Do you recall Costra-Gavras’ 1997 bomb “Mad City,” in which John Travolta played a sad-sack museum guard who accidentally took some children hostage while trying to get his job back, and was then turned into a celebrity-du-jour by an unprincipled newsman (Dustin Hoffman)? If not, you’re in good company; very few viewers took in the dismally “meaningful” downer. But you have what amounts to a second chance to see much the same story in Nick Cassavetes’ “John Q.” To be sure, the hostage-taker in this case is a dedicated dad (Denzel Washington) who, during economic hard times, finds himself without the insurance coverage needed to provide his son with a needed heart transplant and takes over a hospital emergency room to get the youngster on the donor list. He’s pitted against a heartless HMO, a bottom-line hospital administrator (Anne Heche), a rumpled hostage negotiator (Robert Duvall) and the publicity-hungry Chicago chief of police (Ray Liotta). He also has to deal with difficult captives like a sharp-tongued cardiologist (James Woods) and a sleazy fellow (Shawn Hatosy) who’s brought the girlfriend he abused in for treatment. Meanwhile John’s distraught wife (Kimberly Elise) hovers at her child’s bedside.

The essential problem with “John Q.” is that the tale of a heroic common man struggling against the soulless establishment comes off as nothing more than a meretricious melodrama that manages to reduce serious social and economic issues to the most cheaply sensationalistic level; it sets its sights on the easiest of targets, and then proceeds to bombard them with all the subtlety of an atomic blast. The combination of crudely didactic diatribes about the inequities of the medical industry with moments of utter mawkishness involving John’s family proves deadly, and the supposedly exciting business of the hero holding out against the cops in “Dog Day Afternoon” fashion is actually quite conventional and dull. To make matters even worse, the ending is telegraphed from the movie’s credit sequence, and although James Kearns’ script tries to add a new (and supposedly searing) twist about where a heart for the boy might come from, it will be all too clear to the least astute viewer that the device is nothing more than a clumsy red herring. The filmmakers don’t even have the courage to close the picture on a remotely realistic note, opting instead for a montage of feel-good moments that take their already poor product into the realm of absolute absurdity. Busy but empty, in the end the picture also feels like a total cheat.

The alternately insipid and overwrought nature of the material defeats a first-rate cast. After his turn as a meanie in “Training Day”–a showily lip-smacking performance which has garnered unaccountable praise–Washington is back in Sidney Poitier mode. His natural dignity stands him in good stead most of the time, but toward the close he has to deliver a long, tearful monologue to his unconscious son that’s embarrassingly trite, and even he can’t pull it off. Duvall does another of his patented crotchety, take-the-check-and-run supporting turns as the aging cop who learns to respect his quarry, while Liotta is smarminess personified as his inept boss. Woods employs his customary snideness without restraint as the supercilious, sniveling surgeon–it’s really a corrupt performance–and Hecht is all spit-and-polish superiority as the hospital director without a heart of gold. Curiously, Elise comes off much too harsh and unyielding in the role of the tormented mom–one can sympathize with her plight, but the character isn’t as likable as she needs to be. Hatosy, who’s done some refined and effective work in the past, is way over-the-top this time around, but big-guy Ethan Suplee, who’s been pretty energetic in previous pictures, is here so slow-moving as an overweight security guard that he’s virtually immobile much of the time. When a cast as strong as this one fails to bring things to life, a weak script is the primary culprit, but blame must also be aimed at the director–in this case, Cassevetes, who continues to show none of the imagination that his father John exhibited even in his weakest efforts.

“John Q.” deals with important social problems of underemployment and a decidedly imperfect medical-delivery system, but its approach is to treat them in the most simplistic, tear-jerking way. It resembles last year’s raucously specious “15 Minutes,” which presented the issue of the media’s glamorizing of violence and the weaknesses of the American judicial system in a similarly hysterical fashion. The present film isn’t as bad as that one–and maybe not even as bad as “Mad City,” come to think of it. But on its own it’s certainly not very good.

One final note: In the near-obligatory news montage towards the film’s close, in which various television figures who regularly whore themselves out to movies show up to give the appearance of verisimilitude to commentary on what we’ve just seen on screen (Larry King and Jay Leno are the most obvious among them), “John Q.” includes a clip from “Politically Incorrect” with Bill Maher. That would be bad enough, but the insert includes a brief shot of Maher’s guests, one of whom happens to be Ted Demme, the director who collapsed and died only a couple of weeks ago. It’s more than a bit tasteless not to have cut the clip from the finished prints, particularly when the poor fellow is identified in it as “Hip Movie Director.” The continued presence of this sliver of celluloid is, unfortunately, emblematic of the essentially shameless character of the entire movie.