There hasn't been a comparable joker in the left-wing deck since Abbie Hoffman went underground. But while Hoffman played the media, Moore uses it to play fast and loose. Still, Sicko, which had its world premiere last month at Cannes (where mainstream Moore is romanticized as the subversive maker of celluloid samizdats), shows America's pre-eminent cinemuckraker in a seriously polemical mode. The Weinstein Brothers, who produced and are co-distributing Sicko, might have ripped off the title of one of their greatest hits and called it Scary Movie.
Sicko's opening gross-out features a guy suturing his own wound — but, as Moore points out, this movie isn't about him or the 50 million other Americans without health insurance. It's about the 250 million Americans who do have coverage — like the 79-year-old guy working in a supermarket to maintain his prescription-drug benefits. The movie's first half-hour is a virtual sideshow: Step right up and see the medically bankrupt couple forced to live in their daughter's basement trophy room, the woman whose insurance carrier told her that she failed to get an emergency ambulance "pre-approved," the employee who lost her benefits because she didn't report an ancient yeast infection as a pre-existing condition.
Annotating these and other, more ghastly human-interest stories, Moore — who for much of Sicko is narrator rather than participant — adopts a tone dripping with treacle and sarcasm. He's the P.T. Barnum of human misery who, going back to Roger & Me, has never been one to let details interfere with a good story. And yet, as Moore builds his case that health insurance in America is essentially a profit-making enterprise based on bilking the afflicted, the cumulative effect of this material is devastating.
Expert witnesses are called. Dr. Linda Peeno tearfully testifies that in fulfilling her mandate as an HMO medical director, she's withheld services that have cost lives. Politicians are produced — not just Bush, always available for some idiotic comment, but even Hillary Clinton, whom Moore dresses down with the fury of a jilted lover, pointing out that, after the debacle of her 1994 bid for universal health coverage, she is now the No. 2 recipient of HMO donations.
After demonstrating the state of health care in America, Moore visits those industrial societies that enjoy universal coverage — Canada, Great Britain (where even an American nincompoop who threw out his back trying to cross Abbey Road on his hands gets free hospitalization) and, above all, France. This love letter — fawning enough to add the suffix "phant" to the movie's title — inspired a smattering of embarrassed applause at Cannes. But really, it should embarrass us. When Moore jokes that the wonders of the French health-care system were "enough to make me put away my Freedom Fries," he's obviously thinking about the health of the body politic rather than his own.
As filmmaking, Sicko sometimes resembles an infomercial for Ozark real estate and elsewhere demonstrates a Kenneth Anger-like flare for vertical montage — as when Moore mischievously uses a jolly harvest hymn from the Stalinist musical Cossacks of the Kuban to sovietize our own marching firemen, heroic teachers and indomitable mail carriers. In any case, it's as a rhetorician that Moore is most original and effectively demagogic. (In his most shameless stunt, the filmmaker "anonymously" bails out an anti-Moore Web site, paying the proprietor's medical bills.)
Are Bush and Giuliani the only ones allowed to dial 9/11? Cleverer than either, Moore plays that card himself. In an already notorious PR provocation, he rounds up a crew of volunteer emergency workers with untreated respiratory problems and, in answer to some C-SPAN bragging about the excellent health care available to Gitmo prisoners, organizes a flotilla to the one place on "American soil" with free universal health care. The expedition never gets closer than the edge of the base, but they do get to experience the wonders of Cuban medicine — $120 inhalers for five cents, free dental implants, a people's hospital of cathedral-like splendor — complete with fraternal lecture from Che Guevara's daughter.
Sicko has the clearest agenda of any Moore film, albeit one that dares not speak its name. Is there a more vivid image of human garbage than the spectacle of a Los Angeles hospital dumping indigent patients on skid row? What manner of system is this? If the American health-insurance industry is Moore's unspoken metaphor for Capital (feeding vampire-like on human labor), Cuba is his unconvincing socialist paradise. Dr. Moore reveals all manner of symptoms — but is it impossible for him to diagnose the disaster we live in without offering another sort of drug?