None dare call it Terrorism: Recent Events Reflect 2002 film where Hostage-Taker Becomes a folk hero
DIRECTED BY NICK CASSAVETTES/2002
Among the most despised industries in the United States, health insurance is high on the list.
Many Americans have had some nightmare experience with their health care insurer in trying to resolve a claim. They may be told that they neglected to read the fine print on their policy showing that the medical procedure they need isn’t covered. Or they are compelled to speak to numerous insurance company representatives and/or fill out endless forms to address their issue.
And then there’s the cost of health care services and insurance policies covering them. Medical debt is the leading cause of bankruptcy in this country.
The system seems to be rigged against hardworking people who are just trying to provide for their families. It’s enough to make some individuals want to take out their frustrations on a few of those involved in the scheme to steal everything they have while delivering little in return.
The Dec. 4 murder of Brian Thompson, chief executive officer of UnitedHealthcare, led many people to express their animosity toward the health insurance industry and commend the killer. An outpouring of grievances against insurance companies followed this tragedy.
What’s truly vile is that numerous articles of clothing are being peddled online with the words “Deny. Defend. Depose.” emblazoned on them. These words, reportedly inscribed on the bullet casings found at the scene of Thompson’s murder in New York City, make up a phrase employed by critics to decry the tactics that insurance companies supposedly use to avoid paying out on claims.
To observe people cheering a vicious act of violence is disheartening. While many people have legitimate complaints against this industry, nothing justifies such barbarity. At 50 years of age, Thompson left behind a wife and two teenage sons.
In the interest of full disclosure, one of my sisters works for UnitedHealthcare. She’s a registered nurse who examines individual claims to ensure medical personnel follow the proper procedures and provide the patient with all the appropriate health care services.
She’s dedicated to her job, and I have no doubt her colleagues are as well. Thompson’s murder came as a shock to many UnitedHealthcare staff members.
While I understand the acrimony that people feel toward health insurance companies, it’s misdirected to some extent. A 2002 movie exploited these sentiments and gave viewers a reason to applaud something truly vulgar.
John Q. tells the story of John and Denise Archibald (Denzel Washington and Kimberly Elise), a working class couple who can’t catch a break. John’s factory bumps him down to 20 hours a week, and Denise is working a job at a grocery store to help make ends meet. John is also having trouble getting a second job.
One of the film’s first scenes shows their station wagon being repossessed because they’ve fallen behind on their payments. John tells Denise that he needed to choose that month between paying the car bill and paying the mortgage. To maintain a roof over their heads, he chose the mortgage.
When their 9-year-old son, Mike (Daniel Smith), collapses while playing baseball, John rushes him to a nearby hospital. The family’s misfortunes take a horrifying turn for the worse at this point.
A cardiologist (James Woods) tells John and Denise that Mike requires a heart transplant to survive. And then a hospital administrator (Anne Heche) informs them that John’s policy does not cover heart transplant surgery as well as any follow-up care, estimated at about $250,000.
John’s HMO policy won’t cover this procedure because he’s now working part time. Denise doesn’t yet qualify for health benefits at her job because she’s only been working at the grocery store for a few months.
They need to make a $75,000 down payment to get their son placed on the waiting list for heart transplants, and they have few options. John and Denise get some fundraising help from friends and members of their church, but they’re running out of time. If they don’t come up with the money they need soon, the hospital will release their son — and, thus, ensure his death.
When John is told that his son is being discharged from the hospital, he takes matters into his own hands. He pulls out a gun and tells the cardiologist, hospital personnel and emergency room patients that they’re now his hostages. This sets up a standoff with local police and becomes a major news story.
The evils of the health care industry (hospitals as well as insurers) are hashed out in John Q. Despite his threats to kill hostages if he doesn’t get what he wants, John becomes a folk hero for finally standing up to such a corrupt system.
The movie received mixed reviews when it came out more than 20 years ago. While critics praised Washington’s acting, some of them had few kind words for those in the supporting cast (among them Robert Duvall and Ray Liotta) as well as the film’s storyline.
What the reviews I read didn’t touch on at all was the issue at the heart of movie: terrorism. I checked many reviews (including from major U.S. newspapers), and not a single one used this word or referenced this concept.
And there’s no getting around the fact that our “hero” employed terrorism to impose his will on others. He frightened authorities by threatening to kill hostages if his demands weren’t met. That’s the textbook definition of terrorism.
When I first saw John Q. years ago, I was appalled to see how it bent over backward to justify the main character’s violent mindset. John Quincy Archibald is an honest working stiff who dearly loves his family, attends church regularly and follows all the rules. He’s exhausted every legal option available to him, so of course he had to explore an illegal one to ensure his son survives.
The film tries to manipulate our emotions so that we come to view health care insurance companies and hospital administrators as the villains. John has no choice but to threaten to murder innocent people to get his son a new heart. Extreme actions such as terrorism are sometimes required in dire circumstances.
We strongly sense that John has no intention of hurting anyone, which makes it easier to rationalize his actions. If the health care industry operated in the best interests of its patients rather than its executives and shareholders, holding people hostage wouldn’t be necessary.
Sorry, but no. Justifying violence to satisfy your embittered feelings is depraved.
I don’t begrudge people’s hostility toward the health care profession in general and the health insurance industry in particular. Americans have far too many encounters with insurance representatives that prove infuriating. Why can’t the wealthiest nation on Earth devise a way to provide essential health care services in an efficient and affordable manner?
The system we have now obviously doesn’t work well, to say the least. Too many people pay too much money for weak insurance policies that aren’t meeting their medical needs.
However, it’s not sufficient simply to blame greedy executives and administrators for all our problems. Numerous factors complicate the picture, and demonizing those overseeing this system for everything wrong with it is shortsighted.
For one thing, insurance companies are not the primary cause of high medical expenses; health care providers are. In fact, insurers often take measures designed to curb excessive costs. These tactics, of course, are usually cast as nothing more than attempts by these firms to shirk their duty to cover people’s medical bills.
Addressing people’s reactions to Thompson’s murder, journalist Noah Smith published an article on his blog Dec. 9 examining some of the concerns with the health insurance industry. He presented some eye-opening data.
“[W]hen we take a hard look at the question of why Americans pay so much more for their health care than people elsewhere in the developed world, insurance companies and their profits just aren’t that big of a piece of the story. First of all, insurance companies just don’t make that much profit. UnitedHealth Group, the company of which Brian Thompson’s UnitedHealthcare is a subsidiary, is the most valuable private health insurer in the country in terms of market capitalization and the one with the largest market share. Its net profit margin is just 6.11%,” Smith wrote. “That’s only about half of the average profit margin of companies in the S&P 500. And other big insurers are even less profitable. Elevance Health, the second-biggest, has a margin of between 2% and 4%. Centene’s margin is usually around 1% to 2%. Cigna Group’s margin is usually around 2% to 3%. And so on. These companies are just making very little profit at all.”
In his article, Smith presented a graphic showing UnitedHealth Group’s income statement for fiscal year 2023.
“You can see that the company’s net income — i.e., its total profit — was $23.1 billion in 2023. That’s a lot of money, but it pales in comparison to the $241.9 billion that the company spent on medical costs. Even the company’s $54.6 billion in operating costs — of which Brian Thompson’s own $10 million salary represented 0.018% — are dwarfed by actual medical costs.”
A new policy announced last month by Anthem Blue Cross Blue Shield received renewed scrutiny after Thompson’s death. The health insurance firm said it would begin paying a flat fee for anesthesia administered during surgeries rather than paying according to how long the procedure took (a common practice in health care). This would apply to its policies in Connecticut, Missouri and New York.
The decision drew criticisms from many Americans across the country and public officials in these three states. The American Society of Anesthesiologists presented the decision in stark terms.
“In an unprecedented move, Anthem Blue Cross Blue Shield plans representing Connecticut, New York and Missouri have unilaterally declared it will no longer pay for anesthesia care if the surgery or procedure goes beyond an arbitrary time limit, regardless of how long the surgical procedure takes. The American Society of Anesthesiologists calls on Anthem to reverse this proposal immediately,” the organization demanded in a Nov. 14 statement. “If an anesthesiologist submits a bill where the actual time of care is longer than Anthem’s limit, Anthem will deny payment for the anesthesiologist’s care. With this new policy, Anthem will not pay anesthesiologists for delivering safe and effective anesthesia care to patients who may need extra attention because their surgery is difficult, unusual or because a complication arises.”
The pushback that Anthem Blue Cross Blue Shield received was significant. On Dec. 5, the company announced it was reversing its decision on this policy. But in a Dec. 6 article published on Vox.com, Eric Levitz outlined why the furor that resulted was misguided.
“Americans have many justified grievances with insurance companies, which often refuse to cover necessary care. But this particular fight was not actually about putting the interests of patients against those of rapacious corporations. Anthem’s policy would not have increased costs for their enrollees. Rather, it would have reduced payments for some of the most overpaid physicians in America. And when millionaire doctors beat back cost controls — as they have here — patients pay the price through higher premiums,” Levitz wrote. “Anesthesia services are billed partially on the basis of how long a procedure takes. This creates an incentive for anesthesiologists to err on the side of exaggerating how long their services were required during an operation. And there is evidence that some anesthesiologists may engage in overbilling by overstating the length of a procedure or the degree of risk a patient faces in undergoing anesthesia. Starting in February, Anthem had planned to discourage overbilling by adopting a set of maximum time limits for procedures, inspired by data from the Centers for Medicare and Medicaid Services. If an operation went long for medically necessary reasons, anesthesiologists could appeal for higher payment. But the process of reimbursement would be more arduous.”
Levitz noted that anesthesiologists are among the highest-earning doctors in this country. The average annual salary for anesthesiologists in 2023 was $472,000 — a $70,000 increase over the field’s average salary in 2022, he wrote.
And based on the contract that doctors have with insurance companies, anesthesiologists would have been prevented from passing whatever costs they claim to have lost onto patients, according to Levitz’s article. The burden (if any) would have fallen on anesthesiologists, not patients. Doctors must accept the reimbursement rates outlined in the contract they sign with insurance companies.
Such measures can be effective at constraining health care expenses. In fact, this is what many government-funded health care systems in Europe do: They impose limits on reimbursements to control health care expenses. Medical personnel are then obligated to provide the services they’ve offered.
But the American Society of Anesthesiologists presented a misleading image of patients waking up in the middle of surgery in agony because they couldn’t get the gas they required. So the anesthesiologists got to keep their generous salaries by making Anthem Blue Cross Blue Shield look like the scoundrel.
I don’t want to sound like an apologist for the health care insurance industry. It deserves the anger that disgruntled policyholders feel for frequently getting the short end of the stick.
But I was disturbed to watch a movie that had people cheering for a domestic terrorist through whom they could vicariously express their contempt for one industry. Now years later, it’s even more chilling to see individuals applauding someone who actually carried out their blood lust in real life.