“Sicko” does not display Moore at his most cinematically inventive or imaginative. It presents a TV-documentary-style parade of episodes, characters and settings, bouncing from various American cities to Canada, Britain, France and Cuba (and yes, don’t worry, we’ll get to that). Moore plays a far smaller personal role in this film, appearing only occasionally in his comic-relief role as the clueless buffoon who can’t seem to grasp that healthcare in all those other countries is free, or virtually so. When he’s eating dinner with a group of Americans living in Paris who begin to list all the things they can have as free or nearly free entitlements — not just healthcare but an emergency doctor who makes house calls; not just childcare but a part-time in-home nanny — Moore puts his hands over his ears and begins singing “La la la la la.” (If you have kids or any kind of chronic family health problems, your reactions might include weeping in despair, slitting your wrists or booking a one-way ticket.)

Still, there is no mistaking the passion and political intelligence at work in “Sicko.” It’s both a more finely calibrated film and one with more far-reaching consequences than any he’s made before. Moore is trying to rouse Americans to action on an issue most of us agree about, at least superficially. You may know people who will still defend the Iraq war (although they’re less and less eager to talk about it). But who do you know who will defend the current method of healthcare delivery, administered by insurance companies whose central task is to minimize cost and maximize shareholder return? Americans of many different political stripes would probably share Moore’s conclusions at the press conference: “It’s wrong and it’s immoral. We have to take the profit motive out of healthcare. It’s as simple as that.”

“Sicko” purposefully does not focus on the 50 million or so Americans who don’t have health insurance, as scandalous as that is, but on the horror stories of middle-class working folks who believed they were adequately covered. There are so many of these they begin to blur into each other: the woman in Los Angeles whose baby was denied treatment at an emergency room outside her HMO network, and died as it was being transferred hours later; the woman in Kansas City whose husband was repeatedly denied various drugs his physician prescribed for kidney cancer, and who in the last stage of life was denied a bone-marrow transplant that could have saved his life; the woman who was told her brain tumor was not a life-threatening illness, and died; the woman who was told her cancer must have been a preexisting condition, and died.

One might respond that anecdotes like these have tremendous emotional power but little analytical rigor, but in this case I think we all know (and fear) that these worst-case outcomes exemplify the system perfectly. Moore interviews two healthcare whistle-blowers, both now plagued with guilt, who explain what should be obvious: The point of the system is to treat as few people as possible as cheaply as possible, and those who get ahead in the healthcare industry are those who find ever more devious ways to deny coverage. (For example, you can now be denied for certain preexisting conditions you didn’t know about, on the premise that you should have known about them.)

OK, let’s get to the headlines: Yes, in the film Moore travels with a group of ill and injured 9/11 rescue workers (along with several other of his film’s protagonists) to Cuba, where they receive free and apparently excellent medical treatment. It’s unquestionably another button-pushing Michael Moore stunt, designed to provoke controversy. It’s cheap but funny, dubious as evidence but affecting anyway. Moore does not even seem aware of the possibility that the Cubans were shrewd enough to see the propaganda value in this exercise, and put on a dog-and-pony show for his and our benefit. (For that matter, we don’t know how much of the visit was planned in advance with Cuban authorities.) All that aside, within the context of the film and the argument Moore is building, Cuba makes as much sense as anywhere else.

Moore begins his foreign odyssey in the film after meeting a 22-year-old Michigan woman who has moved across the Ontario border (not entirely on the up-and-up) because she’s been denied treatment for cervical cancer. He wanders around emergency rooms in London, Ontario, and London, England (where he discovers that the cashier’s window is for paying patients their travel expenses, not for settling the bill). He zips from one Parisian arrondissement to another with an on-call physician on the night shift. He dines with the aforementioned Americans abroad, who seem dazed and a little guilty about their escape from healthcare hell.

Much of this is played as comedy; Moore corners a young Afro-British couple with a wiggling bundle in the hallway of a London hospital and says cheerfully, “So — how much they charge you for that baby?” But Moore is trying to push us beyond the universally shared idea that something must be done to the slightly more controversial idea that something has been done, and that all we have to do is appropriate it. Americans have of course been conditioned for generations to believe that socialized medicine is first of all a disaster in its own terms, and secondly, the pathway to totalitarianism.

His portrayal of the Canadian, British and French systems is undoubtedly simplistic , and several Canadian reporters took that up with him at the press conference — although all of them admitted they wouldn’t trade their system for ours. But Moore’s overall point is, I think, inarguable: Flawed as they may be, those systems are a hell of a lot more humane and civilized than anything we’ve got. (Life expectancy is significantly higher, and infant mortality lower, in all of those countries than the United States. Whatever outdated stereotypes you may hold, these days poor people in Britain are statistically healthier than rich people in America.)

Addressing a series of questions from foreign reporters at the press conference, Moore said: “We should do what we always do as Americans, steal the best things you’re doing and make them our own. The Canadians do certain things very well. The Brits do certain things very well. The French have the best system in the world, and that’s not my opinion. That’s how the World Health Organization rates them. None of them is perfect, but it’s not my role to make criticisms. It’s my role as an American to say, why don’t we take the best elements you’re doing and blend them together, and call it the American system?”

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.”

* * * * For more coverage of the Cannes Film Festival, click here.

That is in fact how it works. My unknown friend with the unknown film might have had a better short-term commercial future at Sundance (although that’s far from a sure thing), but as far as festival quality-of-life issues go, he’s in the right place. The South by Southwest Film Festival can’t compare with Sundance as an acquisitions marketplace or a high-profile showcase for new movies. Even claiming that SXSW has the countercultural cachet that Sundance once possessed is misleading, because no single event or institution can wield that kind of cultural power in today’s fragmented media environment. But it’s a pile of fun, and whatever people say about Sundance, they don’t say that.

Opening weekend at SXSW 2007 has been a cheerful and eclectic mixture of semimajor premieres and utterly unknown films, some of which may never play anywhere else. We’ve seen a crisp and engrossing thriller from writer-director Scott Frank, just a little too stark and dark to be a Hollywood film, on opening night. We’ve seen an awkward, immediately controversial film about (not by) Michael Moore, which struggles, with intermittent success, to yank the facade off the media superstar.

We’ve had a whimsical documentary about the world of balloon twisting, narrated by Jon Stewart, and I guess it doesn’t get any more made-for-SXSW than that. (Except maybe for the inspirational documentary about the world of inner-city competitive jump-roping.) Protean Scottish actor-director Alan Cumming has premiered his new film, an outrageous horror-comedy carefully designed to offend the entire population of the planet. Then, on Sunday morning, there was church. Or at least there was filmmaker Robert Rodriguez and Ain’t It Cool News founder Harry Jay Knowles leading a reverent lecture-demonstration about “grindhouse” cinema and, of course, about “Grindhouse,” Rodriguez’s new anthology feature made with Quentin Tarantino — which was as close as most SXSW attendees got to religion this weekend.

As this festival crawls incrementally closer to mainstream significance (it’s already an important venue for documentaries and horror films), it hasn’t lost the relaxed vibe, the warm and supportive audiences and the unjaded mode of alt-enthusiasm that represent this city at its finest. People don’t bring their low-budget movies to SXSW believing they’ll be struck by lightning and rendered into insta-celebrities. But they can be pretty confident they’ll have a swell time, overestimate their tolerance for tequila-based beverages and wind up on a patio somewhere at 2 a.m. talking earnestly to some brand-new friends, some of whom, at some point, might actually be able to help them.

For frozen Northerners like me, it’s worth coming here in March just for daytime highs in the 70s and 80s, the early-season wildflowers and those flocks of slightly ominous boat-tailed, ravenlike birds who sing so melodiously at dusk. (Hey Texans, what are those things? Grackles?) Then there’s the chance to catch a few movies at the Alamo Drafthouse mini-chain, where you can consume excellent beer and decent Tex-Mex cooking at your seat, and compared with which every movie theater in New York should basically be blown up.

As far as what’s actually showing on those screens, SXSW is always a defiantly mixed bag. Nothing was more fun this weekend than the movie we didn’t get to see. Rodriguez showed us a splatter-laden zombie car chase from “Terror Planet,” the faux-’70s exploitation pic that makes up his half of “Grindhouse,” and I for one found it completely irresistible. Those who believe that retro-cultural concoctions like “Grindhouse” are ironic, or even campy, are missing the point. As Rodriguez and Knowles made clear, they’re geeks’ geeks, and their affection — nay, their adoration — for the high-concept trash cinema of another age is completely genuine.

Both performed their Tarantino impersonations for us, recalling late-night telephone invitations to Burt Reynolds triple-bill screenings (“He’s a sweaty fucking god!” in that squeaky Q.T. voice) and marathon “Dawn of the Dead” board-game sessions. “Quentin seems to have grown up in some mystical community,” Knowles said, “where there were these movie theaters with, like, shamanistic projectionists who showed only the coolest shit, movies that nobody else had ever seen anywhere.”

Making a film in the grindhouse style, Rodriguez insisted, was not a postmodern affectation but an embrace of freedom. “What really excites me about grindhouse films is that they had to be about ideas,” he said. “They didn’t have stars in the cast. They didn’t have budgets. They had to rely on outrageous ideas and lurid material to get people in the seats. We’ve got stars in our cast — and that’s kind of weird — but we’re using them the way we would if we didn’t.”

As you probably know if you care about these things, “Grindhouse” is meticulously constructed to re-create a filmgoing experience that most of its prospective audience probably never had. (I’ll tell you about my youthful experiences in the long-gone Lux Theatre of downtown Oakland, Calif., some other time.) Rodriguez’s “Terror Planet” will have digitally created scratches, splices, water damage and dye leakage; perversely, since Tarantino’s segment (a cars ‘n’ guns flick called “Death Proof”) is actually shot on film, such manipulation will be harder. In between the two “features,” we’ll see trailers for nonexistent coming attractions; Rodriguez showed us Eli Roth’s unbelievably gruesome trailer for a Thanksgiving-themed slasher pic that’s horrifying, hilarious and guaranteed not to pass muster with the MPAA. (Wait for the DVD, I guess.)

There was also a packed house and a buzz of anticipation for the premiere of “Manufacturing Dissent,” the documentary about Michael Moore made by Canadian filmmakers Rick Caine and Debbie Melnyk. Right-wing docus slagging Moore are a dime a dozen (I think that’s literally true), but Caine and Melnyk began their pursuit of Moore as fans, drawn from the Great White North toward the one American they saw speaking truth to pop culture. After months of fruitlessly pursuing His Mikeness for a sit-down interview — and being persecuted by his handlers and security troops — they shifted focus, and began to track down the many people willing to badmouth Moore instead.

From his days as a struggling lefty journalist in Flint, Mich., to his current career as a media superstar, Moore has undeniably left a trail of unhappy acquaintances behind him. There is no question that his films contain fictionalized elements, and sometimes distort history and chronology way out of context. He’s egotistical, frequently unfair and occasionally downright mean (as in his sandbagging of the senile Charlton Heston in “Bowling for Columbine”).

Still, as indie-film guru John Pierson says here, Moore is also a prodigiously entertaining filmmaker whose self-taught gonzo style has utterly transformed the documentary genre. You don’t have to agree with him politically, or endorse his methods, to see that. Whether the revolution Moore has wrought has been a good or a bad thing, how much he should be called to account for sacrificing truth to rabble-rousing and what the political value of his work really is — those are valid and important questions that “Manufacturing Dissent” merely bounces off.

Journalism wonks and students of the left may be interested in hearing more about Moore’s brief tenure at Mother Jones in the ’80s, or learning precisely what he faked in “Roger & Me,” but Caine and Melnyk’s film offers only a cautious, orderly catalog of his larger and smaller sins (almost all of them already well publicized), never a coherent argument. That’s very polite and Canadian and documentary-film-like, but given the half-accidental similarity of Caine and Melnyk’s film to Moore’s far more graceful and entertaining “Roger & Me,” it isn’t exactly satisfying.

Intriguing and suggestive material is assembled here — I especially appreciated hearing from rock critic Dave Marsh (a Moore hater) and Pierson (an avid defender) — and “Manufacturing Dissent” should spark debate among Moore’s core constituency. But it’s something of a missed opportunity. Somebody really needs to delve deep into the symbolic value, and very real limitations, of the left’s class clown and über-celebrity. (Disclosure: I met Michael Moore once, and he said my kids were cute. So it probably won’t be me.)

My colleague Stephanie Zacharek will review Scott Frank’s thriller “The Lookout” when it opens at the end of March, so I’ll limit my comments here. Fueled by yet another terrific performance from Joseph Gordon-Levitt (star of “Brick” and “Mysterious Skin”), aka the “young Keanu,” it’s a curiously satisfying genre picture, with all the tight plotting and meticulous character building you’d expect from the writer of “Out of Sight,” “Minority Report” and “Little Man Tate” (among other films).

Sparely shot on the depopulated plains of Kansas — Frank specifically cites “Capote” as an inspiration, and I also thought of “A History of Violence” — “The Lookout” is a subtly unsettling picture with a disordered hero. Chris (Gordon-Levitt) is a former high school stud trying to recover from a disabling head injury — and from the accident (his fault) that caused it and killed two of his friends. Befriended by a charismatic, goateed bad boy named Gary (Matthew Goode, in what should be a breakout role for him), Chris is gradually drawn into an ill-fated robbery scheme, motivated at least as much by his damaged self-esteem as his brain injury.

This is Frank’s first film as a director, but after all those years in the movie business he knows what he’s doing. What seems at first to be not much more than a well-acted formula picture turns out to be full of little bombs, lines and images that detonate in your head hours or days later. It’s too gradual, sinister and methodical for a contemporary Hollywood action movie, and too plot-driven for a classic character-based indie. Is it an honest entertainment or a work of art? Irrelevant question, and anyway the answer is a snaky, slithery somewhere in between. (My interviews with Frank and Gordon-Levitt are coming soon to Salon Conversations.)

That leaves Alan Cumming’s indescribable and inexplicable “Suffering Man’s Charity,” which also premiered in downtown Austin’s lovely Paramount Theater on Friday, just before “The Lookout” and for a much smaller crowd. Those who didn’t show up missed seeing Cumming himself as a queeny, middle-aged music teacher who winds up imprisoning and torturing a young hustler played by David Boreanaz (of “Angel” and “Buffy” fame), who is wearing women’s underwear and tied up with Christmas lights and duct tape (oh, and heavily medicated with sleeping pills). “Suffering Man’s Charity” is just that kind of movie: It opens as if it’s going to be a sad-sack gay comedy in a lesser Tennessee Williams mode. And then it goes completely insane.

Even before we get to Boreanaz and the Christmas lighting, we’ve already had Anne Heche as a femme fatale New York editor and Karen Black (Karen Black!) as a drunken, slutty hag stumbling around in her underwear and making obscene promises to Boreanaz’s rent-boy character. Later in the film, there’s a significant splatter quotient, an appalling vehicular accident, a vindictive ghost and a truly horrible New York literary party. This film is all genres at once, and a few that don’t yet exist.

Given Cumming’s far-reaching showbiz as a Shakespearean actor, kiddie-film villain (in “Garfield” and the “Spy Kids” series), novelist, indie director (“The Anniversary Party”) and outspoken activist on gay issues, I have no doubt he can find a distributor for this willfully grotesque picture eventually. It’s either a total disaster or a midnight movie cult hit in the making, and on first viewing I’m not sure which. As I told myself while I stumbled out into the steamy streets of Austin, for better or worse there was nothing like that at Sundance.