his work to the next level, and "Sicko" was no exception. Nevertheless, the film left me laughing, cheering, and crying and particularly gleeful regarding memos sent by management throughout the Blue Cross system warning employees of the possible side-effects of "Sicko" on their company's image.

In the light of Moore's impressive research and documentation, after listening to the film's horror stories of patients raped by the "disease-care" system, after witnessing the confessions of former players in that system who have come clean and can only live with themselves by spilling their guts regarding the devious methods they used to keep the system intact and bloat its profits, after hearing the Oval Office conversation between Richard Nixon and John Ehrlichman in which the two salivated over the spoils guaranteed to the industry as a result of creating a sprawling network of HMO's, after the poignant scenes near the movie's end of real people-9/11 rescue workers, actually getting extraordinarily humane and completely free healthcare in Cuba, there is little left to say about the American system because one can only hold one's nose and gasp for fresh air in face of the overpowering, nauseating stench of the most brutal medical industry on earth. I do not hesitate to label it unequivocally, pure evil.

Not only is the American disease-care industry the biggest rip-off of any healthcare system on earth, but it is being used to prop up an expiring economy because it creates jobs, and without those jobs, the U.S. unemployment rate, already fudged with bogus statistics, would immediately spike. Not only is U.S. healthcare devastating the lives of Americans who use it, but it is being manipulated to give the appearance of economic health in a code-blue economy now in collapse.

Moreover, unlike the healthcare systems of many developed countries, the American system gives much lip service to preventive medicine, but only about 1% of the American healthcare dollar goes to prevention programs and for one simple reason: Sickness is profitable, and prevention is not.

But once again, Moore does not ask the deeper questions such as: What is inherent in the American capitalist system that propagates and rewards such carnage? In fact, he fails to notice that profit over people is at the core of Western civilization and the culture of empire. Ten thousand years of civilization which include the raping and overpopulating of the earth, the depletion of the planet's resources, the dizzying pace of global warming, and the extinction of hundreds of species per day, have brought us to exactly this point. How could the inhabitants of the belly of the beast have access to anything better than a disease-purveying medical system that facilitates the elimination of the middle and working classes while guaranteeing that the ruling elite will wax healthier and more affluent? Fortunately, "Sicko" does not spend much time suggesting that somehow this system can be reformed, improved, or streamlined which would be the proverbial band-aid for cancer. But neither has Moore yet diagnosed the malignancy at the core not only of the American healthcare system but of civilization itself.

To his credit, perhaps the most important line in "Sicko" was the pivotal question: "What have we become that we have allowed this to happen?" And so I sit with the first four words of that question-what have we become? Until this question is explored, Moore and all other well-intentioned progressives will miss the point.

Civilization is in an inexorable, cataclysmic downward spiral of collapse. The American disease industry is only one of a plethora of institutions and systems in a process of abject crumbling-education, religion, economic systems, family, political systems, energy, transportation, infrastructure, food production-the list is virtually infinite. The tragic footage of the Minneapolis bridge collapse, now burned by corporate news media into the American mind, is a ghastly metaphor for the failed fiasco of civilization, as well as a ghoulish consequence of a rotting infrastructure that the corporatocracy refuses to attend to in its frantic obsession with global resource wars.

U.S. healthcare is a nightmare with few options. In order to receive efficient, free care, it is almost necessary to move to another country. Unfortunately, "Sicko" implies that moving to Canada is a viable option, but in reality, emigrating to any country is not easy and usually requires a long, mind-numbing process of bureaucratic red tape-especially for Americans whose investments and government checks are welcome in foreign banks, but whose quest for jobs is not. Furthermore, Canada will soon be inundated with immigrants as Americans move there in droves and as 4000 people per week leave the U.K. for destinations like Canada, South Africa, and Australia.

It behooves every American who takes collapse seriously and is consciously preparing for it, to learn healthcare skills. An individual can enroll in or audit almost any basic emergency lifesaving or first aid course at local community colleges or hospitals around the country. Health care professionals who are preparing for collapse can take their preparation to the next level by offering informal workshops on various aspects of healthcare for non-professionals. Moreover, a basic knowledge of herbal remedies and a generous inventory of them is essential, not only as access to traditional healthcare diminishes but as herbal remedies themselves become more difficult to acquire in terms of prices and the likelihood of government control or elimination of them.

In addition, the Hesperian Foundation offers a treasure-trove of books and DVD's for non-professionals such as "Where There Is No Doctor", "Where There Is No Dentist", "Where Women Have No Doctor", a "Handbook For Midwives", "Helping Health Workers Learn", and a variety of related topics. People with access to medical supplies may want to consider amassing a cache of them for times when they may not have access to healthcare at all, even if they have health insurance. Those who require specific medications for survival may want to work with their physician or experts in chemistry to stockpile medication or chemical ingredients necessary for the medicines they need. A series of articles by Dan Bednarz such as Peak Oil and Healthcare posted at the Energy Bulletin, offers detailed explanations of the impact of Peak Oil and collapse on the American healthcare system which is so energy and technology-dependent.

As I have written innumerable times, federal, state, and local governments are not going to be able to provide basic services in the throes of collapse-even if they want to. Katrina was nothing if not a glaring example of this reality.

I for one am not interested in making American systems better but instead, telling the truth about their irreversible demise. If I'm not honest about that, then I will do silly and meaningless things like vote in elections and believe that buying a Prius and converting to non-incandescent light bulbs or the development of magic-bullet technology will avert a catastrophic global energy crisis. In fact, if I don't tell the truth about civilization's collapse I will become seduced into the lie that we can keep the entire house of cards intact and worse, that doing so is a really good idea.

I want not only Michael Moore but the entire progressive movement to tell us the truth about what comes after the death of the American healthcare system. I want all of them to break the indelicate news that humanity is murdering the earth and all life forms on it-themselves and the rest of the planet. I want them to stop tenaciously, naively, delusionally hanging on to "hope" and other soporifics of consumerism and the American way of life, or more truthfully, the American way of death. I want them to stop calling me "dismal" because I say what is so and refuse to ignore the flatulent neon elephant in the very small room of planet earth which is growing smaller and more diseased by the moment. I want the so-called physicians of socio/political/ecological/and cultural well being to stop telling us terminal patients that there are solutions, elixirs and potions of political choice, actions to take, movements to marshal, candidates who will save us. I want them to tell the truth about their own and earth's prognosis and the sinking of the Titanic and focus instead on creating lifeboats and look at the really, really big picture beyond myopic, truly terminal optimism.

So thank you Michael Moore for your gutsy, funny, but very poignant expose of the U.S. disease-care empire. Yet as much as I loved "Sicko", I want a deeper diagnosis, one that will truly assess the vital signs of a crumbling culture and a civilization that the progressive community insists on keeping on life-support when the kindest and most scrupulous act any of us can perform is to simply, swiftly pull the plug and record time of death.