Friday, January 31, 2014

It's Oscar Time

There’s a popular commercial right now (for an insurance company) where a camel comes strolling into a workplace and says in a loud camel-y voice—DO YOU KNOW WHAT DAY IT IS?  The answer in the ad is “It’s Hump Day.” 

Well, reader, do you know what day it is?  It’s OSCAR MOVIE DAY.  Or month!  Yes, it is that time again. Our annual mad movie dash has begun.  The aim—see as many of the movies nominated for Best Picture Award at the annual Academy Awards.  And, of course, see them BEFORE the show airs on March 2.

In past years, when I have written about “Going to the Movies” I find myself making some obvious linkages between two movies.  But this year, as we went from movie to movie, I found myself scratching my head.  What was a common thread in these movies?  Seemingly nothing. Among the movies nominated as best motion picture, we have not yet see Her or Philomena.  We saw the seven other movies nominated, in this (very arbitrary) order: 12 Years A Slave, Gravity, Dallas Buyers Club, Captain Phillips, American Hustle, Nebraska, and The Wolf of Wall Street.

Today, we saw the last of the movies we are likely to see before the Academy Awards—and then it hit me.  The common theme!  This is the year of the scam.

In varying ways, there is in each of these movies a thread of deception.  Sometimes the deceiver poses as a friend (12 Years a Slave). Sometimes the deceiver is an apparition (Gravity) or a delusion (Nebraska). In Captain Phillips, the deceivers are the U.S. military who come to rescue Captain Phillips. In American Hustle, the whole plot is a deception, compounded by a deception, wrapped in a deception. . .you get the point. Dallas Buyers Club involves a kind of deception, albeit for a good cause.  Finally, The Wolf of Wall Street hinges on selling shady stocks through deceptive means.

Of course, each of these movies has much more to offer. 

For my money, the most stunning movie of the year is 12 Years A Slave. You may recall that last year, the MUST SEE movie for me was Lincoln.  And I fervently hoped it would win best motion picture, only to be disappointed by the selection of Argo.  While I liked Argo, it will not stand the test of time, as Lincoln will.  So with hesitancy, I say this year I would hope that 12 Years A Slave wins.

Watching this movie is a soul-searing experience.  There are only about 15 minutes of unalloyed story telling, which focuses on Solomon Northrup, a free born black man living in Saratoga Springs, New York in the 1850s.  He earns a living as a carpenter and as a fiddler. When his wife and children go away for several weeks—his wife is skilled cook who is sought for special occasions—Solomon is alone.

One day, he is introduced to two white men who have heard of his prowess as a fiddler. They cajole him to accompany them to Washington, DC, where he can earn some money as a fiddler.  What he neither knows nor suspects, they actually have other plans for him—to drug him and have him sent off in chains. They pass him off as a runaway slave named “Platt” which becomes his name.

So begins his 12 years as a slave. The account of Solomon’s life—being forced to strip, paraded like meat, bought by a slave owner, shipped off to a far worse slave owner, and finally regain his freedom—is so graphically portrayed that at times it was difficult to watch.

One of the most disturbing elements of the movie is the degree of depravity exhibited by the white slave owners. While one owner tries to be benevolent, other owners and their overseers, are horrific.  The wives of the slave owners occupy their own morally depraved universe, being alternately jealous of the black female slaves with whom the master sleeps and then being sugary kind to other slaves.  No scene is spared, including a vicious whipping.

That Solomon eventually is able to regain his freedom, while certainly just and right, hardly seems to compensate for the horror he endured as a slave.  Were the story but a creation of a creative writer it would be horrifying, but it is in fact based on an actual account by Solomon Northrup who recorded his memoirs after his experience.

The acting is superb—particularly Chiwetel Ejiofor and Lupita Nyong'o.  The scenery is lush and lovely, at times, providing a stark and ironic backdrop for the depravity of humans.  The dialogue is at times quaint and stilted, but that lends a sense of witnessing something from another time.

I came away from the movie marveling at the resilience of the human spirit, despairing at the depravity of the slave owners and all who were complicit in the institution of slavery. I was especially struck how much the whites involved in slavery had lost their moral compasses and had themselves become enslaved to the institution of slavery. They were far more lost that the black slaves who had been ripped from home and country.

So my first recommendation—go see 12 Years of Slave, if you haven’t already.

To be continued

Tuesday, January 21, 2014

Do You Believe in Martians?

This past Friday afternoon, as my husband and I returned from having gone to a movie matinee, as we approached the street where we turn into our neighborhood, we could see flashing lights further down the block. While we weren’t quite sure what the lights signified, we knew it meant there was some kind of emergency.  The flashing  lights appeared to be at a doctor’s office nearby our home.

We went on home, and then while I was walking our dog around the block, I came near the doctor’s office but decided against walking down to see the commotion. As I turned the corner, I heard a neighbor call out my name—so I walked back to her.  She then proceeded to fill me in on all the excitement—a driver just learning to drive had lost control of his car and hit the accelerator instead of the brakes. Somehow, while driving along a straight street he managed to turn his car almost a full right hand turn…right into the doctor’s office, taking out a large window.  The car then came to rest INSIDE the doctor’s office.*

When I got home and told my husband what the flashing lights had signified, he responded—well, there have been so many stories lately in the news of cars driving into house.  And that was true—within the past week there have been about a half dozen such stories in our general part of central Pennsylvania. My husband then continued to speculate—I think it’s aliens. We have been invaded by aliens from space who don’t know how to drive.

Of course, he was jesting (half) and recalling the scene from the movie “Starman” where Jeff Bridges plays an alien who lands on earth, and then proceeds to try to pass as a human, having taken such a form. One wonderful scene is when he is driving….well, it would be better to see it—rent the movie. Hence, the origin of my husband’s “aliens have invaded and don’t know how to drive” explanation.

Now, this hypothesis might sound preposterous, but hold that thought.
In a recent op-ed piece, Nicholas Kristhof, whose pieces appear in the New York Times, wrote that Americans are “much more likely to believe that there are signs that aliens have visited Earth (77 percent) than that humans are causing climate change (44 percent).”

Admittedly, the percentage of people who believe in something can’t make something true. . .or can it?

Remember Orson Welles’ 1938 radio broadcast The War of the Worlds?  No, I don’t  mean did you listen to it (although maybe one or two readers did).  But surely you have heard about it.  Welles was a wunderkind when he presented an episode of radio drama on October 30, 1938.  The program was staged as a realistic news casting of an invasion from outer space.  While there may not have been as much widespread panic as originally reported, those people who tuned in to the radio broadcast late missed the disclaimer.  So, there were some listeners who mistook the program as an actual news broadcast.  They believed we were being invaded by Martians.

Bah—you say—too far-fetched.  (I assume that puts you outside the 77 percent group).  And I think I too would say that—except. . .  Except for the recent story about the Mars Rover.    The Mars Rover Opportunity is out and about on the planet Mars looking for rocks.  Opportunity is equipped with cameras and sends images back to Earth (including a “selfie”).  Check out the link to see the “before” and “after” photos.  The images were taken 12 days apart, with the first one showing flat Martian ground.  The second one reveals a donut-shaped  rock, right smack in the middle of where there had NOT been such a rock 12 days before. 

Cue the Twilight Zone music—doo doo doo doo.

And then there’s the whole Roswell scene. 

So, who’s to say that all these cars crashing into houses are not evidence of aliens (who don’t know how to drive) having invaded Planet Earth?

Well, maybe, who knows—maybe we have been invaded or at least visited.

Do you believe in Martians?

*No one was in that part of the doctor’s office at the time and no one was injured.

Tuesday, January 14, 2014

The Madness

Every week, my husband and I usually go out for breakfast to a local diner.  We like one particular server, and she always has a space for us in the back of the restaurant.  This Saturday, the booth we sat in was right next to a booth where a young man sat with his girlfriend--all the while he was talking on the phone.

It was really very very annoying. I debated with myself whether it would be worthwhile to ask him, ever so politely, if he would mind talking a bit less loudly.  But I didn't.  And, frankly, one of the reasons I didn't is because it crossed my mind--just a glimmer of a thought--that he just might react violently to my request.  As with many states, the state I live in allows people, who have the correct permit, to carry concealed weapons.  So, yes, that thought too crossed my mind.  What if he has a firearm?

Far-fetched, you say?  An over-active imagination?  I wish that were true, but each day it becomes more and more clear that as a nation we have become gripped with THE MADNESS.  We have taken one of the articles in the Bill of Rights, appended to our Constitution, and have made of it a sacred never-to-be-moderated-in-any-way absolute.  

Just this week, a story flashed across various news sites about a 71 year old man who went to see a movie in Florida.  His experience is one that many of us have had.  You go to the movies, someone sitting near you (in this case, in front of) is talking or texting (in this case texting) on a cell phone.  And, yes, it can be annoying.  But his response was madness.  Reasonably enough, he first talked to the man in front, then he sought the aid from the management, but when he returned and exchanged angry words with the man, the 71 year old man pulled out a concealed weapon and SHOT THE MAN DEAD.  Madness.

This most recent event will not spur any action at all.  We have had so many recent events where someone with a firearm of some kind, whether a handgun or a hunting rifle or a high-powered assault rifle has gone on a shooting spree.  We have had victims numbering from one killed to scores killed.  We have had men, women, and children killed.  We have had drive-by shootings where someone completely uninvolved in whatever altercation is killed.  We have had instances where someone with clear psychiatric illness has gone to a town-meeting, one of the hallmarks of our democracy, with the intent to kill as many people as he could.  We have had occasions where young men with assault rifles have walked into schools, or even shot their way into schools, where they stalk the halls killing whomever they encounter.

After all of these horrific events, we have cried out in anguish and said--something must change.  And, every time the effort to somehow some way restore a small degree of sanity has failed.

As I try to make sense of the madness that has gripped our nation, words from the Bible come to my mind: those who live by the sword will die by the sword.  Of course, Jesus--who uttered these words--is not saying that everyone who uses a sword will be killed by a sword.  But he is saying that if you depend on violence to solve all things, then violence will rule your life.  That is what is happening to our country.  

I read a haunting story recently in the New York Times.  It answered a question that has long nagged at me: why didn't more people, who advocated for guns, support gun control.  The article told the story of  Dick Metcalf who wrote for the magazine  Guns & Ammo.  He wrote an article in October entitled "Let's Talk About Limits."  One of the points he made was that ALL constitutional rights are regulated, so why not gun ownership?

The backlash was almost instantaneous, and Dick Metcalf was fired.  The Times article continued with other examples of gun advocates who have been banished from writing because of their support for reasonable gun control measures.  

I must acknowledge that I am not a gun owner.  If I ever fired a gun in my life, I don't know when that would have been.  The only time I ever handled a gun was during my high school years when I briefly joined the NRA school club...because there was a boy in the club who I really really liked!  My husband held a part-time job once, as a guard, where he had to have a handgun as part of his uniform and equipment.  When he came home, that gun was placed in a small suitcase, locked, and then placed HIGH on a closet shelf in an unused bedroom.

I do not begrudge people who do have guns their right to have those weapons.  But, the absolute tyrannical way that the Second Amendment is being rendered is madness.  We have made it possible for people to "stand their ground" by stalking a young man, then gunning him down because the person with a gun felt "threatened."  We have made it possible for drivers to get into situations where anger rises, then a gun is produced, and shots are fired from moving vehicles with the shots striking innocent people standing nearby.  We have made it possible for a mother to put on a very public display of carrying her sidearm to her children's soccer games, to then argue vociferously of her "right" to have that gun--and then, to have that same mother be shot dead by her own husband while she talked in a video phone call--the person to whom she was talking having witnessed the whole event.  We have made it possible for far too many young people, almost always men, with festering mental illness to acquire a gun, walk into some public venue--a local shopping mall, a movie theater, a school--and carry out a massacre. 

The madness.

All this leads me to a conclusion--the very amendment which was crafted to help liberate us from a tyrannical power*--has now become tyrannical in itself.  The gun lobby has become a tyrannical power.  People are no longer safe, and the very thing that threatens our safety is the thing that was designed to secure our freedom from Britain, which had limited gun ownership to standing armies. 

Forgive my Cassandra-like mood.  But, I only see more death and destruction for far too many innocents in our country--as long as THE MADNESS grips us.  Those who live by the sword will die by the sword.

*A well regulated militia, being necessary to the security of a free state, the right of the people to keep and bear arms, shall not be infringed.

Saturday, January 04, 2014

The Mess We’re In (Part III)

I promised one more entry on the topic—and it’s taken me a long time to produce it.  Not because I don’t know what I am thinking but because it is so complicated and difficult to say what I want to say.

However, it is really simple. Here are two proofs of that statement.  First, Michael Moore—with whom I agree on many things even if his excessive and sometimes faulty leaps of logic drive me nut—has written an op-ed piece in the New York Times ( entitled “The Obamacare We Deserve.”

His conclusion—Obamacare is awful.  And, as usual, he’s right.  He also says “Obamacare is a godsend.”  And, again, he’s right.

I agree with Michael Moore because we both agree on what the real solution is to the mess we’re in—a single payer system with universal coverage.  Maybe now you get a flash of why I say this problem is so complicated.  Because it’s really simple.

Some years ago, when I worked for the state medical society (which is the corollary of what the American Medical Association is on the national level) I got in a discussion with one of the physician with whom I worked closely on a major committee.  I mention the connection to the AMA intentionally—when Medicare was being developed in the mid-1960s, one of the fiercest and most vociferous opponents was the AMA.  They fought tooth and nail to defeat “socialized medicine.”  They lost, but the mindset remained very strong among physicians to oppose any type of single payer universal coverage insurance.

In the discussion with the physician leader, I said I thought we should have a single payer health insurance system in the U.S.—to which he replied—Oh, noWe wouldn’t want to ration care in this country.  To which I replied—we already do.  We ration care by who can pay.

In my previous posts on “The Mess We’re In” I pointed out that one of the things that the ACA was trying to fix was the need for universal coverage.  With provisions such as “no one can be denied coverage because of pre-existing conditions” and “everyone must secure insurance coverage,” the ACA has attempted to address universal coverage.
Perhaps the biggest factor that didn’t get fixed is the COST of health insurance coverage.  This is the argument that Michael Moore is making.  And that’s where the single payer concept has the greatest potential for success.  Medicare—that once spurned and vilified program—is a shining example.  All you need to do is look at an EOB (Explanation of Benefits) to see how health costs are crazy. A doctor or hospital may charge $1,000 for a procedure; Medicare will only allow $250 for the procedure and then actually pay 80% of that allowable cost.  True, Medicare costs are high, but that is because the aging population is growing (I am included as a beneficiary) and the cost of medicine in the U.S. is out of control.  There are some very accessible ways to “fix” the Medicare funding issue.

The biggest opponents of a single payer are…(drum roll) the insurance industry.  They are followed by all the providers who will see their compensation levels capped.  And the biggest culprit of all is the pharmaceutical industry.  When I worked for a large health insurer in our state, I was interviewed by one of the senior vice presidents of the company.  When I left that company, he kindly gave me my entire personnel file.  In it were his notes from when he interviewed me.  I found in his writing a statement to the effect that I support a single payer system—which he had circled several times and noted—that might be a problem.  It always mystified me why the largest insurer in our country—which is colored blue—didn’t step up and say WE CAN BE YOUR SINGLE PAYER.  We already have the experience nationwide.

What happens when people try to contend with the financial aspects of our health system?  They face more hassles than many other industrialized countries, according to a study conducted by the Commonwealth Fund.  See the report here:

Among their findings:
  • ·         MORE than one third of all adults in the U.S. went without care in 2013;
  • ·         About 40 percent of people—insured as well as uninsured—spent MORE than $1,000 out of pocket for care—and that did not include premiums;
  • ·         About ¼ of adults had either serious problems paying or were unable to pay medical bills;
  • ·         About one third of adults spent lots of time dealing with insurance paperwork or on disputes with denied payment;
  • ·         U.S. insurers spent twice as much per person on administrative costs;
  • ·         And, finally, the U.S. spends $8,508 PER PERSON on health care—which is $3,000 more than the second highest spender country.  (See chart at bottom of page)

So, Obamacare was not ALL the fix it was intended to be.  No doubt, many of these financial problems will continue.  People will still continue to pay high premiums, depending on which plan they can select.  They will continue to have outrageous deductibles—if you pay the first $10,000 of your care because that is what your mandated deductible is, it is hard to think that the ACA, which is short for the Affordable Healthcare Act, is very affordable.  But, then, such high premiums and high deductibles were very much in play BEFORE Obamacare passed.

As the bill was working its way through the legislative process, proponents of health system reform abandoned many of their working premises.  What they got instead was largely an insurance system designed by business, providers and the health industry.  They gave up many essential aspects to keep some basic provisions—the individual mandate (that stands in for universal coverage) and a basic set of what insurers must do.  So people can’t be denied for pre-existing conditions, and certain things must be included in all policies.

And what did the people do who got most of what they wanted in the bill?  Since the ACA passed, we have seen nothing but obstructionism—e.g. all the governors who refused to set up the health exchanges in their states OR the scores of votes in the House of Representatives to repeal Obamacare.  Of course, there was the major obstruction effort in the challenge that went to the Supreme Court—which narrowly upheld the validity of the law.  

Now we are beginning a round of legal challenges on various provisions of the required set of what must be insured.  The argument that a religious organization—say the Catholic Church—should not have to pay for health insurance for employees for something they personally oppose might be appealing.  Why would nuns have to pay for birth control?  STOP RIGHT THERE—and think about this. 

Here’s two reasons why you should not get sucked into that argument.  First, the employees who work for them might not be Catholic and thereby have no personal opposition to using birth control. And, second, where do we stop with that argument? Jehovah’s Witnesses oppose blood transfusions.  Should we allow Jehovah’s Witness employers to not pay for such coverage for their employees? Or Scientologists oppose psychiatry—so are they exempt from paying for psychiatric care for their employees?  Or Christian Scientists oppose medical care altogether.  Can they be exempt from providing any health insurance for their employees?  Get my drift?  Either it’s a mandate OR it’s not.

It has been clear to me from the day the ACA passed is that the worst fear all those who have opposed any effort at health insurance reform is this:  IT JUST MIGHT WORK

Back to my physician friend—and the AMA that opposed Medicare.  Can you imagine what things would be like today if we did NOT have Medicare?  Maybe you can imagine it, but my guess is you don’t really want to go back.  And that precisely is the promise of Obamacare—it just might work.  It’s not what we needed—not yet.  But it’s a start.

That mess we’re in—as Pogo said—we have met the enemy, and he is us.

There are so many topics I haven't covered--e.g. cost shifting:  hospitals which provide care to the uninsured but cost-shift to cover the expenses, meaning we have ALL been paying for the uninsured;  the pharmaceutical industry which charges outrageously for drugs, and even changes the prices of long-standing meds--recently inhalers, which have been off-patent for  year, suddenly jumped in price...because the drug company making them just decided to boost the price...because it could.
On and on--but I really want to write about other topics from time to time.