In an issue of Film Comment, Paul Arthur recently wrote about “aesthetic ethics” in relation to documentary filmmaking. Arthur’s argument was that aesthetic ethics are part of the visual landscape in documentary films whereas in narrative cinema the truth and ethical deliberation goes on behind closed doors. It’s no small surprise that Michael Moore was name-checked specifically in the article: his manipulative theatrics have always been poised right next to his muckraker sensibilities. Returning from his Fahrenheit 9/11 (basically the catalyst for the revival of popular documentary filmmaking), Moore goes broader and more heartfelt for his latest investigation, SiCKO.

SiCKO takes the world of health-care, health maintenance organizations (HMOs in the US), and the American medical system into the ring for 12 punishing rounds. Jabs are delivered by horror stories of denied claims, uppercuts by an intense study of how awful the US medical care system is (it is placed 37th in the WHO’s world rankings, right above Slovenia). The most fascinating parts deliberate on the financial gains of the American medical industry, ostensibly outing the entire shindig as a capitalist enterprise rather than an aid for humanity. Reaching all the way back to President Richard Nixon’s idea to privatize health care with Edgar Kaiser, Moore’s portrait of the medical establishment is coal-black and more clear-eyed than the filmmaker has been in years.

At one point, Moore takes a group of 9/11 workers and uninsured Americans to Guantanamo Bay. It turns out Guantanamo has the only universal health care coverage in the US, offered expressly to the US’s so-called enemies. In his patented fashion, Moore asks for health officials to see his passengers and is met with a loud siren. So, he goes to Cuba and the workers are all given express help and are honoured by the Cuban fire brigade for their bravery. As with many Moore moments, this can get a little tough to swallow; most likely they heard Moore was coming and wanted to look good on camera. And remember that list where the US just beat out Slovenia? Yeah, well, Cuba was right under Slovenia. This, however, doesn’t distract from the miasma of human misery that engulfs the rest of the film, creating Moore’s most sincere portrait of American life in the trenches since the groundbreaking Roger & Me.

Take it as a mix of documentary and partisan filmmaking, but the American cultural mindset hasn’t been questioned so harshly on film in a long time. Moore’s biggest enemy is entitlement: the American way of life as “I worked for it so I deserve the rewards” rather than “I worked for it to make our way of life better.” Political leaders and the grey-haired men they work for have been manipulating this ideology for years and, as a foreigner points out, Americans are afraid of their government much more than the government is of its people. Moore’s trips to France and the UK are repetitive in how he frames the US medical establishment as a bad joke, but honestly, that is what it is: a bad joke delivered with the sensibility of a 10-year-old. Beyond the questions of ethical framing, Moore’s ego gives itself a hearty pat on the back but yields a cold, hard slap to the USA’s zombie culture.

Chris Cabin