Sicko (12A)

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One turns to a new Michael Moore film with a heavy heart – can someone so fat and self-regarding really afford to be that smug? – and a weather eye for the usual simplifications and stunts that mar his crusading polemics. But Sicko marks a welcome change: for at least 40 minutes, there's not a shot of the big lump to be seen.

It's actually a devastating exposure of America's iniquitous healthcare system, coolly marshalled and amusingly detailed by Moore. His main argument is that the government and the medical-insurance companies have between them sold Americans short by putting profit before health. He nails corruption and negligence with case studies ranging from a man who was told his severed middle finger could be replaced – for $60,000 – to the appalling story, captured on CCTV, of a dazed woman patient dumped outside an Los Angeles hospital to fend for herself.

He also reveals how US governments have tried to cast "socialised medicine" as a kind of demonic communist plot, and visits Canada, France and the UK to prove the point that public healthcare can function just fine. He visits an NHS hospital in London and finds solicitude, efficiency and a well-paid, contented doctor. Who knew we should feel proud?

The last quarter of the film gets bogged down in silliness as Moore takes a party of ailing, ill-treated 9/11 rescue workers first to Guantanamo Bay, where al-Qa'ida suspects allegedly receive free medical care, and thence to Cuba, where a hospital offers them treatment that they can't afford in the US. It ends in a group hug between the tearful Americans and a Cuban fire brigade.

That's the regrettable side of Moore: he just can't resist grandstanding. This is a better, more thoughtful effort than Fahrenheit 9/11, though, and ought to make The Land of the Free just a little ashamed.