Movies: Could Obamacare have prevented the Jigsaw killings?

It will serve to be sufficient review of the allegedly final Saw flick that, as the movie slumped towards the final scene of a seemingly interminable 91 minutes, I had time to wonder: Would Obama style health care reform have prevented the creation of Jigsaw, the conceptual franchise-like serial-killer meme embraced by the various murderers of the film series?

Admittedly, it's a bizarre idea, but not one without merit.

Let's review the convoluted origin of the Jigsaw meme. Start with John Kramer, a seemingly wealthy architect or engineer. John cooks up the basic Jigsaw concept when he weaves together three key motivational threads: 1) a sort of gonzo moral hyper-libertarianism that arises from a miscarriage his wife suffers, the product of an unintentional act on the part of a petty criminal/junkie; 2) an obsession with the idea that the precious gift of life is being squandered by the majority of people, a product of being diagnosed with inoperable cancer; and 3) a messianic view himself as the man who has a teachable insight into the value of life and how this value can be understood only through facing death in a test-situation, a product of a failed single-auto accident suicide attempt John made after losing his wife and learning about the cancer diagnosis.

Let's assume that these three events are all necessary conditions for the creation of Jigsaw. If John suffers Event 1 without 2 and 3, he becomes a Glenn Beck fan and Tea Party movement organizer. Unpleasant, sure; but not a serial killer. Event 2 without the others and he is just a man whose successful life is cut short tragically by cancer. Event 3 requires events 1 and 2, so it can't occur in a vacuum. Events 1 and 2, without the failed suicide attempt, just leave John a bitter, terminally ill man, but he'd stop short of becoming the head of a moralistic murder-cult.

Though John is mastermind of the whole Jigsaw thing, he's not the sole Jigsaw killer (which is really more of a philosophy or a brand, than an individual). To truly "stop" the Jigsaw killings, I think we'd have to show that none of Jigsaw's various acolytes would have developed the concept on their own. So let's run through the Junior Grade Jigsaws and lay out their origins.

Amanda Young: Amanda was a dead-end junkie with a tangential connection to the miscarriage that started John's transformation. She was an early Jigsaw victim who, after escaping the head-mounted reverse bear trap, became a semi-convert to John's ideology. Later, it is revealed that Amanda doesn't really care that much about John's philosophies – she build's deathtraps, not tests, for example – but is motivated more out of some Stockholm Syndrome-esque love of John as a father figure. (Debatably, none of the Junior Grade Jigsaws seem to actually care about John's philosophy – which makes John, oddly enough, a total failure on the messiah front.)

Mark Hoffman: Detective Hoffman comes to Jigsaw's attention when he discovers Hoffman is conducting vigilante killings under the guise of Jigsaw traps. Viewers discover that Hoffman has a history of police brutality prior to his posing as Jigsaw or becoming a part of the actual Jigsaw killings. Even after joining up, Hoffman's motivations never jibe with John's, a conflict that plays out through the last three or four flicks.

Jill Tuck: Ex-wife of John, it's somewhat unclear whether or not Jill is really a Junior Grade Jigsaw. Her early appearances in the film suggest that she is not linked to John's post-Jigsaw existence in any important way; but, as the film series progressed, there were more and more hints that she was aware of John's actions (Hoffman claims she knew from the get-go) and may have even assisted in his murderous activities. Regardless, she only kicks into serious levels of Jigsaw-like activities after the death of her ex-hubby and the delivery of posthumous instructions on how to protect his "legacy" by offing Hoffman, who is more interested than outright murder than John's odd notions of spiritual trial through extreme mortification.

Lawrence Gordon: Prior to his run in with Jigsaw, Larry was a successful, if self-absorbed doctor, who liked nabbing a little ex-martial nookie now and then. Like Amanda, Larry converted to Jigsawism after surviving his own trap experience.

I propose that, given the Junior Jigsaws' histories, none of them would have become Jigsaw without John's interaction. Amanda would have perished in some appropriately sordid junkieish manner. Jill would have never received any instructions about trap building or acolyte killing. Hoffman might still be a killer cop, but he'd never have the template of Jigsaw to hide behind and he doesn't seem creative enough to have cooked up the idea by himself (the contrast between John's demented creativity and Hoffman's vigorous, but simplistic, violence is one of the contrasts exploited in the film). And, without falling victim to a Jigsaw trap, there's no reason to assume Doc Gordon would live out his life as anything other than a tail-chasing, low-grade douchebag of a medical professional. In summary, if something could have prevented John from becoming Jigsaw, nobody else would have picked up the pig mask and all of Jigsaw's victims (not just the dozens of trap victims, but the two teams of SWAT personnel and the handful of police officers and FBI agents that died in violence related to the case) would have all lived.

This is where the issue of Obamacare comes in.

In descriptions of the Saw franchise, John's discussed as have inoperable cancer. This term might be technically correct, but the commonly understood sense of the term as it is used to describe John – that John was doomed the moment he was diagnosed with cancer – is misleading. John's cancer was, apparently, to advanced to consider an operation to remove the cancer. However, even within the film series, we learn that John was not out of medical options. In Saw VI, it's revealed that John approached his insurance provider – the in-jokily named Umbrella Health – to request that the company help cover the cost of an experimental intervention's clinical trial. Umbrella – specifically, executive William Easton and his crew of hand-picked denial specialists – denied John coverage to save a few bucks, closing John's last door to treatment, creating the second condition (and, by extension, the third) necessary for the existence of Jigsaw.

Under Obamacare, John couldn't have been denied coverage for the experimental intervention. Currently, it is illegal for insurance companies to deny you coverage if you want to participate in a clinical trial. This was law several years prior to the current wave of reform. However, in some states, companies must pay for the clinical trials, but may stop "routine" coverage – that is to say, they'll pay for you to participate in the clinical trial, but you have to pay for every other cost (doctor visits, prescriptions, etc.) – during the trial. Under the health reform bills signed into law by President Obama, not only are insurers required to cover clinical, experimental treatments in a trial setting, but they must maintain a national baseline of routine coverage throughout. So, under Obamacare, John Kramer would have had coverage for the experimental treatment he requested.

Would this have, for certain, prevented John from becoming Jigsaw? Nothing's for certain. We can imagine a scenario in which John takes the treatment, nothing happens, and the second necessary condition for the creation of Jigsaw is still in play. That said, I think it is more likely than not that entering John in the clinical trials would have ended the Jigsaw story before it ever began. Best case scenario, John's cured. The second necessary condition for the creation of Jigsaw never develops. No reverse bear traps or giant pig ovens. Even if the treatment didn't take, there's the question of timing. By denying John coverage and creating the second necessary condition while John was still possessed of some measure of physical strength, Umbrella Health leaves an important window open when John is both obsessed enough to become Jigsaw and healthy enough to do it. The more time John spent in a clinical trial, unconvinced of his doomed state, the less time he has as Jigsaw to create plans and recruit able bodies to replace his ailing one. In this second scenario, I think you've neutralized Jigsaw by stalling John's conversion to the point where he'd either lack the time to become Jigsaw or be so frail that a suicide attempt would be something he'd be unlikely to come back from.

Conclusion: We can't say for sure whether Obamacare would have prevented the birth of Jigsaw had it been in place when John needed it. Still, it's good to know that, come 2014, we can worry a little less about future Jigsaws being made.