I Survived TMI

Today is the 35th anniversary of an event that once was understood by simply saying three letters:  T - M - I.  If you said those letters, anyone living in Pennsylvania, certainly the East Coast of the U.S. and maybe the entire U.S. knew what you meant--THREE MILE ISLAND.  In fact, when we traveled overseas in the 1980s, if people asked where we were from , we could answer "near TMI" and the listener knew where you came from.

Now, with 35 years between that event and now, people may not remember so clearly.  They will have their own current sense of the potential dangers of living near a nuclear power plant--say Fukushima and everyone knows where that is and what happened.

But for me, TMI was a defining moment--herewith, my thoughts on the 30th anniversary.
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Memory is a blessing and a curse.

Thirty years ago on this day a series of occurrences began a chain reaction that almost resulted in a nuclear plant melting down. At the time, the location was unknown to much of the country. In central Pennsylvania, we all knew the familiar sight of the cooling towers--the most recognizable feature of a nuclear power plant. In fact, the power plant at TMI is located very near the runways of the Harrisburg International Airport (no, I am not making up the "international" part). When I flew home last week, our plane came in right over the cooling towers. The sight whisked me back some 30 years, as I recalled the several days of absolute panic wondering what would happen next. I survived TMI.

contemporaneous photo of TMI in 1979

from http://ydr.inyork.com/ydr/remember/ci_8744078

March 28, 1979 was a Wednesday. The specific details of what happened at TMI to set the accident in motion are well-known*. Early in the morning, a valve failed and all the water that cooled the fuel rods drained, leaving them exposed. The emergency back-up cooling system kicked in, but technicians--not understanding what they were seeing on the gages--turned it off. Even though the reactor itself shut down, heat kept building up which resulted in one half the core melting down.

News of what was happening at TMI did not immediately get picked up. If I recall correctly, the first person to break the story was a radio show host. There was no intent to keep things quiet; it was simply a matter of near mass confusion, and many aspects of the situation being unknown. Was the core intact? Had the core melted down at all? If so, how much? Would there be a release of radiation, or not? The local press did not begin covering the news until well into the first day.

By the second day, the news of "an event" at TMI really began to hit the news. At the time, I was working for the Pennsylvania Medical Society. One of my responsibilities was to staff committees--and on Thursday the Commission on Therapeutics had a meeting. The chairman was a physician named Arthur Hayes who was a physician pharmacologist working at the Hershey Medical Center. The meeting was set to begin at 10 a.m. Just as we went into the meeting, word came that the nuclear incident at Three Mile Island was very serious. Since Hershey Medical Center was about 5 miles from the nuclear power plant, Dr. Hayes decided to cancel the meeting and head back to the medical center. It would be a receiving facility if there were any nuclear contamination of people.

When the doctor who chaired the committee decided to cancel the meeting, I knew something BIG was happening. Understandably, news sources did not know the scope of what was going on. I decided to head for home, since my work place was on the west side of the Susquehanna River, and our home was on the east side. If road traffic was going to be restricted, I wanted to be on the same side of the river as our son, who was then 7 years old. I drove from my work place to the elementary school where he was, and gathered him up and went home.

Meltdown is NOT something you want a nuclear power plant to do. A popular movie at the time was The China Syndrome which featured a nuclear power plant accident and an attempted cover-up of the information. Needless to say, for all of us within a ten mile radius of TMI our adrenaline pumps kicked into overdrive.

When day 3--Friday--began, the news at TMI had gotten worse. While the plant had not melted down, a hydrogen bubble had been discovered. The fear was that this bubble could cause the plant to explode which would spew radioactive material over a wide area. While the experts did their best to first understand the situation, and then give advice based on their understanding, the public was genuinely confused. Should we stay or go?

As it happened, my husband was set to go out of town for a training workshop. He left on Friday to go to West Virginia. A family friend of ours had a vacation home in the Poconos that his family was evacuating to, and he offered the place for me and my son to stay. With my husband away, the decision to leave the area was largely up to me. So, I gathered up our son, our dog and cat, a bit of clothing--and drove to the Poconos. As we left our house, our son said plaintively--what about the goldfish? I recall my reaction--the goldfish will have to fend for itself for however long.

By the end of the weekend, the situation was better understood, and it was clear the nuclear event was not going to become any worse. I returned home. No meltdown. No core breach. No hydrogen bubble explosion. No mass radioactive release. But great damage had been done and the plant at TMI remained out of commission until 1985.
So, I survived TMI. Now 30 years later, it is hard to reconstruct the exact sequence of events. My husband was away, so his memories differ from mine. The friend who offered his house has been dead for more than 10 years. My son was far too young to remember. I have my own memories, but I am not tempted to rely on them for unadulterated recollection.

Memory is a blessing and a curse.

Photo from http://www.atomicarchive.com/History/coldwar/p19_image.shtml

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*To learn more about TMI, you can go to these two websites: http://www.threemileisland.org/virtual_museum/march28_1979.html or http://www.nrc.gov/reading-rm/doc-collections/fact-sheets/3mile-isle.html

Indian Winter

I have been been very neglectful of this blog.  A whole month plus a day since I last posted.  Well, I do have a bona fide excuse.  We have had a break from winter--a kind of Indian winter.  

You know how we call that last lovely bit of summer, after a frost and the hint of autumn around the corner, "Indian summer"?  We have had such a miserable winter, here on the East Coast of the U.S., that we decided we needed a sunshine filled break.  As it happens, our son and daughter-in-law live in San Diego.  PERFECT!  Just the place to go to catch a break from winter blahs and yet one more snow storm.

Part of our time in southern California was spent going to Indian Wells (see--I had another reason for the title of this blog).  There is a major tennis tournament played there early each year.  It is a place where big name players can be seen, especially in the early rounds of play.  

We saw Roger Federer...

...and Maria Sharapova.

The desert air is clear with very little humidity.  The sun was shining brightly--a perfect antidote to our frozen eastern bodies.

There is always the Pacific Ocean--with waves crashing and pounding.  Just the sound of the ocean is enough to restore us.

Of course, the real treat (for me at least) is watching yet another lovely sunset over the Pacific.

We flew back to central Pennsylvania, completely rejuvenated...and ready for the next snow storm.  (Not really, but we have to be prepared.)  

It's Oscar Time Part 4

The final two movies I will review are Nebraska and Dallas Buyers Club.  These two movies, with very different stories and themes, share an examination of human relationships and how we interact with and care for each other.

Nebraska features Bruce Dern in a sterling performance as a curmudgeonly old man who receives one of those “you have won a million dollars” come-ons that we are all familiar with.  He either did not read the fine print, or did not comprehend it, because he is determined to go to Nebraska and collect his million dollars. When no one will take him, he sets out to walk there—from Montana where he lives.

Bruce Dern is Woody Grant—such a wonderfully evocative mid-West name. He and his wife, Kate—played with a big dose of spit and vinegar by June Squibb—have two sons, David (Will Forte) and Ross (Bob Odenkirk).  Their lives are really very small.  The more successful son Ross is a television newsman who occasionally gets to substitute as anchor.  David is a small-time salesman selling electronic products, or at least trying to.  It is David who tries to rescue his father, going out to get him as he walks along the road—to Nebraska. 

Eventually, frustrated and unable to dissuade his father, he gives in and agrees to drive his father to Nebraska.  Kate, Woody’s wife, is outraged and annoyed—her solution: put Woody in a nursing home.  He is obviously too confused and too drunk to function independently.

Along the way, David persuades his father to visit Hawthorne, the town where his father grew up and where many of his relatives still live.  There are marvelous scenes between Woody and his brothers—they all sit in a crowded living room, watching television, making an occasional laconic remark.  The sons of his brother—David’s cousins—delight in teasing David at how long it took him to drive from Billings to Hawthorne (Hawthorne, by the way, is not a real place name).  They return several times to remark about how slowly David must drive.

As Woody and David go from place to place in the town, small pieces of Woody’s life are revealed.  When Kate travels by bus to meet them, and then joins them going around the town, her salty observations add a delightful risqué commentary on small town life.  The scene in the cemetery is a classic as she goes from one headstone to another providing a bon mot observation on each of the departed.

It might be tempting to think that the director Alexander Payne is mocking small town life and small town lives.  But the touches in the movie are truly gentle, loving and humorous.  It is not difficult to see that these people’s lives, small though they may be, matter.

When Woody is pressed as to why he wants to win a million dollars, his simple answer is so he can buy a new pick-up truck.  While his motivation is heartfelt and straightforward, all the town’s people with their avaricious reactions to his supposed sudden wealth provide an interesting observation on how people see another person’s good fortune.

There are several twists and turns in the plot, and the ending brings a definite sweetness to the dénouement of the plot.

Dallas Buyer Club, based on a true story, is also a movie about human relationships, but with a very different starting point.  The story revolves around Ron Woodroof, played by Matthew McConaughey, who is living a licentious and free-wheeling life. He is a rodeo cowboy, who earns a living as an electrician.  To play the part, McConaughey lost so much weight (47 pounds) that he looks skeletal.  We are introduced to Ron as a hard driving, alcoholic, drug-abusing, sexually active rodeo cowboy—and all of that in practically one scene.  He is living a life of abandon.

Early in the movie, when Ron Woodroof is feeling ill, he goes to a doctor and learns he has AIDS and only a short time to live.  His immediate reaction is an outburst of disbelief and homophobic invectives—he cannot and does not see himself as the kind of person who would get AIDS.

So begins his journey—which is the subject of the movie.  He learns from his doctor that there is a drug—AZT—which is in clinical trials.  Ron wants it, but the doctor won’t guarantee that he would get the drug if he enrolled in a double-blind clinical trial.  So, he persuades a hospital worker to supply him with AZT, much as a junkie would get illegal drugs.  However, he does not get better.  He spends some time in the hospital because he is so desperately ill—there he meets Rayon (Jared Leto), a trans-gendered woman.

In a desperate bid to get better, Ron travels to Mexico to visit an American doctor who has lost his license because he does not practice traditionally accepted medicine.  He tells Ron that AZT is like a poison—killing not only the AIDS infected cells but also healthy cells.  Instead he prescribes for Ron various drugs that are not FDA approved in the U.S.  He also convinces Ron to clean up his health habits, and stop using illegal drugs. Amazingly, Ron—who had only 30 days to live when he was first diagnosed—begins to get healthy.  He knows it is the combination of drugs he gets in Mexico and the vitamin supplements he is taking that is restoring his health. 

He decides to share his good regimen with other HIV patients, but has trouble finding people who will take him up on the offer.  During this time, he re-encounters Rayon and she can help bring him customers.  Since the drugs are not FDA approved, and not wishing to run afoul of the law, Ron sets up the Dallas Buyers Club.  Members pay a monthly fee to belong to the club, and in return they receive packages of drugs for their use.  Predictably perhaps, the Buyers Club is a huge success—and also predictably, Ron runs afoul of the FDA.

Some of the energy in the movie derives from these interactions between the medical establishment and the FDA and patients like Ron who believe not enough is being done, and sometimes what is being done is the wrong thing.  It is difficult to remember what things were like in the earlier days of treating AIDS, but in this regard the movie rings very true.

Out of the Dallas Buyers Club grows an at first awkward and then supportive partnership between Ron and Rayon.  There are some very touching scenes with Rayon and her father that help underscore how too many people struggling with gender identity do not get the support they crave from parents.

Ron grows as an individual and eventually becomes a champion of the gay patients he has in his Buyers Club.  And, perhaps in the final irony, given his original 30 day predicted life span after initial diagnosis, Ron lived another 7 years.

I liked these two movies immensely.  After the seemingly empty stories of The Wolf of Wall Street and American Hustle, it was rewarding to watch movies where people with all their problems cared about each other and grow in their humanity.

I have no predictions as to which of these movies will win Best Motion Picture award.  I would happily vote got 12 Years a Slave, or Dallas Buyer Club.  But, I have learned time and again that the best picture doesn’t always win.

It's Oscar Time Part 3

The next two movies feature the scam at its zenith.  Having declared this year’s nominees for Best Motion Pictures as being “The year of the scam” American Hustle and The Wolf of Wall Street show the fine art of scamming in two outrageous examples.

Each of these stories is drawn from “real life.”  American Hustle presents a reworking of the Abscam scandal of the late 1970s and early 1980s.  While I recalled having read about the Abscam scandal when it happened, I was a bit fuzzy on details.  So I refreshed my recollection by doing some background reading.  Had I not done that, the plot of American Hustle would have been laughably preposterous and I might have dismissed it as Hollywood hyperbole.  The real Abscam was an FBI conceived sting operation designed to ensnare American politicians taking bribes. 

The movie plot first introduces us to a small time hustler named Irving Rosenfeld, played brilliantly by Christian Bale. I promise you that you have never before seen Christian Bale appearing the way he does in the movie.  Ordinarily, the roles he plays are sleek, masculine, perhaps menacing, high-powered.  In American Hustle, he is a two-bit con man who hatches various schemes to get rich.  He is married to Rosalyn (Jennifer Lawrence) and has a stepson whom he adores.

He meets his alter ego female in Sydney Prosser, played by Amy Adams, who masquerades as an English aristocrat calling herself Lady Edith Greensley.  Lady Edith is not above running her own cons.  Irving and Sydney are well-matched and begin their own company to run scams on a larger scale.  Into this mix  enters FBI agent Richie DiMaso (Bradley Cooper).  He is hungry for recognition and advancement within the FBI.  When he catches Irving and Sydney in one of their scams, he believes he has found a way to make the kind of impact he wishes. He offers them an exchange of sorts—if they can help him make four other arrests, he will let them off on the charges he could bring against them.

The hustle is on.  American Hustle.  The Abscam part?  The politicians getting mixed up?  Well, you will just have to see the movie.  It’s a deception, compounded by a deception, wrapped in a deception.  Along the way, you will see some delicious scenes between Jennifer Lawrence and Amy Adams, like two cats fighting over a mouse.  Or Robert deNiro in a bit appearance as a mob boss. 

The Wolf of Wall Street is a three hour tour de force movie directed by Martin Scorsese.  As a director, Scorsese has directed a number of movies which lay bare an aspect of humanity that is  not always pretty.  Among these movies are Raging Bull, Goodfellas, Gangs of New York, and The Departed.  The most recent movie that Scorsese directed was Hugo—made at the request of his wife who wanted him to direct something that their grandchildren could see.

And now he directed The Wolf of Wall Street.  The pace of the movie is an odd mix—it is a frenetic movie from start to finish, and yet it seems as though the complications will never end.

Like American Hustle, The Wolf of Wall Street is based on the true story Jordan Belfort (Leonardo DiCaprio) who begins his working life as a money hungry success driven stock broker.  In an opening scene his boss (Matthew McConaughey) gives him a primer on how to succeed as a stock broker—indulge in copious consumption of alcohol and cocaine and sex.  Just as his stock broker life begins, the bottom drops out of the stock market on Black Friday.  Unemployed and unable to find a job as a stock broker, Jordan takes his wife’s advice and gets a job selling penny stock.  His high powered sales pitch combined with his drive to succeed make him successful in this marginal world of stock trading.  He attracts the attention of Donnie Azoff (Jonah Hill) and together they come up with a plan to make their small operation a big player.

As his success grows Jordan’s life style becomes more and more flamboyant. He dumps his first wife, marries a gorgeous woman who appears to be the fulfillment of his fantasies.  His wealth is displayed in his splashy wedding to the trophy wife, in the newly acquired country estate house, and in a sea-going yacht with every possible amenity.

There is a sense in which The Wolf of Wall Street is a morality tale.  There is the FBI agent who sets his sights on Jordan and determines to bring him down.  There is the predictable crumbling of his marriage.  There is the ever-increasing over-use and dangerous abuse of illegal drugs, which still involves cocaine, but has now expanded to include Quaaludes.  His life is so out of control.

Enough plot summarizing—I’ll let you continue Jordan’s story.  I must point out that Leonardo DiCaprio's performance is stunning--he is in virtually every scene, dominating them. He is a charmer, a scoundrel, a drug addict, a narcissistic larger than life hero/anti-hero all in one.

After seeing each of these movies, I pondered what the message is. American Hustle seems to mete out a kind of justice—and does so with a touch of humor which helps keep the tone of the movie a bit lighter and more bearable.  The Wolf of Wall Street certainly demonstrates that crime doesn’t pay—but the wreckage is disproportionate.  Just as Bernie Madoff is now in jail for his financial shenanigans, yet thousands of people’s lives were disrupted and diminished by his actions—and they can never regain what they lost despite Madoff’s going to jail—so too does The Wolf of Wall Street seem unbalanced.  Whatever punishment Jordan suffered does not seem to be fit for the wrongs he committed against so many people.  And, I have a very strong sense that he is unrepentant.

The scam most certainly was in its zenith in these two movies.  Let me know what you think.

It's Oscar Time Part 2

Having determined that the common theme was “the year of the scam” I confess that that’s about it for exploring connections or linkages in  these movies.

So, I’ll just take them in twos—and share my observations.

Gravity and Captain Phillips

Gravity is the whiz-bang special effects movie nominee.  We saw the movie in 3-D, definitely the way to see it.  Of course, we were impressed with the technical know-how and the verisimilitude of the space voyage.

Gravity presents a space shuttle mission with Dr. Ryan Stone (played by Sandra Bullock) who is on her first space shuttle mission AND she is performing a spacewalk to fix the Hubble Telescope.

Now, right there, I should have been suspicious.  A rookie astronaut. OK.  A medical doctor.  OK.  Performing a spacewalk on her first space shuttle mission.  Wait just a minute.

She is accompanied by a veteran astronaut, good-old-boy Matt Kowalski (played by George Clooney).  This is his last mission, and his primary goal is to break the record for space walks.  He is buzzing around in rocket propelled free form, untethered from the space shuttle.  Ryan is, of course, tethered.

When they get a message from Mission Control that a defunct satellite is disintegrating, and the debris is out of control and likely to hit the space shuttle, the astronauts try to complete their repairs.  Not soon enough—of course.  The marvelous effects of the movie very convincingly show the space debris pelting the space shuttle, which is destroyed. 

And so the adventure of the whole movie begins.  Kowalski persuades Ryan to unhitch her tether, and when she tumbles and somersaults through space, you tumble with her.

I will let the remainder of the adventure for you to see.  There is little character development in this movie, and the plot is the real engine of the story.  What will happen next? As viewer, you watch anxiously with each unfolding challenge.  My feet were sweating through major parts of this movie.  (I would consider myself “gravity” challenged.  As my family knows, I am not fond of heights—e.g. Ferris wheels high off the ground.) You know little about the characters, and learn almost nothing about them.  As a result, your only identification with them is our common shared human condition.

While Bullock’s acting is first-rate and very convincing, I have two complaints about the movie. First, why the ambiguous ending.  I don’t want to give it away—but, really, is she saved? Or not?  Second, just this—Gravity has no gravitas.

Captain Phillips is another voyage movie.  Unlike Gravity, the events depicted in Captain Phillips “really happened.”  The story is well-known.  Tom Hanks plays Captain Phillips, who is the captain of a container ship Maersk Alabama, which is transporting cargo in the Indian Ocean off the coast of Somalia.

After a brief introduction to Captain Phillips in a family setting, and a drive to the airport with his wife, the remainder of the movie is set at sea.  We see him as captain, sense his wariness in the waters he is sailing.  His insistence on safety drills seems intelligent, and obviously foreshadowing of the challenges to come.

We also see the Somali pirates and their desperate circumstances as they squabble among themselves.  We learn that they are controlled by an almost anonymous leader of the mother ship.  As the pirate boat chases the container ship, you experience real excitement in the chase. 

When the pirates successfully commandeer the ship, we meet the lead pirate Muse, played by the remarkable newcomer actor Barkhad Abdi.  Thus begins the duel between Muse and Phillips for control of the ship.  When the pirates succeed, and the pirates flee with Phillips as hostage aboard the small lifeboat, the tension mounts.

As I said, we know the story.  We know that the U.S. mounts a rescue effort with the Navy Seal Team Six.  The account was well-covered in national news at the time.

What works so well in the movie is that even knowing the story, we still feel the tension.  We know how things will turn out, and yet we still grip our seats.

The surprise for me in watching this movie is that I experienced some sympathy for the pirates.  Not for their methods, of course, or their means of redressing the inequality of their lives, but for their desperate circumstances that would drive them to such a high stakes dangerous way of securing any kind of living.

So, whichever of these two movies you see—bon voyage.

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.

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To be continued

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.

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.
Loudly.
LOUDLY.

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.


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*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.

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 (http://www.nytimes.com/2014/01/01/opinion/moore-the-obamacare-we-deserve.html?_r=0) 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, no.  We 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: http://www.commonwealthfund.org/Publications/In-the-Literature/2013/Nov/Access-Affordability-and-Insurance.aspx

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.

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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.

The Mess We're In (Part II)

We hear stories these days, both on national and on local news, how some poor soul lost her health insurance “because of Obamacare.” These stories infuriate me because it makes it sound as though solid full coverage health insurance policies are being cancelled…just because President Obama pushed through a law designed to expand health insurance coverage.

The problem with these stories is at least two-fold. First, since we don’t know who these people are, we have no idea why they lost their health insurance or what kind they had before they lost it. Second, as anecdotes, the stories are engaging, but anecdotes make lousy policy. What makes good policy is understanding what the ACA is intended to do.

President Obama made a statement, that has been characterized as a promise, that "if you like your health insurance plan, you can keep it.”

What President Obama should have said is that with the ACA, if your health insurance is cancelled, that is you lose it, you can get a new policy. He most certainly misspoke. Sadly, his statement obscured something too many people do not know—before the ACA was passed, you could have your health insurance policy cancelled for many reasons. And before the ACA you might not be able to get new coverage.

Ezra Klein, in a recent blog ran some of the reasons why people can lose their health insurance.

If you're one of the 149 million people who get health insurance through your employer, you can lose your plan if you get fired, or if the H.R. department decides to change plans, or if you have to move to a branch in another state.

If you're one of the 51 million people who get Medicaid, you could lose your plan because your income rises and you're no longer eligible or because your state cut its Medicaid budget and made you ineligible. You could lose it because you moved . . .
If you're one of the 15 million Americans who buys insurance on the individual market, you could lose your plan because your insurer decides to stop offering it or decides to jack up the price by 35 percent. And that's assuming you're one of the lucky people who weren't denied coverage based on preexisting conditions in the first place.

So the outrage that some of the pundits on television are voicing is at best disingenuous, and at worst thoroughly misleading. President Obama, and the ACA, are NOT the true reasons people’s health insurance policies are being cancelled. The real reason is the standard practices of health insurance companies, and the hodge-podge system we have for health insurance.

What the ACA does—or perhaps it is better to say attempts to do—is provide a baseline of what an adequate health insurance plan would look like.

In the past, people in the individual insurance market, and perhaps even employers, shopped for health insurance trying to cut deals which would lower the premium costs. So some plans have been written with incredibly high deductibles—the amount a person has to pay before health insurance kicks in. Or some plans only cover certain services and exclude others. For example, excluding maternity services. Or excluding hospitalization all together.

The essential services required under the ACA are listed here. So, any plan that does not include these services would have to be rewritten to include them. That is a reason why someone’s health insurance might be cancelled now. Sub-standard and inadequate health insurance policies now have to meet a baseline of coverage, and if they don't, those policies have to be re-written to include the essential services.

What has really occurred over the last 30 or so years is an increasing fracturing of how health insurance policies are crafted. When health insurance began, the concept was simple. But with more and more add-ons, with increased specialization, with advances in medical technology, with new drugs being introduced, health insurance companies responded by offering to CONTRACT plans, rather than expand them.

Perhaps the most heinous practice that limited who got health insurance was the denial for pre-existing conditions. The result was a cruel Catch-22—just when you need insurance, you can’t get it because you need it.

As health policies undergo an annual review, and an employer is told what the premiums will be to continue to cover the employees, there have been many instances where employers have asked to help bring down costs. Reducing the number of services covered was one way to do that. Some areas of care have really been “nickel and dimed”, for example mental health services, or the rules governing how services can be accessed have been tightened. Many of us have experienced a health insurance plan that includes pre-certification.

Shana Alex Lavarreda, Ph.D., director of health insurance studies for the UCLA Center for Health Policy Research, said it best when she pointed out that before the ACA was enacted, there was "a race to the bottom, with insurers cutting benefits to lower premiums. The essential health benefits set a standard for insurance. Anything below that is not true health insurance."

To lower premium costs, what health insurers were really doing—and what employers were accepting—is offering less for the same premium price. As more and more health costs were uncovered by health insurance, the individual was left having to pay but with no way to be able to pay. And people who had onerous health bills began to go bankrupt.

That is why the way the news coverage about the ACA drives me nuts. We have seemingly forgotten the people who have been bankrupted by out of control health costs. We have forgotten people who were denied coverage because they had pre-existing conditions. We have forgotten that, despite lofty statements that we don’t want a health care system that rations health care (which is how some people view a national health insurance system), we DO ration health care—if you don’t have health insurance you cannot and do not get adequate consistent life-saving health care.

(One more entry on this topic—I will share the findings of a report about how Americans interact with our health insurance system)