31 John Q (2002)
John Q vs. The System
by Michael St Clair
Navigating the healthcare system in the United States often feels like you’re running through an endless obstacle course filled with bureaucratic hurdles and walls of paperwork, not to mention the extremely high cost. Many complex dynamics find their way to the forefront – the power dynamics between the patient and medical establishment, institutionalized discrimination, and intersectional differences. No film demonstrates these dynamics better than Nick Cassavetes’ 2002 film John Q. The film follows the story of a man called John, who becomes desperate to save his son after news of a terminal diagnosis. After exhausting all his resources and options, John takes drastic measures to ensure his son gets the medical care he needs to save his life.
Our protagonist, John Quincy Archibald (played by Denzel Washington), is a working-class black man who earns a modest living. The issue of class difference is raised after finding out his son needs a heart transplant that his insurance will not cover. Tragically, this scenario is far from novel. According to a 2010 study by the American Journal of Public Health, “Those with the lowest income and who were least educated were consistently least healthy, but for most indicators, even groups with intermediate income and education levels were less healthy than the wealthiest and most educated.” (Braveman).
In one notable scene that conveys working-class angst, John has just finished rushing his son to the hospital and must go through the check-in process. After answering all the basic information about his son, he is faced with a vexing question – he is asked to produce his insurance card. The background noise of the bustling hospital fades and the camera slowly zooms in on John’s troubled face as he stares at the receptionist in silence for a few long seconds. Encoded in this scene is that socio-economic status can be a barrier to life saving health services, prompting viewers to decode the implications of a healthcare system that promotes class-based discrimination.
John quickly finds himself in a disempowered position. The film’s mise‐en‐scène does an excellent job of displaying this power dynamic. There are a multitude of relatable scenes where John is at the mercy of the system, waiting in long lines, filling out large piles of paperwork, and becoming frustrated while waiting on hold for hours on end. After selling all his valuable belongings to fund his son’s surgery, John makes his final plea to the hospital’s head of cardiac surgery, Doctor Raymond Turner (played by James Woods). The scene starts with Raymond talking warmly with a wealthy patient who has received top level care. John interrupts and politely asks him to talk alone. The scene then cuts to a wide shot of a broad hallway with a double door at the end, and the two men step out center shot to talk mano-e-mano. John desperately attempts to convince the doctor to do the surgery for his son on credit, but the doctor declines. In this film, the protagonist flips the power dynamic when he uses a gun to take the hospital and the staff hostage. In real life, however, power is not so easily shifted. This is, at least in part, due to institutionalized discrimination.
According to the book America on Film, “Just as a single person can be a bigot, those same biases can be incorporated into the very structures of our “free” nation: this is known as institutionalized discrimination.” (Benshoff & Griffin). John Q shines a spotlight on the issue of institutionalized discrimination within the healthcare system. The film concludes with a montage of soundbites from famous comedians, political commentators, and talking heads, all of which have a lot to say about the inequities and institutionalized discrimination prevalent in the healthcare system. This scene is presented to the viewer in low resolution and scratchy sound quality, similar to watching a video recording of a TV screen playing a film. The montage features a spectrum of well-known figures from various political and cultural backgrounds sharing their thoughts on John’s case, creating a sense of relatability that can be decoded by viewers from all walks of life.
The film does an exceptional job in creating a feeling of relatability through literary design. The title of the film (and name of the protagonist) was not chosen by chance. “John Q” is a colloquialism for the common man, or ordinary person. John Q. Citizen, John Q. Taxpayer, John Q. Public – these are all generic terms for a hypothetical member of society. This deliberate choice in vernacular is designed to speak to a diverse audience and create a sense of familiarity. John Quincy Archibald serves as a paradigm of the average American citizen and his (or her) typical experience navigating the healthcare system.
The cinematographic choices in John Q encode messages in a way that is enjoyable and relatable for most viewers. Of course, the film is not everyone’s cup of tea. According to one scathing review by film critic Neil Smith of the British Broadcasting Corporation, “The woeful state of healthcare in the United States is a pressing concern (for Americans, anyway), but manufacturing such a patently absurd scenario is hardly the best way to address it.” (Smith). He goes on to comment that the film “doesn’t so much need a heart as a brain transplant.” Although Mr. Smith is not a fan of the film’s plot, he cannot disagree that the film draws attention to the arduous issues of healthcare in America.
The American healthcare system does have glaring flaws that urgently need to be addressed, however it is not without some redeeming qualities. It has historically been the world leader in medical research, advancement, and innovation. It has a highly skilled and diverse workforce employed by world class medical institutions and hospitals. Comparatively, the average wait time in the emergency room is 58 minutes as opposed to Britain’s 3-hour average (Trudeau). In many instances, these averages can be accurately extrapolated into other areas of medical care that require urgent and complex treatments, such as a heart transplant.
John Q is more than an entertaining film about a father’s unwavering devotion, it’s an indictment on the issues of power, discrimination, and intersectional differences within the United States healthcare system. As the viewers decode these messages, it becomes clear that the barriers to life saving healthcare services are rooted in these systemic inequalities. We the people must come together and find a solution that provides socially and economically equitable medical care to patients without sacrificing the high-quality standards that the United States is known for. These issues transcend all distinguishing factors among us. We must push for reforms that align with the principles of justice and equality in healthcare.
References
Benshoff, Harry, M. and Sean Griffin. America on Film. Available from: VitalSource Bookshelf, (3rd Edition). Wiley Global Research (STMS), 2021.
Braveman, Paula A, et al. “Socioeconomic Disparities in Health in the United States: What the Patterns Tell Us.” American Journal of Public Health, U.S. National Library of Medicine, 1 Apr. 2010, www.ncbi.nlm.nih.gov/pmc/articles/PMC2837459/
Smith, Neil. “Films – Review – John Q.” BBC, BBC, https://www.bbc.co.uk/films/2002/04/18/john_q_2002_review.shtml. Accessed 22 Nov. 2023.
Trudeau, Noah. “Across the Pond: A Comparison of Healthcare Systems in the US and UK.” Choate Public Health, 24 Sept. 2019, publichealth.choate.edu/across-the-pond-a-comparison-of-healthcare-systems-in-the-us-a nd-uk/
