As the film opens we see a white sedan driving recklessly on a mountain highway through the Canadian Rockies. Remember that, because it's going to play an important role in the conclusion of "John Q," which is otherwise set in suburban Chicago. Until we get to that conclusion, though, we are presented with the most direct appeal yet for converting America's cruel and inane health care system - a system based on profits - into a Canadian-style single-payer system, a system based on need.
John Quincy Archibald (Denzel Washington) is a factory worker with a wife, Denise (Kimberly Elise), and son, Mike (Daniel E. Smith); John has just been downsized to 20 hours of work a week and Denise has just started her job as a grocery store checker. One afternoon at a Little League game Mike stumbles and collapses. At the emergency room we learn that he has a hugely enlarged heart, and will die without a transplant. Okay; let's get him the transplant. Not so fast, though. John's HMO won't spring for the transplant - "It's experimental" - and neither will any other private or public agency. At this point Mike becomes a Dickensian character we should call Little Mikey. The hospital's director (Anne Heche in a role so cruelly caricatured as to make her seem like a comic-strip villain) refuses to allow the surgery without a cash payment, and even moves to kick Little Mikey out of the hospital.
What to do? Well, Denzel being Denzel, he gets a gun and takes over the hospital's emergency room, complete with hostages. "I'm not gonna bury my son," he says. "My son is gonna bury me." The police bring in a hostage negotiator, Lt. Grimes (Robert Duvall) and the standoff begins; a critic has likened it to "Dog Day Afternoon," which in a way it resembles. As the standoff continues, the police chief (Ray Liotta) takes over, the media get closer, and the film descends into standard melodrama - the kind that only a miracle can save.
And here is where we come back to that mysterious opening sequence. It turns out that the driver of the car - killed through her own bad driving - just happens to have a perfect heart for Little Mikey. And it also turns out that Anne Heche will allow Little Mikey to receive that heart. And that heart is even now being flown by helicopter right to the hospital. And despite the fact that the Canadian Rockies are two thousand miles from Chicago that helicopter makes it in about a minute and a half - just before Denzel pulls the trigger on himself in order to give Little Mikey his own heart. So the great American health care system turns out to work anyway, saving Little Mikey and preserving God, the flag, and the American Way of Life. What could be better?
P.S. After the drama has ended, director Nick Cassavetes (who dedicated the film to his daughter Sasha, who has a congenital heart condition) brings in clips of famous people (Hillary Rodham Clinton, director Ted Demme) talking about the need to reform our health care system. Is it ironic that two months ago (after the film was finished but before its release) Demme died - of a heart attack?