It’s the Doctors, Stupid

Time: Bitter PillSteven Brill has gotten a lot of attention for his big cover story for Time, Bitter Pill: Why Medical Bills Are Killing Us. In general, I don’t pay that much attention to healthcare policy. The truth is that the issues are clear. The only things that get in the way of good policy are the installed interests and the Republican Party. So I didn’t even hear about the article until Brill showed up on The Daily Show. I was none too impressed.

Brill’s main claim is that hospitals are charging too much for things. Three dollars for a capsule of Tylenol?! I understand that these things are outrages, but they aren’t the main issue. Even the centrality of insurance companies in healthcare delivery isn’t the main issue. The main issue is that doctors make far too much money in the United States. Primary care doctors make 50% more in the US than they do in Germany and Canada; they make almost double what they make in France and Australia. I don’t think anyone is arguing that doctors in the US are better than they are in Germany, Canada, France, and Australia.

And yet, in Brill’s big bad indictment of the healthcare system, the doctors are the heroes. He dismisses the idea of a single payer system because—This is rich!—the doctors wouldn’t make as much money. So we have a system where general practitioners make roughly $200,000 per year, but we can’t have a decent healthcare system because these doctors would suffer if they were only making $150,000 per year. It really is that pathetic.

Note: this has nothing to do with single payer systems. The government keeps doctor salaries artificially high by lowering the supply of doctors through immigration policy and certification standards. I understand that we probably want to keep certification standards high. But why are American doctors shielded from the effects of globalization but manufacturing workers aren’t? I suspect that Brill has never even thought about that question. I’d bet he has friends who are doctors. This is same old thing: one member of the upper (or perhaps upper-middle) class taking care of another.

The United States has two big problems with its healthcare system. Doctors are paid too much and insurance companies increase costs while denying care. It may be unfortunate that a hospital charges $3 for a capsule of Tylenol, but that problem isn’t anywhere near central. You would think in 24,000 words that Brill would have figured that out.

Daily Beast Likes My Video

Zero Dark ThirtyWhen I first created my Zero Dark Thirty trailer parody, I was very pleased. For the first time, something I did came out exactly the way I expected. But more than that, I thought this was the parody that the film was begging for. The trumpeting of their good reviews seemed to require replacing them with pointed political commentary that indicated the film was wrong and nefarious. In fact, I thought it was so clear that I searched in depth to see if anyone else had already made it.

People seemed to like the video, but it got almost no traction—not much more than 100 views. In retrospect, I can see why. It’s pretty subtle. If you weren’t paying attention, you wouldn’t even know it was a parody. I did end up making more changes to it than I had planned to, but the sound is exactly the same as in the original. I just replaced the review quotes with my own and then added a couple of others where they weren’t before.

This morning, I went to check on my videos on YouTube, and I thought something was wrong. My Zero Dark Thirty parody had received a few thousand views. So I figured someone with some traffic must be embedding it. I did a search on “zero dark thirty parody” and an article on The Daily Beast came up: ‘Zero Dark Thirty’ Parodies: Lena Dunham, 50 Cent & More.

My video is the last listed. It is also by far the shortest. It is the only one that isn’t comedy. And it is the only one done by an amateur. I feel honored, because the other videos are amazing. There are two that most amused me, and I highly recommend watching them. The first was from Jimmy Kimmel, called “Zero Dark Fiddy” about the real story of 50 Cent’s search for bin Laden:

The second is “Zero Bark Thirty,” which is not particularly a parody, but just some very funny stuff about a dog from the bin Laden raid who is suffering from PTSD. It makes fun of a lot of stuff that needs it:

Only one of the videos makes much of the politics: Capture the Flag. But I didn’t think it worked all that well. It does, however, get to the heart of an important matter. Torture isn’t about effectiveness. Those in favor of torture justify it in the same way as those of us against it. One of the strongest arguments against torture is that it makes us the bad guys. “What does it say about us that we torture? It isn’t about who they are; it is about who we are!” Those who favor torture love what it says about us, “We’re badasses!”

Anyway, I am very grateful to Kevin Fallon for including me in his list of Zero Dark Thirty parodies. It at least validates my thinking that it was a good idea. But I do wish that I were capable of coming up with something as brilliant and silly as gunchucks.

Happy Birthday Lou

Lou ReedIt is March 2 and some interesting people were born on this day. The wonderful Alvin Youngblood Hart is 50 today. John Irving is 71 today. The genuinely great Mikhail Gorbachev is 82. John Cullum, the fine musical theater actor, is 83. Theodor Seuss Geisel — Dr Seuss — would have been 109 today, but he died at a reasonable age. And Kurt Weill would have been 113. All of these men are or were greater than the man I want to discuss.

When I was younger, I loved Lou Reed and the Velvet Underground. Like many people, I was inspired by Reed. I remember Iggy Pop claiming he got into music after seeing the Velvets because he realized that like Reed, he too was ugly with limited talent. I don’t mean to rag on the man. He’s a pretty good songwriter and what’s more important, he has written about interesting things. The real problem with him is his pretense to be a real poet. He’s at his best when he lets his id fly. When he overthinks something, it means disaster because Reed isn’t a great thinker.

Another aspect of Reed is that he’s an asshole. When I first got into him, I researched him, which is SOP for me. And in those few interviews that he did, he always came off as a total dick. I remember him ranting about how he was a published poet and how people ought to respect him more. (I too am a published poet, and in better journals than he was in 1972.) Then I read Diana Clapton’s biography of him, which was no kind of hit job — she was a fan. One of the most detailed chapters was an interview with a young guitarist who toured with Reed. His treatment of the young man was absolutely terrible. And then there was the whole thing about Reed not allowing Doug Yule to be inducted into the Rock and Roll Hall of Fame. (I think that Yule is the real hero of Loaded.)

So while I loved Reed’s music, I was well aware that he was no kind of decent human being. And as I wrote and performed music, I had recurring dreams in which he would appear and abuse me in various ways. This mostly took the form of telling me that I was a no-talent and that I should give up. And that was doubtless good advice!

After a couple of years during which Reed basically never performed (once at the Bottom Line, as I recall), he came to California. He was performing at the Great America theme park. So my friend Will and I went. We are wandering around the park waiting for the concert and we come upon Reed, surrounded by four beefy men. They are all looking up at the Edge, a free-fall ride. So I walk right up to him. I have this ability. I am literally as threatening as a mosquito, so bodyguards don’t even seem to notice me. Lou looks down at me. He is not pleased. He looks at his bodyguards like, “What the fuck?!” I absolutely don’t know what to say so I ask for an autograph. He frowns and sighs almost hard enough to blow me over. “You got a pen?” he asks. I pat my pants. He shrugs, turns, and walks away.

It was a wonderful moment because it was the same dynamic in my dream: dismissive and bothered. This isn’t surprising, given that I knew the kind of guy he was. Some artists love fans because it makes them feel valid, but artists like Reed need to trivialize fans because they make them feel less valid — like teen idols or something. Of course, Reed isn’t that famous. I doubt that 1% of the people in the country would recognize his face. Perhaps 5% would recognize “Walk on the Wild Side,” and frankly, that’s because of David Bowie and Mick Ronson.

The other important performer from that time was Jonathan Richman, who was also a huge Velvet Underground fan. Admittedly, Richman has on average been a disappointment. He has a very poor work ethic. But his best work is better than Reed’s best. Plus, he never tortured me in my dreams. And I’ve met him many times and he is a very friendly guy. That isn’t to say that he’s an angel — just that his particular demons don’t require him to dump on everyone around him.

But given that it is Reed’s 71st birthday, here’s hoping it is a Perfect Day.[1] I’m sure this article will help.


I always thought that Wikipedia had a mechanism that automatically updated the ages of people. But this isn’t the case. People apparently have to do it manually. Justin Bieber’s age was updated at midnight East Coast time. Lou Reed’s birthday got updated during the writing of this. John Irving’s birthday hasn’t been updated.

Antoine-Frederic Gresnick lived at the same time as Mozart and composed pieces that can easily be mistaken for him. He was born today in 1755. Here is his Symphonie Concertante in B-flat Major. It is delightful:

[1] I still love this song, but I can have a hard time listening to it now. How could they allow some of the notes to be so out of tune?! I don’t care that much about pitch and I don’t have that great an ear, but jeez!

See also: Lou Reed Sowed and Reaped for 71 Years.