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John Q and America's Uninsured
February 20, 2002
by J. Carlos Jiacinto

A 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 a vote.

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 stagnates.

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 poor.

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 overtones.

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 (jiacinto@hotmail.com), 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.

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