About forty minutes into Sicko, Michael Moore's excellent, frustrating new documentary about the American healthcare industry, Ronald Reagan makes his first and only appearance. It's surprising, if only because, unlike in his previous film Fahrenheit 9/11, Moore focuses relatively little attention on the villains in his story, choosing instead simply to allow their victims to tell their tales. It's a montage of hard luck and innocence. But after introducing us to the horror stories all too typical among even the 250 million Americans fortunate enough to have health insurance, Moore takes a few moments for a brief history lesson. How, he asks, did we get here? And it's in this time warp that we encounter the Gipper. This is not Gipper the Governor or Gipper the President or even Gipper the B-list actor. This is Gipper, silver-tongued shill for the interests of capital. 

It's a little-studied chapter of Reagan's career, but perhaps the most formative. As chronicled in Thomas Evans's The Education of Ronald Reagan: The General Electric Years and the Untold Story of His Conversion to Conservatism, Reagan was employed by GE first as a spokesman and later as a kind of employer-to-employee ambassador. With management facing a restive labor force, an obscure PR guru named Lemuel Boulware hatched the idea of using the emerging techniques of public relations to turn factory-line workers against their own unions. Reagan would be the vessel for this message, and it was in the hours he spent propagandizing the working class about the benefits of free markets that he forged the distinctive Reagan appeal: hard-right economics delivered in the sunny cadence of an amiable uncle. 

So as momentum for national, universal healthcare built during the Truman Administration, foes such as the American Medical Association sought to build grassroots opposition. In an ingenious stroke, as Moore reports in Sicko, it organized thousands of coffee klatches across the country where suburban housewives could sip coffee, gossip and listen to a special recorded message about the evils of socialized medicine, a message delivered by the one and only Ronald Reagan. 

The presence of Reagan in the film, making an argument that is the inverse of Sicko's, is fitting. Moore's entire post-Roger & Me career can be understood as a multimedia attempt to undo Reagan's great achievement: persuading blue-collar factory workers and other members of the working class to embrace his heady brew of jingoism, anticommunism, contempt for government and admiration for the virtues of unfettered capitalism. 

For years Moore has, like Ahab pursuing the whale, been hunting the elusive Reagan Democrat--the heartland-dwelling, beer-drinking, blue-collar guy (or gal) who bowls on the weekend, loves his country and is fighting to stay afloat in winner-take-all America. He may look on the left with contempt, but it's not because he doesn't intuitively share its views: He is a visceral collectivist and unionist and an enemy of corporations. He is ready, Moore believes, to come over to our side, if only we would talk to him. 

That's why Moore spends the final chapter of his first book, Downsize This!, talking to Norman Olson, a co-founder of the Michigan Militia: "You know, you guys were right in the sixties," Olson tells him. "The government lied to us.... So when we finally wised up in the nineties after all these jobs were lost, where were you liberals when we needed your help?" Writing in this magazine in November 1997, in an article titled "Is the Left Nuts? (Or Is It Me?)," Moore asked a variation of the same question, "just who the hell is reading this? Who is the Nation readership? Is it my brother-in-law, Tony, back in Flint, who last night was installing furnace ducts until 9 o'clock?" 

It is Tony the furnace-installer who haunts Moore's work like a specter, and for whom the rotund and slovenly Moore acts as a kind of aw-shucks proxy. But the central paradox of his career is that his success in reaching the Tonys of the world is spotty at best. Though he's always communicated his politics in a comedic, accessible, populist vocabulary, his public image is that of an ideologue, a lighting rod, a polarizing figure: more Barry Goldwater than Ronald Reagan. 

In what may be a tacit acknowledgment of this unfortunate fact, Sicko is different from Moore's last two efforts. Not just because of an absence of gimmicky gotcha moments, or a reduction in screen time for Moore himself, but because its topic isn't fundamentally polarizing in the way his previous works were. There's a whole lot of Americans who love their guns, and in 2004 there were a lot of Americans who loved their President, but it's pretty hard to find anyone who loves their health insurance company. 

Moore's solution is simple: Get rid of the health insurance companies. Don't just tinker with the healthcare system, banish profit from the delivery of healthcare altogether. Socialize it. Make it a public good. It's a testament to the health insurance industry's power that as "universal healthcare" lurches toward the political middle, this proposal seems in some ways more radical than ever.

 Moore recognizes that if single-payer is ever going to come to America, it's going to be over the insurance companies' dead bodies. One way of understanding Sicko is as the opening salvo in a battle to make that happen. The movie alone can't do that, which is part of the reason Moore has teamed up with the California Nurses Association/National Nurses Organizing Committee, the labor union most zealously committed to single-payer. It'll be sending its members, along with like-minded doctors, to every single showing of the film's opening night to talk up single-payer to audiences. And it's currently rolling across the country in a multicity tour designed to leverage the film's publicity to push single-payer back into the national conversation. 

But Sicko is more than a potent weapon in the battle for single-payer, because in a deeper sense, the movie isn't really about healthcare. At its best, it uses healthcare as a kind of gateway drug to much harder stuff: a robust social democratic vision, articulated eloquently by legendary British Labour gadfly Tony Benn, who waxes poetic in the film about the radical promise of democracy to move power from the "wallet to the ballot." It's the extension of the logic of democracy into provisioning of public goods that provides the philosophical justification for socialized medicine. "The principle," as Benn says, "is solidarity." 

As we sat in a movie theater in Bellaire, Michigan, an overwhelmingly Republican town where Moore and his wife, Kathleen, own a house and where Kathleen is vice chair of the local county Democratic Party, I asked Moore if the movie was intended as an argument for social democracy. His eyes lit up. "That's correct," he said. "You know, it works for the fire department, why can't it work for healthcare? They're both life-and-death issues, and we agree that profit should have no interest at all in how we run our fire department." 

It's a message at once subversive and nonthreatening. Look at Canada, Moore argues in the film, or England or--gasp--France, where Moore even spends one scene reveling in the bourgeois comforts of a "typical" French couple as a means of rebutting arguments about the country's onerous tax burden. Or look at the United States: We "socialize" a lot of things here in America, Moore notes, as clips roll by of police officers and schoolteachers and public libraries. Why not this most crucial and important service? 

That's the argument in a nutshell. "It's a simple thought," Moore told me, "but I think people get it when you put it like that." Oprah sure did. During Moore's recent appearance on her show, she was careful not to seem to be endorsing anything too radical, and Moore obliged by saying that healthcare wasn't a "partisan issue" and he was looking to reach across the aisle. Then Oprah turned to the audience and said she finally "got it" when in the film Moore points out that we don't charge for the services of firemen or think profit should have anything to do with firefighting. Then she told her audience to go out and see the film. 

It's not surprising to find commentators noting, as Oprah did, that this film is less political than Moore's previous offering. It's less caustic, less outraged. But to call it less political than Fahrenheit 9/11 is a category error. Fahrenheit was an intensely partisan project, focused with laserlike precision on building a damning brief indicting the Bush Administration. And like a lawyer, Moore was only too happy to grab whatever argument he could find, even if it was at the expense of internal consistency. The film, while effective as propaganda, suffered a bit from this ad hoc approach, like the old law school chestnut about "arguing in the alternative": The kettle was in perfect condition when I returned it; it was broken when I borrowed it; and I never borrowed the damn kettle in the first place. 

Sicko is far, far less partisan than Fahrenheit, but much more ideological. And as such, it is more consistent in what it offers--with one major caveat. The film's final half-hour, in which Moore takes 9/11 rescue workers to Cuba, serves only to reinforce the decades-old slander that equates social democracy with repressive socialism. It's a major miscalculation and nearly squanders the first hour and a half of the film in which Moore so deftly guts arguments that socialized medicine represents the vanguard of Marxism. But that final section aside, the film functions as a compelling advertisement for an alternative way of ordering society, one in which, as in France, there's vacation, paid sick time, doctors who make house calls and even, amazingly, a state-supplied nanny who will come to your house and do your laundry after you've had a child. Who wouldn't want that? 

The healthcare industry, for one, and it's betting that itcan once again persuade Americans not to want it either. At a press conference after the American premiere, Moore said that in response to the film we should expect to see all the old chestnuts rolled out by the health insurance industry: "Canada's bad, they've got long lines they wait in, you know, blah, blah, blah," said Moore. "In the Canadian system, there is no wait if you have an emergency situation, if it's a life-and-death issue. The wait to see a specialist or if it's elective surgery, I think the most recent statistic I saw was that it was down to four weeks. But you know, sometimes that's what you have to do when you share with everyone--you have to wait." 

Moore continued, "When you share the pie, sometimes you have to wait for your slice. Sometimes you get the first slice, sometimes you get the third slice, sometimes," Moore chuckled, "you get the last slice. But the important thing is that you get a slice, everybody gets a slice of this pie. That's not what happens in this country." 

"There are no easy answers," Reagan once said, "but there are simple answers." Social democracy as pie. The Gipper himself couldn't have said it better.