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John Q [Movie Review]

Summary

If you are looking for a heart wrenching and action-packed movie about a desperate father trying to get medical care for his ill son then my review of “John Q” is for you.

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Show Notes

I was familiar with the concept and overall story of John Q but had never actually seen the film before. When I sat down and started watching the movie, the beginning which shows a woman dying in a car crash was a bit jarring for me. It hit close to home because just the day before a family friend died unexpectedly in a freak car accident. The circumstances of the crashes were different but the results were the same, a person losing their life. So I was already in my feelings and it didn’t get much better as the film went on.

From the start, I loved the family dynamic within John Q because portrayals of solid Black family units are a pretty rare occurrence. It’s a common occurrence in real life. But music, television, and movies rarely show families with two unambiguously Black parents that aren’t wallowing in dysfunction.

Yet, here we have John (Denzel Washington) and Denise (Kimberly Elise) who are married, obviously in love, and respectful towards each other. There’s also a positive loving relationship between John and Mike (Daniel E. Smith), a Black father and his son that isn’t built on hyper-masculinity or the passing on of dysfunctional behavior and beliefs. If everything was hunky-dory we wouldn’t have a story but it’s refreshing that the drama comes from outside the family and draws them closer.

Death is a difficult thing to come to terms with but at least in situations with older people we can somewhat console ourselves with the idea that they had an opportunity to live and hopefully enjoy life. I don’t think most people are hoping for or happy about anyone dying. But when people live to a certain age (and that number varies) we more readily accept the inevitable fact that they will eventually die. Adults dying from accidents, environmental factors, illnesses, etc. are sad but after grieving we can usually learn to cope in time.

Although we hope it’s far in the future, we accept that as our parent’s children, the day might come when we have to bury our parents. It would be difficult but seems like the natural course of life. But, it seems wrong for a parent to go through the experience of having to bury a child. There is an unnatural feeling about a young child or teen being deathly ill and/or dying. That situation doesn’t seem to follow the natural course of things.

Therefore, it’s an emotional moment when this little boy who is so loved by his parents suddenly collapses while playing in a little league game. And the tsunami of emotions continues as we watch a mother and father grapple with their son’s very serious heart problems. That was difficult enough but watching them try to make decisions about his plan of care with the added pressure of figuring out how to source the tens of thousands needed to pay for his care was overwhelming. Unfortunately, it’s a situation that many people are faced with daily. Trying to navigate difficult life-threatening medical conditions and the associated emotions while also dealing with everyday life and difficult financial decisions.

It doesn’t help matters that John and Denise were already struggling financially. John’s hours have been cut at work and Denise seemed to be a waitress so the two aren’t on a solid financial footing. It varies between workplaces but some healthcare policies differentiate between full-time and non-full-time employees by increasing premiums for non-full-time employees and/or reducing their benefits. John’s reduction in hours therefore doesn’t just affect his take-home pay but also his healthcare benefits.

I’m a very healthy person but have had a few episodes of unforeseen illnesses that required emergency room and doctor visits. I know from personal experience how prohibitively expensive it can be to obtain medical care as both an uninsured and insured individual. Health insurance is one of those things where it can seem like a begrudging expense when you don’t need it but you wouldn’t want to be caught in a health emergency without it.

The details of your health insurance coverage can be the difference between manageable bills that require little to no payment on your part versus finding yourself with a medical bill amounting to thousands or tens of thousands of dollars. For quite some time, debt related to healthcare and medical expenses was one of the leading reasons for bankruptcy filings. Some of these issues have been resolved or at least partially addressed through recent legislation but problems remain. The reality is that an individual’s ability to obtain health care as with many other resources in society is greatly impacted by their socioeconomic standing and knowledge of navigating the system.

With that being said, I’m sure some creative license was taken with regards to the details of how health insurance and hospitals work. But I’m saying this several years after John Q was released so things have likely changed in that time. Private hospitals, which the hospital in the movie appears to be, can turn away patients if they don’t have insurance or the ability to pay for their care. But that’s generally only true in non-emergency situations.

Turning away a patient in an emergency and especially a life-threatening situation would violate the Emergency Medical Treatment & Labor Act (EMTALA) which was enacted in 1986. Violation of the Act could leave a hospital open to a lawsuit, especially if the prospective patient dies. Though, I honestly don’t know how vigorously the law is enforced. Where John Q is likely quite realistic is that once admitted to the hospital and medically stable, although not cured, a patient can be discharged if they’re in a hospice type situation or care can be continued at home or as an outpatient.

On the surface, it might sound heartless but regardless of mission, the business of any business is making money. This applies to corporations, hospitals, non-profits, and every combination in between. The reality is that hospitals have expenses like any other business and part of how they generate revenue is being paid for services rendered. Insurance companies also operate along similar lines in the sense that they make a profit by generating revenue and controlling expenses. Having an insurance enrollee who needs expensive care would mean a payout from the insurance company to the hospital. If the insurance company is refusing to pay for expensive surgery and the patient has no clear means for self-pay, moving forward with the surgery might not be in the hospital’s financial best interests.

And that’s the problem that John Q tries to address, the real possibility of situations where someone’s life hangs in the balance because providing care and/or coverage is bad for a hospital or insurance company’s bottom line.

I’ve worked in positions in the healthcare industry and while I might have to speak to patients or their family members, it’s never directly related to patient care. I’ve often heard the conversations before and after patients and family members have discussions with the medical staff about end-of-life decisions and weighing the pros and cons of medical interventions. Seeing the wins and recoveries are great. But the deaths and declines in addition to other factors let me know for certain that being directly involved with patient care is not at all for me. It requires a special kind of person, which I am not.

It’s expensive to become a doctor, and especially a surgeon, so they are paid relatively high salaries to offset the financial and time costs. Those high salaries and professional liability insurance costs are then passed on to hospitals. And hospitals also have to provide facilities, equipment, and ancillary staff all of which represent additional expenses. There’s a symbiotic relationship between those various things and recklessly cutting corners in any area can have adverse effects on patients and their medical outcomes.

In watching the film, Mike’s diagnosis was explained as being an enlarged heart that wasn’t pumping his blood effectively or efficiently. This leaves him teetering on the brink of heart failure. I don’t have kids so I don’t know much about their development but it seems like they go to the doctor quite often as babies and toddlers. I would assume that Michael would have had frequent wellness checkups as a baby that would have gradually decreased as he became an older child.

Granted, I’m not a healthcare professional. But, it seems unlikely that this heart condition would have occurred within a relatively short amount of time without being accompanied by some other major health event. With wellness checkups, vitals, blood work, etc. how would this medical condition have gone undetected for the amount of time needed for it to become so serious?

Now I ask this question as someone who has only dealt with PPO plans where my copays are a flat fee regardless of facility and coinsurance is less when I remain in-network but I’m not required to only see doctors at a particular facility or network of facilities. As John Q points out, this might not be the case when an individual has an HMO plan. I don’t know how accurate or realistic the scenario is but the film implies that within an HMO the insurance company and medical staff work in tandem and might not exactly deny care but rather not take all available steps to identify and address potential health issues. In the movie, the insurance company and Mike’s regular medical doctors are suspected of working closely together to manage expenses and increase profits.

I found the healthcare scenario in John Q and its implications to be extremely fascinating. Instead of an academic documentary, the filmmakers put together a heart-pounding drama that packs an emotional punch which surely got audiences talking. Where the film went left for me was with the hostage situation which seemed a bit unbelievable.

There have been several hostage films but most of the ones I’ve seen have been in banks during a robbery. A hospital just seems like the worst place to take hostages because the hostages which you use as a bargaining chip can unintentionally die. I mean, this is a hospital. What if one of your hostages just happens to have a heart attack? Not to mention hospitals tend to have multiple entrances as well as various units which would be difficult for one person to secure while also keeping the hostages under control. The decision seems devoid of logic and purely based on emotion. But maybe that was the point. John, a father at the end of his rope and seemingly out of options, takes desperate action in an attempt to help his son.

Obtaining care for Mike is complex but from a medical perspective, there are three major hurdles. Getting him onto the donor list, obtaining a heart, and undergoing surgery. This is another reason the whole hostage scenario doesn’t make sense to me. Let’s say you take hostages to force the hospital to put Mike on the donor list. The hospital puts patients on the list but the lists are national so the hospital isn’t the final authority on controlling the list or deciding who gets the organ.

And even if you get on the list, you won’t necessarily shoot straight to the top. People often have to wait for an organ to become available and for which they are a good match. If they can easily put you on the list, couldn’t they just say that they did and not put you on the list? Or put you on the list and then take you off when things die down? What would John do during that time? Is he going to hold these people hostage for the months or years that it might take for a match? Performing surgery under normal conditions is enough of an issue but add a gunman and I don’t think it decreases the risks of something going wrong.

Another thing that I didn’t like was that the movie seemed to imply that the catalyst for John taking the hostages was Denise calling him distraught and yelling at him to do something. This whole Adam and Eve thing is a lazy story device that often occurs where the man does something wrong or reckless and the woman is painted as the instigator. Though it was less irksome than some of the other points of the movie. And to a degree, Denise was given something to do throughout the film unlike in many other movies where female characters are just there.

With all of that being said, enjoying John Q requires a degree of going with the flow and overlooking things that fly in the face of reality. This is a heart wrenching and action-packed movie where the tension runs so thick throughout that you grip your armrest and hold your breath. I think we can all put ourselves in the minds of being a parent with a sick child and having no easy means to get them the help they need. Loving your son to the point that you decide to sacrifice your life for that of your child.

It’s an extreme example but I like films like this that use creativity and a compelling story to offer commentary on real-life issues and situations. Granted the film was released back in 2002 and things have fortunately changed a bit since then but there is still a lot of room for improvement. The film focuses on the difficulties that surround navigating the obtainment of medical care. But I think another point of concern that gets lost in the shuffle is the reality of just how many people are only one missed paycheck or emergency away from financial devastation. Early on John Q briefly touches on how John’s reduction in work hours affects all of these other areas of his family’s life. Yet, that becomes less of a factor when Mike’s health issues emerge.

There have been countless movies and television shows about people and families struggling to survive unemployment, underemployment, and other work-related difficulties. So I don’t see it as a drawback that John Q didn’t zoom in on that particular issue because it’s been done before. But I think it’s still a good conversation starter for discussing how these obstacles in life and financial emergencies tend to beget more obstacles and financial problems.

Outside of the movies that I review for Noire Histoir, I enjoy thrillers and action movies about mysteries, espionage, heists, bank robberies, etc. But I was surprisingly stressed when the hostage part of John Q began. It was like a car accident where you don’t want to watch but can’t help but watch. Not all of the points in the film make logical sense and you’ll likely walk away with more than a few questions. But, that’s part of what makes it an entertaining movie and one that I recommend checking out.

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