You know that Michael Moore’s “Sicko” is being taken seriously by the medical community when you see it reviewed in The New England Journal of Medicine. The issue that came online last week contains Jacob Hacker’s take on the film—as well as his prescription for national health care reform.

Hacker calls the first half of the film “ruthlessly efficient,” declaring that, “along with Al Gore’s global-warming warning, An Inconvenient Truth, Sicko may well be remembered as our generation’s Silent Spring or The Jungle — propaganda, in the best sense of the word, that pricks our collective conscience about problems that are hidden in plain sight.”

But as a political scientist (Yale) and New America Foundation fellow, Hacker is dissatisfied that, in the second half, Moore doesn’t offer a better solution to the crisis. This may be asking a bit much of Moore. My theory is that a film-maker, like any other artist, need only raise the right questions, (however abstractly), spurring his audience to think—and to imagine.

That said, Hacker’s point that Moore ignores the best model for reform by never mentioning Medicare is a good one: “He talks about the post office, the fire department, public education — but not the one public program that most resembles the ‘free universal health care’ he extols.

“That’s too bad,” says Hacker, “because the Medicare model is the not-so-secret weapon in the campaign for affordable health care for all. Today, many advocates of national health insurance have wisely started calling for Medicare for All’ rather than their old rallying cry, ‘Single Payer.’”

Hacker’s right. To many Americans, “single payer” evokes images of long lines—not to mention the Specter of Socialism. Medicare, on the other hand, represents the Promised Land –that point in time when you no longer have to worry about whether or not you have health insurance, or whether it will cover what you need. Medicare is hardly perfect, but not a few seniors breathe a huge sigh of relief when they finally find themselves in the warm embrace of the second-most-popular federal program in the U.S. (Social Security comes first.)

But Hacker doesn’t think we’re ready for “Medicare for All.” Instead, he suggests that “For now, the best step may be to require employers either to provide their workers with good private coverage or to enroll them, at a modest cost, in a new public program modeled after Medicare. Workers enrolled in this new public framework could be asked to pay a modest premium on top of employers’ contributions, based on their income, and they could be allowed to enroll in qualified private plans — as people with Medicare coverage can today. No doubt many employers would seize the opportunity to obtain inexpensive coverage for their workers, which would give the new public insurance plan a large, diverse enrollment and a great deal of leverage to contain costs and improve care.”

It’s a perfectly reasonable idea, and could, as Hacker suggests pave the way for “increasingly broad public coverage over time” allowing more and more Americans to gain access to a national Medicare-like plan that guarantees affordable, high quality care.” (See Hacker’s own proposals in a briefing paper for the Economic Policy Institute.)

But here’s my concern: as Hacker points out, today “employers are rushing to shed or shred insurance.”  Many of them simply want to get out of the health care business. It’s not just that they can’t afford it. It’s not their business: Most lack the expertise needed to pick the best plans, and they know it. They don’t want to be held responsible for improving health care in America. That’s why I’m not convinced that employer-based insurance is the best platform for national healthcare reform.

But I could be wrong. Employers and health-care experts will be exploring this, among other questions, at a conference on “Business and National Health Care Reform” co-sponsored by The Century Foundation, The Commonwealth Fund and AARP in Washington on September 14. There, Richard C. Leone, President, The Century Foundation; Karen Davis, President, The Commonwealth Fund; Carl Camden, CEO, Kelly Services; Michael Critelli, Chairman and CEO, Pitney Bowes Inc; Len Nichols, Director, Health Policy Program, New America Foundation; Bruce Bodaken, CEO, Blue Shield of California; Carl Guardino, President and CEO, The Silicon Valley Leadership Group; Helen Darling, President, National Business Group on Health; Francois de Brantes, National Coordinator, Bridges to Excellence; Peter Neupert, Corporate VP for Health Strategy, Microsoft; and  Robert Galvin, M.D., Director, Global Health, General Electric will be speaking.

I’ll cover that event here.