The big guy with a baseball cap knows his stuff

He has a point to make and he makes it

efficiently and amusingly

His latest movie, Sicko asks the question:

What has happened to the idea of

universal health care in the United States?

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

It is now fashionable to rubbish Michael Moore.

Apart from anything else, he has single-handedly hugely increased the audience for documentary films in the USA, filling a gap that American television has left wide open.

He should be thanked for that. What he produces (however he does it) is agitprop and he makes no bones about it.

He deserves a lot of commendation for opening doors and pushing the boundaries of what can be covered in a documentary and reach a wide audience. Whatever his failings are, tomorrow's documentary makers will owe him a lot.

So, he is a self-publicist and may be difficult to work with. So, big deal. Would there were more of him, with a similar agenda.

Who can forget the vividly made point that the American gun lobby took over where the Klu Klux Klan left off in 'Bowling for Columbine'? He has an instinct for making the case for those battered or excluded by the system and he makes it powerfully.

It is silly for some to harp on about how he didn't prevent a corrupt electoral system for returning George W to power.

That the Democrats have been slow off the mark to try and reform electoral skulduggery is not his fault.

In lambasting the Republicans, he has certainly misjudged the virtues of the Democrats, but, at the same time, there is no indication that he will fail to hold them to account.

The American Right had for too long crowded out voices raised against them by lies and repeated lies and more repeated lies and sheer audacity in smear tactics.

They are now at a point where they don't even bother with lies and they need to be doggedly pursued - by 'whatever means necessary' in whatever party they have clustered or wherever they regroup.

Michael Moore has not been ground down, thankfully, and has kept his agenda intact. He enjoys a facility for liberating outrage from the pounding it gets on a daily basis and for that, he and others like him, are sorely needed.

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 health care 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.

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. Agnès Poirier @ Guardian