The Home of Steven Barnes
Author, Teacher, Screenwriter


Wednesday, December 16, 2009

"Up In The Air" (2009)

I fail to see how anyone who isn't an insurance company stockholder, or a rabid political partisan, could object to me buying into Medicare at 110% of the actual cost of delivering services. What exact harm am I doing to you? The only broad negative effect I see from the entire possibility of Universal Health Care is that, if it was tax funded, wealthy people might end up paying for services they don't use (they might well remain with private providers). I sympathize, but sympathize more with the dozen or so people I know, RIGHT NOW, who are suffering from lack of health care, or frightened to leave a bad job because they can't get reinsured. I remember a dear friend who was seriously considering suicide because her pain management was simply out of control, and she was too ill to navigate the bureaucracy. My own mother postponed medical tests, afraid that she wouldn't be able to pay for them. And died of a (potentially) curable cancer. This is nuts. Isolating some one small group and comparing their life spans merely invites the other side to isolate some other small group and trump them. At which point each side will go off and study the reasons, until another generation is gone, and tens of thousands more people are dead who could have lived. Are bankrupted, who might have kept their homes. And America slides into being a Third-world country while the rest of the world provides education and medical care, creating a safety net from which the talented can truly rise and contribute.

Why are you trying to control my behavior? Why don't you want me to have the option to buy a non-profit plan, since you're so convinced that profit-driven plans are superior? Do you think people are too stupid to see that the government plan isn't working? It feels that those who believe that Capitalism is the best system for all (or at least this) aspect of life don't really have confidence in their position. I think that private health insurance will continue to exist, they simply won't have a monopoly on medical care. And why anyone except stock-holders would cheer for that monopoly makes little or no sense to me.

Please...would someone please tell me why it is so important to some of you to stop me from buying into Medicare at cost plus 10%?

The current health care bill sounds horrendous. Christ--the role model for success and efficiency is all around us.

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"Up In The Air" (2009) Hey, I love award season. Almost every day a new Oscar-bait film appears in my mail box. Monday George Cloony's latest starring role, under the direction of Jason Reitman, the guy that did "Juno". Cloony plays Ryan Bingham, a professional corporate down-sizer. This guy literally flies around the country firing people for bosses who lack testicular fortitude. He has no life, other than airports and hotel rooms. The story revolves around his relations with two women: a youngster named Natalie Keener who wants to computerize/teleconference the process (Anna Kendrick) and Alex Goran (Vera Farmiga) who seems to be exactly the same creature as Ryan...only "with a vagina." And the story winds through their various interactions, romantic, mentorship, business, whatever. Brilliantly written, it has a lovely sense of rhythm, and knows when to go for the gut-punch. It feels like "Jerry McGuire" but turns into something considerably different. Not better, not worse, but different. And I loved it. An "A." It really is one of the very best studio films I've seen this year. Maybe the best. Cloony is one of the very few actors who could have pulled off this role, revealing callousness, intellect, emotional pain, and ultimately a devastating self-awareness, in layers. This is fine film-making.

##

"Tournament" (2009) is a British action film about a clutch of assassins killing each other for a ten million dollar prize. Look: it is what it is. What is different is that there is a bit, just a bit of genuine heart: Robert Carlyle as an alcoholic priest accidentally caught up in the competition, and Kelly Hu as the killer with a heart who protects him. Ving Rhames plays a former champion who returns for personal reasons, and most impressively, Sebastian Foucan (the freerunning bomb-maker from CASINO ROYALE) as, well, Spider Man. There is an extended sequence of Foucan chasing a car down an alley that just has to be seen to be believed, Jackie Chan-level movement that had me scraping my jaw off the floor. There is other fine stuntwork as well. This is a good deal better than most DTV, and for action fans, check it out. A solid "B."

20 comments:

Reluctant Lawyer said...

I've yet to actually hear anyone come up with a convincing reason for not allowing a medicare buy-in at cost plus 10%. One of the guys that I work with simply will not leave his job because he would not be able to get sufficient insurance coverage for his family. So he stays in a job he doesn't like for crappy benefits because they benefits are better than he would get on the individual market. Oh, forgot to mention, he's a lawyer, so this is not a problem unique to the working class and the poor.

---
Sebastian Foucan: Now, I'll definitely see the movie. One of the originators of parkour/freerunning. The sequence from Casino Royale is one of my favorite chase scenes.

Anonymous said...

Here are a few answers as far as opposition to Medicare buy-ins go. Perhaps members of the hospital and medical groups who oppose this idea do not assume that Medicare costs will somehow miraculously stabilize because of slight mark-up in price for some new members.

Marco

"Hospital and doctor groups that have generally supported the effort to revamp the nation's health care system pushed back Wednesday against a new idea proposed by Democratic leaders to let younger Americans buy into Medicare."

"Bringing more people into a system that doesn't work very well is not a good answer," said Jeffrey Korsmo, executive director of the Mayo Clinic Health Policy Center. "The current Medicare program is not sustainable."

Medical groups balk at Medicare 'buy-in'

http://www.usatoday.com/news/washington/2009-12-09-health-care-medicare-buy-in_N.htm

Anonymous said...

The health care system that people think they want and need will bankrupt every society regardless of what country or system you are talking about. Only the rich will be able to afford to chase those last few miserable years that cost everyone so much. I pity them.

Marty S said...

Let's say I'm one of those unfortunate people who can't buy a private insurance policy because I have a pre-existing condition. Let's say to make up numbers that the typical individual with my problem will need $300,000 of medical care over the next five years. Now we let them buy into medicare at cost plus 10%. Does this mean they pay $66,000 a year for those five years, or does it mean that these costs are spread over all medicare participants including those living only on a small social security check. If the buy in between 55 and 64 is mainly attractive to people in such a situation how will that affect a medicare system that is currently in bad financial straits. Those of us who question various health care previsions are not heartless. I wish everyone could get all the medical care they need. What we question is the economic feasibility of accomplishing this goal. We believe that giving everyone the ultimate in medical care is not feasible and so compromises will be made and some people who would have been properly treated under the current system will be less well treated under a government system. The idea of sacrificing older people for the sake of younger people is an old one in science fiction. This is result I expect if health care in this country takes the road we appear to be headed down.

Dan Moran said...

Those of us who question various health care previsions are not heartless. I wish everyone could get all the medical care they need. What we question is the economic feasibility of accomplishing this goal.

But not of endless war. This isn't a money problem, it's a priorities problem.

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Frank said...

Well though I would vote against it, if they do reduce the age of getting Medicare to age 55, I’ll retire in a heartbeat and let all you young (and/or working) folks support me in my “old” age. That is assuming there will be any doctors or hospitals that will accept Medicare after the change because, you know, Medicare pays below market value for services. There are lots of people in my situation who will do the same.

I’ll also want to get in early because who knows how long it will last…

Of course the good thing about that is that the work force will get rid of the majoirty of us “old timers” making room for all those degreed people who are currently flipping burgers or unemployed a chance to get a good job.

The bad thing about it is they may not get the same deal when they retire. Not to mention the whole bankrupcy thing.

Of course, that won’t be my problem. So long as you pay for me to get my health care, that is…

Dan Moran

But not of endless war. This isn't a money problem, it's a priorities problem.

Well if the President is as smart as everyone thinks he is, then why isn't he ending the wars so he can put the money into healthcare?

Of course, if we keep going the way we're currently going, we won't have enough money to fight any wars and we'll all be depending on China for our security.

Nancy Lebovitz said...

In re pain meds: a big piece of the problem with people getting access to them is the war on drugs. A side effect of the war is an exaggerated fear of addiction-- doctors risk prison for prescribing adequate pain control.

As for Medicare, I used to see a lot of complaints that the payments to Doctors were so low that a lot of them weren't taking Medicare patients. I'm not sure about what happened, but those complaints seem to have fallen out of the discussion.

Steven Barnes said...

Marco, did you actually read the article? The only reason cited is from the president of a hospital trade group, complaining that it would cut into their profits. Considering the number of times I've heard that insurance companies allow inflation of reinbursement, I could care less. Someone else says Medicare will run out of money in 2017. Err--I'm suggesting cost plus 10%. This would actually shore up Medicare. Sorry, I just don't see the problem.

Steven Barnes said...

Marty--
So 55 to 65'ers buy into Medicare. They will NOT, contrary to some opinions, just be those who cannot get health care elsewhere. I myself would be among them. I see no reason to believe that the per-patient cost would be higher than in the 65+ group. Even if it is, yes, that additional expense is spread across the pool of those who have bought in. If it gets too expensive, guess what? They'll drop out in preference to the private plans, and no harm no foul.
##
I know of no government OR private program that offers "the ultimate" to each person. This is a straw man. The question is whether you believe that hefty executive salaries and advertising costs somehow improve the quality of your health care. If you think "yes" you should have the right to buy such insurance. If like me you think "no" you should have the right to buy non-profit. I'm not trying to control your behavior. YOU are trying to control mine.

Steven Barnes said...

Frank--
the discussion is NOT about 55-65 year olds "getting free Medicare". It is about allowing them to buy into the system at cost plus 10%. You are sharp enough to know the difference, and I wonder why you ignored it.

Frank said...

It is about allowing them to buy into the system at cost plus 10%.

Uh huh. And since I will be retired, i.e. unemployed, will I not then be able to get the heath care tax credit?

Health insurance is going to cost me when I retire no matter what. What prevents me, and a number of people I know from retiring is the cost of private health care. So many wait until they are eligible for Medicare.

So if I get eligible, and I'm going to get a tax credit, what's to prevent me from retiring at 55?

Of course, the problem is that to pay for the new legislation they are talking about tax increases and medicare cuts. So who knows if medicare will even be worth anything.

Steven Barnes said...

Oh, and Frank--as to your rather snide question ("if he's so smart"), a couple of answers.
1) It takes time to get the bull back out of the China shop. Your guy made the single worst mistake in foreign relations I've ever heard of, and my guy is just trying to clean it up.
2) For me, and many like me, it seems that Bush was trying to figure out a way to STAY in Iraq, while Obama is trying to figure out a way to LEAVE without causing more chaos. Big, big difference.
3) Afghanistan is the right war, and was from the beginning. That's where our enemies were (there, and Saudi Arabia...but that's another matter). How to prosecute that war, what we should hope for and how we should plan our exit strategy...those are different questions. There is a legitimate use of force, and defeating the Taliban may fit that description.
So long as we don't try to hold or colonize Afghanistan, it may well be possible to get a positive result.

Marty S said...

Steve: You may not be trying to control me, but indirectly you are. In nine months I turn 65. I don't get a choice between medicare and my current employer based plan. I lose that plan and must sign up for medicare. When public options exist private options tend to go away and only perhaps the richest get to use the private option.

Frank said...

And again I ask, you are aware that right now you have the option of buying you're health insurance from a non-profit, right?

The biggest are Blue Cross/Blue Shield and Kaiser Permanente.

So what is the value of another, government-run non-profit?

More importantly, people have been warning for years that Medicare is going bankrupt; that it was in more sever distress than Social Security itself. And all the solutions proposed (though never acted on for political reasons) up to this point was that they were going to have raise the age of eligibility for Medicare. Now all of a sudden, out of the blue, people are proposing to lower the age of eligibility.

Really?

How did that change so radically all of a sudden?

Frank said...

Steve

For me, and many like me, it seems that Bush was trying to figure out a way to STAY in Iraq, while Obama is trying to figure out a way to LEAVE without causing more chaos. Big, big difference.

For the record, I'll note that the President is adhering to the withdrawal timeline negotiated by Bush.

And I'll also point out that Afghanistan got dangerous only after al Qaeda et. al. were driven from the battlefield in Iraq, a place al Qaeda declared to be the central front of Jihad.

Dan Moran said...

Frank,

Well if the President is as smart as everyone thinks he is, then why isn't he ending the wars so he can put the money into healthcare?

I wasn't speaking of Obama's priorities, but those of conservatives. Conservatives appear to think that a trillion for war and another couple trillion on tax cuts for the rich are fine and dandy, but that spending on health care is insane and dangerous.

Watching conservatives rediscover fiscal responsibility has been an astonishing sight, let me tell you.

Dan Moran said...

So what is the value of another, government-run non-profit?

What's the harm? Since they already exist, having another one's not such a big deal, right? But in fact, conservatives (you aside) do seem to see a difference between Blue Cross and the public option that liberals want .... so maybe there is a real difference.

Frank said...

Dan Moran

Watching conservatives rediscover fiscal responsibility has been an astonishing sight, let me tell you.

Yeah. But it would have been nice if when they had their chance, Democrats would have shown that they knew about fiscal responsibility to begin with. Perhaps if they had, they wouldn't have lost so many seats by this time next year.

so maybe there is a real difference.

Yeah, one is run by the government with the expressed purpose of undermining private insurance and putting them out of business while the other is prevented from creating a monopoly by government regulation.

So yeah, I'd call that a big difference.

Dan Moran said...

OK, so we agree that the public option is in fact different from the "non-profit" insurance currently offered. That's progress.

But the monopoly thing, well ... there are two industries in the U.S. that are exempt from anti-trust legislation. One's baseball. I'm guessing you know what the other one is ....