The United States national healthcare plan: don't get sick. So says the clever bumper sticker chastising the richest country on Earth for not providing what virtually every other civilized democratic society has been able to. In Sicko, Michael Moore throws in his lot with that crowd. To Moore, and to many figures in that iconoclastic crowd, the healthcare crisis of nearly 50 million uninsured Americans is a sin and a national disgrace. It’s hard to disagree with them. Moore’s argument becomes all the more persuasive since he says from the first frames in the film that Sicko is not about them: it’s about the 250 million unsatisfied customers of a HMO program run for profit.

Most of Sicko represents in many ways a kinder and gentler Michael Moore. He’s still the gruff provocateur in the ball cap, but his latest film is tamer than one might anticipate. There’s less of the zing of early efforts. Moore is now thought of as a figure indistinguishable from the dreaded Hollywood elitist left, but that could not be said with his earliest years in the spotlight after his 1989 documentary debut. That documentary, Roger & Me, was a populist film that held appeal to everyone from concerned liberals to lower-middle class conservatives horrified by the insatiable greed of a corporate America willing to "downsize" them out of existence. In other words, the appeal of Roger & Me could not be more sharply contrasted with films like Bowling for Columbine (who has more fondness for guns than lower-middle class blue collar types anyway?) and his anti-Bush screed Fahrenheit 9/11.

Both Bowling for Columbine and Fahrenheit 9/11 identified a problem, America’s culture of violence and the Bush administration’s reckless assault on democracy and the Middle East, respectively. But neither documentary extended much effort to offer a remedy. Sicko does. Moore is very clear on this matter (he’s never been crazy about shades of gray): the United States of America should offer every citizen, regardless of income, health insurance through a single-payer plan as found in countries like its neighbor to the north. That’s an admirable and humane stance, but it leads to some problems in the film. Repeatedly Moore refers to countries like Canada and England as having “free” healthcare. But it’s not free. The first lesson one learns in any high school economics class is about the non-existence of a free lunch. So when person A receives an expensive operation for “free,” what that really means is that person A has had their bill absorbed by the tax revenue from every other citizen in the region or country, including his own (I’m not arguing it’s theft, but it can hardly be referred to as free). Moore clings to that wording though, and no one challenges him on it.

Moore assembles some utterly damning cases against the American for-profit system, which he very effectively argues, and proves, that they deny patients needed medical care to increase revenues. One of them, Maria Watanabe, was told by her provider (Blue Shield) that she didn’t have a brain tumor (she contended that she did however). When she went to Japan, which has a national healthcare plan, the doctors informed her that she indeed did have a brain tumor. Now, as Moore wryly notes, she has a lawyer. In many of the cases, the patient is denied treatment for absolutely no logical reason. The only underlying logical reason is a cruel one he argues, a desire to promote profits ahead of care. Moore interviews a man who used to act as a money-man for the insurance companies, leafing through their medical histories in the hopes of finding one mistake that would retroactively disqualify coverage of a surgery or medication (just wait until you hear his explanation, it will tie your head into knots). Moore shows footage of Dr. Linda Peno who testified before the U.S. Congress in 1996 that she had withheld urgent care from patients, outright killing them. In return she saw huge career advancement, and a salary in the six-figures.

Moore also makes a somewhat narrow attempt to frame the history of the issue of healthcare in the United States. He discusses the American Medical Association’s vehement and vigorous opposition to socialized medicine from over fifty years ago. At one point the group distributed a vinyl record of a familiar voice speaking about the evils of national healthcare, which is really an incipient form of socialism ("First they’ll nationalize the hospitals, then the oil fields, banks, and churches!"). That voice? None other than the Gipper himself, Ronald Reagan.

Furthering his expose of the opposition, Moore turns to an earlier Republican president, Richard M. Nixon. It’s a great moment in Sicko: he plays the audio recording of Nixon being told of the Kaiser HMO and how it’s focused on making profits. The less care they provide, the more profit it makes. Nixon is enthusiastic. But wait a minute. Moore is simplifying things and glossing over history. The moment of Nixon embracing a sick system is damning, but it’s not quite that simple. He is so eager to paint the entire late 1940s through early 70s as a time of institutional, and public, widespread opposition to socialized medicine, but he refrains from mentioning that those supporters of a national healthcare plan had some very powerful allies. After all, Presidents Roosevelt and Truman both supported covering every American, and President Nixon himself flirted with the idea.

Fast-forwarding to the 1990s and the colossal controversy over President Clinton’s healthcare proposal, Moore fashions a wickedly funny tribute to the former First Lady in which he shows pictures of her and describes her as "sexy" and "cool." Some men he suggests just couldn’t handle her because of it. And the more conservative of these men certainly couldn’t handle the recommendations of the healthcare task committee that she was put in charge of by her husband. Moore plays the very amusing exchange between Mrs. Clinton and arch-economic conservative Dick Armey over his plan to destroy the proposal in the House (he says to her at one point that reports of her personal charms are greatly overrated, but adds, to even more laughter, that reports of her wit are greatly underrated). Then in 2003, the U.S. Congress with fierce support from the Bush administration passed a bill to make more prescription drugs available for seniors. The problem was, as Moore notes, the bill was a give-away to the pharmaceutical companies and would lead to many instances of the drugs becoming even more expensive. Billy Tauzin, the Republican put in charge of whipping up support in the House, actually retired afterwards to become a CEO of Pharma. His salary is two million dollars.

So this is madness. But what about the other systems? Michael Moore is confident: a single-payer plan is the way for the United States to go. He crosses the border to Canada where he meets, as he did in Bowling for Columbine, with select individuals that refute many of the common American perceptions of their system. There, he purports to show, the waiting times aren’t too long at all, individuals are allowed more freedom to choose their doctor or hospital, and it doesn’t run the entire economy into the ground. As someone with family in Canada, I can attest that Moore is wildly misguided in his praise of the Canadian system. When my aunt was in a serious car crash six or seven years ago, she had to wait months and months for some very essential treatment, and even recently her problem with kidney stones took forever to attend to. That wouldn’t happen in America. Still for all the flaws that Moore ignores, he’s right when he points out that Canadians live three years longer on average than Americans. In England, he attempts to further refute American perceptions and fears of socialized medicine with varying success. He interviews a young doctor, and wonders jokingly if he lives in the slums. The doctor in fact drives an Audi, makes the equivalent of nearly $200,000 dollars a year, and lives with just his wife and kid in a three-story house worth over a million in American dollars. That doctor, well spoken and cooperative with Mr. Moore, says that he wouldn’t want to work in a system where he’s compelled to deny patients essential care. Every foreign doctor that Moore speaks with in Sicko seems to share in that sentiment.

Again, Moore proves himself unable to question the absurdity of anything promulgated by speakers or systems he agrees with. In one funny scene, he roams around an English NHS hospital, wondering where people pay when their stay is over. Every patient is baffled by the question. Finally he arrives at a cashier’s desk, and with a righteous sense of "a-ha!" attitude he grills the man on why he’s there if everything is free. As he discovers, the cashier doles out money to lower-income patients to reimburse them for the cost of their travels. In France (Sicko eventually morphs into an amusing travel brochure to the country), Moore drools over a system that allows workers weeks and weeks off a year, at employer and taxpayer expense. Much of it is reasonable and well meaning, but the most egregious aspects of the France entitlement state-a paid day off to move residences and nannies that will do your laundry (and to think that conservatives in the States complain of the "nanny state"!) are quaint. He doesn’t present them, or the cashier’s desk in that English hospital as overkill, or a waste of government revenues. To Moore, it’s just a different, better system. No questions asked.

Sicko is less energized than earlier efforts. Shot in a grainier style, this is most likely Michael Moore’s attempt to connect with a larger audience than a Bush-bashing such as Fahrenheit 9/11 did. Moore employs less of the techniques of those documentaries. He’s scaled back reliance on nifty cartoons and montages, the bizarre moments of people caught off guard that he has perfectly captured in the past, and quixotic crashings of hostile territory. Moore also shows noticeably less of himself. He doesn’t appear until at least forty-minutes have passed, and even then, he’s not in it anywhere near as much as he was Bowling for Columbine or Roger & Me or his The Big One.

It would be nice if Michael Moore gave serious airtime to a conservative dissenter, or God forbid, if he had actually talked with an economist. However, most of what he lands on in Sicko is moving, disturbing, and galvanizing. It’s amazing that the United States is so hesitant to support any form of national healthcare; Moore is right in that amazement. But while he makes the issue into one that tries to reach members from all across the political spectrum, he still approaches the whole issue as a progressive or liberal with progressive or liberal aims. It’s not like that though. Even conservative parties in countries with universal healthcare basically support the program. They may, as in Canada, fight for more control by providences, or in England and elsewhere, battle to contain enormous costs, but no serious political party anywhere advocates what the United States has. Or take the case of mercantile Japan, hardly a haven for lefties, which has national health insurance, but with a decidedly conservative subtext: keep everyone healthy so that they can keep working and participating in the economy. Sicko would greatly benefit from the inclusion of these basic truths about the debate and about the purpose of such coverage.

In what will most likely be the most controversial scene of the documentary, and one that has already aroused the attention of the U.S. State Department, Moore takes 9/11 rescue workers by boat to Guantanamo. The prisoners of Guantanamo (or "enemy combatants") are provided (and Michael Moore backs this up with footage of military personnel testifying) with first-class medical care that is unavailable to the average American. So Moore approaches the camp by loudspeaker, asking that these American heroes be treated (it's a lot less dorky than the ice cream truck scene in his previous picture). He is ignored of course, so he takes the group to mainland Cuba where they receive, to their astonishment and understandable anger, medical care and prescription drugs for almost nothing at all. When the local firefighters hear about their presence, they honor their life-saving American counterparts in a ceremony that would be a lot more moving if it were more believable. Moore sweeps Cuba’s crimes under the rug in these scenes, and shows Cuba as a place of peace and progress. Castro isn’t so bad, and American animosity is misguided. The lack of political or economic freedom in the tiny island barely registers. It’s classic Michael Moore, scenes in Cuba that are touching but are also a combination of staging and sheer dumb luck. Provided Moore had ventured further into the island and farther from the land of black and white, he wouldn’t have foregone what could have been Sicko’s most persuasive argument: if a country like Cuba, with its strict control and detention camps for homosexuals, can show compassion to the sick and needy, but the world’s most free and prosperous society can’t, then we are in very, very grave trouble.