The big guy with a baseball cap knows his stuff. He has a point to make and he makes it efficiently and amusingly. In the past his targets were General Motors ruining Flint, Michigan; the gun lobby as the culprit for America's crime culture; the lies behind the Iraq war. He's back with a vengeance with Sicko, premiered at the Cannes film festival on Saturday. His question: what has happened to the idea of universal healthcare in the United States?
In four tidy acts, Michael Moore spells out the facts. Act one: 50 million Americans have no health cover, and 250 million who think they do, through costly health insurance schemes ($2,000 per person a year), are often denied treatment when they need it. A guy without cover who chopped off two of his fingers in a bout of DIY was presented with an invoice for $12,000 to reattach his ring-finger and $60,000 for his forefinger. Being a romantic, and skint, he chose to get his ring-finger back.
Act two: when did it all start going wrong, asks Moore. The answer: in August 1971. President Richard Nixon and his adviser Edgar Kaiser plot to break the system. "The less care they give, the more money they make," says Nixon, caught on tape. They? Their friends, the health industry moguls, the same ones who fund the political campaigns of US congressmen. Moore shows us the price tag on every single one of them. One in particular, Billy Tauzin, leaves Congress to become CEO of the drug industry's top lobbying group, PhRMA, with a $2m a year salary.
Meanwhile astute national publicity campaigns have demonised the concept of universal healthcare by associating it with "socialised medicine", which in American English translates as "Soviet medicine" - the kind such oppressive regimes as Canada, Britain and France have adopted for their citizens.
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Act three: Moore pays these regimes a visit. Britain's NHS is paid a well deserved tribute, with Tony Benn appearing as the country's conscience. Then off to France. A mother of three explains that her state nanny does the family's laundry while the creche down the street, with professionally trained staff, costs her 50p per hour. Moore concludes his French tour by asking: "Is there a reason why they want to make us hate the French? Are they afraid we might want to live like them?"
Act four, the most powerful: Moore decides to test the US administration's claim that Guantánamo Bay prisoners get the best free healthcare in the world. He takes 9/11 volunteer rescue workers, whose health problems were not covered by the state because they weren't on its payroll when they ran to help, to Guantánamo Bay in Cuba. At least he tries to. Arriving at the gates, Moore shouts through a loudspeaker: "I have 9/11 sick rescue workers, can you please open the gates?" A siren begins to wail. Moore and his troops make off as fast as they can - to Havana. Where they are treated immediately.
I know what you're thinking, I know what you're going to say. And so what? Yes, Michael Moore has an agenda. No, he isn't among the giants of documentary film-making. No, he isn't an ordinary journalist. He is, as he says, the op-ed variety, the kind who is constantly angry. He has issues with the way of the world and wants to set records straight. His goal is simply to put universal healthcare back at the centre of the American debate. And while Moore's main objective is to reach his fellow Americans, his film should also make Europeans ponder on the system they too often take for granted. George Orwell would hate it. But forget about him for a minute. There may sometimes be such a thing as good propaganda.
AgnÃƒÂ¨s Poirier, a journalist and film critic, is an independent adviser on British films for the Cannes film festival firstname.lastname@example.org
© 2007 The Guardian