Adapted from the novel of the same name, The Reader spans forty years of the Holocaust’s aftermath as experienced by two people whose paths briefly intersect before diverging in wildly different directions. Michael is a teenager growing up in postwar Germany who, purely through happenstance, meets and falls in love with an older woman, Hannah. They enter into an intense physical relationship, but Hannah is a deeply guarded woman who carefully maintains a certain distance from the enthusiastically lovestruck Michael. But the two develop a routine in the course of their affair: Michael reads to Hannah from assorted literary works before they make love. Hannah eventually drops out of Michael’s life only to resurface several years later when he is a law student and he discovers that she is on trial for war crimes she allegedly committed as a guard at a concentration camp.

The film masterfully explores the consequences of that short relationship on both their lives, even long afterwards. To say much more would spoil the story, but it does avoid predictability and cliche. These characters are both deeply wounded and there will be no Hollywood ending, which is as it should be. Kate Winslet delivers a fine performance and it’s good to see Bruno Ganz–the star of Wings of Desire–make an appearance here.

What am I listening to? So glad you asked.

“Collapsing at Your Doorstep” by Air France–In the unlikely event that I ever find myself zooming along a Pacific Coast highway in a convertible with the top down, this is the song I want playing on the stereo. It’s a propulsive mix of lush electronic arrangement, distorted vocals, and fragments of sampled dialogue. Just the thing to ward off my seasonal affective disorder.

“Believe the Hype” by Lookbook–Lookbook is a local band that I’ve grown to love over the last few months. The lead singer, Maggie Morrison, has a rich, seductive voice that blends perfectly with the dark, smoky beats. I almost want these guys to sell out and have their songs featured on some television show, just so more people can hear how great they are.

“My Delirium” by Ladyhawke–This New Zealander has crafted some irresistible pop music that riffs heavily on the Eighties. She captures the pure fun of that decade’s music without cheesing it up. And I read somewhere that she has Asperger’s Syndrome, so she’s got disability cred to boot.

Dear Hollywood,

Let’s get something straight. I’m not your tool. Sure, like a lot of geeks, I was excited to hear that you were planning a movie based on Isaac Asimov’s Golden Age space opera Foundation. A film that combines a cerebral tale of a galactic empire’s fall with healthy doses of eye candy would be like a big box full of awesome wrapped in win. But then you go and sign Roland Emmerich to direct it. Have you seen Roland Emmerich’s movies? All the man knows how to do is direct splashy scenes involving the destruction of famous landmarks. There’s nothing wrong with that, but letting him adapt Foundation is a little like letting an American Idol finalist sing the lead in Carmen. It’s just not a good idea.

Then I hear that some other hack is trying to pitch a sequel to Blade Runner. No, no, a thousand times no.

I’ve cut you a lot of slack over the years. The Star Wars prequels. The Matrix sequels. But I’m starting to think you’re taking me for granted. If you keep it up, you’ll leave me no choice but to avoid the cineplex until you can give me a little respect.

Sincerely,

Mark

Fellow wonk Ezra Klein looks at the vast differences in state Medicaid programs and proposes a plan for simplification: set eligibility at 250% of the federal poverty line “with states able to use state money to expand categories or add services”. Well, that’s basically how it works now. Minnesota has devoted billions of dollars to expanding Medicaid eligibility and providing a multitude of services that are considered “optional” under Medicaid law. To make things even more confusing, states can seek waivers from the federal government to provide an expanded set of Medicaid services to a defined population, like people with developmental disabilities or people who have complex medical conditions. On the one hand, this flexibility gives states the freedom to tailor Medicaid to the needs of their populations. On the other, it creates an environment where one state can offer many more services than the state next door. Klein’s solution wouldn’t change that situation.

Here’s what I would do if I was ruler of everything. Require every state to offer a common menu of Medicaid services that are funded using existing federal matching rates. If a state wants to provide additional services, the feds should provide an enhanced matching rate for those extras. Yes, it will cost more at the federal level, but the alternative is an unpredictable cycle of service expansions and draconian cuts; a wasteful process that devours billions of administrative dollars at the state level.

And we can fund all this by nationalizing Citibank and Bank of America. Viva la revolucion.

The state Legislative Auditor released a report yesterday heavily criticizing the Medicaid-funded personal care assistance service (summary and full text available here). The PCA program provides assistance to people with disabilities and the elderly with the ordinary tasks of daily living: eating, bathing, dressing, etc. The report several structural problems with the program, such as workers being paid for more than 24 hours of service in a day and home care agencies providing insufficient supervision for workers.

Before I go any further, I should make a disclaimer: the views expressed here are my own and not those of the Minnesota Department of Human Services.

The report makes a few points that deserve further discussion:

• Workers being paid more than 24 hours in a day: Fraud and abuse undoubtedly occurs, but the some of these billing irregularities can be attributed to shortcomings in the Medicaid reimbursement system. Every PCA worker is required to have a unique provider number. But the backlog for issuing provider numbers is several weeks long and, in the meantime, agencies need to fill shifts for their clients. So agencies might use an existing provider number to bill for those hours until the new provider number is issued. I’m not excusing the practice, but it’s one created by external factors. 
• All PCA consumers should have professional supervision of their workers: I have mixed feelings about this. I understand the need for supervision, especially in cases where the individual is particularly vulnerable. But plenty of people are capable of supervising their own workers and sending in a professional would simply be a waste of time and money.
• Some PCA workers are working more than 40 hours a week, raising questions about quality of care: Well, if you earned only $9-$11 an hour with few benefits, you might be inclined to pick up extra shifts. And I don’t sense the same collective hand-wringing about physicians and nurses working overtime in hospitals. Finally, I’m not sure that raising amorphous concerns about quality–without presenting any supporting data–is either helpful or particularly insightful.

The Legislature is sure to pass several policy fixes for the PCA program and many of them are overdue. But it’s worth remembering that the vast majority of PCA recipients are using the service to meet basic needs and, in its absence, they would be placed in institutions.