It was at a panel at the Biotechnology Industry Organization's BIO 2005 in Philadelphia that I first learned Michael Moore was working on what would become the movie Sicko. The panel, as I remember it, was called something like, "Why they hate us."

It's been a while, but the way I recall it, the scene was like when the police chief in the Transylvanian town square might utter the name Baron von Frankenstein on a moonless night to a crowd of villagers holding torches and pitchforks as they waited to be deputized. In this case, the people in the room appeared mostly to be public relations professionals working for biotech and pharma companies, or agencies that represented them. When the name "Michael Moore" was whispered, I felt a shudder through the crowd.

As it turns out, the pharmaceutical industry does not fare too well in Sicko, but it suffers only collateral damage. It is portrayed as peddling influence in Washington to protect its own financial interests, but anyone at BIO 2005 who lost two years of sleep waiting for Sicko should pop a few Ambien and call me in the morning. It's the insurance industry that takes a shellacking, and one that seems well deserved.

Rather than focus on the estimated 45 million Americans without health insurance—a scandal in itself—Moore instead describes the false sense of security having insurance gives us. He tells the story of people who had health insurance, only to find that when they became stricken with a catastrophic illness, their insurance companies denied them needed diagnostics, treatments and drugs. Industry whistleblowers offer confessions of how they helped deny people coverage by scouring patient records to find reasons to deny claims, dismiss procedures as experimental or deem them as unnecessary without a medical basis for arriving at the decision. The consequences for the patients portrayed in Moore's film are chronic suffering, financial ruin and even death. Though billed as a comedy, these stories are heart-wrenching and it's hard to imagine even the harshest critics of Moore not being moved by them.

But the greatest damage from Sicko is perhaps to Americans' collective sense of ourselves. It asks how, in a country as wealthy as ours, we can allow our fellow countrymen to go without the healthcare they need. Moore, who is an advocate of universal healthcare, offers an unblemished look at the healthcare systems in Canada, England, France and Cuba. Though Americans have learned to fear all things "communist," "socialist," and "French," —all labels that have tarred universal healthcare—Moore wants to shatter popular misconceptions. Though largely anecdotal, his interviews with doctors and patients in these countries bust myths about these healthcare systems.

Critics of Sicko are quick to point out that the film is not balanced. Moore doesn't offer the industry an opportunity to defend itself or speak to its positive contributions. He has defended this by saying he is the balance and arguing that the industry has had unfettered access to the media to get its message out. Of course, to criticize the film as lacking balance is to miss the point. Sicko is not an attempt to provide a 360-degree view of an issue; it is an effort to start a national debate and to mobilize people to push for universal healthcare.

As the New York Times noted in a front-page story today, healthcare is already taking a prominent place in the 2008 presidential election, with six of the candidates promising to overhaul the healthcare system 16 months ahead of the election. In part, this is because of the anxiety voters have about their own healthcare. But it is also a reflection of the financial toll it is taking on American businesses.

The debate around universal healthcare often comes down to an argument over whether healthcare is a right or a privilege. There are better questions to ask, and Moore does that in his film. Are there alternative ways to providing healthcare than the ones we use in this country? Are we better off collectively when people get the medical care they need without worrying about how they will be able to afford to pay for it? Is the healthcare system an adequate reflection of the people we are or how we choose to think of ourselves?

It would be nice to have an honest discussion in this country about these questions—one not shaped by the bogeyman of big government, taxes and Sputnik-era fear mongering, but instead one shaped by a very American impulse to find a better way of doing things.