Sicko is a great movie, one of the most emotion-evoking films I have ever seen. In a CNBC interview, Moore said something that is at the heart of Sicko:
They [HMOs] are required by law ... to maximize profits for their shareholders. That's what the law requires them to do. The way they can maximize profits is to deny care, is to not pay out claims. The more claims they pay, the less profit they make. You should never have the idea of profit enter into a health decision. We wouldn't allow it for the fire department or the police department. We wouldn't say, well, you know, we've got to be sure the fire department posts a profit. We wouldn't turn it over to a private company, have investors invest in it, say, well, some people are going to get fire protection and other people aren't. We wouldn't allow that, would we? It would be immoral.
This is what Systems of Survival by Jane Jacobs is all about. Jacobs argued that there are two sets of "moral" rules -- one appropriate for "guardians" (such as firemen, police and doctors), the other appropriate for "traders" (business people) -- and that the two should not be mixed. When guardians follow commercial rules or when traders follow guardian rules, bad things happen. Sicko is about the bad things that happen when doctors follow commercial rules and how these bad things are avoided when (in other countries) doctors follow guardian rules.