Healthcare is consistently rated second only to Iraq on a list of American voters’ concerns. But as Barack Obama became the latest Democratic presidential candidate to unveil reform proposals yesterday, a familiar maverick figure helped to propel it into the spotlight.

Michael Moore’s new film, Sicko, which savages the American healthcare industry, is threatening to have a similar impact on the 2008 presidential election as his last effort – Fahrenheit 9/11 – had in 2004 when it galvanised the antiwar movement.

The film, which opens in cine-mas across the US on June 29, has already attracted direct fire from Fred Thompson, a potential Republican presidential hopeful, for one of its stunts. This involved shipping a boat-load of sick Americans – including some who became ill after working at Ground Zero after the September 11 attacks – to Guantanamo Bay, Cuba.

Moore is shown shouting a request for treatment through a megaphone to the US naval base where terror suspects allegedly receive excellent medical care. When this meets with no response, he sails down the coast to Havana where Cuba’s Communist regime is only too happy to treat the Americans.

BACKGROUND

• Sicko review

• Weinstein braces for backlash

• Moore is wrong about the NHS

• Ministering to the Sicko

BACKGROUND

• Moore in hot water for Cuba trip

• Citizen Moore

• Moore's ill wind blows over political agenda

• Review: America: Dude, Where's My Country by Michael Moore

• Tables turned on Fahrenheit 9/11’s maker

Just how good is Mr Good Guy?

Michael Moore is misleading, vain, irritating, greedy, hypocritical, pointless and ineffective. Or is he?

Related Internet Links

• 2007 London Film Festival coverage

• Times Online Film Trailers

Mr Thompson condemned Moore for giving Cuba a propaganda boost and noted that such was the imperfection of its medical care that Fidel Castro had to fly in a Spanish surgeon to repair damage done by a botched bowel operation.

Moore responded by pointing out Mr Thompson’s fondness for Montecristo Cuban cigars – importing of which is banned by the US.

All this might be regarded as mutually beneficial knockabout, were it not for the seri-ousness of America’s healthcare crisis.

The Organisation for Economic Cooperation and Development (OECD) issued a report yesterday giving warning that the US faces soaring budget deficits unless it does more to control spending on health, which far exceeds that of even the richest European countries, even though 47 million Americans – including nine million children – have no cover.

Much of Moore’s film is devoted to pouring praise on other countries’ healthcare systems, including those of Cuba, Canada and France, as well as Britain. He interviews Tony Benn about the foundation of the NHS and films empty waiting rooms in a London hospital where he searches for any sign of a billing department. Finally, he spots a cashier sign but learns that this is where people who paid for travel to hospital can get reimbursed.

“I’m an American looking at the British system through American eyes,” he said. “It doesn’t mean it doesn’t have flaws or problems, but it’s a hell of a lot better than what we have.”

There is little sign that America is turning towards the socialistic solutions of Britain or Cuba, however. Last week Hillary Clinton, who is praised by Moore’s film for seeking universal healthcare 14 years ago as First Lady and criticised for “selling out” to the insurance industry since, set out her latest proposals on the subject.

“I’ve tangled with this issue before, and I’ve got the scars to show for it,” she said. “I learnt some valuable lessons from that experience. One is that we can’t achieve reform without the participation and commitment of healthcare providers, employers, employees and other citizens.”

Her plan, set out on Thursday, focused on reining in healthcare costs and extending the reach of private insurance to cover preventive treatments such as cancer screening.

Mr Obama proposed retaining private insurance yesterday, but also injecting more federal funding by reversing President Bush’s tax cuts to give everyone the chance of being covered.

Mitt Romney, a leading Republican candidate, has already pioneered a system as Governor of Massachusetts to extend health insurance by making it mandatory, like that for driving a car.

Bill of health

— $1,988 billion was spent nationally on healthcare in the US in 2005

— $1,085 billion was spent by the private sector

— $903 billion by the public sector

— 16 per cent of GDP went on healthcare in 2005 – the highest rate in the world

Source: US Census Bureau, WHO

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