Menlo Park, CA -- If the potential impact of Michael Moore's documentary "Sicko" were dependent solely on those who have actually seen the film, the result might be a passionate but narrow conversation among the 4% of adults who said they watched it in a new Kaiser Family Foundation poll.

But, with a big free media bounce reaching beyond the movie reviews to the news and talk shows, the new poll finds that almost half (46%) had seen the movie or heard or read something about it a little over a month after its national release. This is not much less than the share of adults (61%) who were aware of "An Inconvenient Truth," the documentary on climate change featuring former Vice President Al Gore released in May 2006.

Among those familiar with "Sicko," 45% said they had a discussion with friends, co-workers, or family about the U.S. health system as a result of the movie; 43% said they were more likely to think there is a need to reform the health system; 37% were more likely to think other countries have a better approach to health care; and 27% said they were paying more attention to the positions of presidential candidates on health care.  About equal numbers of those aware of the movie thought it accurately represents problems in the U.S. health system (36%) versus overstating them (33%), and positive impressions of "Sicko" outweighed negative ones 48% to 33%.

"Our poll shows how the combination of good timing, a controversial director, and lots of free media attention can generate real impact for a film that very few people have actually seen," said Kaiser President and CEO Drew E. Altman, Ph.D.  "Sicko is not a commercial juggernaut like Transformers or Harry Potter, and we're not likely to find Michael Moore action figures at fast food restaurants any time soon.  But we are starting to see how films about social issues that capitalize on free media rather than traditional marketing can become social phenomena too."

The movie has been much more likely to resonate with those already inclined to support its point of view.  For example, 43% of self-identified liberals who are familiar with the film had a very positive impression of it, compared to 9% of conservatives.

But its impact is not entirely predictable -- while 56% of liberals familiar with the documentary report that they are more likely to believe there is a need for reform of the U.S. health care system as a result, a smaller but still substantial share of conservatives aware of "Sicko" (29%) also said so, as did 23% of Republicans.  And, 37% of conservatives said they had a discussion with friends, co-workers, or family about the health system following the movie, while 18% said they were paying more attention to what the presidential candidates are saying about health care.  Results were similar by party identification.

Still, "Sicko" has not altered what have long been the fundamental factors shaping the public's views on health care.  When asked what has had the biggest impact on their opinions about the issue of health care recently, just 2% of the group aware of "Sicko" cited the film; 62% pointed to their personal health care experiences, and 9% said it's what they've heard or read about proposals from presidential candidates.

The film’s main targets -- health insurers and HMOs -- were viewed unfavorably by about half the public overall (51% and 46%, respectively), which is similar to perceptions of drug companies (52% unfavorable) and a larger share than viewed defense contractors unfavorably (41%).  By contrast, hospitals and doctors were viewed largely favorably by the public.