Q and America's Uninsured
by J. Carlos Jiacinto
man who plays by the rules suddenly faces a horrible tragedy.
His son collapses during a baseball game. He rushes him to
his local hospital, where the doctors tell him that his son
needs a heart transplant and will face certain death without
the operation. His insurance at his employer, having been
switched to an HMO, refuses to cover the costs of the procedure.
Fundraising efforts bring in some money, but not enough for
the hospital to treat the boy. Indifferent bureaucrats and
hospital administrators decide to discharge the boy to "hospice"
- and certain death. In order to get his son the heart that
he so desperately needs, the man takes the hospital hostage.
The plot above depicts the story of John Q, a newly released
film that focuses on America's health care crisis. Denzel
Washington plays John Q, who must go to extreme measures to
save his son's life. Although the movie sensationalizes the
dilemmas facing the uninsured and the underinsured, nevertheless,
the story reminds us that the United States remains one of
the few modern countries with an excellent health care system,
but with numerous barriers to the uninsured and the poor.
It is a crime that many Americans fear "getting sick" because
of the potential financial ruination that may follow. The
last hurdle of the twentieth's century New Deal, access to
quality health care, remains unfinished.
Last week I wrote about how my mother succumbed to breast
cancer after refusing to go to the doctor. She lacked quality
health insurance because she worked as a maid and she could
not afford to secure a quality plan on her own. Like John
Q she played by the rules and refused to recieve charity from
anyone. Although, as I said last week, perhaps catching the
cancer early might not have saved her life. Still I often
live with the unanswerable questions of "What If?"
Today many Americans face these questions and beat themselves
over for circumstances beyond their control. Conservatives
blasted the Clinton plan for being too "big" and too "bureaucratic."
The health insurance lobby spent millions to defeat then-First
Lady Hillary Clinton's health care plan. Conservatives decried
how "taxes would be raised" and how the middle class would
be funding the "lazy, slothful poor." Although the media periodically
cover stories of HMOs refusing to cover life-saving operations,
the perception of the "lazy" poor benefiting at the "expense"
of the middle class derailed the plan from ever coming to
The New Deal's greatest failure was not providing access
to health care for all Americans. The far right of the Republican
Party refuses to compromise on this issue because it undermines
their electoral base: the uneducated middle class voter who
lives in the states of the "sun belt". Across the world the
first institutions that dictators undermine are often those
organizations that provide for the general welfare: public
schools, public health departments, and institutes of higher
education. They thrive - and need - an ignorant populace to
remain in power.
In his work "Up from Conservatism," although a little dated
(Written during the mid 1990s at the height of the "Republican
Revolution"), Michael Lind explains Republican opposition
to such programs: "The purpose of the culture war, as I have
argued, is to divert the wrath of wage earning populist voters
. . .to other targets: the universities, the media, racial
minorities, homosexuals, immigrants" (154). By shifting their
anger to these "cultural issues" middle class Americans forget
how their insurance premiums rise and their own development
I admit that I am not sure what the solution to the health
care crisis, but I do know that the current system subjects
millions of Americans to an uncertain future and needless
suffering. I am not advocating national health insurance necessarily,
but I believe that some option should be available to the
working poor that provides at least some level of care. Whether
government or the private sector should provide the remedy
depends on further research on this issue. There should be
some, basic form of health care available to those unable
to pay (based on a sliding scale determined by income) or
those unable to secure coverage from the private sector due
to preconditions. Before conservatives assail I advocate not
a giveaway program, but a system where those unable to help
themselves can find and pay for affordable coverage. Life
and death should not depend on whether someone is rich or
Conservatives, however, will continue to oppose any meaningful
reform because a healthier, more educated America undermines
their base. They need ignorant and uneducated voters in order
to remain in power and prevail at the polls. Michael Lind
argues that "we will be lucky indeed if conservative policies
do not turn the middle class into tommorrow's poor" (187).
Is it any real coincidence that the states which rank in near
the bottom in terms of raising children, access to health
care, and education are in the deep south and the rural areas
in the country? They need a lower class of white voters who
will respond positively to their rherotic laced with racial
The prospect for future health care reform, in spite of the
movie "John Q" and stories on the local/national news, remains
bleak. Although the cases fill the headlines daily about Americans
who find out about how their HMO will "not pay" for their
operation, most voters will not realize how vulnerable they
are until they need a life saving operation and "insurance
won't cover it." I then wonder if they will care more abou
their "guns" or whether they live or die.
J. Carlos Jiacinto (firstname.lastname@example.org),
who graduated from Dickinson College in 2000 with a major
in Political Science, lives in Washington, DC. He is currently
pursuing an MA in International Politics and International
Economic Policy at American University.