CONTENTS:

1
SiCKO ACTION GUIDESmall groups may use the
following details from the movie and questions to
begin a conversation about health care reform.
Groups larger than five may break into smaller
groups for discussion, and share highlights of
their conversation with the whole group
later.The guide builds upon the movie, and
filmmaker Michael Moores own belief that
ordinary citizens can affect change, by
encouraging real, action-oriented dialogue.
Everyone is affected by our sick health care
system every one of us can be part of the cure

• CONTENTS
• Pages 2-5 may be used by any small group after
  experiencing the film. Facilitators need only
  review the questions briefly before beginning the
  dialogue with the group.
• Page 6 contains additional material that can be
  used for a student, youth, or college discussion
  group.
• Page 7 contains additional material that can be
  used with faith, mission, or congregational
  groups.
• Page 8 has specific questions for working adults
  and may also work well with college groups,
• Page 9 includes questions designed for union
  members and
• Page 10 contains questions specifically for
  business people.
• Page 11 focuses on concerns of womens health and
  
• Page 12 includes questions that can be used
  specifically by parents.
• Page 13 gives additional information about the
  health care reform movement and about getting
  involved.

2
SiCKO uses the experiences of regular, insured
people to underscore the brokenness of the U.S.
health care system. Again and again, Michael
Moore presents facts about the state of health
care in our country and others as he weaves
personal experiences throughout. The film
examines a complex issue through the lens of the
personal.

• TO BEGIN
• 1. Recall a recent health care experience of
  your own. What made it positive or negative?
• 2. Which of the stories in the film resonated
  with you the most? Why?
• 2

3
Facts from the filmIn spite of per capita costs
that far exceed those of any other industrialized
democracy, the U.S. is ranked 37th in the world
in overall health outcomes. Sources World
Health Organization and the Organization for
Economic Cooperation and DevelopmentIn 2004
medical bills contributed to 54 of bankruptcies
in the U.S.. Most of these people were insured
when illness struck. The rest of the bankruptcies
were caused by job loss, divorce, death,
gambling, and addictions. Source Journal of
Health Affairs, Feb. 2005

• FOR DISCUSSION
• 1. Does the U.S. feel like a wealthy nation to
  you? Describe some features of your everyday
  life that support your answer.
• 2. When you think of your health, job, and
  finances, do you feel personally secure?
• 3. How do you make sense of the disparity
  between ordinary peoples lives in this country
  and in the countries featured in SiCKO?
• 3

4
In SiCKO, Michael Moore argues that change is
possible if we all find our voice within the
democratic process. Moore repeats that we are
not only a nation with the resources to solve
this problem, but with a history and an ethos of
helping one another.

• FOR DISCUSSION
• 1. How did stories from the movie influence the
  way you think about citizens in the U.S. getting
  involved in their democracy?
•  
• 2. What do you think is your personal stake in
  changing the way our health care system works?
• 3. How can your experience or story help bring
  about change?
• 4

5
As you may know, many groups throughout the
United States are working, at every level, to
bring about single-payer health care for all.
Soon after the release of SiCKO, Michael Moore
sent a letter to all of his contacts asking them
to join with Health Care NOW!, a nation-wide
network of activists. Health Care NOW!, and many
of its allies, support H.R. 676, the only bill
before Congress that would bring every person in
the United States full, just, and complete health
care.

• FOR ACTION
• Michael Moore recently wrote a letter to all of
  his fans asking them to join, connect with, and
  support Healthcare NOW in its work. Not only
  does Healthcare NOW support people of all walks
  of life in all areas of the country, it has the
  means to help you and your groups act now.
• Begin by visiting www.healthcare-now.org
• to read H.R. 676 for yourself, add your story to
  a petition for Congress, and link up with others
  who believe our country can live up to its
  promise and bring health care to all.
• Other sites with information, resources, and
  connections
• Sicko Cure www.sickocure.org
• California Nurses Association www.calnurse.org
• Talk, think, and write about the issue. Contact
  your Congresspeople. Write your newspaper.
  Share your story. Add your voice to the cause.
• 5

6
Just as every single voice will contribute to
lasting change, different groups bring different
perspectives, abilities, and drives for change.
One challenge in revolutionizing a national
system is in hearing and harnessing the voices
and strengths of all groups. And yet, its
happening now, as unions join retirees and nurses
and medical students and teachers and parents...
One way to begin the process is to think about
the unique ways different groups can contribute
to a shared cause.

• FOR DISCUSSION
• 1. What does activism mean to you? Does it
  have positive or negative connotations?
• 2. Thinking of the experiences portrayed in the
  film, what are the major problems in the United
  States health care system? Why hasnt it been
  fixed?
• 3. Excluding health care, what are some social
  justice or human rights issues that concern you
  or your peers?
• 4. What can your voice and perspective add to
  the discussion Moore began with his film?
• 5. How can you appeal to others who might
  disagree with your political views, but agree
  that health care is a major problem? Where is
  the common ground?
• 6

7
Faith communities have frequently been at the
forefront of human rights issues in the United
States. Also, most faith traditions specifically
call for their members to right injustice, care
for the poor and sick, and stand with those
oppressed by corrupt systems.

• FOR DISCUSSION
• 1. What do the canons, sacred texts, or
  traditions of your faith teach regarding care for
  others?
• 2. How might faith communities bring about
  change in our health care system? How might
  there be barriers to faith communities effecting
  change?
• 3. Does your congregation or group engage in
  working for health care justice? Why or why not?
• 4. How does your personal faith inform your
  activism in the world?
• 7

8
FOR DISCUSSION1. Describe your first real
job. How are jobs for young workers often
different from careers? 2. Are your parents
and family members healthy? Have you experienced
any family illnesses like those filmed in
SiCKO?3. Do you think our government should be
responsible for taking care of the health of
working people? Of those who cant work? Why or
why not?4. Imagine your dream career, and
picture yourself in that position. What benefits
are you looking for? What will make you a
productive worker?
8
The percentage of working adults (18 to 64) who
had no health coverage climbed from 18.5 percent
in 2004 to 20.5 percent in 2005 -- an increase of
over 800,000 uninsured workers. Nearly one (1)
million full-time workers lost their health
insurance in 2005. Young adults (18-to-24
years old) remained the least likely of any age
group to have health insurance in 2005 30.6
percent of this group did not have health
insurance.---from the National Coalition on
Health Care at www.nchc.org
9
Working families are experiencing double-digit
increases in the costs of health insurance, more
out-of-pocket costs for doctor visits and
skyrocketing prices for prescriptions, forcing
many to delay getting needed medical care or
worseto decline coverage for themselves or their
families because of cost. Health care costs are
rising at five times the rate of inflation. --
Whats Wrong with Americas Health Care, by the
AFL-CIO

• FOR DISCUSSION
• 1. What does living wage mean to you? Describe
  the differences in a life with and without a
  living wage.
• 2. Some argue that if people make good money,
  they can afford to buy their own health care.
  What do you say to this, based on your own
  experience and knowledge?
• 3. Thinking about your entire career, when has
  health insurance been crucial for you and your
  family?
• 4. What do unions and activists have in common?
  How can the movement for universal health care
  use and build from the strengths and historical
  experiences of unions?
• 9

10
The U.S. has a loose arrangement that
wastes billions of dollars in administrative
costs created by the vast number of different
health insurance companies offering various
health plans and all requiring different types
and amounts of paperwork. Its cheaper to pay
directly for the medical costs than to pay
insurance premiums, said Dr. Deborah Richter,
who is a member of Physicians for a National
Health Program. Every other industrialized
country realized this long ago. --from
Universal health insurance makes business
sense by PNHPThe United States spends at
least 40 more per capita on health care than any
other industrialized country with universal
health care, and Federal studies by the
Congressional Budget Office and the General
Accounting office show that single payer
universal health care would save 100 to 200
Billion dollars per year despite covering all the
uninsured and increasing health care benefits.
--from The Case for Single Payer, Universal
Health Care for the United States by Connecticut
Coalition for Universal Health Care

• FOR DISCUSSION
• 1. In your opinion, how are social activists
  different from business people?
• 2. How do you respond to Moores--and
  others--argument that single-payer health care
  makes fiscal sense for the U.S.?
• 3. Using issues from the film and your own
  knowledge, articulate what you think is the best
  solution for our failing system.
• 4. How might business leaders help this cause?
  What obstacles might keep them from joining it?
• 10

11
There are 23 million women currently without
insurance in the U.S.women require a more
diverse set of health services than men putting
many women at greater risk. Women of reproductive
age are at a particular disadvantage, as nearly
one in five do not have private insurance or
Medicaid coverage. Women are more likely than men
to be in low-paying jobs that do not offer
employer-sponsored insurance. --from the
National Womens Law CenterWomen have less
access to their own employer-sponsored
insuranceare more likely to depend on their
spouses for their insuranceare more likely to
have lower incomes than menand use more health
services than men ---from Women and Health
Coverage A Framework for Moving Forward by
Patchias and Waxman at the National Womens Law
Center

• FOR DISCUSSION
• 1. Choose one of the facts from above. How does
  one of your own experiences underscore the facts?
• 2. Think about all of the interactions a woman
  has with the health care system over the course
  of her life. How does our government or health
  care system positively or negatively impact the
  lives of women?
• 3. If you were to begin helping reform the
  system, which area most speaks to you, your
  needs, and your history and experiences?
• 4. As a group, where do your calls to activism
  connect?
• 11

12
An estimated 2 million babies die within their
first 24 hours each year worldwide and the United
States has the second worst newborn mortality
rate in the developed world, according to a new
report. American babies are three times more
likely to die in their first month as children
born in Japan, and newborn mortality is 2.5 times
higher in the United States than in Finland,
Iceland or Norway, Save the Children researchers
found. --from a CNN Special Report by Jeff
Green, May 10, 2006

• FOR DISCUSSION
• 1. Charles MacCormack, president and CEO of Save
  the Children, has said In countries where
  mothers do well, children do well. What does
  your own experience add to his observation?
• 2. What do you know about health care costs? If
  a family paid for prenatal care and delivery with
  cash, how much would it cost? Is the care youre
  family has received commensurate with the money
  health care industries are receiving?
• 3. What were your biggest challenges as a new
  parent? What do you think of the benefits
  parents in England and France receive, as shown
  in SiCKO?
• 4. What unique perspective does your experience
  as a father or as a mother lend to the health
  care reform movement?
• 12

13
MORE INFORMATIONWhat is H.R. 676?The United
States National Health Insurance Act, (Expanded
and Improved Medicare for All)Introduced by
Rep. John ConyersSummary of the
legislationThe United States National Health
Insurance Act establishes a unique American
national universal health insurance program.  The
bill would create a publicly financed, privately
delivered health care system that uses the
already existing Medicare program by expanding
and improving it to all U.S. residents, and all
residents living in U.S. territories. The goal of
the legislation is to ensure that all Americans
will have access, guaranteed by law, to the
highest quality and most cost effective health
care services regardless of their employment,
income, or health care status. With over 45-75
million uninsured Americans, and another 50
million who are under- insured, the time has come
to change our inefficient and costly fragmented
non- health care system.View the entire bill at
www.healthcare-now.org/hr676.htmlWhat is
Healthcare NOW! ?We are building a movement for
a Guaranteed National Health Insurance System in
this country, quality healthcare for every human
being.  How do we do that? One person at a time,
one organization, union, church, synagogue,
mosque, community center, neighborhood at a
time...  Here's how we do it By developing an
empowered leadership at the grassroots who
understand the issue and engage in a variety of
tactics to make it happen. No one tactic or
strategy will move something this big. No one
organization can do it. Top down efforts have
never worked and that is why, for at least a
dozen years, people have been led to believe that
we cannot get real universal health care in this
country.  People have tried over and over to get
national healthcare from the top down -- but it
won't work.  We are the ones that must make it
happen. Every other advanced nation has it, but
many people are still negative about the prospect
of getting it here because the media and the
politicians have deemed it impossible. --from
www.healthcare-now.org Where can I tell my
story? Adding your voice to the growing
movement is one of the most important steps you
can take. On the Healthcare NOW! website, you
can sign a petition and leave messages for
Congress. On MySpace, you can comment, add
photos, or upload videos about your experiences
at www.myspace.com/nowhealthcare. 13
"Words without actions are the assassins of
idealism. --Herbert Hoover "I am only one, But
still I am one. I cannot do everything, But still
I can do something And because I cannot do
everything I will not refuse to do the something
that I can do. --Helen Keller "Do not wait for
leaders do it alone, person to person. --Mother
Teresa