Parallel Encounters: Culture at the Canada-US Border

3. Meanings of Health as Cultural Identity and Ideology Across the Canada–US Border

47 THE CANADA–US INTERNATIONAL BORDER is a social space where a juxtaposition of health care systems exposes ideological tensions. Using Michael Moore’s political documentary SiCKO (2007) as an entry point, this chapter questions the meaning of health in terms of cultural identity and ideology as well as what can be learned from the stark differences in health care systems from one side of the Canada–US border to the other. To locate this analysis, a brief social history traces federal policies as part of the social shaping of Canada’s health care system. The Canada Health Act is then analyzed as a policy that inscribes and embeds national identity and ideology. The meaning of health in the context of border crossings is also linked to Michael Moore’s activism and politics; this chapter looks north to Canada in order to apply insights from SiCKO to current struggles around public and private health care in the United States. This chapter also draws on the argument that “both enclosure and mobility are defined against the other, hence reflecting our sense of borders as ongoing social processes governed through political, economic, and cultural struggles” (Cunningham and Heyman 293). While border crossings reflect mobility in many economic and ideological ways, the juxtaposition of different health care systems based on health as commodity versus health as human right reflects a form of ideological enclosure across the border. Michael Moore grew up in the 1950s and 1960s in Flint, Michigan, an auto industry town close enough to the international border for him to be aware of contrasts between the United States and Canada that would later become part of several of his films. The first film in which he looked at the Canada–US border through his American eyes was the comedy Canadian Bacon (1995); he then returned to Canada for part of his film Bowling for Columbine (2002). His exposure of health care practices in SiCKO again compares Canada and the United States, this time with regard to the harsh personal consequences of capitalism. Moore’s unique style is evident in his first documentary film, Roger and Me (1989), a personal and political documentary that traces the decline of three Meanings of Health as Cultural Identity and Ideology Across the Canada–US Border Jan Clarke 48 Jan Clarke the auto industry in Flint through stories of working-class families in Moore’s hometown. Moore’s down-to-earth, hard-hitting documentaries expose the greed of capitalism hidden behind the American dream of economic opportunity and social mobility. This unique approach often disarms audiences: “Moore is of the left, but it is also important to him that he is mainstream. He wants to change things, and he knows that to do so he must prove to his followers that they are the majority” (MacFarquhar 133). Moore’s documentary SiCKO, “infused with Moore’s trademark boundary -pushing and in-your-face irreverence” (Kennedy B8), offers an insightful entry point into the meanings of health across the Canada–US border. SiCKO focuses on the consequences of the private health care system in the United States, where poverty and loss of savings as a result of the costs of illness or accident are widely feared, even among those who do have private health insurance. Much of the film’s content is drawn from personal stories selected from more than 25,000 respondents to Moore’s public email request that they explain why 47 million Americans do not have health insurance and why so many who do are routinely denied treatment options (Smith, “Anniversary”). Kennedy aptly describes SiCKO as “filled with stories that break your heart at the same time they enrage you” (B8). Unpredictable health care costs are shown to be an ever-present reality for Americans, regardless of class and privilege . To contrast private health care in the United States with different forms of universal health care elsewhere, Moore compares health care costs in the United States, mostly for emergency and surgical cases, to the costs for similar cases in Canada, England, France, and Cuba. He highlights Cuba to demonstrate the significance of socialized universal health care funded entirely by the state. In Cuba, a communist state, health care is a human right that is to be prioritized even when Cuba is under severe economic constraints. As a social activist and populist, Moore is clearly trying to do more than simply compare radically different health care systems: “Moore is making a...