May 19 (Bloomberg) -- Rick has sawed off the tops of two of his fingers. He is American and he doesn't have health insurance, one of almost 47 million people in that category. Reattaching the middle finger would cost $60,000, and the ring finger $12,000. In a grim arbitrage, Rick picks the cheaper option.

Across the border in Canada, a man with severed fingers has them all sewn back in a round-the-clock operation involving multiple surgeons. The operation costs him nothing.

That stark juxtaposition is one of many in U.S. filmmaker Michael Moore's documentary ``Sicko.'' Unveiled to cheering critics at the Cannes Film Festival today, it is an attack, as grave as it is humorous, on the U.S. health-care system. In his latest motion-picture editorial, Moore lets the episodes and those who lived them do the talking -- more than he has in past works, including the 2004 Cannes winner ``Fahrenheit 9/11.''

``The film is a call to action. The film is meant not for Michael Moore to go and do it, but for the American people to do it,'' Moore told a packed press conference after the screening, with as many reporters inside as were kept out for space reasons. ``I wanted a different tone to the film, and I wanted to say things in a different way.''

``Sicko'' introduces a less hyperbolic and more measured Moore, who descends from his customary soapbox and delivers a work that is more documentary than rant. The film is engaging, by turns sad and funny, and effective throughout.

``I would rather throw my lot down with the majority of Americans who know that something is wrong and want things to change,'' said Moore. He wants the private sector out of the provision of health insurance, he said.

Dapper at Debut

Almost 16 percent of the U.S. population didn't have health insurance in 2005, according to a U.S. Census Bureau report last year.

The director, 53, looked dapper for today's debut. No baseball hat, his hair neatly cut, and a dark suit jacket hiding a less bulky frame. ``Sicko,'' he said, drove him to lose 25 pounds (11 kilos) and eat more fruit and vegetables.

The 123-minute film opens with tales of the uninsured. One couple in late middle age, bankrupt after heart and cancer treatment, move into their adult daughter's cramped computer room. An elderly ex-plumber works as a supermarket janitor to afford his health bills. One young man is denied insurance for being too thin, and one young woman, for being too fat.

Even those with insurance are rejected. A woman's operation is refused upon discovery of a past yeast infection. Another patient is denied a bone-marrow transplant and dies.

Rejected Conditions

Former health-industry employees then take turns in front of Moore's camera. A teary ex-call-center operator recalls turning sick people away on a daily basis. The long list of reject ailments is then filmed by Moore's camera in alphabetical order, accompanied by the main ``Star Wars'' theme music. A repentant medical reviewer recounts how, by denying one patient a $500,000 operation, she caused his death. The scene is set to the poignant strains of Mahler's Symphony No. 5.

``Who invented this system?'' asks Moore, off camera.

The film is less an indictment of individual health insurers and providers than it is of the overall system, although several of the U.S.'s largest medical insurers are mentioned by Moore.

In today's press conference, Moore, referring to health insurers, said he had ``a word in their favor.'' They are ``legally required to maximize the profits of their shareholders,'' he said. ``If they don't do that, their executives could be in huge trouble for violating the law.''

Britain, France

``How do they maximize profits?'' Moore said, resuming his accusatory tone. ``The way to maximize profits is to give as little care as possible to the patients. And that to me is immoral, and in our society, it shouldn't happen.''

In ``Sicko,'' Moore introduces levity by contrasting the U.S. with Europe. The U.K.'s inefficient but free National Health Service is depicted as a health-care haven, where women give birth without charge and cashiers give rather than take, offering up money for extras such as taxi rides.

The most glaring contrast is with France, a place, as Moore notes to accordion music, where people have long lives even as they drink and smoke. Middle-class families are shown getting a range of benefits -- including, in one case, a tax-funded nanny who drops by for four hours a week to help a young mother do her laundry.

Moore doesn't show the coin's flip side. Almost one in 10 French workers is jobless, in part because employers are burdened down by the level of social charges they must pay on every person they hire.

Guantanamo, Havana

Moore being Moore, there are regular references to U.S. President George W. Bush. In the most Moore-esque stunt, the filmmaker takes a team of sick 9/11 rescue workers -- uninsured, as they are not on the government payroll -- to the U.S. military base at Guantanamo Bay, Cuba. The prisoners held there, suspects in the Sept. 11, 2001 terrorist attacks, get state-of-the-art medical treatment. The filmmaker says he wants the rescue workers to get ``the same health care as al-Qaeda detainees.''

Moore and his companions are greeted with an ominous siren. They retreat to a Havana hospital instead, where the patients are treated and comforted at no cost. Later, they even get a tribute from rows of Cuban firemen.

The U.S. Treasury has given Moore 20 days -- expiring Tuesday, May 22, he said -- to provide information for an investigation into his trip. U.S. law prohibits trade with or travel to Cuba. Moore says he risks a fine and even a jail term.

Still, as Moore concluded, politician-like, at the press conference, ``It is my profound hope that people will listen this time, with this film, because I don't want to wait 10 or 20 years before we have universal health coverage in America.''

The film is scheduled for U.S. release on June 29, which should allow it plenty of time to become a talking point in the U.S. presidential campaign.

(Farah Nayeri is a critic for Bloomberg News. The opinions expressed are her own.)

To contact the reporter on this story: Farah Nayeri in Cannes at farahn@bloomberg.net.

Last Updated: May 19, 2007 14:51 EDT