Politics on Screen: Breaking Bad & the reality of the US healthcare system

Beware, spoilers lie ahead – surely everyone’s watched Breaking Bad though, right? Right? If you haven’t, then what the fuck are you doing?! We have all been locked indoors for the last year – there really are no excuses.

There has been a Breaking Bad-shaped hole in our lives for almost ten years now, though its legacy definitely still lives on – in 2019, Vince Gilligan picked up the pen again to tell a classic ‘what happened next’ story of universally-loved character, Jesse Pinkman.

There is also the highly-rated prequel series ‘Better Call Saul’ – this follows the original series’ shady lawyer Saul Goodman, or Jimmy McGill, in the years leading up to Breaking Bad.

And yet, Breaking Bad is arguably still to be replaced as the TV show that everybody talks about.

When people reminisce over the series, they tend to think of the series’ complicated protagonist, Walter White, killing his arch-nemesis Gus Fring, or when he ran over those two drug dealers, or when he ordered Jesse to kill Gale, or when he watched Jesse’s girlfriend die…yeah, that guy was fucking tapped.

Something that is perhaps not remembered as commonly is the social commentary inextricably tied to the series – specifically, what it said about the American healthcare system.

This is particularly intriguing coming from the UK, where there is universal access to a state-funded, national health service.

After all, Walter was originally lured into the world of methamphetamine due to the financial disaster surrounding his cancer diagnosis.

And though his ascendancy to the throne of a methamphetamine empire within the space of two years might have been exaggerated for entertainment, the inability to pay for one’s medical bills, or even insurance, is the reality for millions of people across the US.

Despite being the self-proclaimed leader of the free world, the United States is one of the only nations in the Western world void of a universal healthcare program.

Healthcare facilities are largely owned and operated by private sector businesses. Over 58% of community hospitals in the United States are non-profit, though still profit; a mere 21% are government-owned and a staggering 21% operate on a for-profit basis.

Unsurprisingly, there are real-life repercussions to the United States’ flawed system of healthcare – out of 35 industrialised OECD countries, America ranks 22nd for public health.

Since Breaking Bad aired, the situation only seems to be getting worse: in 2016 and 2017 life expectancy in the United States dropped for the first time since 1993.

A 2017 survey conducted of the healthcare systems of 11 OECDs also found the US healthcare system to be the most expensive and worst-performing in relation to health access, efficiency, and equity.

It is no wonder that Gilligan felt so compelled to centre his dramatic drug-infused crime-drama around an average American citizen who simply could not afford to pay for his cancer treatment.

The persistence of the healthcare problem since the show aired demonstrates Gilligan’s understanding of the scale and nature of the crisis, only making its social commentary more profound upon rewatch.

Most disturbingly, the 27 million uninsured Americans do not have the luxury Walter had – we are talking about a TV show here, a highly-dramatised piece of fiction. Walter, in his own fucked up way, ended up paying for his medical bills, and those of his DEA brother-in-law, Hank Schrader.

Outside of Walt’s world, millions of Americans work for the rest of their lives in order to pay for any sudden medical problems that come their way – given that these are often fatal, people can be left with little dignity as they succumb to illness.

This is not fiction, it is reality: America’s healthcare system costs lives every year. This was confirmed by a study carried out by Harvard Medical School in 2009 – it found that over 45,000 preventable deaths occur every year in the US and are directly associated with a lack of medical insurance.

In a scarily-ironic metaphor for the American healthcare system, Walter White’s method to pay for his medical bills led to the deaths of countless people across the series. In real-life, thousands of people die no matter what.

And so, while Walter White starts off as a victim of the healthcare system, he soon becomes a representation of it – a money-driven, ruthless cancer that leaves countless victims in its wake across the United States.