If you were around in 2007, you probably remember the poster. A scruffy guy in a baseball cap pulling on a surgical glove with a grin that said, "I know something you don't." That tagline—This might hurt a little—wasn't just a clever marketing hook for Michael Moore’s documentary Sicko. It was a warning.
Moore didn't just want to talk about health insurance. He wanted to rip the band-aid off the entire American medical complex.
Honestly, looking back at it now, the film feels like a time capsule that somehow never got buried. While the world has changed, the core frustration Moore tapped into remains incredibly raw. It's that specific brand of "American dread" where you’re more afraid of the hospital bill than the actual disease.
The Reality Behind the Tagline
When Sicko premiered at the Cannes Film Festival, it received a 17-minute standing ovation. That’s a long time to clap. But the film resonated because it moved away from Moore’s usual targets—like CEOs or politicians—and focused on the "victims" of a system that most people assumed was working "well enough."
Moore’s hook was simple: he wasn't looking at the 47 million Americans without insurance (at the time). He was looking at the people who had insurance and still got screwed.
Remember the guy who had to choose which finger to sew back on? Rick, a woodworker, lost the tops of two fingers in an accident. The hospital gave him a price list: $12,000 for the ring finger or $60,000 for the middle finger. Being a "hopeless romantic," he chose the ring finger for the bargain price.
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It sounds like a dark comedy sketch. But it was real. That’s the "hurt" Moore was talking about. It’s the realization that in a for-profit system, your body parts have a literal MSRP.
The Global Tour of "Better" Systems
The middle of the film is basically a travelogue of Moore being shocked by "socialized" medicine. He goes to Canada, the UK, and France.
In the UK, he wanders through an NHS hospital looking for the "billing office." He can't find one. He finds a cashier, but it turns out the cashier is there to give people money for their bus fare home.
Why the France Segment Hit Different
The French segment is often the one people remember most vividly. Moore spends time with a group of American expats in Paris who seem almost embarrassed by how good they have it.
- 24-hour House Calls: He follows "SOS Médecins," doctors who ride around on motorcycles to treat you in your living room.
- Government Nannies: He highlights "municipal help" where the state sends someone to help new mothers with laundry and cooking.
- The Cost: Zero. Or close to it.
Critics often pointed out that Moore ignored the high tax rates in these countries. He didn't care. His argument was that the "tax" Americans pay in the form of premiums, deductibles, and co-pays is far higher and provides way less security.
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That Controversial Trip to Cuba
You can't talk about Sicko without the Guantanamo Bay stunt. Moore took a group of 9/11 first responders—people suffering from respiratory illnesses who were being denied care by the U.S. government—to the gates of the detention center.
His logic? The "detainees" there were getting free, high-quality medical care. Why weren't the heroes of 9/11?
When they were turned away, they went into Havana. The footage of these Americans receiving inhalers that cost pennies and undergoing advanced screenings for free was a massive PR nightmare for the Bush administration. The U.S. Treasury Department even opened an investigation into Moore for violating the travel embargo.
Was it a stunt? Totally. Was it effective? It made the point that a "third-world" country could provide the basic dignity that the wealthiest nation on earth wouldn't.
Did "This Might Hurt a Little" Actually Change Anything?
It’s been nearly two decades. We’ve had the Affordable Care Act (ACA). We’ve had endless debates about "Medicare for All."
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If you watch Sicko today, the most depressing part is how little the dialogue has evolved. We are still arguing about whether healthcare is a right or a privilege. We still have "GoFundMe" as a primary source of medical insurance for millions of people.
The Legacy of the Film
- Mainstreamed Single-Payer: Before Moore, the idea of a UK-style system was fringe. Sicko put it on dinner tables.
- Exposed the "Denial" Industry: It showed the world the "medical directors" whose job it was to find reasons not to pay for surgery.
- Humanized the Statistics: It wasn't about charts; it was about a woman whose husband died because their insurance wouldn't cover a bone marrow transplant.
What You Should Do Now
If you haven't seen the film, it's worth a re-watch, even if you disagree with Moore's politics. It provides a necessary baseline for understanding why the American healthcare debate is so high-stakes.
First, check your own coverage details. Don't wait for a crisis to find out what "out-of-network" really means for your specific plan. Most people don't realize their "good" insurance has a "maximum out-of-pocket" that could still bankrupt them.
Second, look into local advocacy. Organizations like the PNHP (Physicians for a National Health Program) continue the work Moore highlighted, using data rather than just dramatic film scores.
Finally, stay skeptical of the "choice" narrative. One of Moore's biggest points was that we don't have "choice" in a private system—the insurance company chooses for us. Whether you agree or not, knowing how those choices are made is the only way to protect yourself.
The pain Moore promised didn't come from the movie itself. It came from the realization that for many, the system is working exactly as it was designed to—which is the scariest part of all.