The Curious Case of Brad Pitt Being Nominated for Best Actor

We usually try to see all five of the best picture nominees. This year, so far, we have seen Slumdog, Milk, and The Curious Case of Benjamin Button. But The Reader likely won’t make it to Bozeman, and I am willfully skipping Frost Nixon. I like Richard Nixon too much to see him humiliated.

Milk is the best movie I saw last year (for my wife: Mama Mia). Sean Penn is magnificent as Harvey Milk – I forgot a few minutes into the movie that it was him. His performance was sensitive and nuanced, the movie was well-paced and interesting throughout. It adds insight into the gay rights movement of that time – we take so much for granted now, but coming out in the late 1970’s was an act of real courage.

On the other hand, in Benjamin Button I never forgot for a second that Brad Pitt was Brad Pitt, acting. My God was it boring! Take away the fact that the central character was aging backward and you have a bland and uninteresting man leading an unremarkable life. How on earth he was tapped for a best actor nomination is beyond me – he didn’t seem to be suffering his fate much, wasn’t holding in any great pain, never much tried to understand himself. He never even raised his voice, not that there was any great unreleased energy behind the odd laid back man. There wasn’t a trace of anguish to be found in his knowing that he would eventually be a suckling to the beautiful woman he loved. He was just Pretty Boy Pitt.

The technology is fairly remarkable. Towards the end, before other actors take over, Pitt’s face has the sheen of a teenager, his body light and athletic. That’s an accomplishment for the technicians behind the scenes. Maybe the movie should win some of those awards they give away at the dinner the night before the formal ceremony. But best picture? Best actor? Please.

Building on What We Have

Dr. Atul Gawande, author of “Complications: A Surgeon’s Notes on an Imperfect Science”, and its follow-up, “Better: A Surgeon’s Notes on Performance“, is also a staff writer for the New Yorker, and in the January 29 issue has an article titled “Getting There From Here“.

Gawande laments the factions that have formed in American health care reform circles, and suggests that no solution will come from either camp.

…[factions] believe that a new system will be far better for most people, and that those who would hang on to the old do so out of either lack of imagination or narrow self-interest. On the left, then, single-payer enthusiasts argue that the only coherent solution is to end private health insurance and replace it with a national insurance program. And, on the right, the free marketeers argue that the only coherent solution is to end public insurance and employer-controlled health benefits so that we can all buy our own coverage and put market forces to work.

Neither side can stand the other.

Indeed – we have had some of that at this little blog. Gawande suggests that other industrialized countries have been so successful at building their systems because they took what they had and made it more expansive rather than starting over from scratch.

In Britain, for example, the National Health Service came about as the government was forced to move millions of people out of the cities and into the countryside in the face of bombing by the Nazis. The government found the then-existing health care system inadequate, and had to build clinics and hire doctors, in addition to subsidizing private hospitals.

Churchill’s government intended the program to be temporary. But the war destroyed the status quo for patients, doctors, and hospitals alike. Moreover, the new system proved better than the old. Despite the ravages of war, the health of the population had improved. The medical and social services had reduced infant and adult mortality rates. Even the dental care was better. By the end of 1944, when the wartime medical service began to demobilize, the country’s citizens did not want to see it go. The private hospitals didn’t, either; they had come to depend on those government payments.

By 1945, when the National Health Service was proposed, it had become evident that a national system of health coverage was not only necessary but also largely already in place—with nationally run hospitals, salaried doctors, and free care for everyone. So, while the ideal of universal coverage was spurred by those horror stories, the particular system that emerged in Britain was not the product of socialist ideology or a deliberate policy process in which all the theoretical options were weighed. It was, instead, an almost conservative creation: a program that built on a tested, practical means of providing adequate health care for everyone, while protecting the existing services that people depended upon every day.

France had a similar story. Labor unions and employers had built a private, not-for-profit insurance system (“not-for-profit” being the key to success) through a self-imposed payroll tax. In 1945, when seventy-five per cent of the population paid cash for medical care, the de Gaulle government built on what it had, expanding the payroll tax and private insurer system to cover the entire population. The 2000 World Health Organization survey found this system to be the best in the world. The U.S. ranked 37th in that survey. (U.S. conservatives have taken the survey to task.)

Switzerland has a similar story, but had built a system of private for-profit insurance coverage. But the system had so many gaps and inconsistencies that in 1994 they passed universal coverage. But they built on what it already had, electing to cap household insurance expenses and subsidize insurance companies.

Contrast this with the U.S. attempt in 2006 to extend drug coverage to senior citizens via “Medicare D”. The congress opted to forego Medicare itself as the disbursing agent, and used private insurance companies.

On January 1, 2006, the program went into effect nationwide. The result was chaos. There had been little realistic consideration of how millions of elderly people with cognitive difficulties, chronic illness, or limited English would manage to select the right plan for themselves. Even the savviest struggled to figure out how to navigate the choices: insurance companies offered 1,429 prescription-drug plans across the country. People arrived at their pharmacy only to discover that they needed an insurance card that hadn’t come, or that they hadn’t received pre-authorization for their drugs, or had switched to a plan that didn’t cover the drugs they took. Tens of thousands were unable to get their prescriptions filled, many for essential drugs like insulin, inhalers, and blood-pressure medications. The result was a public-health crisis in thirty-seven states, which had to provide emergency pharmacy payments for the frail. We will never know how many were harmed, but it is likely that the program killed people.

Medicare is prohibited from bargaining for lower prices – private sector competition was to take care of that. Since it took effect, drug prices have gone up, the system has become no less stodgy and confusing, and pharmaceutical companies, luxuriating in subsidy, are wont to change anything.

What does Gawande propose for the U.S.? That we build on what we have – he thinks we could move seamlessly from over fifty million uninsured to universal coverage by leaving the existing private system of employer-sponsored coverage intact, along with Medicare and the very efficient and effective VA system. Massachusetts oft-derided system offers an example (Gawande practices there):

It didn’t organize a government takeover of the state’s hospitals or insurance companies, or force people into a new system of state-run clinics. It built on what existed. On July 1, 2007, the state began offering an online choice of four private insurance plans for people without health coverage. The cost is zero for the poor; for the rest, it is limited to no more than about eight per cent of income. The vast majority of families, who had insurance through work, didn’t notice a thing when the program was launched. But those who had no coverage had to enroll in a plan or incur a tax penalty.

The results have been remarkable. After a year, 97.4 per cent of Massachusetts residents had coverage, and the remaining gap continues to close. Despite the requirement that individuals buy insurance and that employers either provide coverage or pay a tax, the program has remained extremely popular. Repeated surveys have found that at least two-thirds of the state’s residents support the reform.

Like every universal system everywhere, the Massachusetts program is very popular, and will be improved. However, an individual state cannot control runaway nationwide medical costs, and that state is facing increased costs without cost controls. But as a laboratory experiment, it’s had impressive results.

So we won’t get single-payer. We might not even get anything, as President Obama is yet to mention health care reform since taking office. Whatever happens, to be successful, has to come about by pressure from below and build on what we already have for seamless transition. Gawande seems to favor opening up Medicare for more clients, and opening up the VA system to the general public. If this were done, these systems might eventually force private insurers out of business. It might even force them to institute much-needed reforms.

But something’s gotta give. What we have isn’t working. What we will have will be better … but

It will be no utopia. People will still face co-payments and premiums. There may still be agonizing disputes over coverage for non-standard treatments. Whatever the system’s contours, we will still find it exasperating, even disappointing. We’re not going to get perfection. But we can have transformation—which is to say, a health-care system that works. And there are ways to get there that start from where we are.

Note: I hope anyone who wants to read Gawande’s article can access it in its entirety. As a New Yorker subscriber, I have web site privileges. I don’t know if the New Yorker site is open to the public.

Are Public Lands Poorly Managed? (II)

I started and stopped below, having to leave town for a day. The responses were interesting – Swede lamenting his lack of ability to wrought further destruction upon our public lands with ATV’s, and Bob locating the words from PERC (Hamowy, Anderson and Leal, none of whom I have read) about how public ownership is a curse upon the land itself. No one was able to locate Professor Natelson’s words, leading me to believe that I had a psychic interaction with him that left me slightly scarred and cynical.

There are two types of land ownership – private and public. Both are necessary – private ownership so that we may enjoy privacy and harvest the resources, public so we all may enjoy the benefits. Some types of land are suitable for private ownership, some private, and some are suspended for various reasons.

Private land is used for occupancy and resource production. There are few more important freedoms than the ability to own a piece of land, to keep all others off, to have privacy. From the standpoint of public good, we need the resources the land offers, and private farms and ranches and mines are the best way to get at these resources, providing us all that we use and eat. Public ownership of resource-producing land has not shown any advantage over private. Communal farms in the Soviet Union were a sad joke. The profit motive serves us well.

But because private ownership of land is such a benefit to us, does it naturally follow that all ownership of land should be private? No, it does not. It is often more important for many of us of ordinary means to have private enjoyment of special lands. If our wilderness areas, National Parks and national forests were privately owned, there would be little access, and they would naturally exist for the benefit of the wealthy. Our most pristine and beautiful lakes would be fenced and gated, as many are anyway. Our rivers would be blocked to public use as many landowners in Montana are trying to do. It is just as important to have public as well as private land.

But what about the condition of public land – is it worse than that of private lands? Yes, and no. It depends – ask anyone in Butte, Montana about the public lands that became private now known as the Berkeley Pit. Since that land was stripped of its resources, private owners have run from it, and it is left to the public to clean it up. That’s an extreme example, of course, but the point is that when there are no resources left to exploit, private owners often abandon land with haste.

I see four levels of public land, in descending order of quality:

Wilderness: This is our most pristine land, rescued from development and preserved for future generations to enjoy – places where “man himself is a visitor”, as the law is written. Many on the right complain that resources on these lands are “locked up” – what is really locked up is private enjoyment of the commons for all time. If they were opened up to development and extraction, future generations would be robbed of something precious but not appreciated by all – the natural experience. (Often times we read of a Boy Scout or hunter who perished in a wilderness area. Edward Abbey thought that losing a few people was an important part of the wild experience – if it ain’t dangerous, it ain’t natural.) Some, like those who think it a right to ride an ATV anywhere, don’t seem to care about that. Thankfully enough of us do that we have millions of acres of wilderness. We will always have to fight to keep it, but for now, it is there for all of us to enjoy.

National Parks: These are also pristine lands, but are not “wilderness” per se, as the law that supports them mandates that the public be allowed to enjoy them as much as possible. No profit-motivated development of these lands is allowed, but lots of public money is expended to allow public access. Roads and hotels and restaurants abound, along with public facilities like museums to highlight the features. Yellowstone Park is such a place – visited each year by millions, healthy and handicapped alike, who enjoy the place – each in their own way.

National Forests: The public (especially environmentalists) are at odds with the government over management of national forests. Public land managers, industry and the conservationists perceive the lands differently. Conservationists see the forests as potential wilderness, and tend to resist any incursions for timber harvests, roads and trails, especially for off-road use. Industry sees a resources in need of development, and often exerts its influence through lobbyists and campaign contributions to exert its will over the public. Managers, on the other hand, preserve the lands as best they are able for harvest and exploitation, but also private enjoyment. There is a constant battle going on, with land managers caught in the middle. They are no one’s friend, everyone’s enemy.

In fact, what Teddy Roosevelt saw in the early 20th century was the slow but inevitable destruction of these lands. He realized that if he did not intervene, we would lose the resource entirely. Public ownership saved our national forests, but the urge to develop them so that they lose their natural appeal is still there. We have all seen private forests – no diversity, deer an enemy rather than a friend, roads all about – a sterile experience. We have also witnessed extreme development where the resources are depleted in full, leaving moonscapes and desert, ala Haiti. That was our fate before TR stepped in.

The conflict over national forests will go on in perpetuity, but public ownership has been a greater good than private ownership. Conservationists have to come to grips with the fact that resource development has to be allowed. Industry has to be forced by law to allow for the other resources, like big game, to be enjoyed by the public.

BLM Lands: Eastern Montana is largely owned by the public and managed by the Bureau of Land Management. So are wide swaths of Colorado, Utah, Wyoming, and virtually all of Nevada. BLM lands are bottom-of-the-barrel type – having little profitable use or natural appeal. I grew up in Eastern Montana, and remember May and June, still my favorite months, because they were green. The rest of the year …. not so cool.

Montana is widely perceived as a cattle state, but Midwest states have better claim to that title. Indiana outproduces Montana. The reason is that it takes so damned much land to raise one cow out here, due to the low quality of the land. BLM lands are usually managed by the public because no one else wants them. They sit idle, offering grazing acreage for ranchers, or waiting to be turned private should some valuable resource, like oil or gas, be discovered. In the 19th and 20th century much of this land was given to the public as part of the Homestead Acts – thousands of families were lured out west only to be turned away by nature and the poor quality of the land.

The land naturally had two fates – one to be turned back to public ownership after the private owner failed, the other to be congregated in huge ranches – economies of scale being the only way to justify private ownership.

I think it is BLM land that gives public land its bad name, and allows PERC and others to say that our lands our poorly managed. But that is far from the case – our public land managers are doing a wonderful job for us, managing our resources for various purposes as the law requires, all the while caught between our vigorous disputes. Gloria Flora, former Superintendent of the Lewis and Clark National Forest in Montana, was a tough administrator. But she was practically driven from office by loud and various right wingers, receiving personal threats and wide abuse. Like teaching in the inner cities, such work is a calling for only a few brave souls.

To summarize, private land ownership is our heritage and an essential right for every citizen of the world, but public land ownership is also as important. The very best lands must be publicly owned, lest they be lost to all of us and future generations. Private land often suffers when its resources are depleted. Government often ends up owning our worst and most unprofitable land, and for that reason gets an undeserved reputation as a poor land manager.

Addendum: I inadvertently overlooked one category of public land, the National Monument. This type of land comes into being under the Antiquities Act of 1906. The purpose of the act was to protect resources from looting or destruction during the time it might take Congress to act to protect them – say, for instance, a mining company coming across ancient ruins, the president has the right to step in and protect the site. A president can create a National Monument, but cannot unmake one. (Miners and oil and gas companies usually operate under the mantra STFU.)

President Clinton used Antiquities as a means of bypassing Congress and protecting some small tracts of land, including parts of the Missouri River. It was his way of giving a green hue to his very ungreen administration.

Are Public Lands Poorly Managed?

Maybe I dreamed this, but at one time I could have sworn that Rob Natelson wrote over at Electric City Weblog something to the effect of the words that follow:

public lands are poorly managed because if everyone owns them, no one does. …

I’ve been through his posts now back to the beginning of October, have used Google and my search feature, and I cannot find these words. Is anyone familiar with the concept? I think at the time he said it, Natelson was quoting someone – probably some right wing think tank guy.

Anyway, it’s one of those propositions they have over on the right, like “cutting taxes raises revenues” that is patently absurd yet accepted as gospel. The baseline assumption is that public lands are poorly managed, private lands well-managed.

Anyway, I’m willing to debate both the substance of the debate and the facts on the ground. First, I need to find the source of Natelson’s quote. Any helpers?

Bond: Holder to Hand Out Free Passes

According to the Washington Times,

President Obama’s choice to run the Justice Department has assured senior Republican senators that he won’t prosecute intelligence officers or political appointees who were involved in the Bush administration’s policy of “enhanced interrogations.”

Missouri Senator Christopher “Kit” Bond said he was given assurances by Eric Holder that there would be no prosecutions. Liberal pundits and bloggers are said to be skeptical about the assurance, as the Washington Times is a “Moonie” paper.

I take little comfort in that. I’ve been suspicious from November 4 forward that Bush/Cheney/Rumsfeld/Ashcroft/Gonzales would get a free ride from Obama. They can say anything they want about it, but it comes down to the U.S. having a bipartisan foreign policy. Bush didn’t pardon anybody for a reason. He knew he didn’t have to.

No comment yet from Holder. But if there is to be prosecution for war crimes, it appears it will only come about due to pressure from citizens of this country, or from United Nations Special Rapporteur on Torture Manfred Nowak.

It would indeed be humorous to know that these above-named parties could not leave the country for fear of being arrested – aka – the Pinochet treatment.

Take That!

A favored political tactic among those of us who debate down here in the gallows is to take words uttered by opposition leaders that happen to harmonize with our own thoughts and feelings, and toss them at the other side like guacamole at a food fight. I hereby indulge myself.

Now it is true that I believe this country is following a dangerous trend when it permits too great a degree of centralization of governmental functions. I oppose this–in some instances the fight is a rather desperate one. But to attain any success it is quite clear that the Federal government cannot avoid or escape responsibilities which the mass of the people firmly believe should be undertaken by it. The political processes of our country are such that if a rule of reason is not applied in this effort, we will lose everything–even to a possible and drastic change in the Constitution. This is what I mean by my constant insistence upon “moderation” in government. Should any political party attempt to abolish social security, unemployment insurance, and eliminate labor laws and farm programs, you would not hear of that party again in our political history. There is a tiny splinter group, of course, that believes you can do these things. Among them are H. L. Hunt (you possibly know his background), a few other Texas oil millionaires, and an occasional politician or business man from other areas. Their number is negligible and they are stupid.
Dwight Eisenhower, letter to his brother, Edgar Newton, November, 1954

Joshua Bell Plays the Metro

From an email I received and verified at Snopes:

A man sat at a metro station in Washington DC and started to play the violin; it was a cold January morning. He played six Bach pieces for about 45 minutes. During that time, since it was rush hour, it was calculated that thousands of people went through the station, most of them on their way to work.

Three minutes went by and a middle aged man noticed there was musician playing. He slowed his pace and stopped for a few seconds and then hurried up to meet his schedule.

A minute later, the violinist received his first dollar tip: a woman threw the money in the till and without stopping continued to walk.

A few minutes later, someone leaned against the wall to listen to him, but the man looked at his watch and started to walk again. Clearly he was late for work.

The one who paid the most attention was a 3 year old boy. His mother tagged him along, hurried but the kid stopped to look at the violinist. Finally the mother pushed hard and the child continued to walk turning his head all the time This action was repeated by several other children. All the parents, without exception, forced them to move on.

In the 45 minutes the musician played, only 6 people stopped and stayed for a while. About 20 gave him money but continued to walk their normal pace. He collected $32. When he finished playing and silence took over, no one noticed it. No one applauded, nor was there any recognition.

No one knew this but the violinist was Joshua Bell, one of the best musicians in the world. He played one of the most intricate pieces ever written with a violin worth 3.5 million dollars.

Two days before his playing in the subway, Joshua Bell sold out at a theater in Boston and the seats averaged $100.

Joshua Bell playing incognito in the metro station was organized by the Washington Post as part of a social experiment about perception, taste and priorities of people. The outlines were: in a commonplace environment at an inappropriate hour: Do we perceive beauty? Do we stop to appreciate it? Do we recognize the talent in an unexpected context?

One of the possible conclusions from this experience could be:

If we do not have a moment to stop and listen to one of the best musicians in the world playing the best music ever written, how many other things are we missing?

Some of the best sidewalk music and acrobatics I’ve ever seen was in Barcelona, Spain. One man held a hundred of us captive for half an hour as he performed various tricks with a bicycle, like balancing it on his nose. Walking through the ancient architecture we found various groups singing and playing instruments. The quality was very high.

But we were on vacation, and had time to take it in. We weren’t on our way to work. I wonder what they proved here?

Passing thoughts …

Been kind of slow here. We’ve been traveling – it was shirtsleeve weather in Colorado. We drove from Denver to Bozeman today – icy roads around Cheyenne, but thankfully the Mrs. was driving. The temperature dropped from 40’s to low tens as we moved north. Between Billings and Bozeman we had drifting snow and those tempestuous SUV’er who pass and blind you with snow. I need flashing window sign – never mind what it would say.

I wondered today as we passed through miles of prairie how the election would have turned out if Obama had two kids who had dropped out of high school, one of whom was knocked up.

It may be true that we have a black president, but I’m pretty sure we still have double standards.

Mind Your Manners

Just sayin’ here, I think it is unpatriotic to criticize a sitting president while we are in the midst of two wars. Especially a president that was actually elected.

And by gawd, don’t dare say anything about him overseas. Clear Channel will be on you like white on rice. I know that, because they are balanced in their approach to public policy.

Any criticism of President Obama will heretofore be knowns as “Obama bashing.” It’s not allowed.