He wants you to be disgusted by ‘Sicko’

Michael Moore and his movies have always been hard to miss. But with “Sicko,” his acidic new documentary about healthcare, there’s suddenly less of the filmmaker and his usual methods.

Not wanting the limelight, Moore is forgoing the competition at this year’s Cannes Film Festival, where he won the top prize with 2004’s “Fahrenheit 9/11.” In “Sicko,” he isn’t chasing down insurance and pharmaceutical executives for confrontational interviews. The famously outsized filmmaker, having spent several years studying healthcare, even has lost 25 pounds -- “One way to fight the system,” he says, “is to take better care of yourself.” But what’s most striking about “Sicko” is that Moore’s current target is much harder to pinpoint.

Whereas the foils of his earlier films were obvious -- General Motors in “Roger & Me,” the gun industry in “Bowling for Columbine,” the Bush administration in “Fahrenheit 9/11” -- the ultimate protagonist in “Sicko,” opening June 29, is American indifference.

“To me there is a big confrontation in this movie,” Moore said in an interview. “Because I am confronting the American audience with a question: ‘Who are we, and what has happened to our soul?’ To me, that’s maybe more confrontation than going after the CEO of Aetna or the CEO of Pfizer.” Moore believes the country unthinkingly settles for substandard and ruinously expensive medical treatment, especially when compared with countries that have universal healthcare.

Although the film is filled with terrible medical outcomes -- the movie opens with an uninsured carpenter with severed digits who must decide if he wants doctors to reattach his ring finger for $12,000 or his middle finger for $60,000 -- “Sicko’s” central thrust is to hold up models of superior, government-provided care in France, Canada and (in a twist that has landed Moore in hot water with the U.S. Treasury Department) Cuba.

“I don’t have to convince the American public that there is something wrong with our healthcare system,” said Moore. “That’s why I don’t spend a lot of time in the film on the healthcare horror stories. I’m hoping that the American people, when they see this film, will say, ‘You know, there is a better way, and maybe we should look at what they are doing in some of these other countries.’ ”

In a choice that endeared “Sicko” to the local audience, Moore spends much of the film on France’s socialized medicine. Doctors lead comfortable lives, patients receive attentive care, employers grant extended health-related leaves -- all reasons the World Health Organization ranked France tops in its global 2000 survey of the best countries for healthcare.

That the United States ranked only 37th on the WHO list, just two slots ahead of Cuba, particularly infuriates Moore. As “Sicko” anecdotally documents, many Americans eligible for insurance can’t afford it, and a long inventory of preexisting conditions limits the insurability of those who can.

Among “Sicko’s” villains are politicians who pocket millions from HMOs and pharmaceuticals while denouncing universal care as little better than a communist plot. The film is particularly tough on Sen. Hillary Rodham Clinton (D-N.Y.), once an advocate for universal care and now among the healthcare industry’s biggest money recipients. (Moore says “Sicko” distributor Harvey Weinstein, a longtime friend and supporter of the Clintons, asked him to cut the sequence, but he refused.)

To highlight the shortcomings of U.S. healthcare, Moore at one point focuses on the plight of several chronically ill Sept. 11 rescue volunteers. Convinced that enemy combatant detainees receive better care in Guantanamo Bay, Moore and the volunteers take a boat to Cuba. Despite its poverty, Moore says, Cuba’s healthcare system is a model for the Third World.

But what makes for one of “Sicko’s” most memorable sequences also sparked the wrath of the Treasury Department, which said the visit violated the Trading With the Enemy Act. Moore said he had until today to respond to government requests for information about the trip and that the penalties conceivably could include confiscation of the footage and criminal prosecution. “The lawyers are cautioning me to not treat this as a joke, which was my initial reaction.”

If the Cuba inquiry put the spotlight back on Moore, the filmmaker says that wasn’t his intention.

“I’m not going to be the one sticking my neck out here,” he says. “People are going to have to come along. They are not going to be able to say, ‘Let Mike go after this. We’ll come along later when it looks safe.’ And I don’t need to convince the American public that there is something wrong here. I am hoping to inspire them in some way, to become active, and to do something.”

john.horn@latimes.com