So much has been said and written about Sicko that what else is there to add? Let me take a shot. To move past propaganda and counter-propaganda (from all sides) and try to take a pragmatic approach. Several key questions exist:

• What are the historic parallels?
• What is likely to happen as the public debate progresses?
• What should people and institutions actually do?

In my analysis I am assuming that Sicko is going to create a strong enough wave for some kind of healthcare reform. Do not let middling box office numbers fool you about the power of Moore's message to galvanize public interest.

So, let's start with a title analogy on where we have seen this movie:

Actually a book, written a hundred years ago. The one that made a name for Upton Sinclair, who bears striking similarities to Michael Moore. The message of The Jungle (1906), rings a lot like Sicko. An industry with a lot of problems. An enterprising author finding some great metaphors to make the public listen. A call for socialism, stirring the public debates.

The Jungle exposed unsafe and dangerous conditions of Chicago meat packing plants. There is a spectacular horror story: workers falling into meat processing tanks and being ground, along with animal parts, into "Durham's Pure Leaf Lard" (compare to Moore's style of film making). Like Moore, Sinclair thought the capitalism itself was to blame. But instead of creating a "socialist revolution", the public outcry simply pushed Congress to clean up the meat packing business, passing the Meat Inspection Act and the Pure Food and Drug Act of 1906, which established the Food and Drug Administration. 

Sinclair himself was dismayed at the failure of his socialist crusade and even opposed FDA legislation. His quotations sum it up pretty well:

"I aimed at the public's heart, and by accident I hit it in the stomach."  

"It is difficult to get a man to understand something when his salary depends on his not understanding it."

This in a nutshell is what the future holds for Sicko's impact

America loves freedom, choice and capitalism. The very notion that healthcare decisions would be monopolized by faceless DC bureaucrats is terrifying to most people (not all). Why do you think Harry and Louse commercials worked so well back in the days of Hillarycare? Debates on the finer points, such are how US and Cuba compare on world health system rankings dominate Sicko coverage but are largely irrelevant. This is not where the real action will be.

Make no mistake, I am not advocating the status quo. Sicko put the spotlight on many "Durham's Pure Leaf Lards" brought to us by our dysfunctional healthcare system. There will be some legislative activities. Yet, instead of chasing and killing the Great White Whale of the healthcare "profit motive" expect to find the same profit motive turned around towards better incentives - activating the power of entrepreneurship. Just like it happened in meat packing.

This is where healthcare leaders can take cue from FDR's New Deal

Great Depression has thrown the country in such turmoil that a socialist revolution seemed possible. Fortunately, the America's leadership was not as incompetent as Russia's to let it actually happen. Instead Franklin D. Roosevelt made a case for addressing specific problems that led to economic collapse and won Americans to his cause. The change was radical enough for conservative critics to decry "socialism in disguise", while outraging Commies over the "preservation of capitalism".

Net result for American people? Capitalism and financial markets work darn well. There was nothing like Great Depression ever since. Problems solved.

In a nutshell, this is the kind of forces Sicko is putting in motion

Public's outcry over the movie is real and will lead to serious action. This presents the healthcare industry with the real choice: embrace the people power or get rolled over. The usual marketing gloss will be about as believable as Moore's caricature of villainy. The answer is to embrace practical solutions from real people in the real world and not expect Washington DC to solve all of the nation's healthcare problems. Remember how HIPAA turned out?

There will be more Health Reform coverage here. Expect specifics on how it relates to People Powered Health(care) movement.