The writer, director, and actor Michael Moore has cleverly woven the funniest, saddest, and most gruesome of more than 25 000 healthcare horror stories submitted to his website into a powerful and affecting film. Sicko will inflame his supporters as well as his detractors.

In the film's opening scene a man without insurance sutures a gaping wound on his own leg with what looks like a regular needle and thread. We then hear from an uninsured man who cut off the tips of two fingers with a saw. As it was not a life threatening illness and he had no insurance, the hospital told him he could pay $12 000 (£6000; €9000) to reattach his ring finger or $60 000 for his middle finger, or both. “Ever the romantic,” Moore quips, “he chose the ring finger.”

But Moore's real target in the movie is not the amorphous healthcare “system” in the United States or even the government. The villains are the large health insurance companies that sell coverage but then use all manner of tactics to worm out of paying for needed care, leading to discomfort, suffering, …