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 theatres 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 pre-approved.

"They try to find every way they can to deny it to you or not sell it to you," he told a packed theatre. "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 privatised 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 organisation that had declined a pancreas transplant for a diabetic man. The HMO later relented.

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.