For St-Jean-Baptiste Day - Quebec's soi-disant fête nationale - here's one of my favourite Québécois movies of recent years - and one which I always used to get a lot of mail about whenever I mentioned it on The Rush Limbaugh Show. "What was that film about the Canadian health system you talked about? Where can I get it?" Well, it's called Les Invasions Barbares and it won the Oscar for Best Foreign Language Film in 2004. But don't let that put you off. In English, it's Barbarian Invasions, and you can get it wherever fine motion pictures are sold, rented, or downloaded. It's a view of government health care from the sharp end, and all the more persuasive for being made by a francophone director of impeccably leftie credentials. Full disclosure: My friend Dorothée Berryman, who plays the dying man's much put-upon wife Louise (second from left in the bedside group shot), was a guest on our Frank Loesser centenary CD, so I will say no more about her performance except that it's excellent (as it was in the film's predecessor, Le Déclin de l'Empire Americain). But, all that aside, this is one of the best cinematic treatments of a timely topic:

It's the best part of two decades since Denys Arcand gave us The Decline Of The American Empire, a very Québécois gloss on The Big Chill about a group of boozy, bed-hopping, bantering boomers connected one way or another to a university history department. They were in their prime, though they did not fully realize it. Eighteen years on, one of their number is now facing the biggest chill: death.

In his mid-50s, Rémy (Rémy Girard), a self-described "sensual socialist", is perforce heavy on the latter and lighter than he'd wish on the former. He's no longer banging co-eds, though the hairless head makes him look randier than ever. He has cancer, and, worse than that, he has it in Quebec. British audiences, disheartened by the state of the National Health Service, may find it oddly comforting to discover a G7 nation whose health care system rivals the crappiness of the United Kingdom's. Americans will be less cheered. As the film opens, Arcand's camera weaves its way to Remy's bed through a maze of corridors clogged with patients lying on gurneys hooked up to tubes snaking their way under miles of ceiling tiles back to wherever the overflow started. In the course of the film, no doctor ever addresses Rémy by his correct name.

His son, Sébastien, is rich and successful and living in London, doing something crass and vulgar with markets that Rémy has never troubled himself to inquire about. He and his son are separated by more than the Atlantic. But, at the behest of his mother (the philandering Rémy's ex-wife), Sébastien flies back, and is horrified at the conditions his father is being treated in. "I'm lucky I'm not in the corridor," says Rémy, looking on the bright side.

So his son contacts an old friend in the medical profession. Like many (most?) Québécois doctors, he's now working in America, at a hospital in Baltimore that could help with the diagnosis if the chaps in Montreal were able to e-mail them a scan. Unfortunately, the only machine in the province that can do the scan is 90 minutes away in Sherbrooke and there's a six-to-twelve month waiting list, by which time they'll have to dig Rémy up to do it. Or he can have it done tomorrow, if he drives an hour south to Burlington, Vermont and pays $2,000. For Americans, one of the odder aspects of the movie is to hear patients refer to "Burlington" the way outlying residents of the Land of Oz speak of the Emerald City - a glittering metropolis on the far horizon where all things are possible. Montreal has a population of two million. Burlington is a city of 40,000 people, and to most Americans a peripheral backwater. But, in Her Majesty's northern Dominion, the public health system is such an article of faith that no private hospitals are permitted: Canada's private health care system is called "America" (granted, this is pre-Obamacare).

So Sébastien pays for a trip to Vermont. The differences between these two adjoining medical systems are such that the building Arcand uses as a stand-in for the American hospital as the ambulance pulls up outside looks, if anything, slightly too old and faded to be part of the actual real Fletcher Allen Medical Center. But nevertheless it's many times better than the war-zone refugee camp conditions back in Montreal. "Good morning, guys," says the chirpy nurse opening up the door. "Welcome to America!" "Praise the Lord!" responds Rémy in exaggerated Bible Belt vowels. "Hallelujah!" agrees Sébastien. M Arcand can be allowed his little jests.

Sébastien wants his dad to go to Baltimore for treatment, but Rémy roars that he's the generation that fought passionately for socialized health care and he's gonna stick with it even if it kills him. "I voted for Medicare," he declares. "I'll accept the consequences." So the cocky London trader goes to work. He tries to get his dad transferred to a better facility. "The Ministry of Health forbids changing hospitals," he's told firmly. But he doesn't give up. He pushes through the door marked "Accès Interdit" and, when the security guard demands a badge, blags his way past by saying he's from Lloyds of London. To return to my earlier analogy, this is the equivalent of the moment in The Wizard Of Oz when the grey Kansas dustbowl monochrome bursts magically into full color. On one side of the door are the wards, the doctors, the nurses, the patients: everything is filthy and crumbling. On the other side of the door is the bureaucratic administration: plush carpets, pot plants, window shades, attractive prints on the walls. Having talked his way in, Sébastien tells the head lady that he's noticed that, for some reason, the second floor is entirely empty, and he'd like his dad to have a private room there. The lady explains that it's not possible to "target our responses in terms of individual beneficiaries" because "our allocation of infrastructure is determined by the Ministry's ambulatory thrust" on "diagnostic parameters defined by the Region 02 consultations". (The obstructive bureaucratese is beautifully written.)

So he bribes her, and he bribes the union, and he bribes everyone else he needs to. "We are not in the Third World," insists the administrator. But it turns out we are, at least when it comes to getting anything done. So eventually Sébastien gets his father a freshly-painted room on the abandoned floor. "You must be a friend of the Premier or a big hockey star," says the nurse to Rémy.

And then Sébastien invites the old gang back – his dad's buddies and mistresses - to fill the room with good cheer, reminiscences of great blowjobs in days of yore, and meditations on the state of the world. He even goes to Rémy's university, a public institution of drab breezeblocks almost as grim as the hospital, and bribes some of Rémy's former students, indifferent to his fate, to come and visit him and pretend they care.

Denys Arcand is a leftie, as almost all French-Canadians are, but he's a leftie realist. Back in 2004, I saw Les Invasions Barbares with a hometown crowd in Montreal and the biggest laugh went to a predictable George Bush sneer late in the picture. That must have been small comfort after 90 minutes of a rueful requiem for Canuck boomer assumptions. Arcand's film is an elegiac comedy, a difficult trick to pull off – there's jokes, but the music is formal (a lot of Handel plus Haydn, Mozart and suchlike). Rémy and his pals were clever and witty and well-read, fiercely anti-clerical and, as they concede, subscribers to all the fashionable "isms". Yet, in Quebec as elsewhere, the "isms" decayed in practice into an incompetent suffocating bureaucracy. Arcand's title refers to 9/11, from a telly intellectual's analysis of the event. But it also describes what Sébastien does when he returns from London. He is a barbarian ("If only he would read a book. Just one!" rages Rémy) but his barbarianism – the hundred-dollar bills he spreads around – gives his father his old life back.

Like the good wishes of his students, it's an illusion. But, consciously or not, Arcand makes the point very literally that the ability of the intellectual class to sit around making condescending cracks about capitalism depends on the likes of capitalists like Sébastien. Rémy is emblematic of a certain type you find in the salons of the west: better, smarter, funnier than those unsophisticated Yanks, but ultimately a bystander in his own fate. For a man who's spent four decades rogering anything that moves, the "sensual socialist" is in the end impotent. There is a crudeness to some of the visual shorthand for Sébastien – the cellphone and the discarding thereof is too tritely familiar an emblem for the heartless yuppie coming to terms with what really matters. But, conversely, the hyper-literate conversation of Rémy and his friends seems at times like an excuse to avoid doing anything with oneself. A man who has "lived life to the full" worries about how little he's done.

At one level, this is a father/son bonding drama, but it roams far and wide through many digressions, from the priorities of urban policing to post-Catholic Quebec's glut of unwanted religious art: One day in 1966, explains a melancholic priest, everyone stopped coming to church, and they never came back. The performances are marvelous – Rémy Girard is always reliable but Stéphane Rousseau (Sébastien) is someone I knew mainly as a stand-up comic. And the women are eloquent testimony to Quebec's most vital asset: aside from très chère Mme Berryman, Louise Portal and Dominique Michel return as Remy's favorite mistresses, while Marie-Josée Croze plays a sad-eyed junkie. I take issue with the film only in respect of Arcand's perplexing decision to show Rémy and Sébastien driving from Montreal to Burlington via the border post at Derby Line rather than Highgate Springs. But, if you're not a Quebecer or Vermonter, this detail may not be so worrisome.

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