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Martin heaved a pained sigh. "That’s a tragic tale, Maplecroft, but who’s going to write a check for 24-hour supervised medical care? That’s three doctors on call, at least five nursing staff, the facilities, the infrastructure, the insurance billing, the secretaries, the janitors, the cafeteria staff, the bleach, the Mop & Glo, multiplied by how many seriously mentally ill people there are in America.”
Businessman Martin Queller faces Laura Juneau, disguised as Dr. Alexander Maplecroft, in a debate held at an economics conference in Oslo, Sweden. In the course of their debate, Laura accuses Martin of neglecting patients who suffer from mental illness at the Queller Healthcare Facilities, which he runs as CEO of private healthcare company QuellCorp. In particular, she cites the example of Robert Juneau, who murdered his children, shot his wife, and killed himself after being denied care at a Queller facility. In fact, Laura is the widowed former wife of Robert, though she does not disclose this fact in order to maintain her assumed persona. Martin, however, grows impatient with Laura’s complaints, which he regards as naïve and idealistic. Acknowledging that Robert Juneau’s story is “a tragic tale,” he nevertheless insists that it is not economically feasible to offer the kind of round-the-clock healthcare that Laura advocates for. He lists the various expenses involved in healthcare, arguing that these expenses would cut away at profits. Here, his argument reflects his priorities. Martin is far more interested in profit than he is in delivering adequate healthcare to those in need. Through the character of Martin, the novel argues that the American private healthcare system sacrifices patients to maximize profit margins.
Robert was on a yearlong waiting list at the VA. There was no state mental hospital to go to because there was no state funding. The regular hospital had barred him. He’d already attacked a nurse and hurt an orderly. They knew he was violent, but they moved him to a group home because there was nowhere else to warehouse him.
During his debate with Laura Juneau at an economics conference, Martin Queller argues that his private healthcare company, QuellCorp, should not be held morally responsible for turning down patients, as there are other public resources that they might turn to instead. Laura, however, is ready for this argument. She counters that the VA, or the Department of Veteran Affairs, which helps to arrange healthcare options and provide resources to American military veterans, was so over-crowded that it had a “yearlong waitlist.” As a veteran, Robert should have been eligible for help, but Laura suggests that these state resources are unable to accommodate demand. Further, she notes that there was no “state mental hospital” where Robert might receive treatment due to a lack of funding. This lack of resources is in fact tied to QuellCorp, as Martin has successfully lobbied to divert state funding to private Queller Facilities, owned by him. Laura, then, argues that the privatization of mental healthcare resources has led to serious social problems—in this case, to Robert killing his children and then himself himself after being denied necessary mental healthcare.
Was their blind devotion another form of sickness? All of them but Jane had been in one psychiatric facility or another. Nick had purloined their files at Queller […] He knew about their hopes and fears and breakdowns and suicide attempts and eating disorders and criminal histories and, most importantly, Nick knew how to exploit this information for effect.
When Jane meets with the other members of the Army of the Changing World after speaking with Agent Danberry, his words begin to haunt her. Agent Danberry had discussed various real historical organizations that are generally considered to be “cults” such as the Jonestown Compound and the Symbionese Liberation Army, subtly implying that Jane is involved in a similar cult-like organization. When she sees the group follow its leader, Nick, with “blind devotion,” she begins to feel that the group members suffer from a “form of sickness,” or in other words, mental illness. The group members, she notes, have all been institutionalized for psychiatric care in the past, for disorders ranging from depression to psychosis. She later reveals that this is no coincidence, as Nick has deliberately selected vulnerable patients from Queller facilities. Because he knows the intimate details of their psychiatric histories, Nick is able to “exploit” their fears, weaknesses, and vulnerabilities to ensure their loyalty to the group and to him. Though Nick opposes Martin Queller and claims to be fighting on behalf of those suffering from mental illness, he nevertheless exploits psychiatric patients, recruiting them to pursue his violent goals.
