Oh, the fickle hand of fate. One minute mid-west factory worker John Q Archibald (Washington) is bowling along in blue-collar heaven, with only the repo men towing away his wife's car and looming unemployment to worry about.

The next, his son - a scarily old-looking twelve-year-old in the line of Arnold from Diff'rent Strokes - keels over clutching his chest during a little league baseball game.

So now poor ol' John is facing up to a $250,000 medical bill to fund the tearful tyke's heart transplant op. Seems like Mighty Whitey - in the shape of uncaring bosses, tight-fisted health insurance companies, and money-hungry hospital chiefs - are conspiring to pass a death sentence on the little fella. What's a dad to do?

It goes without saying that any dad who took more than a second to think it through would swiftly reject the idea of storming into the hospital's emergency ward waving a pistol and demanding the transplant.

But that's exactly what John Q does. Saddled with a roomful of racially-mixed patients, this out-of-his-depth everyman ends up going up against experienced hostage negotiator Grimes (Robert Duvall) and his media-crazed police chief boss (Ray Liotta). And does the little guy get his new ticker? Well, take a wild guess.

Denzel Washington is flavour of the month after his Training Day Oscar win. His portrayal of a decent family man backed into a corner by the system goes a long way to making this film as watchable as it is.

The other factor in the film's success is the willingness of director Nick Cassavetes to play to the gallery with his damning look at the machinations of the money-hungry health care system. Hospital administrator Rebecca Payne (Anne Heche) is a hard-faced bean counter who could care less about the poor kids taking up valuable dying space in her wardrooms, while transplant surgeon Dr Turner (James Woods) is more interested in hob-nobbing with his millionaire patients than in honouring his Hippocratic oath. Boo! Hiss!

These baddies may just be stereotypes, but Cassavetes plays the morality tale game by allowing them to redeem themselves at the end. Payne puts little Michael on the transplant list, and sawbones Turner mucks in to do the messy stuff when a suitable donor miraculously wraps her car around a Mack truck with just minutes to spare. See, they're human after all.

As in nearly every stand-off drama - from Dog Day Afternoon to Bandits and every point in between - the hostage taker ends up a hero and the media have a field day. That's hardly ground-breaking satire. But John Q is more a gut reaction kind of film. Everyone can feel for the family's plight, and Cassavetes at least raises the uncomfortable question about what the viewer would be able to do given the same circumstances.

Simplistic stuff, certainly. Morally dubious, perhaps. But in its twisted way, amid the tear-jerking sentiment and harrowing gunplay, John Q manages to preserve an undeniable feelgood, David-slaying-Goliath appeal. Just don't trade that insurance policy in for a Magnum.44 just yet.