Michael Moore’s Fahrenheit 9/11 came out there was a ripple of hope in my liberal circle of friends: this movie was going to make a difference. After four years of dealing with a man who was manifestly the worst president in history, a year after getting into a war that we knew was a mistake and a quagmire, months before the next presidential election, we thought that this movie and it’s astonishing popularity and success marked the end of the reign of George W. Bush. In case you haven’t been following the news, we were wrong.

The truth was that Fahrenheit 9/11 was too early. Back in 2004 too many Americans were still blind to the truth of their incompetent president, his culture of corruption and his war of imperial evil. In 2004 showing wounded soldiers was almost revolutionary, because nobody was yet accepting the cost in carnage of the pointless war we were waging on the people of Iraq. I think that Fahrenheit 9/11 (a movie I didn’t particularly like, for the record, feeling that it was a polemic, too scattershot and cut too many corners) helped wake people up to the horrible truth of this country in the 21st century, but it wasn’t able to make enough of an impact on the presidential election.

Three years later Moore’s back with a new film, and this time his timing is perfect. Sicko, a look at how desperately broken our health care system is, is going to be hitting theaters just when the national debate seems to be accepting the fact that we need to do something about how we deal with our sick citizens and we need to do it now. Moore’s film, which clearly shows the problems with and some of the alternatives to our for profit insurance industry, could be the spark that ignites a national sense of outrage among the people who are most getting screwed by the HMOs – working people, once the Democrats’ traditional base. These are folks who have been ruthlessly tricked by sleight of hand tax cuts and escalating terror warnings, all while being told to ignore the man behind the curtain who has been bankrupting them with medical bills and denying them life saving operations because they’ll hurt the bottom line.

Moore is more reserved this time out; rather than bring us his outrage he lets us find our own by showing the tragic stories of decent, hard-working Americans who have been destroyed or killed by the HMOs’ unwillingness to lose money, and then comparing that with the health care systems in Canada, England and France. By the time we’re shown a dazed, confused woman who has been dumped in front of a homeless shelter by a Kaiser Permanente hospital – still in a hospital gown and with no shoes! – because she couldn’t pay her bills, only the most heartless audience member would be unmoved. The truth is there in front of our eyes: this is not what America is about. This is not the country I love. This nation isn’t built on getting ahead by climbing over the wounded bodies of our neighbors, but we’ve somehow been convinced in the years since World War II that this is our national character.

The most powerful aspect of Sicko is also what’s going to hurt it when it comes to the right wing blowhards: Moore shows how 9/11 emergency responders, suffering mightily from illnesses they contracted working on that pile of smoldering debris, searching for anyone who was trapped, have been left behind by the government and their insurers. This is America in the 21st century: you sacrifice for your ideals and fellow Americans and we’ll give you a parade and a concert, but after that, you’re on your own. It’s obviously wrong, and seeing a woman who has not only been sick for years but who has been unable to work and properly support her children because she gave her time to help is heartbreaking. This should be the message, but Moore does his only gag with this group of heroes – he takes them to Cuba for treatment. It’s obvious to anyone that these people are not getting the same treatment Cuban citizens get, despite Moore’s claims on the soundtrack, and this is what pundits will focus on. Moore has given these dishonest bastards the opportunity to ignore the painful truth – we are letting people get destroyed and die because they can’t pay for services – by focusing on the Cuba stuff. This is how the right wing bloviasphere works, selectively pinpointing the weak parts of the argument and ignoring the other 99% that stands strong and impregnable.

What needs to happen is that the good, decent souls who support universal health care for all Americans regardless of race, color, creed or bank account must learn these tactics from the right and utilize them. In 2003 anyone who was against the obviously wrong war in Iraq was called anti-American or pro-terrorist. Pro-choice people get branded as pro-abortion. It’s time the tables were turned. Anyone who is against universal health care must be stigmatized as anti-life, anti-health, anti-humanity, pro-death, pro-cancer, against the poor, against the working class, against human beings, against decency, against the teachings of Jesus, as despisers of fairness, as haters of their neighbors, as black hearts, as putting money before mothers, as exchanging lives for profits, as cruel and debased monsters who are nothing more than money-grubbing sociopaths.

Those who oppose universal health care can only bring excuses, many of which Moore destroys in his film, anyway, including canards as ‘socialist’ health systems being subpar – he meets a group of Americans living in France who can’t imagine going back to the US system – or ‘socialist’ health systems forcing out good doctors – meet the UK doctor who has a million dollar home and a fancy car. The opponents can bring excuses, but they can’t bring real reasons why a woman in America should pay 120 dollars for an inhaler she needs while she can get it in Cuba for five cents. Why all prescription drugs in the UK cost the equivalent of ten bucks. Why France offers doulas, government employed nannies who support new mothers in the home. They can’t give reasons why these are bad things, except for inane sloganeering with no basis in the real world – less government when the government you elected wants to eavesdrop on me without a warrant? I’ll take the doula washing my clothes over that, thanks – to economical equations… equations which in the end show that they care about money more than lives. And that, to me, is unacceptable math. To any American with a shred of decency that must be unacceptable math. There’s no savings worth the death of a father and husband because his HMO wouldn’t approve life-saving marrow transplants. If you disagree with that, I can’t imagine how you still count as a member of the human race.

Moore’s film isn’t even handed – he certainly doesn’t get into drawbacks of universal health care, but that’s just a distraction anyway. The system we have is a disaster, and trying to hang on to it because another system isn’t perfect is asinine at best. You’d certainly get rid of your unreliable death trap junker car in favor of a new, better, safer model, even if that car didn’t have a CD player. That’s what we’re facing with health care in America.

If people beyond Moore’s loyal fanbase see Sicko, there’s a chance for real change in American health care. Even if only Moore’s fanbase sees the film (and I think this is a topic that cuts across political and social divides, by the way), Sicko is going to have an impact on the Democratic primaries. Moore delivers a blow that, if not fatal, will hurt Hillary Clinton in a big way. It’ll be interesting to see the results of that in the coming months. But more interesting is going to be seeing how Americans react to the fundamental truths in this film: we have a health care system that does not work, and we’re letting people die because it’s financially inconvenient to save them. Sicko doesn’t just refer to the American system, it refers to everyone who allows this to continue.