It was a bizarre merging of worlds at the New York premiere of Sicko, the theater packed with media A-listers and 20-something billionaires watching tales of health-care woes beside activists in matching slogan T-shirts. "Could it have been any more didactic?" sniffed one media patriciate, as chanting nurses paraded through the lobby during the closing credits.

Yes, it could have.

Michael Moore wasn't catapulted to the rank of documentary film's most profitable (and controversial) director for embracing subtlety. Like its predecessors, Sicko lays it on as thick as a Morton's rib eye. But this time Moore approaches his topic with a welcome gravity, cutting down on the scene-hogging and winking camera tricks that gave Fahrenheit 9/11 its infuriating (even for Bush haters) smugness. Here, Moore sticks to the basic formula, offering a hybrid of contrite interviews with former insurance employees, extreme close-ups of smoking-gun documents, and personal testimonials from distraught victims who sacrificed fingers and babies to the commodified monster known as privatized health care. And the film builds to a doozy of a climax: sick 9/11 rescue workers voyaging to Guantánamo in search of affordable medical treatment. It's enough to make the heart of any well-heeled Gothamite swell (at least for that minute or two before the Blackberry chimes).

Surprisingly, the film seems catered, in part, to the East Coast intelligentsia. When interviewing Midwestern subjects, Moore is careful to establish their solid middle-class credentials—one woman, nearly bankrupted by cancer, is established as a former newspaper editor, her children having attended "good schools like the University of Chicago." And the praise he heaps on other countries (Look! The French even get government-subsidized nannies!) borders on unqualified worship.

Still, the number of shaking heads and outraged expressions after the screening indicated that Moore's message struck home. Or maybe it was the dawning realization that, someday, every one of us will get sick and be forced to enter this cold, counterintuitive medical system. Even the billionaires.—Melissa Lafsky