Moore decided to go to Cuba, as he explains in the film, after learning the peculiar irony that detainees at Guantánamo Bay are entitled to something American citizens are not: free healthcare. In a brief and awkward scene, he tries to bring a fishing boat with his 9/11 refugees aboard into U.S. waters just off the naval base. They are refused entry (Moore is evasive about the details) and then seek treatment at the best hospital in Havana.
"The point of this was not to go to Cuba," Moore said at the press conference. "The point was to go to Guantánamo Bay, to get the 9/11 workers the same medical care we're giving to members of al-Qaida." If the detainees had been at a U.S. base in Spain or Italy or Australia -- all countries with universal healthcare -- he'd have taken his 9/11 workers there instead. In fact, when Moore drops the jokes and political attitudinizing during the Cuba sequence, the pathos of the story makes his point for him: A poor Caribbean island, whatever its ideology, can afford healthcare for everyone while we do not. The only possible conclusion is that our society has chosen not to.
When asked about his potential prosecution for violating U.S. Treasury sanctions against trade with or travel to Cuba, Moore was uncharacteristically sober. "I know a lot of you have written things like, 'How dumb are they?'" he said, "but I don't take this lightly. The Bush administration may try to claim that my footage was obtained illegally. We haven't discussed this possibility yet, but actions could be taken to prevent this film from opening on June 29. I know that sounds crazy to the Americans in the room. I guess it is crazy."
When Americans do get to see "Sicko," Moore says, "They will understand that this was about helping 9/11 rescue workers who've been abandoned by the government. They're not going to focus on Cuba or Fidel Castro or any other nonsense coming out of the Bush White House. They're going to say: 'You're telling me that al-Qaida prisoners get better medical treatment than the people who tried to recover bodies from the wreckage at ground zero?'"
When Moore interviews Tony Benn, a leading figure on the British left, his larger concerns come into focus. Benn argues that for-profit healthcare and the other instruments of the corporate state, like student loans and bottomless credit-card debt, perform a crucial function for that state. They undermine democracy by creating a docile and hardworking population that is addicted to constant debt and an essentially unsustainable lifestyle, that literally cannot afford to quit jobs or take time off, that is more interested in maintaining high incomes than in social or political change. Moore seizes on this insight and makes it a kind of central theme; both in the film and aloud, at the press conference, he wondered whether some essential and unrecognized change has occurred in the American character.
"I hope this film engenders discussion, not just about healthcare, but about why we are the way we are these days," Moore told us. "Where is our soul? Why would we allow 50 million Americans, 9 million of them children, not to have health insurance? Maybe my role as a filmmaker is to go down a road we might be afraid to go down, because it might lead to a dark place."
Moore's last revelation in "Sicko" is sure to be endlessly debated in the right-wing blogosphere that is so obsessed with him (and may be of little interest to ordinary viewers). Some time ago, Jim Kenefick, proprietor of the especially bilious anti-Moore site Moorewatch, almost shut down his site to focus on his wife's worsening illness and escalating healthcare costs. An anonymous donor then sent him $12,000 to cover his wife's bills and keep the site running. (She has apparently recovered.) Now that donor has been revealed and, as Kenefick now says he suspected all along, it turns out to be Michael Moore.
"I want him to know that it was done with all the best intentions," said Moore, adding that he planned to phone Kenefick personally after the press conference. (According to Kenefick's blog, Moore left him a voice-mail message later on Saturday.) "I went back and forth about whether to use that material," Moore went on. "I asked myself, would you be doing this if it weren't in the film? I decided that I would, and I should, and that that's the way I think we should live."
Moore says he began exercising and lost 25 pounds while working on his healthcare film; "I'm actually a fairly skinny person for the Midwest," he quipped. He says he's tried to maintain a lower public profile since "Fahrenheit 9/11" and would like Kenefick and his many other critics to cut him some slack. "You know, I begin to hope that as I enter the discourse with this film, I might get some kind of a break. As far as the accuracy of my movies goes, I think the record speaks for itself. Maybe people will say: He warned us about General Motors, he warned us about school shootings and he warned us about Bush."
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About the writer
Andrew O'Hehir is a senior writer for Salon.
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