Sicko, the new documentary by Michael Moore that calls for healthcare reform, shouldn't have the same polarizing effect as his last film, the anti-Bush political screed Fahrenheit 9/11.
But there is one segment in Sicko bound to rile at least some viewers. In the film, which opens Friday, Moore travels to countries that offer free medical care to citizens -- Canada, Great Britain, France -- trying (and failing) to find chinks in their systems and pondering why we can't establish a similar infrastructure in the United States.
But it's the climactic sequence in Sicko -- in which Moore takes three 9/11 rescue workers suffering from respiratory ailments to Cuba for medical treatment they can't afford at home -- that has brought the film the kind of controversy Moore can't help but attract.
At first, Moore attempts to take the workers to the U.S. military base at Guantánamo Bay, seeking ''the same kind of medical attention al Qaeda is getting.'' When they are turned down, Moore and his crew go to Havana Hospital, where a swarm of doctors descends on them, and visit a neighborhood pharmacy where one worker discovers the medicine that costs her $120 at home goes for a measly five cents in Havana.
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''Cuba is a very poor country, our embargo has made life very difficult for them, and yet in spite of that they are able to put together a healthcare system that guarantees they have a better life span than we do, a better infant mortality rate and more doctors per capita,'' Moore says in an interview. ``They've done quite well with what they have.''
But some Cuban exiles claim that Moore has simply fallen for the dog-and-pony show the Cuban government puts on for cameras.
Dr. Julio Cesar Alfonso, 39, who practiced medicine in Cuba for four years before coming to Miami in 1999, describes the Cuban healthcare system as ''a disaster,'' from doctors reusing needles to draw blood from patients (and keeping a sharpening stone for the needles ) to the X-ray machine at Cardenas Regional Hospital, which hasn't been replaced since 1959.
''The treatment Moore and the rescue workers receive in the film was done specifically for them, because they knew it would make great propaganda,'' says Alfonso, a general practitioner in Little Havana. ``The medical centers in Cuba that treat tourists and government officials and VIPs are very different than the ones that treat the general population. If you're a Cuban citizen and need a prescription drug, most doctors either tell you to ask your relatives in the U.S. to ship it to you or recommend alternative herbal remedies. That's the degree of scarcity on the island.''
This is why Cuban Americans might be angered by a scene in Sicko in which Moore interviews Aleida Guevara, daughter of Ernesto ''Che'' Guevara, who works as a pediatrician in Cuba and wonders why the United States is unable to provide free healthcare for its citizens. ''Why are we able and you are not?'' she asks.
''There's no question our healthcare system needs to be fixed and improved,'' U.S. Rep. Ileana Ros-Lehtinen (R-Miami) sa. ``But to compare our system in any way, shape or form to the healthcare Castro supposedly provides to the Cuban people is just preposterous.''
Ros-Lehtinen claims that the medical attention the 9/11 rescue workers receive in the film is an example of the island's apartheid healthcare system. ''If you're a tourist in Cuba, yes, you're going to get healthcare, because that's one of the things Castro uses as propaganda to create goodwill around the world,'' Ros-Lehtinen says. ``But that is completely different from the kind of care everyday citizens get. To hold that up as something the U.S. should emulate is ludicrous.''
In May, the U.S. Treasury Department launched an investigation of Moore's trip to Cuba, which may have violated long-standing travel and economic embargoes against the island. But Moore dismissed the probe, saying journalists can legally visit in pursuit of a story.
''The documentary is a work of journalism; no laws are broken,'' Moore says. ``It's just an attempt by the Bush administration to use our federal agencies as they've been known to do in the past to politically harass opponents.''
When pressed, Moore doesn't deny that the Cuba segment in Sicko might be disingenuous -- a shorthand way to drive home his point that the our healthcare system needs reform.
But Moore chooses not to debate the specific realities of life in Cuba.
''When I go to Canada, I don't point out while I'm there that they don't have a First Amendment,'' Moore says. ``People have various levels of freedom around the world. But how free are we when we force people into a situation like the one we have now, in which medical bills are now the No. 1 cause of bankruptcy and homelessness? We don't take care of people when they become sick and they lose their homes. How free is that?''
Interestingly, Sicko offers proof that Cuba's healthcare system may not be worth crowing about when a list of the World Health Organization rankings is shown.
Atop the list is France, followed by Spain and San Marino. The camera pans down until it finds the United States in the 37th spot.
Briefly visible -- at No. 39 on the list -- is Cuba.