MARCH 2024:

A Right, Not a Privilege…

When John Q. arrived in theaters on February 15, 2002, it was met with generally negative reviews from critics who argued the films compelling results through threats of violence. But despite the negativity it faced from the critics of the film community, film viewers made the film a commercial success at the box office, grossing $102 million on a $36 million budget. So the question becomes why did the film panned as a critical failure, become such success despite the naysayers? With the release of John Q., it fueled a debate about access to healthcare in the United States, more specifically, the transplant program, and film viewers found it to be a relatable topic making it a film that moviegoers all over America could connect to on some level. It was an examination of the healthcare system in America through the eyes of a blue collar citizen faced with insurmountable odds in the face of life, death and being a parent.

John Q. is a 2002 American thriller drama film written by James Kearns and directed by Nick Cassavetes. It stars Denzel Washington as John Quincy Archibald, a man who feels he is forced to take a hospital emergency room hostage in order for his son to receive a heart transplant, after he’s exhausted every option financially. Robert Duvall, James Woods, Anne Heche, Kimberly Elise, and Ray Liotta appear in supporting roles.

The movie depicts a father who takes people in an emergency room hostage in order to compel a hospital to place his son, Michael Archibald, played by Daniel E. Smith, on the waiting list for a heart transplant. John’s health insurance has a $20,000 cap on benefits, and his son does not qualify for publicly funded health care. Because John Quincy Archibald is not able to raise a percentage of the cost of the transplant, the hospital refuses to add Mike to the transplant list. There has been a great deal of commentary regarding, and surrounding the movie on its subject and character study of the flaws of the American healthcare system.

Among the negative reviews by critics was the argument that the scenario presented in John Q. wasn’t realistic. The argument was presented against facts of the transplant program and it resources for financial needs. it was thought critically that various funding sources are available for transplants, including insurance, state and federal funding, along with private foundations. The United Network for Organ Sharing (UNOS), which heads the organ transplant lists throughout America, says that transplant hospitals have financial advisers that assist patients in seeking funding. Indeed, in recognition of the daunting task of financing a transplant, federal regulations have required the Organ Procurement and Transplantation Network Board of Directors to develop “policies that reduce inequities resulting from socioeconomic status, including . . . procedures for transplant hospitals to make reasonable efforts to obtain from all sources, financial resources for patients unable to pay such that these patients have an opportunity to obtain a transplant and necessary follow-up care.” ¹ Of course, these policies cannot guarantee that funding will in fact be made available for the transplant, and that is the unknown factor that John Q. attempts to explore, the uncertainty of protections under the healthcare system, based on financial need, instead of matter of life and death. I failed to see where that is not a realistic scenario in the United States healthcare system.

John Q. in fact raises realistic questions of a system of health care finance that has been called “morally flawed and unjust.”²  Most Americans would agree that the situation portrayed in John Q. is very much realistic and unfortunate, and our immediate reaction when watching the film might be to make funding widely available for all transplants, much like the benefits available for kidney transplants under the End Stage Renal Disease Program. ³ However, when deciding whether to publicly fund all transplants, we must remember the words of Childress on a flawed and unjust system: “if we ask about the fairness of providing or not providing funds for extra-renal transplants, it may be difficult to answer that question in an unfair system.” When John Q. came out in 2002, 40 million Americans were uninsured, and 10 to 15 million Americans were underinsured, fast forward 20 years, and 27.6 million Americans are still uninsured. Thus, before we consider a plan that involves expanding funding to cover all transplants and/or other extraordinary measures, we should first consider whether that same money might be allocated more justly to provide basic health care to more Americans in a more universal way.

John Q. is available now on Hulu…