It’s summer, the sun is blazing, and we only have one thing on our minds – the upcoming thirtieth anniversary of the high-octane, expertly paced thriller The Fugitive, originally released August 6, 1993 starring Harrison Ford. Oh, and Medicare for All. We’re always thinking about Medicare for All. Now that we mention it, isn’t it funny how if we had a single-payer healthcare system, The Fugitive wouldn’t exist? In a single-payer system, there would have been no nefarious pharmaceutical executive to frame Harrison Ford for murder in order to cover up the side effects of Provasic. There would have been no need for Walter White to cook meth in order to pay for his cancer treatment. In fact, a lot of our favorite movies and TV shows would be entirely without conflict. In this episode, we take a look at a uniquely American subgenre: movies where our healthcare system is the villain! Plus, we dip into the Healthcare-NOW mailbag to hear from our listeners about your favorite movies where for-profit healthcare is the bad guy.
SPOILER ALERT. Some of these movies are masterpieces, and we’ll be discussing spoilers. Seriously, we advise that you pause the podcast and watch Dog Day Afternoon now.
Let’s discuss the uniquely American film genre that depicts the healthcare industry as the villain. One of the biggest healthcare villain blockbusters was, of course, The Fugitive (1993). Our hero Dr. Richard Kimball is falsely accused of murdering his wife. He escapes police custody and along the way uncovers the truth, that he was framed by an evil pharmaceutical executive who killed Mrs. Kimball to cover up the side effects of a profitable new drug. Fun fact: Tommy Lee Jones was the former college roommate of Vice President Al Gore.
The term “healthcare industry” dates back to the 1970s, and so does the reality of for-profit healthcare. Major transformations of our healthcare system have created real-life nightmares and impossible situations for patients, and that growing widespread experience of a healthcare dystopia then creates an audience for Hollywood script writers to build drama around healthcare situations. Two of the films submitted by our members come from the very beginning of the “healthcare industry,” in the early 1970s:
- The Hospital (1971) stars George C. Scott and Diana Rigg. A serial killer targets doctors by making them patients in their own hospital, where they die due to hospital negligence. CW: weird sexual politics.
- Dog Day Afternoon (1975) starring Al Pacino and John Cazale, dramatizes a true story of two Brooklyn bank robbers, motivated to steal to pay for gender reassignment surgery for Pacino’s character’s partner. In 2015, real life dad Bryan Randolph of Detroit robbed a bank to pay for his 1-year-old daughter’s cancer treatment after his health insurance canceled her plan.
The next explosion of healthcare plots comes in the 1990s and early 2000s, when “managed care” plans and HMOs spread like wildfire, replacing traditional insurance. Intended to bring down rising healthcare costs, managed care brought us such classics as prior authorization, widespread claim denials and limited networks. This kicked off a new wave of films in the 1990s that start using health insurance villains become key plot points. The failed Clinton health reform efforts also happened in 1994, which created probably a sense of hopelessness around Congress fixing these problems.
- As Good As It Gets (1997): This cringefest features Jack Nicholson as a cranky, bigoted and obsessive compulsive writer. Nicholson’s character can only eat at one restaurant, where he meets waitress Helen Hunt, and pays for her child’s cancer treatment so she can continue to work and serve him. All kinds of toxicity, sexism, and structural inequities on display in this one.
- Patch Adams (1998): features Robin Williams in a real life story about a doctor whose unorthodox ways bump up against the medical establishment. Or something. Gillian refused to watch it because it was stupid. RIP Robin Williams.
- John Q (2002): Multiple villains in John Q! First factory worker Denzel Washington gets screwed by his employer, who switches to an HMO with tiered coverage. Then they cut back his hours and classify him as a part-time employee whose insurance won’t cover his son’s heart transplant. Villainous hospital administrator Anne Heche refuses to put Denzel’s kid on a transplant list until they get a down-payment. A nurse points out the son’s heart problem could have been detected earlier, but nefarious HMOs gave doctors bonuses for reducing the amount of testing they do. So Denzel holds the ER hostage until they give his kid a new heart, brandishing a gun and announcing “The hospital’s under new management. From now on, free healthcare for everybody. How’s that?” In this fictional world, Denzel becomes a folk hero and the conversation about healthcare changes in this country.
In the late 90s/early 2000s, after the failure of the Clinton health reform we saw the spread of managed care tactics, the growth of for-profit hospitals, physician networks, insurers, and more. Healthcare costs continued rising and insurance coverage started dropping year over year. This is when we first see the growth of the Medicare For All movement. Most state M4A groups were formed in the late 1990s, and Healthcare-NOW was launched in 2004! The growth of the healthcare crisis paired with increasing social movement activism creates another wave of films and tv, and of course created the pre-conditions for the Affordable Care Act and Barack Obama’s first presidency.
- Breaking Bad (2008): In this TV classic, a chemistry teacher starts a criminal empire in order to afford the cancer treatments his insurance won’t cover.
- Saw VI (2009): this horror gem was made during the run-up to the debate about the Affordable Care Act. The Jigsaw killer confronts an Umbrella Health insurance executive about his denied cancer treatments, the origin of his murderous ways. Jigsaw puts the insurance executive face to face with people whose claims he’s denied. In the end the insurance executive suffers a spectacular death and we can’t really argue with that kind of poetic justice.
In the present day it feels like tragedy and desperation in film increasingly revolves around our characters’ absolute inability to get the care they need or to afford paying for it. We’re getting into real healthcare dystopia territory.
- Joker (2019): Joaquin Phoenix as Arthur is a frustrated clown and aspiring comedian with a bunch of health problems including a psychological condition that causes him to laugh uncontrollably in inappropriate settings. The film takes place in 1981, so keep in mind that’s when Reagan gutted the American mental health system. Arthur could use some healthcare and social services, but is turned into a supervillain because his community abandoned him.
- 65 (2023): 65 million years ago, Adam Driver lives on an alien planet and the inciting incident is that he has to take a job to pay for his sick daughter’s medical bills. He is required to travel to planet earth 65 million years ago, so there are dinos and time travel but somehow still for-profit healthcare.
There’s a lesson here for Medicare for All activists. Individual stories have an impact. Hollywood loves individual stories about one person who takes on a system, but we know that what really changes the system is collective action. But our individual stories are important – we need to continue to shape the narrative about our healthcare system and not leave it up to the whims of Hollywood. In fact, Healthcare-NOW is offering storytelling trainings, among others, this summer! Visit our website to register.