Today I went and saw an advance screening for Michael Moore's latest vehicle, Sicko.

As far as Moore movies go it wasn't a bad example of the genre - some melodrama, some sticking it to man yee-hah moments, a little additional pathos and some laughs.

NOTE: For the hard of thinking I of course add on the obvious rider that he, like most people, believes in truth management. Far be it from me to fail in pointing out the flaws of everyone who considers themselves a mouthpiece.

Now that that's out of the way, let's move to his material.

The US health system. Call me crazy, but in the unlikely event that there are any Americans reading, your healthcare system bites monkey balls.

I'm not simply saying that because I saw the movie and, like any good man of the world, believe everything I see on a movie screen that's bigger than I am.

The figures are all there, peoples. Child mortality - bodgy. Life expectancy - limited (although these figures really don't matter much - one or two extra years of being a helpless old cripple aren't exactly golden years). Medical fees - astronomical.

And, I'm sure you'll be pleased to hear, the problem isn't socialised healthcare or exploitative hmos.

It's the American people.

Let's go through this like rational adults. The United States is the world's only real superpower. Their influence extends across the entire planet. Their military can strike anywhere with almost no notice needed. They spend more on international aid than some countries get through their entire GDP. There are literally dozens of foreign governments that would fall mere weeks after the US stopped propping them up.

Basically the US is the man, it's the top dog, it's the bomb diggety if you happen to be a 16-year-old rapper from far north Queensland with a lisp and a strange way of pronouncing vowels.

It's also a country that doesn't believe in cooperation, it believes in competition. It doesn't believe in community, it believes in individuals. It doesn't believe that governments are the representatives of the people but are, oddly, something entirely separate.

But, and let's get back to this for a moment, it's a country with a global empire.

Its industries operate almost entirely outside of the national borders. It attracts tribute of one sort or another (largely skilled workers) from nearly every nation on earth, including those who are its sworn enemies.

And it can't afford to look after the health of its poorest. That's their problem, seems to be the American thinking.

And frankly it's bizarre. For a country of patriots they don't seem to think highly of each other. They squabble incessantly over important issues, where they should be united, and are united on trivialities, where they can afford to squabble. They think that every American should pull themselves up by their own bootstrap, and that if they fail to do so it's their fault.

And then, somehow, the decision is made that failures don't deserve any help.

That puzzles me. These days the US claims to be Christian (in spite of its roots), yet doesn't seem to contain a single good shepherd in the entirety of high-level government.

One would expect that they would go after those stray sheep with everything they had available to them - protect the individual sheep and you don't lose the herd after all.

But they don't. They let them run off and top themselves, or get lost and die alone in the wilderness.

I realise that the US' war footing is based on the 'have cake and eat it too' principle put forward most eloquently by Stone and Parker (2006), but from the looks of its medical situation not only is no one owning any cake, but no one gets to eat it either.

Is it because the meritocratic tendencies of Americans make them despise weakness of any kind? If so, how do we explain their prodigious aid donations? They're clearly not averse to helping the foreign helpless. But when it comes to their own they say, "Bugger 'em."

They leave their most vulnerable in the hands of money-grubbing private industry. They abandon their middle classes, the very foundation of their wealth, to the predations of lawyers and accountants who are just waiting for someone to call for a doctor.

What is wrong with Americans?

As a case study for this increasingly lengthy rant, let's consider the Australian situation. My country lies somewhere between the socialist states of Europe and the private industries of the US. Residents can choose to hold private cover as well as the 'free' healthcare provided for by the traditional social cohesiveness and egalitarianism of the Australian people.

All residents pay a Medicare levy. This is used to pay for the public health system. Don't get me wrong - it's a creaky, haphazard little construct barely surviving under the weight of a political system that allows blame to be thrown between state and federal governments. But it works, after a fashion. Waiting times can be lengthy, but things do happen, it's free and, depending on where you live, it can give you some of the best care available anywhere in the world (the Darwin hospital has a particularly fine reputation for burns treatment).

Another note for the hard of thinking: This doesn't necessarily apply for those idiotic enough to live in remote communities or those unfortunate enough to be born aboriginal. Their health, education and general lifestyles are appalling. No government has really done much to change this, although a lot has been said and spent to little avail. But as they comprise less than 1.5% of the population they're barely even numerically significant.

The average person my age (23) can get private cover for around AUS$10 (US$7-8) a week. This covers for most things that could conceivably happen. Private cover means you have a private room at hospital, free ambo coverage (I think it's about 80 bucks a year to just get that; a private ambo trip could cost a couple of hundred dollars depending on what they give you and how far they have to travel), coverage for most procedures and all that rubbish. If the provider refuses to pay you're in a similar situation to poor unfortunates in the US, but with one crucial difference - there's a public system to fall back on.

Our system is heading towards the US model, but at this stage it still has some advantages. Let's recap them. One - there is a system where you will never have to pay for anything done under it. Ever.
Two. If you consider the free healthcare unsatisfactory you can choose to have private health coverage as well, and get a discount to your medicare levy to thank you for unburdening the public system. This private system is generally although not always better than the public one.
Three. All drugs are heavily subsidised. The most any citizen is likely to pay for medical care in a year is $AUS2000. Subsidies mean most drugs are $50 or so max, and limits on pharmaceutical costs mean you get tax writeoffs and various other benefits the more you spend (the interested can check the Medicare website for the details).

Australia's ranking in the health stakes? Pretty much top ten in every category, although we're rapidly catching up with America in the number of fat tubs of goo lazy enough to sweat copiously and smell awful within our borders.

So I guess if I have a point at all at the end of this rather rambling little piece it's that Americans have only themselves to blame for their problems. They don't care about each other. They refuse to make the only nationwide institution in which they are all involved do the legwork of looking after everyone. And so they all suffer in the end, whether it's through getting dead homeless person on their shoes after a nasty cold snap or getting a wall street broker's leather shoe attached to their chest wounds after a nasty cold snap.

But really, when we get right down to it, they really need to stop their bitching. Nothing is going to get better because they don't want it to get better. They want their unfortunates to suffer. They like to see failures understand all the nasty little consequences of failure in life.

And who can blame them? With their international efforts disastrous on nearly every front it helps to have someone to look down on, even if you have to find them within your own people. God knows it's hard to look down on foreigners when they're kicking your arse across a few hundred miles of desert and camels.

So next time you hear an American complain about their health system, or you hear an American complain about Americans complaining about their health system, just remember - they wouldn't have it any other way.

Oh, and be glad you live somewhere else. But I'm sure you don't need me to say that!