Will Health-Care Reform Affect TV Medical Dramas?

There's a scene in the season premiere of Nurse Jackie that would make a fine addition to a stump speech. Alternately saintly and wicked nurse Jackie Peyton (Edie Falco) sees a patient come into her emergency room with a ghastly wound—a .357 Magnum shot most of her fingers off. The rub comes when Jackie looks at the woman's other hand and sees her furiously gesturing. As it turns out, the woman is deaf. Her husband is stuck on hold negotiating with an insurance company that refuses to pay for the surgery to fix her hand, in spite of his $425-a-month premium payments. Jackie takes the phone and spends the afternoon campaigning until, finally, the company approves the treatment. It's an of-the-moment scene, as so many scenes on television are these days, but given the passage of health-care reform, it feels both just in time and a few minutes late.

Granted, many of the benefits of Obama's landmark health-care legislation don't go into effect for months or years, but given the length and vitriol involved in the battle, for supporters of reform, victory feels like victory. To see a scene like the one on Nurse Jackie either serves as an example of the inhumane health-care system we've begun to improve, or a reminder that insurance companies haven't been rehabilitated, merely corralled. Either way, it's hard to imagine that scene playing the same way if it was part of a television episode five years from now. Insurance companies may still be the bogeyman, but thanks to the new law, they're going to seem far less bogey.

That's great news for uninsured Americans and elderly Medicare recipients struggling with a "doughnut hole," but for television writers, it could pose a challenge. That's because medical shows of late have shied away from the E.R.-style surgeon-is-God concept and moved toward a great focus on the particulars of patient care. In addition to Nurse Jackie, NBC's Mercy and TNT's Hawthorne are all about noble nurses who do their best to offer patients the best quality care in spite of interference from penny-pinching bureaucrats and sinister insurance companies. Even shows that aren't explicitly hospital related are dealing more with the difficulties of securing and paying for medical care. In Breaking Bad, high-school chemistry teacher Walter White (Bryan Cranston) resorts to manufacturing crystal meth in order to ensure that his pricey lung-cancer treatment doesn't bankrupt his family. When Showtime's The Big C debuts this summer, it's hard to imagine that Laura Linney's portrayal of a woman with cancer won't broach the subjects of insurance-company runaround and financial burden.

But perhaps now, those aspects of such shows will be more muted. Or maybe they'll give way to a new opportunity for health-care-based dramatic tension: the gap between the high hopes for near universal coverage and the realities of it.Nurse Jackiehas been renewed for a third season, so here's a fun drinking game you can play when it debuts: any time Jackie mentions a "high-risk pool," take a shot. But keep your phone nearby in case you need to call an ambulance.