Sicko: Doctor in the house?

Irreverent and often sophomoric, Michael Moore's documentaries are like a Mad magazine for grown-ups, dedicated to revealing the delusions and hypocrisies under which we live. Moving forward from his attacks on corporate downsizing (Roger & Me), gun violence (Bowling for Columbine) and the rush to war in Iraq (Fahrenheit 9/11), his latest, Sicko, takes on an even bigger target.

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And if you weren't scared about the state of health care in this country at first, you will be by the end of this latest foray into activist cinema. In this at-times rousing, sickening and funny citizen documentary, Moore reveals a Kafkaesque insurance bureaucracy whose entire mission is the bottom line of maximizing profits by purging the sick from its ranks.

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The figures Moore cites are staggering: There are 50 million uninsured Americans, and 18,000 die every year because of a lack of health insurance.

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Despite a new spirit of compassion and soft-pedaled shtick, Sicko does traffic in some of the usual Mooreian techniques. There is tongue-in-cheek, 1950s footage of a kinder, gentler America to contrast with our own, more jaded age. (Any documentarian worth his or her salt should declare a moratorium on this cheap and facile tactic.) Then there is Moore's self-consciously honey-dripping voice-over narration; the manipulative use of music; and finger-pointing at villainous bigwigs such as Richard Nixon, whose policies Moore argues helped set the stage for the out-of-control health-care industry.

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And yet despite some of the familiar conventions, this time around Moore has struck gold, milking comedy from American gullibility. His juxtaposition of vintage Soviet film and American "Red Scare" footage (centered on the demonization of universal health care as "commie" stuff) is alternately hilarious and sickening. Moore reveals just how easily we have been led by the noses.

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Moore apparently did not lack for anecdotes in delving into America's health-care crisis. He builds his case with nauseating images of an uninsured man stitching closed his own gaping knee wound, and an insured middle-aged couple so devastated by medical bills they move in with their adult children. He also exposes the trend of hospitals dumping elderly, disoriented and uninsured patients on the streets in their hospital gowns. Recognizing the power of individual stories over abstract political causes, Moore's of-the-people strategy pays off.

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The power of the topic – and, by extension, Moore's film – is its universality. Most Americans on both sides of the political and anecdotal fence – doctors or patients, Republicans or Democrats – have had front-row evidence of how outrageously expensive and grossly bureaucratic our health-care system has become. If Moore's films in the past have functioned as a kind of liberal venting over such politically divisive issues as gun control and the Iraq war, it's easy to understand Sicko's refusal to be dismissed as a niche issue.

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A blue-collar jester ambling comically toward his targets, Moore often has made his points in a by-now predictable way, by pushing his bulky body into the path of big business – whether GM chairman Roger Smith or members of Congress – and videotaping the hilarious David-meets-Goliath results. Perhaps recognizing how dire the subject is, Moore this time takes a welcome backseat and allows others to speak to the issue.

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Part of the power of Sicko is avoiding easy or singular scapegoating; as one former insurance-company employee points out, the health-care system is far more labyrinthine than that.

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By way of example, Moore takes numerous comical – and instructive – road trips. He travels to France and to Canada, where government health care is a privilege of citizenship. Through Canadian eyes, it is America that looks like the Third World country. It's a place whose health care is so primitive that Canadians buy health-care insurance before traveling here for fear they will break something on a golf vacation and be handed an astronomical bill by a Yankee doctor.

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One field trip in particular dramatically illustrates his point about how easily we allow fear – of commies or debt – to dictate our behavior. Loading up a boat of sick Sept. 11 workers denied treatment in their own country, Moore takes them to Cuba for medical care in a typically showboat move. In one sweeping gesture, Moore illustrates the epic failure of the market approach to medicine, a kind of desperate and cruel every-man-for-himself strategy. Cuba, of course, had something to gain from putting its best face forward for the visitors. But it is hard to argue with the weeping rescue workers happy to have someone even feigning interest in their plight. It is possible, though, that like the other countries Moore visits, the Cubans take pity on these people abandoned by their government in their hour of need.

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Moore's primary target is health care, but his larger target is the culture of fear under which most Americans live: fear of financially devastating illness, fear of losing our jobs, fear of paying for our own retirements and our children's college education. Moore makes his appeal a far broader one than the insurance companies raking in enormous profits or the politicians acting out the agendas of powerful pharmaceutical lobbies. He aims his film at all of us, at a citizenry that has been asleep at the wheel as its government and business have chipped away at the democratic values and sense of solidarity that make something such as universal health care such a no-brainer.

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In Sicko, Michael Moore's irreverent comedy has become less bleating and more purposeful, perhaps in part because the times we live in have become more desperate.

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To hear Felicia Feaster and Curt Holman discuss Sicko, click here.