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Insurance - hospital

The movie I chose to write my review about is John Q. This film was released in 2002 and written by James Kearns and directed by Nick Cassavetes. In the film John Q. ; a couple was faced with a previously undetected heart failure of their 9yr year old son at his little league game. Quickly into his care the director of the hospital and the director of cardiology approached the couple with the news that there son had (3) Septial defects in his heart. These defects induced myopathy resulting in pulmonary edema and malignant ventricular ectopy.

The cardiologist then went on to explain that the damage was irreversible and beyond corrective surgery and saying good bye would be the next thing to happen. Since Mrs. Archibald worked at a grocery store and didn’t carry insurance and Mr. Archibald was currently working part time. His insurance policy had changed. He was under HMO insurance coverage and it would cost $250,000 to do the surgery he needed and his insurance would not cover the expenses. The director of the hospital informed the Archibald’s that in order to continue receiving care they would need to become a cash patient of the hospital or their son would die identify medication which demands the measurement of specific physiological measurements.

The cardiologist gave them months, weeks, or days of life left without a new heart. The major medical issues are that the son; Michael, went was in heart failure. His heart was (3) times the size of an average 9 yr. old, and that his heart was working too hard. The septal defects that induced the myopathy and pulmonary edema and malignant ventricular ectopy were restricting the blood from being pumped by his hear so it backs up into the lungs and collect like a sponge. Over the course of the movie Michael’s BP was 87/57.

The nurses expressed how important it was that his systolic stay above 90, not dropping below 70 which would mean he is in heart failure again. His atrial BP should be in low teens and it was 35. While in hospital care the staff also had to administer several different medicines prolong his quality of life. He received Lasix; a diuretic, potassium, because the Lasix depleted his potassium, dopamine for his blood pressure, primacor for his heart and an antibiotic as a precautionary measure.

Lastly they had to find him a match for a heart with b-positive blood and a tissue match as well to be able to go on with the surgery. The ethical issues were that Michael needed a $250,000. 00 surgery and the only insurance they had was HMO. HMO insurance is a minimal insurance policy available to part time employees at John Q. ’s workplace. HMO insurance is almost extinct as an option for insurance for today's healthcare. HMO is an organized structure of keeping health costs down for patients but compensation low for providers.

This is what the Archibald’s were experiencing with the hospital. They needed coverage that wasn’t available. As John Q scrambled to pull together the money his wife was still told in spite of the money they had paid to keep him in their care they were still going to release him. The director of the hospital had been made aware of their current income situation and had already spoken to the insurance company. The director feeling as if this was an obviously deteriorating situation they told them to enjoy their last day worth there some.

John Q would not accept that as an answer. After John Q took the hospital he had decided since no one was able to save his son but him he would be the one to do so. The cardiologist that John Q had insisted he use his heart to save his son because he already knew it would match. This put the cardiologist in a very ethical bind because John Q was taking about killing himself fin order to save his son, he also insisted that he perform the surgery directly following.

Had he gone through with the surgery his doctors would be revoked; his practice should be over and he would have to relocate. John Q saw a problem he couldn’t afford what the doctors told him he needed in order to keep his son alive. So he locked down the ER and decided not to take “No” for an answer. In doing so he made and irrational decision to use a weapon to subdue the hostage and have leverage with the police so they would give him what he wanted. I believe violence is never the answer.

So by putting others in danger I believe that was a bad life choice, I only hope and pray that I could be as BRAVE and courageous as John Q while facing adversity with my child. I disagree with the way HMO’s have perks for doctors avoid certain extended searches that could result in spending g more money for the hospital. I feel it is disgusting for a doctor to “NOT “check because this came back a little abnormal or these test were inconclusive. It is appalling to me that they would receive for going along with charade like that when there is a real human life hanging in the balance.

I also agree with the way they were handled because the hospital gave them an opportunity to see what they could come up with but as director they have to know even I very sensitive case hoe to work under the assumption that this is in the best interest of the hospital. The director has a responsibility to both the hospital and the patient; were the parents do not. I was conflicted. I understand the rules, but I feel as if only after we’ve done all we can do should we set any patient out on the street that was still sick.

Since watching John Q I’ve learned that in the US there are $40 million people without medical coverage/ Hmo’ s are a scam that I believe the government had to get involved in to change. I believe I would have tried a little harder had I been the director of the hospital. Children are our future. They are all we have and staying within the lines of the law I would exhausted all my capabilities before ordering them to leave. Ethically there is no way I would operate on a man that shot his brains out so his son could have his heart, but I would work very hard to ensure that that was the case.

Ethically I suppose the hospital could have gotten by with the work that had been administered on the patient an could have released them for nonpayment, but they would John have been a hard pill to swallow. I The movie John Q was based on a true story, and the signs depict could happen in real life. I laughed I cried, I listened with intent, I learned that sometimes life leaves us facing situation that are hard to combat, but if we hold our composure. “Wait on the Lord,” as my grandmother would say, your miracle is on the way.

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