Sicko review

Michael Moore tackles the American health system head on in Sicko, his first film since 2004's Fahrenheit 9/11 propelled him to the forefront of the modern documentary movement. It's at turns shocking and moving, but Moore's trademark humour, insightful research and knowledge of how to entertain audiences make this a captivating affair.

It's widely known that around 50 of the 300 million residents of the US live on the edge of safety without any health insurance. But as Moore explains in the film's opening sequence, Sicko isn't about those unfortunates. Rather it focuses on the 250 million who do pay extraordinary amounts to health insurance companies for piece of mind should they require medical aid. What we learn, through a series of pointed first-hand accounts, is that the last thing the companies want to do is pay out, and they will go to any lengths, including illegal ones, to put profits before patients.

We learn of bizarre events such as a car crash victim who is charged for her ambulance ride to hospital because it was not authorised (the victim was unconscious at the time), and tragic situations where deaths have resulted due to the ruthless policies of the institutions meant to save lives. Insiders recount how the medicare companies force them to look for any reason not to pay out, and middle aged and formerly middle class citizens are forced to spend their life savings on care they thought they had already paid for.

Moore examines the history of the situation: how cronies of Richard Nixon came up with the plan and sold it as health for all in the early 70s, and how attempts to repeal it in the 90s under the Clinton administration were choked. In the film's most humourous sequences, Moore travels to the UK and France, issuing mock naivety and wide-eyed wonderment at the notion of free healthcare. 'In America, people are afraid of the government', a US exile in France tells him, ' here the government fears the people'. This is a common theme in Moore's work - that the US is a society run on fear - and here he hammers his message home with impeccable clarity.

Moore often faces accusations that his films are manipulative - but every film, fact or fiction, is subject to choices and editing. It is true that he makes no mention of superbugs and funding crises in the NHS, and he has no interviews - or mention of trying to interview - with those running the insurance companies.

Such quibbles apart, Moore's tone throughout is one of despair. 'Who are we?', he asks of his own society. 'How did we let this happen?' The larger than life character so familar from his previous works takes more of a backseat this time, and the final sequence, in which he takes a group of 911 rescue workers who are unable to afford care at home to seek treatment in Cuba is both joyous and highly charged.

Paul Hurley