It’s a kinder, gentler Michael Moore on display in his new activist documentary. But that doesn’t mean he’s gone soft. As he rambles around in his scruffy, ordinary Joe persona in “Sicko,” he constructs a direct assault on the American health-care system, taking well-deserved aim at what’s euphemistically called managed care, insurance companies, pharmaceutical corporations, callous hospitals and governmental complicity with them. He also takes aim at the American xenophobia that deters us from learning from other countries’ experience. But though the picture is as pointed in its positions as Moore’s earlier efforts, it’s not nearly as barbed. There’s plenty of ironic comment, but this time around there’s less anger in Moore’s manner and rage in his words. Instead he speaks in tones of almost bemused shock, feigning an almost “Candide”-like naivete as he castigates the private American system and undermines the contentions of its protectors that it’s preferable to what they decry as “socialist” alternatives. The overwhelming feeling one’s left with is one of resignation and regret over a deplorable situation that powerful forces are determined to maintain.

“Sicko” begins with a prologue on people without medical insurance, so that Moore can puckishly tell us that the movie isn’t about them. Rather it’s about people with insurance who are nevertheless stymied in their attempts to get what their policies promise; individuals who have suffered in this way get their say, and those who’ve worked for the insurance industry to exclude claims or deny treatment, even retroactively, get ample opportunity to offer their mea culpas as well. Moore also traces the failed system back to its political roots, which he’s happy to identify with Richard Nixon’s legislative support for the profit-based HMO program dreamed up by Kaiser. And after deploring the failure of the Clinton universal health plan proposal, he equally deplores the Democrats’ capitulation to the current system for political gain. (Curiously, Moore doesn’t even mention that the choice goes back to the Truman years, when the president proposed in 1945 a voluntary national health insurance plan that was rejected in favor not only of a private insurance system, but one that was eventually organized—with ultimately disastrous effect—by employers.)

Juxtaposed with this funny-sad assault on the American system is a consideration of the alternative, a single-payer plan run by the government, which opponents claim results in long waits for patients, substandard care, high taxes and poor conditions for physicians. To investigate whether such charges are true, Moore travels to Canada, England and France, playing not the firebrand his rabid critics love to hate but the wide-eyed innocent who’s shocked, shocked to learn that Canadians are pleased with their coverage (and appalled by the U.S. lack of something similar), and that some Americans actually go north to take advantage of it; that the British national health service is extremely popular (a point made by eloquent Old Laborite Tony Benn) and doctors are pleased to function within it; and that the French system, which American expatriates enthuse over, doesn’t bankrupt ordinary middle-class citizens, who still lead quite comfortable lives. The obvious conclusion is that the horror stories Americans are fed about such a system are ploys to keep them willing to suffer with the profit-oriented one that benefits the special interests rather than them.

The last part of “Sicko” moves into more familiar Moore territory with the stunt that’s earned the picture so much notoriety—his trip to Cuba, ostensibly to get medical help for 9/11 volunteer rescue workers with severe conditions at Guantanamo Bay, where terrorist suspects are provided with free care. (They skedaddle quickly when an alarm goes off at the camp gate.) It’s an amusing bit but not much more than that, which is then followed by the workers being treated in Cuban hospitals under the Castro regime’s socialist system. And it’s here that things go a bit awry. Frankly, the Cuban material looks and sounds very staged, something that it would have been wise to avoid when the picture occasionally uses excerpts from Communist propaganda films (as well as American movies and archival footage) for comic effect. But the picture recoups with a good gag, and one touched with poignancy, involving an I-hate-Michael Moore website. One’s left wondering what its webmaster will make of it.

Some people will attack “Sicko” simply because it was made by Michael Moore, and dismiss its argument simply because he’s the one making it. Others will happily overlook some of its more dubious assertions and cinematic flaws for the same reason. Of course it has an agenda, but Moore is straightforward about it, and of course it’s not “fair and balanced” except in the Fox sense of the phrase–which is to say not fair or balanced at all. But the fact is that although one-sided, it’s arguably a lot less problematic than the health system it asks viewers to cast a critical eye on and consider alternatives to.

And it just happens to be very entertaining to boot.