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For the majority of even minimally insured people, things will never come to that. Coverage caps--which in John Q. limit the family's reimbursement to just $20,000--do exist, but they're typically lifetime maximums rather than annual caps, and the majority of them are $1 million or more. Such a payout is usually more than adequate, though a catastrophic injury like paralysis can blow through the whole reserve in just a few years. Similarly, surreptitious policy switching--which in John Q. causes the family's coverage to shrink as the lead character's work hours are cut--is not as much of a danger as the movie would suggest. Even barebones policies ought to cover "medically necessary" procedures (a term that can be slippery), and in many cases, coverage doesn't dwindle as hours do, though such workers may be required to pay more to maintain the policies they have. Yet no one disputes that the health-insurance safety net remains badly frayed. "There are many people who still fall through the cracks," says Ray Werntz, of the Employee Benefits Research Institute, "but in some cases, that's because they don't know what their options are." Learning and acting on those options may be the best thing people can do to avoid a John Q. scenario. It's not always pretty when life imitates movie art, particularly when it's this movie--and your life.
--By Jeffrey Kluger. With reporting by David Bjerklie/New York