health care system... control over as much of the economy (and your lives) as possible. Wake up UK and US! You need to fight against your politicians who want to socialize you. Fight for your freedom or you will be slaves.

Dave, Carmel, IN

It was WInston who caused me to get rid of my mustache!

carr, turku, finland

Well, here in South Australia, I live near a purpose-built hospital that was erected in 1993 and has rooms rather than wards in which to accommodate public patients, maximum occupancy being two per room with an en-suite bathroom. I was a patient there on three separate occasions and it didn't cost me a cent either under Australia's taxpayer fundedi 'Medicare' scheme. I once held private health insurance but not only did the premiums become too expensive for me to continue my membership, the treatment I received was not one jot better than I have received under the Government-run system. Frankly, I would sooner my tax dollars be spent in this way than on an unwinnable war in the Middle East.

Colin Cumner, Adelaide, South Australia.

The US service might cost us more, but we do get more for our money. For instance, almost all patients here have private rooms with their own bathrooms. I was surprised to learn here recently that patients in Britain and Europe have to share rooms with multiple other patients, and have to be escorted down the hall to go to the bathroom! And sometimes, there are no nurses to escort them, so they have to go in their bed! Privacy in a room is not only better for the mental state and the family but also better in cutting down spreading infections. Okay, sorry, but I think our system has some definite advantages that we don't want to give up, expensive though they may be.

Claudia , Atlanta, USA

So Michael Moore is the only documentary maker who promotes the side of the argument he happens to also believe, and all others are well balanced. And we are all too stupid to take this into account. Your answer to this is to censor his work by urging us not to see it. If "journalism has more power than ever before, . . . become ever more disreputable", you sure are playing your part.

Graham, Portsmouth, Hants

The problems of NHS do not undermine the message sent by Moore. Americans have not any state healthcare system at all and we should be grateful to Labour who introduced such system in Britain fifty years ago. Yes, NHS has many problems and Labour have failed to run it properly but we should do what we can to improve our system, to scrap all flaws and to make it better. You should make it in future like Moore sees it now.

Ilya, St. Petersburg, Russia

I just found your online paper and I will be reading it! I can't find the date of the edition I am reading. Where is it?

David Kimball, Alexandria, Louisiana

Funny the people who are pushing a NHS plan for the USA
are the ones who would never have to use it.

Liz, Mission KS, USA

It's unfortunate that a subject so deserving of informed debate in the US has been distorted by Moore's film, because little more than inflammatory demagoguery from both sides has ensued. Medical insurance coverage in the US is absurdly expensive, and it gets worse with each passing year. It is a drag on the whole US economy, with the average cost of family coverage now exceeding $12,000 per year. This is why, flawed and biased as it is, Moore's film strikes a chord with so many Americans: many, many people believe there simply must be a better way. And while he has done a disservice to the debate by painting a too-rosy picture of health care in the UK and France, so too do those who emphasize only the problems in those countries. Such problems should be a source of guidance for the US in planning its own system, not a reason to refuse even to entertain the idea of universal health care.

NicholasM, New York, NY

I am truly, truly amazed that not one comment to this story mentions the ROOT cause of what shortcomings there are in the US health care system.

Trial lawyers.

R&D costs for drugs, new procedures and med equipment are completely out of control thanks to too much power, manipulation and greed in the FDA and AMA. But what really gets my blood boiling are the 'malpractice' suits. Let me give you an example:
A middle-aged farmer is out working with a piece of machinery, and has his arm severed near the elbow. The surgeon cannot reattach his arm. The family sues the doctor. Of course this is an absurd suit. We can all see this, right? However, because the "jury (not) of the doctor's peers" feels sorry for the farmer and his family, they award him an astronomical sum.
Because cases like this are all too common, malpractice insurance rates are outrageous. Just one more "little" problem with the US system.
Free market health care CAN work, and work very well.

Robyn Knapp, Bentonville, USA

Overbearing, shrill, cake-wolfing yobbo he may be, but Moore's root premise - that U.S. healthcare is up the spout - is undoubtedly a sound one. Do you realise that U.S. life-expectancy is in fact going down? Disgraceful. Inaccuracies concerning the N.H.S. may well damage this film, but to rubbish it entirely on the basis of those errors is to miss, what is for the U.S., a troubling root point.

jay, London,

Ive worked as a nurse in both the private critical care sector and the public critical care sector here in Australia where we have 'universal healthcare'. I can say that in my experience the public system although wasteful and poorly run at times is infinately better than the private. The level of care, training of staff and availability of special services is far better. OK, both systems have thier share of bad managers who make it difficult to deliver good care, but the public system, because it is not hamstrung by counting the pennies can give people what they need. Healthcare when they need it.

Steve Phillips, Perth, Western Australia

It is curious -- and a little depressing -- to see just how many citizens of Britain believe that poor people in the United States have to pay for their own care.

In fact, the United States has an immense program, Medicaid, which has provides insurance for our poor. (And, for many years, hospital emergency rooms have been required to give emergency treatment to anyone who shows up -- regardless of their ability to pay.) There is another immense program, Medicare that provides insurance for those 65 and older, some of whom are poor.

These two programs are about four decades old, but news of them has still not reached many in Britain, judging by the comments I see here and have seen elsewhere.

In short, US taxpayers spend immense sums to pay for medical care for the poor and elderly -- but, unlike British taxpayers, do not directly subsidize care for the young and well off.

I am not a defender of the US health care "system", but I do wish our critics overseas were better informed

Jim Miller, Kirkland, WA, USA

It is said that the best cure for socialism is socialism. For some curious reason this does not apply to care of the sick. The grip on "health care" by the State seems to be unbreakable. It defies reason.

The obvious answer is competitive insurance, sold to individuals rather than companies, paid from government funded tax free individual Medical Savings Accounts. This places the responsibility for good health where it belongs, in the hands of the individual. Providers would be privately owned and run and compete on quality of care. Any money left in the MSA would belong to the owner of the MSA and insurance deductibles could be set to make premiums low if so desired.

The high cost of pharmaceuticals will bankrupt State systems because the pharmaceutical industry is politically too powerful. Witness the comulsory HPV vaccine for young girls in the UK. It has killed 11 and injured over 3700 in the USA, so far. The Brits are very naive.

David Robertson, Inverness, Scotland

as a responce to john williams

where does it say the government exist's to facilitate huge profits for corporations and insurance companies that have zero interest in the patient yet feel no quallms about lying to them when its time to make your monthly payment to the insurance company
insurance companies have no place in the healthcare industry because it is in fact good buisness to deny as much as possible and cut as much as you can

the government is for the people by the people

not for the dollar by the dollar any means necessary

DM, miami, fl

"The person who cracks that one will deserve the Nobel Prize for economics. Certainly not Mr Moore."
JF, Canterbury, UK

I believe I have done just that. See my other post for a sketch. Unfortunately there is no Nobel Prize for Economics since it is not recognised as a proper science. In any event I would turn it down. I would not relish being on the same list as Al Gore and Yasser Arafat.

David Robertson, Inverness, Scotland

There is no such thing as "free" healthcare, unless you are unemployed and therefore not paying taxes. Those of you who are working for a living are indeed paying a high price for health care wherever you live. Personally, I would rather pay for my own insurance and make my own health care choices.

Vicki, Athens, USA

Sicko is essentially honest. It has two simple messages:

1. The US system is unfair to the less well off.

2. European sytems are better and fairer for the poor.

All reasonably intelligent people are aware of the manipulations Moore engages in but you can not argue
against the two main points of his film.

John, LONDON,

Tim: how about NO transplant at all for the majority of patients who need them at any price. How about No dialayis for fany one(except parliment members, Royal members of the arts, science, and sir this and that). if you are 55 or older its No dice. If you are in hospital and 65 or older an suffer an cardiac arrest--no attempet is made to rescusitate you. If you need a pacemaker yjou cannot get one unless you are an "important" figure of note. I could go on but i think you should th ink about these things awhile and this is in England. Other countries it's much worse. Frank Elliott MD.

Frank Elliott, Dallas, Texas

Some of the commenters in Britain seem to think that poor people in the US have to pay for their own health care. In fact, poor Americans have insurance coverage provided by the taxpayers through an immense program called Medicaid. (And elderly Americans have coverage through another immense program called Medicare.)

Simplifying greatly, but not unfairly, one could say that American taxpayers pay for the care of the poor and elderly, while British taxpayers pay for those groups -- and the better off young, as well.

I am not defending the American "system" of health care, which has many faults. But I do wish our overseas critics would get the basic facts right.

Jim Miller, Kirkland, WA, USA

It is most interesting seeing the repeated mis-statements of the UK commenters concerning healthcare in the US.

Half the population of the US uninsured?! Only in the Beeb's wildest, socialist dreams, which apparently, all of you have heard so often that you parrot them unaware that they are flagrant lies.

Parents watching children die because they can't afford treatment? Absurd. Cite the verified instance or please retract this. In Cuba, maybe, but not in the US.

Inferior, under-equipped US hospitals? Get serious. The average US hospital makes UK hospitals look like 19th century museums by comparison. In case you didn't notice, that's why so many people from around the world come here for advanced treatment. In fact, there are daily instances of Canadian and UK citizens coming here to acquire specialized services that they can't get in their systems.

Can the US do more? Yes. Is it's healthcare inferior? No way.

GT, Santa Barbara, US

I'll support NH for the US when the NHS stops killing my friends and business acquaintances in the UK.

richard mcenroe, n hollywood, CA, USA

Tim, I believe that Michael Moore did the same in Cuba that he did in England and France; show the best and hide the worst. I have seen pictures of other hospitals in Cuba that would rend your heart, as they certainly did mine. Filth on the walls and floors, cockroaches, patients lying on filthy cots, etc. I would say that that is the care being shown to the poorest of Cubans, and it certainly doesn't have anything to recommend the system that Cuba has.

As to HMO's, you are completely right. I despise those organizations and refuse to use them myself.

The Federal Government is notoriously inefficient in managing anything that gets down to an individuals level. Just look at Medicare as an example.example. Managing this type of system needs to be done at the State and Local level, those who know what the needs of thier citizens are.

This will end up being run by a combination of the Government and the Insurance Companies, giving us the best list of choices.

Jim, Woodbridge, Virginia, USA

Moore's film is a lie.
A rosy lie to get people to believe that under total sovialism life is a party.
And quite a few posters are severely misinformed. You don't die in the US because you can't afford the surgery. I know. It was my job for a good long time to make sure that expensive surgery was paid for--or the costs alleviated--no matter the patients level of insurance.
Patients that came in without any insurance were never turned away. That's 'never'. Occasionally, if a patient needed immediate care, and wasn't already a patient, they'd be sent to the ER--but even in those instances financial alternates were made known and available to them.
Finally, that 44 million without healthcare number is created from the guesstimate of about 12-20 million illegals, the guesstimate of 4 million homeless, everyone between jobs, and about 18 million people who do not have insurance by choice.
Add it up.

Jack, Covington, US

Healthcare is *absolutely* a commodity. There is simply no way around this truth. To disagree is to assume that a person would spend hundreds of thousands of dollars, years of hard work and the application of their great mental capablitly, only to find at the end of the road, if they want to work in medicine, their labor is not their own. Ask yourself, why can't we have a universal food program, or a universal housing program? Are food and housing any less important than healthcare? Do you as an individaul have a right to someone elses labor? No you do not. Just because you need something, doesn't mean that it's moral or correct for you to have it for free, even if it's medical care. Wake up, socialism in any shape or form is a failed experiment. The sure fire way to fix health care is to get the government OUT of it. Socialism kills.

A. Elstner, St. Louis, MO

Well written article and as a believer in free speech I was glad to read another point of view on the American Health Care System.
Unfortunatley there were glaring omissions.
What do you say to Mr.Moore's portrayal of the Cuban Health Care system. Do you think it is 'fair' that their citizens only pay 5cents U.S. for an inhaler that would cost them up to $120 in the U.S. ?
Do you think it is fair that a bone-marrow transplant is considered experimental and often not covered by health insurance in the U.S. ?
What do you think about bonuses for HMO employees who deny benefits to more people ?
I could go on but I'm sure by now you see my point. You have written about some of the issues in Sicko that you could fairly easily find differing opinions to back up your point of view. Now try to find similar differences of opinion in the 'rest' of the movie

Tim, Halifax, Canada / Nova Scotia

This well-written article takes direct aim at the American democrat, socialist sympathizers that want the government to provide everything and shield everyone from any responsibility, including the ability to reason and make decisions.

Where does it say that the government exists to provide healthcare?

John Williams, New York , NY, USA

To JF in Canterbury - all systems are in chronic deficit obviously and we will all have to pay more whichever system we choose, again - obviously.

Nevertheless it is clear to all that the French system is the worlds best. Choice, universal ,quality , care and it is NOT free at the point of need. A private public hybrid - which is why of all systems it works best.

There are good and bad points to this film but he raises genuine questions - and when it comes to arguing on priniciple he is damn right. Health care should not be a commodity. That civilised nations cannot either offer healthcare without cutting out millions of hard working people out of the system - or offering them mediocre services is a disgrace. The comments here so far are nutty for failing to even get that.

Judith, Kent,

I was interested in SICKO because of the high cost of health insurance quotes for tourists. I showed medical care as a source of income for the providers, not a service to the needy. Others may sneer at Michael Moore but do remember the US does not have a national documentary TV station nor newspaper such as The Times. By the way, if you have dentures you must insure them when you go to America.

Jay, Whittlesey, UK

As an American, the first thing I will say is I believe we need universal health care in our country and we can certainly learn plenty of important lessons in how to do so from England and France.

Having said that, I must correct some mis-statements made in this comments section:

1) Your health care is not *Free*. You don't have to pay when you go in, but your health care is paid for by the taxes collected by your government. The average tax rate in both the UK and France is significantly higher than in the US, primarily because of health care.

2) One commenter stated that half of the people in the US are uninsured. The latest figures have it at 45 million people, approximately half of that number are people illegally in our country. So, 23 million out of 300 million, less than 10%. Horrible yes, half the population, no.

Hopefully we will have universal care in the near future, maybe after the current administration is GONE!

Take care,
John

John Pierce, Denver, CO, USA

I went to my local U.S. hospital with chest pain. I was given a treadmill test test that day after being assigned a cardiac specialist, and an MRI the next day. Day three I received a triple by-pass surgery of my heart.

How many days would such treatment have taken in NHS?

jlg, Montgomery, Tx. USA

The rich have historically always subsidised the poor in the matter of healthcare, and properly it should continue that way, given the high costs of the supply of health care but much the same demand, rich or poor; especially if the gap between rich and poor remains as it is in this country.
I don t doubt what you say about Michael Moore is true. I have never seen any of his films, but he himself is somewhat of a visible contradiction and I would presume his films echo that position. It is so easy now to make a film, or any sort of programme, that carefully undermines what it superficially states it is promoting, by the technique of making carefully timed and obliquely stated contradictions along the way.

Henry Percy, London, UK

No society can have all the medical care that it's members desire for themselves or their loved ones and not bankrupt itself trying. Rationing always occurs. In the U.S. it is done by making the sick person (or the family) pay for much of the care needed, either by having insurance or out of savings. If people have to at least share the cost of treatments, they will forgoe frivolous doctor's visits. In Florida, a huge subgroup of seniors use doctors' visits as part of their social life and elect many minor procedures, and some major, because they have Medicare to pick up the cost. Extend this to the whole population and economic disaster awaits.

Europe can afford a NHS because the US carries the cost of a large miltary that has protected the continent since WW II.

Margaret M, Libertyville, IL, USA

The point of the movie is to highlight the shortcomings in the US health system. Living net to the US (Vancouver, Canada) and hearing almost daily about the horror stories of the millions of uninsured in the US, I am continuously thankful for our state run system which is similar to that in the UK. If Sicko helps to change the situation across the border even a minute amount it has done a fantastic job.

Misha L, Vancouver, BC.CANADA

Misha Low, Vancouver, CANADA

"Sicko is a dishonest film"

Just look at its creator, nothing new there and to call Moore a documentary maker is an insult to true practioners of the art.

I wonder how many of those who act so "knowingly" about the American system have actually lived there ? I have and I will say that I'd far prefer to be in hospital here than in the UK.

By the way, the NHS is not free and never has been.

Stan(expat), Texas, USA

Imagine for a moment if you can where the money would come from to support "free" health care if England and other quasi-socialist Western countries did not have the U.S. defending the free market system whereby the NHS is supported?

Joe, Healdsburg, U.S.A.

As an american woman that has had breast cancer I can only say I wish you the best. I was treated under the american system and the British system (my husband is British) I had to have A large DOLLAR sign on my forehead in order to be treated in the US. If it had not been for my radiation treat ment in the UK my husband and I would still be in massive debt. TO ADD TO OUR STRESS . You do not know what you are talking about. People should not profit from the misfortune of others. I did not chose to have breast cancer. I was willing to pay for a fair treatment. What is fair? I know that the massive profits that our health care executives make is not fair. I also know that paying some doctor to turn down a treatment you need is not fair. You take your highground. Do me a favor and use another word besides "DISHONEST" You need to come up with a better argument that the one you put forth.
From someone that know better !

MS Nye, New York Hamptons, US

I personally feel this article is "dishonest"... the documentary was good.. although he painted a rosy picture of NHS. The point was to show the lack of facilities in US. What do you think about the Canadian couple he interviewed?

Abhi, Shrewsbury,

Minette, could you join up a couple of facts? Who are the poor? Overwhelmingly women, and the children of lone-parent women. Who suffers under the US healthcare system? The poor. Ergo....

For a quick crack at a functioning but flawed NHS, you have provided support for lethal inertia in the US. Do you really value US women so little?

FH, Norwich,

I believe the ideals stated in the film are the valuable truth behind the NHS part. Hence the interview with Tony Benn.

I see you missed that point.

It's the ideology that access to life enhancing medicine should not be based upon personal wealth that is the real point to the film.

Sugar coating the realities is in some way a necessary evil given the intense anti-social medicine message that's pervasive in the States. According to Fox, we have to wait YEARS for cancer treatment and most people die waiting. Nothing could be further from the truth.

To allow people to die because they are poor is indefensible.

Robert Leather, Manchester, Greater Manchester

Loss of home visits?? Here in the US, no-one even remembers home visits. That's something that stopped happening in our grandparent's generation.

The main point is that through some additional taxation, Europeans including the UK pay probably the same amount or less than we do, but _everyone_ is covered. My older relatives in the UK are quite impressed with the quality of their care, BTW.

I'm a business owner who pays six thousand dollars a month to cover a dozen staff. I have another dozen temporary workers who are not covered.

Tim Sassoon, Venice, California

Michael Moore has an agenda. His "documentaries" serve that agenda. The US health care system is imperfect, so is Canada's, the UK, and many others. But the imperfections of socialized medicine do not serve his agenda.
The US must address the issues of the ininsured and why we can provide health care to illegal aliens but American citizens with "pre-existing conditions" can go bankrupt because they cannot quality for either insurance or state or federal aide. Micheal Moore, however, is not the prophet to take us there.

Mary Knight, Pittsburgh, USA

This article is simply an example of that which it criticises - using indignation and disgust for a more powerful read!

Miranda, Cheltenham, UK

I haven't seen the film, but we do seem to have a slightly different ethos this side of the pond. For example, if you want to see somebody about breastfeeding in the US, you probably will go to see a lactation consultant at 140 USD/hour and up, whereas in the UK the first stop is likely to be a voluntary clinic run by the NCT's trained advisors, bless them.

My personal view of the NHS is that it should be free at the point of use, but that should not exclude them purchasing services from reputable private providers in certain cases, provided (a) that the standard of care is at least as high and (b) there is not an erosion of NHS expertise as a consequence.

Lance, London,

I saw Sicko last night in defiance of Ms Marin's recommendation and it was very interesting, often very funny and made me very grateful indeed for the NHS. I have had some second-hand experience of the American system in that friends of ours had a son born with problems in the USA. Much of the treatment he needed the insurance company wouldn't pay up for. They agreed to everything the doctors said he needed and ended up with huge debts which took years to pay off. Other parents after 'discussions with the financial advisor' decided against treatment for their babies. I've used the NHS all my life and mainly it's pretty good. Surveys show that most patients feel the same when asked about their own experiences of the NHS. Of course there are horror stories - but then the press jumps on these because they make news. The daily excellent work that the NHS provides day-in day-out never makes headlines and should be celebrated.

Rebecca Jones, Henley-on-Thames, UK

I have seen the film and liked it. I doubt that anyone thinks its purely factual, Its an emotional plea for people to be treated according to need, not to the width of their wallet. As to moore's alleged grossness, that is simply an insult unbecoming of a professional journalist. The NHS isnt perfect but rather than naysaying it why not pay your full share of taxes like the rest of us? and your boss too!

Elwin parsley, london , UK

this is an extremely hostile summary. the point of the film was not to show how great the nhs is but to illustrate that an alternative "privatized" version would exclude millions and that's no exaggeration. MILLIONS of the most vulnerable. whatever the short comings of the nhs. it is infinitely better than health care provision in the US. that's the point moore was trying to make.

muhammad ikram, blackburn, uk

So why is Sicko so dishonest? What has Michael Moore so misrepresented? Is Marrin saying that Health Insurance companies do not look for get out clauses so they do not have to pay up, patients without health insurance are dumped outside charity hospitals, some Americans do not have surgery because they cannot afford it as Moore documents in his film. No she is basically saying that Micheal Moore is fat and Robert Winson thinks that the NHS is not as good as Moore portrays it, not sure what Winston means by that as I don't remember the Moore's portrayal of the NHS as false. I have had personal experience of care in
3 Hospitals recently and am profoundly grateful and lucky to live in a country where free health care is taken as granted. Pay no attention to Marrin go and see Sicko and see what could happen if profit and tax cuts are put above free health.

Rob Brookes, Tewkesbury, UK

Oh dear Uitlander,

Thackeray took the title Vanity Fair from John Bunyan's Pilgrim's Progress.

Andrew, London,

Yes Moore can be vain and self serving and his films are about as subtle as a speeding train, but they serve an important purpose. His rose tinted picture of the NHS is indeed ridiculous but the basic tenet of free healthcare being the basis of a decent society is one that the American Healthcare system has been squirming out of for years. And Moore at least holds this basic and appalling iniquity up for scrutiny. That he does it in a cartoonish way is questionable but at least he does it.

I've worked in the US and it is truly shocking to be faced with parents who have to watch their child die because they can't afford the operation. That this should be happening in one of the richest countries in the world is scandalous and yes it does make you appreciate our tattered, but still upright NHS.

Dr Evie Wallace, London,

I agree totally with the writer. There are very serious concerns and implications of the current trends (for the worse) in the NHS. Above all, the morale of the main service providers at the hospitals is extremely low.

M K Aslam, Manchester, UK

When our child's arm got burned many years ago, we very worried about going to an NHS hospital in London due to bleak media reports then, yet we received wonderful attention and treatment from some wonderful nurses and doctors. Whilst I understand that there are real problems with NHS, if money is not the problem than management of the NHS is the issue. Why does the Times not strongly criticise the Labour government for mismanagement rather than the NHS itself? Healthcare is the key government responsibility and government has sole responsibility for NHS .Are we really setting up the case for private medical cover? Whilst Michael Moore pushes limits, thank God that he is around. I wonder why the Times and the Guardian have such opposing views on the value of this film?

Jon Michael, Cape Town, South Africa

Yes, he oversimplified and overpraised the NHS. But, at its worst, the NHS is an advance on the deplorable American free-for-none system. When half of the US population is without medical insurance or any form of easily available health care, Minette Marin is simply wrong to accuse Moore of dishonesty in his description of the situation of millions of Americans..

Gerry Lewis, London, UK

Amen. To call Michael Moore a documentary film maker is to contradict the very idea behind documenting film making, which is purely to document events without skewing the facts. Moore is a disgrace to we Americans who want change in our social systems. He makes change appear attainable only if we dump our values and blindly attack those who might oppose.

Marisa Maupin, London, UK

Michael Moore is terrible, and what you have written about him is well expressed and well overdue. But the NHS is not anywhere as bad as you make out; in fact it is rather good. In any case, instead of a campaign against the NHS, which has the effect of undermining something worthwhile (journalism seems to be reduced to this negativity activity), how about some positive suggestions and alternatives. Without them, all you do is trash the NHS, with the danger that nothing good will take its place.

Michael, London,

Many in the US press are committed socialists who believe, passionately, that the government should run everything. I've worked at government hospitals through the years. There is always mismanagement: plenty of Viagra (because people want it) where other medicines are rationed as being too expensive. While a resident at a Veteran's Hospital, an indigent vet showed up 15 minutes after the clinic closed. I was willing to see him. The nurse in charge of the clinic said, "You will see him in the parking lot then, because no one comes to my clinic late." This is what people will get with socialized medicine. They will pay a fortune for it with taxes, and have no idea what they are getting themselves into: A culture of pusillanimity, sloth and lowest common denominator medicine. One wonders: if Michael Moore has a heart attack or gets cancer, will he go to Cuba for his treatment? I doubt it.

Tony Francis, Wichita, KS/USA

Having experienced both the US system and the NHS, I choose the US every time. When I broke a major bone in the UK, I was given nothing more than cheesecloth and paracetemol by my NHS hospital. Ultimately, I ended up flying back to the US 4 months later to get the bone rebroken and set by a proper physician. In the UK, it took me 12 hours to get an x-ray and 12 weeks to get an mri (that was the wait even after paying privately for one). When I went back to the US for care, both the x-ray and mri were performed in the doctor's office and took a total of 2 hours to complete. By the way, my US insurance cost me only a little more than my FREE NHS health insurance tax did. Factoring in the cost of airfare, etc, the US deal was much better.

Michael Moore is a nut and doesn't know what he is talking about. How could anyone prefer the NHS over the US system?

Oh yeah, I'm one of those "downtrodden" US middleclass folks who struggles to make ends meet.

Bill Dow, Cumming, Georgia, USA

I totally agree with Ms Marrin about Michael Moore. As for the French system, which I know well, it is in chronic deficit (and here we're talking many billions of euros) in a country that its own prime minister admits is technically bankrupt (i.e. liabilities exceeding income & assets). So there's not a lot of sense in the French having a health-care system that is adding year-on-year to an already astronomical national debt. So nobody - not the USA, not the UK, not France - seems to have the answer to the question, "how do we provide health care to the whole population ar a price that the state and/or individuals can afford?" The person who cracks that one will deserve the Nobel Prize for economics. Certainly not Mr Moore.

JF, Canterbury, UK

Michael Moore has become the high priest of Pilgerism. Fortunately, more and more people are now seeing him for what he is, and, with Sicko even his most gullible fans - and I know quite a few of them - will finally understand the slight of hand that has been played on them.

jonathan Anthony, london,

Thackeray wrote Vanity Fair. More proof of the poor standards of the fourth estate?

Uitlander, Reading, UK