2030: A novel by Albert Brooks.
Easily one of the most interesting satires on social order of the USA I have seen. From the pen of Albert Brooks, American actor, writer, comedian and director. He received an Academy Award nomination in 1987 for his role in Broadcast News (Of note- Brooks attended Carnegie Mellon in Pittsburgh for a year).
There are a multiplicity of characters and interlocking plots, but of most interest to us is his conception of health care in 2031. I will summarize and paraphrase the way I understand them his most interesting vision below.
**WARNING: THERE BE SPOILERS AHEAD**.
At some point in the year 2030 the big one, Richter 9.1, hits Los Angeles and completely destroys it. There are no government funds to rebuild, or even care for the 50,000 citizens out in the cold. The national debt, such as it is, in 2030 has reached the point where all the revenue collected by the government only pays off the interest on the payments to the Chinese. So there is little else in the way of government services that haven’t been privatized. So citizens pay taxes and fees for services.
So the President approaches China for a 20 trillion dollar loan to rebuild the city and deal with the expenses of its citizens. The Chinese politely but firmly say no. The USA has outstripped its ability to even pay the interest in current loans, much less absorb another one. However, always desiring to be helpful, the Chinese premier floats another proposition.
The Chinese will come to Southern California and totally rebuild the city on their dime, using the amazing technology they created. For that service, they will be equal partners in the resulting Los Angeles economy, splitting the profits thereof 50-50% indefinitely. They will own 50% of Los Angeles in perpetuity. And Chinese immigrants moving to that city will get automatic American citizenship.
At some point during these negotiations a sub plot emerges. A working takes a second job as a security guard to maintain his meager lifestyle, which has become unaffordable. One night he gets shot in the chest by armed punks and is taken to an emergency room followed by a trip to an operating room and a convalescence in an ICU for a while.
Unfortunately, he had not been able to afford his government health insurance premiums for over a year. Wasn’t much use to him anyway as it only allowed one doctor visit a year and one ED visit every four. So after he is discharged, he receives a bill for $350,000 and notices of dire collections techniques to get it if not paid quickly. His adult daughter arrives to pick him up and she’s told their only option is to take out another loan to pay the bill at the usual exorbitant interest rates, which the daughter will be responsible for.
She consults a “never a fee unless we get money for you” lawyer who tells them they are out of luck. The Health Insurance game is bullet proof. No Tickee-No laundry. The lawyer then presented them with a bill for $1000 consultation fee. (The “no fee” only counts if they take the case).
Several days later, the man unexpectedly drops dead in his kitchen and the daughter phones for an ambulance. She is requested to hold the phone over her father’s head and chest for 5 seconds, following which a scan is performed that shows no heartbeat. She’s then advised to cover the body and someone would be around in time to pick up the body.
By 2030, end-of life-care has been directly affected by the religious right wing of a conservative political party perpetually in office. They have successfully lobbied to define “life” at end-of-life as the presence of any form of electrical brain wave. They successfully convinced the Supreme Court that any such brain wave might constitute a “dream”, and no one had the right to disturb it. (The Court disagreed with the opposition who said such a wave might be a nightmare).
So, in 2030, any attempt by any means to terminate a brain wave is defined as murder. Indolent patients pile up in specifically designed warehouses where they are stored until relatives come to visit, whereupon makeup is applied and canned homilies are rendered to families “we think he smiled yesterday”, and “he’s doing a little better today”. Then the rise of Kevorkian clones quietly sneaking in and terminating these hominids at the behest of their longsuffering families much in the likeness of Archibald “Harry” Tuttle (Robert DeNiro) in Terry Gilliam’s “Brazil”. “I came into this game for the action, the excitement. Go anywhere, travel light, get in, get out, wherever there’s trouble, a man alone”.
That should be enough to pique your interest if you have any. The book is fascinating, as is the incredibly multi-talented Albert Brooks.
Highly recommended by me. I give it four and a half of five Borscht Belt Kurt Vonneguts.
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