A Horror Franchise Comments on Health Care Reform

Ignore, for a moment, that the transcript below comes from a scene in a horror movie. Indeed, forget that one of the two participants in the dialogue is the eponymous serial killer "Jigsaw" (here referred to by his alias, John Kramer), while the other is one of his future victims. Instead just focus on the surprising literary quality of the words being exchanged, as well as the remarkable intelligence of the insight it offers into our health care system today.

When I wrote my review of "Saw VI" all those months ago, I had hoped that its main theme would be rendered obsolete within a few weeks. Instead the acrimonious debate over health care reform lingers on - and so too, thus, does the relevance of this scene. In it, John Kramer - a brilliant engineer who has known for months that he is dying of cancer - seeks help from an old business acquaintance, Bill Easton, a high-ranking executive at an insurance company.

Kramer: I've found a treatment for my cancer that I think holds a lot of promise, but my requests for coverage have all been turned down...

Easton: Yeah.

Kramer: ... so I was hoping that if I came and explained it to you, that you might be able to get that overturned for me.

Easton: Well, the buck stops here, John. Fire away.

Kramer: Okay. (Kramer pulls out a piece of paper with relevant information on it and hands it to Easton.) This is a doctor in Norway. He's got a thirty-to-forty percent success rate with gene therapy. He injects what he calls suicide genes into cancerous tumor cells. Then an inactive form of a toxic drug is administered...

Easton: Yes. I'm familiar with the therapy you're talking about.

Kramer: Right. And a new trial's starting. He's looking for new patients, and he seems to think that I'm the perfect candidate.

Easton: John, if your primary physician, Dr. Gordon, thought you were a suitable candidate, he would have pursued it.

Kramer: (laughs) No. Dr. Gordon is a specialist. You know, he's making money on his specialty. He's not a thinker. I mean, the man has his hand on the doorknob half the time that I'm there.

Easton: I'm gonna be straight with you. At your age, and with the development of your cancer, it's simply not feasible for Umbrella Health...

Kramer: Wait, wait, wait, wait. What's not feasible? By whose mathematical equation is this not feasible?

Easton: It's policy, John. It's policy. And if you go outside the system and seek out this treatment, which has been deemed ineffective, you will be in breach of policy and you will be dropped from coverage completely. (pause) I'm sorry.

(Kramer reels from this revelation. He walks toward the window of Easton's skyscraper office and gazes out thoughtfully.)

Kramer: Did you know that in the Far East, people pay their doctors when they're healthy? When they're sick, they don't have to pay them. So, basically, they end up paying for what they want, not what they don't want. We got it all ass-backwards here.

(Kramer pauses, then points to a television screen showing a C-SPAN debate)

Kramer: These politicians, they say the same thing over and over and over again. Healthcare decisions should be made by doctors and their patients, "not by the government". Well, now I know that they're not made by doctors and their patients or by the government. They're made by the fucking insurance companies.

(Kramer notices something in a fish tank from Easton's office, and shows an appreciation of the irony in what he sees.)

Kramer: Piranha.

Easton: John, please. If you do this, you'll be on your own, and the subsequent cost to you will be staggering.

Kramer: Don't talk to me about money. I have money. This is about principle. You see, Will, this is my life we're talking about. You remember?

Easton: What about Jill's life? How's she gonna be taken care of when you're gone?

Kramer: Let me worry about Jill.

Easton: (sighs in exasperation) The type of cancer you have is malignant and inoperable.

Kramer: That rolled off your tongue real smooth.

Easton: Even if the treatment works, the cancer will return eventually. It's an unwinnable battle.

Kramer: That was even smoother. As a matter of fact, that was downright slick.

(Kramer shakes his head in disgust.)

Kramer: You think it's the living who will have ultimate judgment over you, because the dead will have no claim over your soul...

(Kramer picks up the paper he had placed on Easton's desk earlier, crumpes it up, and throws it into a wastebasket.)

Kramer: ... but you may be mistaken.

"Say, in lofty madness, that you own the sun, the stars, the moon; but do not say that you own a man, endowed with soul to live immortal, when sun and moon and stars have passed away."
- Charles Sumner