UK release date: 26 October 2007

directed by
Michael Moore
Unless youve been on kidney dialysis in an Afghan cave for the last six years, you cant have failed to notice the rotund figure of documentary polemicist Michael Moore popping up about the place to deliver swingeing attacks on the USAs handling of its domestic and foreign policy.

Never has a filmmaker become so loved by liberals, and so loathed and feared by the hawks in the White House. 2002s Bowling for Columbine was a brutal, but often hilarious assault on the US obsession with firearms ownership, and 2004s Fahrenheit 9/11, while containing the odd unpalatable conspiracy theory, was the first mainstream film to actually suggest the war on terror might be little more than a smokescreen for international interventionism.

His extreme-left views have seen him castigated by millions as un-American, but it is the accusation that he plays fast and loose with the facts that is most distressing. Right-wing sites like have picked up on any discrepancy in his films with gusto but worse is recent documentary Manufacturing Dissent, where two avowed liberals come to the same conclusion. Whatever the controversies, however, Moore remains the most prominent dissenter of his nation, and in new film Sicko he turns his lens on the countrys flat-lining healthcare system to devastating effect.

A few facts before we begin. The USA is one of the six richest nations (per capita) on Earth, but it is also the only developed nation in the world to have a completely privatised healthcare system. Apologies for spelling this out I do this because the system seems so alien to us Brits who enjoy the NHS free system but this means the average American spends $4,200 a year on private health insurance from numerous different companies. Thats a public spend of over $2 trillion a year into the pockets of huge companies often linked to incumbent political administration. This country is ranked 37th on the World Health Organisations (WHO) ranking of worldwide health systems. Thats below Morocco. And Costa Rica. And Chile. And 16 per cent of Americans (47 million people) cant even afford the insurance. And if they cant pay, they dont get treated.

But it doesnt stop there. Moore concentrates, for the first half of the film at least, on the stories of the people who CAN pay, but cannot afford treatment or are turned down by insurers the ones with terminal illnesses, the ones with debilitating conditions who cannot pay enough to get better. Here is where Sicko is at its most effective – when Moore allows people to just talk. Like last years jaw-dropping When The Levees Broke, Spike Jones four-hour documentary chronicling Hurricane Katrinas devastation of New Orleans, the voices of everyday people, not Hollywood celebrities or untouchable politicians, are the ones that stand out.

Moore can try as many stunts as he likes (the films ending, where he rounds up 9/11 survivors up to get free health service in Cuba is a powerful punch, but one that doesnt really stand up on closer inspection); but watching an elderly couple moving into the box-room of their daughters house because the money needed for treatment has meant selling theirs will be the image that sticks in your mind long after the final reel.

Similarly, archive footage of a sick woman being dumped on the street because her money runs out is a horrifying moment, and Moores understated interview technique (yep, he can turn on the charm when he wants to) pays dividends as a healthcare insurance assessor breaks down slowly before your eyes as she recounts the sick people she has turned down to save costs.

So its almost a shame when Moore wanders back in front of camera on the hour mark to try to prove to the viewing public that a socialised health system demonised by American conservatives can actually work. And unfortunately, for an international audience, this really is just preaching to the choir. He visits Canada, Britain, France, Germany and Cuba to prove that healthcare should be a right, not a privilege and a rosy-tinted trawl through the British system, where he trundles about feigning surprise at the plentiful free medical care, is patronising to say the least. No mention of MRSA, no mention of the huge queues for life-saving operations, just happy doctors driving BMWs. It will, however, make NHS naysayers think twice before attacking the system that doesnt have to offer its patients a choice of which finger to sew back on after an accident due to insurance shortages.

And the celebrated stunt at the end, Moore taking a group of 9/11 rescue volunteers, denied medical care in their homeland first to Guantanemo Bay and then to pariah state Cuba to gain the attention they need is a smart move, highlighting both the US contempt for their own citizens and a communist states care for any citizens who happen to appear on their shores. Its also a stunt that Moore cannot help tacking a sickly ending onto (the 9/11 heroes end up in a tearful embrace with a crew of Cuba firemen) and it almost negates the rest of the film which, although flawed, is a persuasive and impassioned plea for rationality in an insane system.

For an American audience, this will be a revelatory experience, ramming home how sick and corrupt their health system is. To everyone else in the world, itll serve as a timely reminder that, while not perfect, at least their system isnt built on lining the pockets of fat cats.

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