TORONTO -- First, General Motors. Then gun control, followed by George W. Bush. Now rabble-rousing filmmaker Michael Moore has turned his irreverent camera on health care in America.

"Sicko," Moore's dissection of the health care system, promises to be another hilarious documentary romp, based on excerpts he showed Friday night at the Toronto International Film Festival.

During a two-hour appearance, Moore discussed his career as a counterculture journalist, provocative filmmaker and liberal standard-bearer, and he played three clips from "Sicko," which he said would be in theaters next June.

The segments presented stories of personal health care nightmares, including that of a woman denied payment for an ambulance ride after a head-on collision because it was not preapproved.

"They try to find every way they can to deny it to you or not sell it to you," he told a packed theater. "Or they try to find anyway they can not to pay the bill."

The "Sicko" excerpts also included a segment comparing Canada's public health care to the privatized system in the United States, concluding that Canadians have more equitable access to medical services.

The idea for "Sicko" grew out of a segment from Moore's TV show "The Awful Truth," in which he staged a mock funeral outside a health-maintenance organization that had declined a pancreas transplant for a diabetic man. The HMO later relented.

Health care representatives downplay the potential impact of Moore's documentary.

"We can't control what a major Hollywood entertainer does," said Mohit Ghose, a spokesman for the trade group America's Health Insurance Plans. "Our focus remains on a positive agenda of high-quality health care for more Americans."

With a laid-back persona but an in-your-face documentary style, Moore broke onto the scene with 1989's "Roger & Me," chronicling his efforts to meet with GM boss Roger Smith amid the economic chaos the automaker's plant closings had on Moore's hometown of Flint, Mich.

Moore's 2002 gun-control film "Bowling for Columbine" won the documentary prize at the Academy Awards.

He followed with 2004's "Fahrenheit 9/11," skewering Bush for his actions over the Sept. 11 attacks. The film topped $100 million at the box office to become the biggest documentary hit ever.

Given Moore's devoted fans and a subjective, opinionated documentary style the filmmaker likens to a newspaper's op-ed section, "Sicko" has set the health-services industry on edge.

Ken Johnson, senior vice president of the trade group Pharmaceutical Researchers and Manufacturers of America, said industry officials were "freaking out and pulling their hair out" when they first got word of Moore's documentary.

They have since calmed down, Johnson said.

"Michael Moore is a political activist with a track record for sensationalism. He has no intention of being fair and balanced," Johnson said.