Hollywood heart-strings need a transplant

John Q, directed by Nick Cassevetes, written by James Kearns

The release of John Q has been greeted with derision by some in the media, who question whether anyone in his or her right mind would want to see a movie about managed health care in the US. As it turns out, tens of thousands filled the theaters for the film on its opening weekend. In fact, millions of American moviegoers undoubtedly identify with the Denzel Washington character in John Q, who wages a desperate struggle against a system that denies his son a life-saving heart transplant. Unfortunately, the expectations of the audience are not met by the film, which never delivers either the drama or a strong social message.

Washington portrays John Q. Archibald, a factory worker feeling the effects of the Bush “recovery”: working a shortened week and unable to make ends meet; his wife’s car has just been repossessed; he is doing everything he can to keep his family going.

John is an easy-going guy. He’s a loving husband and a devoted father to his son, Mike. When Mike collapses during a Little League game, John and his wife Denise (Kimberly Elise) are informed by the icy hospital director Rebecca Payne (Anne Heche) and the arrogant heart surgeon Dr. Raymond Turner (James Woods) that only a heart transplant will save the child and that John’s insurance won’t cover the procedure. Rebuffed by his employers who have downgraded his insurance since he is no longer considered to be working full-time, he is informed that under his current coverage a heart transplant is “an elective procedure.” The family must come up with a $75,000 down payment toward the $250,000 charge just to get Mike on the donor waiting list. Payne coldly lets them know that Mike will probably die within months, so they should “make it a happy time.”

Determined to save their son’s life, the Archibalds raise money by selling everything they own, accepting donations from friends, their church and Denise’s co-workers at a restaurant. It’s not enough. So when the hospital administration determines that Mike’s stay is becoming too costly and decides he must go home to die, the ordinarily mild-mannered John Q. takes Dr. Turner, some staff and patients hostage in the hospital emergency room.

Veteran police negotiator Frank Grimes (Robert Duvall) is called in to try to convince John to surrender, while the vain and politically ambitious police chief (Ray Liotta) organizes the SWAT team to deal with John’s criminal actions in more typical and brutal police fashion. The stereotyped TV announcer, seeking to advance his own career, broadcasts the siege live, but concern for the family is obviously not his motivation. John becomes a hero to the gathering crowds and television public.

When John announces that a new administration has taken over the hospital, and that health care is now free for all who need it, the audience in the movie theater applauds. Unfortunately, there is a disappointing dichotomy between the audience’s response to the character’s fight against the system and the failure of the filmmakers to present more than a tepid melodrama, one that never develops a thoughtful or consistent outlook on the disastrous crisis that millions of Americans face when they cannot afford adequate medical care.

The patients John has inadvertently taken hostage are caricatures of the “rainbow” of urban America. The plot becomes less and less believable as John threatens to kill hostages unless his son is put on the donor list. While waiting interminably for Payne to acquiesce to this single demand, he engages the emergency room staff, the patients and Dr. Turner in an unfortunately pedantic discussion as to what really happens under HMO care. The young ER doctor (Kevin Connolly) explains to John that the likely reason his son’s condition was never recognized earlier is that doctors are paid by HMOs not to test and diagnose expensive medical conditions. Dr. Turner confirms that doctors are given year-end bonuses by the HMOs for denying these services and saving the insurance companies millions of dollars.

When the police commissioner’s assault fails, a cynical scheme is presented by Grimes and Payne telling John that the hospital will agree to his demand. Inexplicably, the steely Payne is transformed and Mike’s name somehow actually ends up on a donor list. The cranked-up action at the end loses all credibility. What is meant to be a tense race against the clock is dissipated by totally misplaced laugh lines and a lack of direction.

It’s a shame this is not a good film. Despite a talented cast, the script is so conventional, the plot so weak and the characters so shallow that John Q fails to make any clear political point or touch us deeply. Out of the hundreds of films released every year almost none deal with serious social issues. The crisis in American health care is perhaps one of the most acute of these issues, but while director Nick Cassavetes—son of director John Cassavetes and actress Gena Rowlands—and producer Mark Burg offer a story with possibilities, they fail to follow through with any powerful message or even clearly present intelligent questions. Snippets of truth are expressed, particularly through the mouth of the hospital director: “50 million people in this country don’t have health insurance.... People get sick every day and they die every day, why should we do anything different for this family?” She lets us know that life and death are business like every other business in America.

The film exposes the class divide that rules health care in the US, and to its credit does not play the “race card.” It laboriously demonstrates that if you have money you get taken care of and if you don’t, well, you may have to resort to desperate measures unless things change. But what change do the filmmakers advocate? The political issues, inevitably raised in the film, are neither probed nor are any solutions advanced. As the film winds to a close there are television clips of CNN talk show host Larry King, Senator Hillary Clinton, Rev. Jesse Jackson and other politicians and celebrities offering sound bytes for health care reform, but the most memorable remark from a television personality seems to hold all John Q. Publics responsible: “We are the ones who don’t want our taxes raised.” So, unlike the teaser for the film (“Give a father no options and you leave him no choice”), the filmmakers don’t give their audience any alternatives either.

What was perhaps more interesting than the film itself was the audience response. When John is told that his insurance has gone from PPO to HMO, there was an audible gasp of universal recognition from a typical urban audience, many of whom live in circumstances much like that of the characters on the screen. It is significant that sold-out crowds in working class areas sought out this film purporting to take on the health care industry and offering a hero who exhausts all legal and acceptable means to resolve his predicament. The audience clearly identifies with John Q. but is left with very little new to consider, and no real insight into the fundamental cause of the class-biased health-care system in America.