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Judging by its title, Sicko might be mistaken for a slasher flick, and the assumption is not far off the mark. Not because of violence. Not because of gore. But because it is, in some ways, a horror film.

Among its victims:

Rick, who sawed off two fingertips but could only afford to reattach one — for $12,000. Carole, who couldn't pay her hospital bills and was dumped at a homeless shelter in her flapping white gown. Tracy, who was denied coverage for a bone-marrow transplant and died, weeks later, of kidney cancer.

Michael Moore's latest documentary-as-soapbox-vituperation is a damning, touching, darkly comical exposé on the United States health-care system. It is also a deeply impassioned appeal for change. Moore haters like to dismiss the man as a whack job and a lying partisan crank, but he's really an idealist.

Look past the omnipresent ball cap and slumping gait, and you'll find a patriot — a true believer in the American dream. When he says, "We live in a world of 'We,' not 'Me,' " he's not being the least bit campy. He has, for a moment, no sense of irony whatsoever. He believes this stuff. 

As he did to the American gun culture in Bowling for Columbine and the Bush administration in Fahrenheit 9/11, Moore uses Sicko to assail the insurance industry and pharmaceutical companies and the politicians who accept their contributions. Bush gets slapped around some, but so do Hillary Rodham Clinton — once reviled by the industry for trying to establish universal health care — and former Louisiana congressman Billy Tauzin, who pushed for the Medicare prescription bill before leaving to head the drug-company trade group PhRMA.."     

As usual, Moore assembles his argument from poignant anecdotes and factoid-driven diatribes that use graphics, music and archival material to make his point. Just listen to that fuzzy audio of Nixon and Ehrlichman discussing Kaiser Permanente. But we also get lots of winking video footage (I especially liked the old Soviet agitprop) and choice music clips that run from the Khachaturian Saber Dance to a French rendition of Feelin' Groovy.

With Sicko, Moore himself doesn't pop on-screen until some 40 minutes in, a shrewd move for a filmmaker who understands his role as cultural irritant. People who hate him might continue to hate him. They might call Sicko an overly theatrical, sucker-punching screed that paints France as paradise, Canadians as smiling (but we knew that), Britain as maddeningly reasonable and Cuba as a cure for what ails us.

But it's a fiercely effective call to arms — a film that persuades and shames and chills. And he asks why a group of ill 9/11 emergency workers, volunteers not on the New York City payroll, couldn't find affordable health care until he took them to Havana.

You could dismiss it as a stunt, this trip to Cuba. You could point out the country's problems or the movie's cherry-picked health statistics. But nothing so illustrates Moore's rumpled brand of optimism as those few minutes near the end of Sicko when Cuban firefighters stand at attention to honor their ailing American brethren. It's as uplifting and heart-rending a thing as you will see at the movies all year. And it speaks of Moore's enduring faith — his angry, nettled, exasperated belief that "despite all our differences, we sink or swim together