John Q is just your ordinary average blue-collar worker in Middle America trying to make ends meet. Unfortunately things are slow at the plant and John's hours have been cut in half. To make matters worse his wife's car has just been repossessed and he can't find a second job to bring in more income. Then the hammer really falls: his son collapses during a Little League game and the doctors say the boy needs a new heart--and fast--or he will die. When John finds out that his insurance won't cover the operation (his policy has been downgraded by his company because his hours were cut) and that the hospital won't put his son on the organ transplant list without a stiff up-front cash payment John takes matters into his own hands. Holding the ER hostage John demands that the hospital put his son on the organ transplant list.
Denzel Washington is Everyman letting his hair get unruly packing on some un-Hollywood-star inches around the middle and wearing nothing but cheap hats and jeans. Despite some silly screenwriting Washington manages to raise John above soap-opera dramatics and weak polemics ("The enemy is us--we shot down national healthcare") with genuine emotion and convincing resolve but barely. James Woods is perfect as the sniveling smarmy and supercilious doctor but unfortunately he and the rest of the talented cast are wasted as one-dimensional characters and saddled with routine clichéd dialogue. Anne Heche (who should be commended for taking on such a villainous role) is the icy hospital administrator; Robert Duvall is the by-the-book hostage negotiator; Ray Liotta is the trigger-tempered police chief; and Shawn Hatosy is the big-city brat who just won't stand for being a hostage. The rest of the hostages aren't even remotely interesting nor are any of the other characters.
While weak dialogue is partially to blame when a cast as strong as this one can't breathe real life into their characters some of the culpability must be laid at the feet of the director. Nick Cassavetes' (She's So Lovely) movie suffers from heavy-handed treatment: every five minutes the audience is beaten over the head (again) as someone rails against the country's failing health system and places guilt on this party or that complete with obligatory tight close-up shot (and halo) directly on that character. Not to mention Cassavetes tips his hand with the opening scene. The patter by screenwriter James Kearns (TV's Highway to Heaven) is cute at times but on the whole the script is didactic yet inane and would make for a poor episode of E.R.. The story however does manage to engage the audience on an emotional level with its timely message. One cannot help but root for John Q no matter his vigilante ways. After John's denouement Cassavetes closes the film with news clips of celebrities stumping for the cause. This is typical of the movie as a whole; while it attempts to deal with the serious issue of health care reform it only does so on the most superficial level.