Though Moore indulges in acts of political theater that are self-sabotaging, for the most part Sicko pointedly contrasts the for-profit system bleeding Americans to death with the socialized systems of other countries. In England and France, people at their most physically and emotionally vulnerable don't worry about money to pay for doctors and drugs.
How should the world's richest nation treat a leukemia patient, an infant with a dangerously high fever, ground zero volunteers who've developed respiratory troubles?
Moore hears out the widow of that leukemia patient, tears of grief and frustration pooling in her eyes, as she explains how her husband's HMO denied his bone-marrow transplant as "experimental."
He witnesses the infant's mother, cradling a photo album of her late baby and telling how her HMO, Kaiser Permanente, wouldn't approve her baby's treatment at the closest hospital and how the infant had seizures and eventually "expired" as she was transferred from USC's King/Drew facility to a Kaiser-run operation farther away.
He listens to the pained testimony of a 9/11 angel of mercy bankrupted by the high cost of an inhaler that runs $120 in the United States and a nickel in Cuba, where medicine is socialized.
These stories prompt Moore to ask whether other nations have a better answer to health care than managed care.
In Moore's composite portrait of the U.S. system, the nation's ailing middle class, beggared by deductibles and copays, is banging at the gates of the health-care citadel and can't get past the gatekeepers.
Barring their entry? Ex-HMO administrator Becky Malke shamefacedly describes her former job as "being in charge of keeping people from getting coverage."
Linda Peeno, once the medical director of Humana, is now a whistleblower who describes the function of the HMO as denying, limiting or obstructing care in order to maximize profits.
Moore subscribes to George Bernard Shaw's maxim that "If you want to tell people the truth you better make them laugh, or they'll kill you." And he leavens his serious comedy with absurdist anecdotes.
Funniest is that of the young woman, made unconscious by an auto collision and rushed to the hospital, who awakened to learn that her insurer had denied reimbursement for the ambulance because it wasn't "preapproved." Equaling this story for laughs is the one about the woman who lost her benefits for having had a yeast infection characterized as an undisclosed preexisting condition. Then, there is a delicious one involving Philadelphia's Cigna Corp., which ultimately does the right thing by one patient.
Moore points his camera at the gaping cracks in the American system where, as Malke says, "You're not slipping through; somebody made the crack and swept you in it."
The antidote to this system? Moore proposes socialized medicine. The most eloquent passage in Sicko is an extended interview with Tony Benn, a Labor leader who explains the democratic ideology of England's National Health: "Pay according to your means, get treated according to your needs."
It is a system defended by Conservatives and Laborites. And while it may not be as ideal as Moore implies, with short waits and every patient cured by the end of his or her visit, the single-payer system is simpler to navigate than the maze of preapprovals and preexisting conditions encountered by Americans. Some countries, Benn says, keep their citizens poor because they're easier to control. On the other hand, "The National Health relieves your money worries in times of illness."
Where in America, HMO physicians are awarded bonuses for denying care, in England, physicians are awarded bonuses when their patients lower their cholesterol levels.
Admittedly, Moore shows only the upside of the English and French systems. A downside: Taxpayers contribute 27 percent and 42 percent, respectively, of their annual incomes for coverage, which Moore conveniently neglects to mention.
Would Americans agree to assign a third of their income for the guarantee of universal health care? In this run-up to the 2008 election, it's an important question. I'm grateful that Moore has guaranteed it a prominent place in the national debate.
Sicko ***1/2 (out of four stars)
Produced by Michael Moore and Meghan O'Hara, written and directed by Moore, distributed by Lionsgate and the Weinstein Co.
Running time: 1 hour, 56 mins.
Parent's guide: PG-13 (medical candor)
Playing at: area theaters
Contact movie critic Carrie Rickey at 215-854-5402 or firstname.lastname@example.org. Read her blog, "Flickgrrl," at http://go.philly.com/flickgrrl/