(CNN) -- America's most inspired polemicist -- and most polarizing filmmaker -- Michael Moore returns to the fray with his first movie since "Fahrenheit 9/11" broke box-office records and challenged George W. Bush's White House.
Michael Moore talks with a medical professional in "Sicko."
With "Sicko," this time Moore has set his sights on a more amorphous, and possibly an even more powerful target: HMOs and the American health care industry.
A little over a year ago, Moore invited citizens to send in their health-care horror stories. Within the week his Web site was inundated with 25,000 emails. If this is anecdotal evidence, it's on a scale worth talking about.
"Sicko" begins with three cases illustrating the plight of the 46 million Americans without health insurance, but quickly moves on to address wider concerns about the kind of care reserved for the lucky 250 million who do have coverage.
In a nutshell, Moore's argument comes down to this: the insurance companies are making a killing at their customers' expense. And in this industry, that term is all too literal.
Moore adopts a low profile in the film's relatively somber first half, softening his familiar snarky stridency for a hushed sincerity more appropriate to the hospital waiting room. Many of the people here are in desperately dire straits: sick, bereaved, or just plain broke. Other interviewees are whistle-blowers, guilty and angry about their roles in the Machine.
As well they might be. As countless stories have documented, Americans face countless problems with their health care. They may be denied coverage for pre-existing conditions -- or retrospectively denied coverage for pre-existing conditions they never knew about.
HMOs employ teams of investigators to disallow claimants on technical grounds and some offer medical directors financial incentives to deny drugs and treatments that -- by definition -- cut into corporate profits. (This style is a legacy of the Nixon administration, according to a striking scene from "Sicko" that plays a snippet from the White House tapes.)
When Moore does eventually slouch on screen, it's to play the innocent abroad, a wide-eyed chump bowled over by the wonders of socialized medicine as it's practiced in Canada, the UK and France. This will be an eye-opener for many -- including the Canadians, the Brits and the French, probably.
Having "enjoyed" first-hand experience of two of these three health systems -- the British and the Canadian -- I can attest that they're not quite as idyllic as Mr. Moore paints them. Except in comparison with the U.S. system, of course, and that's the point. Moore is a master of overstatement, but his comic shtick hits the target more often than not. It only hurts when we laugh.
If Moore missteps, it's in the one sequence he and the Weinstein Company have made sure everyone has already heard about (with a little help from the U.S. government): the boat lift to Cuba for three ailing 9/11 heroes. It's Stunt Man Mike at his crudest, and not as effective as he intended.
To be sure, it's bitterly ironic that Guantanamo detainees have access to better medical care than the soldiers who guard them, but Moore is easily diverted into a silly commercial for Cuban socialist medicine that plays exactly like the kind of Soviet propaganda films he sends up earlier in the movie.
It's tough to see firefighters who have been let down by their own country receiving proper care in Havana, but what makes it harder is the suspicion that Michael Moore is treating them like hostages in his own propaganda war. You have to wonder how this squares with the results of the World Health Organization report cited in "Sicko," which placed the U.S. at No. 37, one spot above Slovenia -- and, if you look fast enough, two places above Cuba.
But all is fair in love and Moore, and the system is sick, no question. With four times as many health lobbyists as there are congressmen, and with multimillion-dollar campaign donations at stake, the prospect of universal care seems a distant hope. (In that regard, the brief sequence implying that Hilary Clinton has been bought off may be the most significant.)
It's not impossible that this bitterly funny, bitterly sad call to alms could move reform back up the political agenda. For that reason alone, you owe it to yourself to see this movie.
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"Sicko" is rated PG-13 and runs 113 minutes. E-mail to a friend
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