Three years after winning Cannes' top prize, Michael Moore returns to the Croisette with more polemics-as-performance-art in "Sicko," an affecting and entertaining dissection of the American health care industry.

Three years after winning Cannes’ top prize for “Fahrenheit 9/11,” docu helmer and agent provocateur Michael Moore returns to the Croisette with more polemics-as-performance-art in “Sicko,” an affecting and entertaining dissection of the American health care industry, showing how it benefits the few at the expense of the many. Pic’s tone alternates between comedy, poignancy and outrage as it compares the U.S system of care to other countries. Given Moore’s celebrity and fan base, plus heightened awareness of the pic resulting from the heated battle that’s already begun between left and right, returns look to be extremely healthy.

Pic should also play well internationally, providing an eye-opening lesson for foreigners who may be inclined (like Moore’s Canadian cousins) to take out insurance from their homeland before visiting the States.

Chief criticism of the film is that it paints too rosy a picture of the national health care of the countries he compares America to, including Canada, England, France — and Cuba.

Employing his trademark personal narration and David vs. Goliath approach, Moore enlivens what is, in essence, a depressing subject by wrapping it in irony and injecting levity wherever possible: a graph shows America’s position in global health care as No. 38 — just above Slovenia — and is followed by film footage of primitive operating conditions; and he offers a long list of health conditions that can deny a person insurance coverage, with the list scrolling into deep space accompanied by the “Stars Wars” theme.

Pic explores why American health care came to be exploited for profit in the private sector rather than being a government-paid, free-to-consumers service as are education, libraries, fire and police. Moore comes up with an archival audio recording of Richard Nixon from February 1971, praising Edgar Kaiser and his system using incentives for less medical care. The next day Nixon addresses the nation, proposing a new health care strategy that amounted to a less-per-patient expenditure to maximize profit.

Pic starts by sketching a gamut of health-care horror stories from average Americans: those who can’t afford insurance, those who are denied coverage for various, often ludicrous reasons, and those who believe themselves well-protected, but find that the moment they avail themselves of medical services their insurance provider uses obscure technical reasons to refuse coverage, retroactively deny claims and cancel insurance, or raise rates so astronomically that the patient is forced into the ranks of the nearly 50 million uninsured.

Perhaps the most emotionally affecting story comes from Julie, a hospital worker whose husband had a potentially terminal illness that the medical staff thought could be treated with a bone marrow transplant. Insurance deemed the treatment experimental and refused to cover it. Unable to afford an alternative, the husband died.

The congressional testimony of a former Humana medical director provides a devastatingly direct description of what she calls “the dirty work of managed care.” Constantly told that she was not denying care to patients, rather simply denying them Humana’s coverage, her career advanced as she saved her corporation money.

Moore appears in his shambling folksy persona about 40 minutes into the pic, interviewing foreign citizens, American expatriates, hospital workers and doctors in countries with nationalized health care. The dramatic contrast with America is played for laughs, as the seemingly incredulous Moore continually mutters, “What do you mean it’s free?”

Pic’s most dramatic (and now controversial) tactic involves Moore taking a group to Cuba that includes 9/11 rescue volunteers with medical problems that haven’t been covered by insurance. First they go to Guantanamo Bay, which Moore proclaims as the only place on American soil with universal health care, and then to a Havana hospital where they are given treatment. Cuban seg wraps with a poignant expression of emotional solidarity between 9/11 volunteers and Cuban firemen who pay them homage.

Pic incorporates extensive archival footage (some of which comes across as grainy on the bigscreen) as well as home movies and photographs. Extracts from Communist musicals, classic comedies and horror films provide Moore further opportunity for comic editorializing.

Sicko

Production

A Weinstein Co. presentation of a Dog Eat Dog Films production. (International sales: The Weinstein Co., New York.) Produced by Meghan O'Hara, Michael Moore. Executive producers, Harvey Weinstein, Bob Weinstein, Kathleen Glynn. Co-producer, Anne Moore. Directed, written by Michael Moore.

Crew

Editors, Dan Swietlik, Geoffrey Richman, Chris Seward; music, Erin O'Hara; associate producer, Rehya Young; line producer, Jennifer Latham. Reviewed at Cannes Film Festival (noncompeting), May 19, 2007. Running time: 113 MIN.

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