Sicko is ostensibly about health care in America

It's not, any more than Moby Dick

is about a fishing trip

Like Moore's other documentaries,

Sicko's central theme is American democracy

- how it works, where it doesn't -

and the culture of capital

Moore has, as ever, a great taste for the absurd

- as footage explains how Congressmen Billy Tauzin

went from the committee overseeing

the pharmaceutical industry to heading

the Pharmaceutical Researchers

and Manufacturers of America,

the industry's lobbying group,

the song "I've Got a Golden Ticket"

from Willy Wonka and

the Chocolate Factory plays on the soundtrack

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."

It is 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 pic resulting from the heated battle that's already begun between left and right, returns look to be extremely healthy.

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.

Sicko, Michael Moore's new film

It's ostensibly about health care in America; it's not, any more than Moby Dick is about a fishing trip.

Like Moore's other documentaries (Fahrenheit 9-11, Bowling for Columbine), Sicko's central theme is American democracy -- how it works, where it doesn't -- and the culture of capital.

Moore's a polarizing figure -- the right wing loves to hate him, and at the same time much of the left wing hates to love him:

I know many people who agree with Moore's ideas and yet despise how he articulates them, if only because his arguments are designed to provoke a general response more than they are to prove a particular point.

But, like Fahrenheit 9-11 and Bowling for Columbine, Sicko certainly tackles a topic worthy of discussion, and Moore's quick to explain that his film isn't about the 50 million people in America without health care.

Although an opening anecdote about a man who loses two fingertips in an accident and, without insurance, is told it'll cost $60,000 to re-attach his middle finger but only $12,000 to re-attach the tip of his ring finger demonstrates that life without healthcare is pretty bad.

Instead, "This is about the 250 million of us who have health insurance, who are living the American dream."

And Moore makes the point -- swiftly and well -- that even health care isn't healthcare; bureaucracy, the labyrinth of paperwork and weasel-word legal language about pre-existing conditions and denial of service all make having coverage as much of a challenge as lacking it.

A listing of pre-existing conditions which will make you ineligible for health care coverage flies past in the style of the opening credits of Star Wars; it's a nice visual, and it gets a laugh, but does it really convey the facts of the matter?

This is the challenge of Moore's work -- is he a journalist, or an entertainer? A fact-finding seeker of truth or a deadpan comedian of the socially absurd? Are his arguments constructed to make a point, or get a laugh?

Much of Sicko revolves around how other nations have "free universal health care" -- but it takes Moore an hour-and-a-half to explain that actually, citizens of those nations pay for their health care through their taxes.

I know it's nit-picking, but I don't think I'm the only person who watches Moore's films and wishes they had more clarity and less hilarity,

At the same time, I think that a large mass of the American public is so desperate for someone to speak truth to power that they'll settle for someone willing to say anything to it, no matter how specious or muddled.

There's an old axiom that anecdotes aren't evidence, and that's well-demonstrated here; when Moore takes a group of 9-11 rescue workers to Cuba for 'free' medical care, it's a reminder that stunts aren't stands, either.

At first, Moore tries to take his ill charges to Guantanamo Bay by boat so they can get care at the hospital at the notorious 'Gitmo' military base, shouting to the guard tower through a megaphone:

"These are 9-11 rescue workers ... they just want the same medical care Al-Qadea is getting!"

It's a nice line, and a great image; it's also sort of beside the point, and destined to failure from the get-go.

Moore has, as ever, a great taste for the absurd -- as footage explains how Congressmen Billy Tauzin went from the committee overseeing the pharmaceutical industry to heading the Pharmaceutical Researchers and Manufacturers of America, the industry's lobbying group, the song "I've Got a Golden Ticket" from Willy Wonka and the Chocolate Factory plays on the soundtrack.

He's also got a well-developed capacity for self-promotion: More explains in the film how the head of anti-Moore website www.Moorewatch.com posted that he'd have to stop running the site due to a financial crisis brought on by his wife's illness.

Moore then tells how he anonymously sent a check for the cost of the wife's treatment -- $12,000. It's a funny bit -- and, to anyone who can parse a sentence, not actually 'anonymous' at all, anymore.

It's that tone -- of selfless self-celebration, of public altruism, of snide sensitivity -- that undercuts a lot of Moore's work, and it undermines Sicko.

I don't expect a film to solve the American health care crisis, but even as a call to arms, Sicko's more muddled and muted and scattered than it should be.

Moore may be challenging the system, but he still feels like the guy who brought a clown's squirting flower and a joy buzzer to a knife fight and then wonders out loud why he lost.

The Gospel of Luke tells us "Physician, heal thyself"; if Moore wants to really challenge unfair systems and inhumane systems, he's going to have work harder to make sure that his methods are as clear as his motives. James Rocchi @ Cinematical