When Diane Shore got a letter that her health policy would be canceled, the small premium increase for the new plan didn't bother her that much.
But the changes in her choices for care really bugged her. "My physicians will no longer be in this network of physicians, or the hospitals," she says.
Sixty-two-year-old Shore owned an information technology consulting business in the San Francisco Bay Area, and retired when she sold it in 2000. She wants to stick with the health care providers that she's had for years, she says, including the surgeon who cared for her when she had breast cancer in 1998.
"I have full confidence in her," she says. "And my primary care doctor has been my primary care doctor for 20 years."
In Shore's case, the problem is that the Blue Shield of California plan being offered limits her choice of doctors and hospitals to Marin County, where she lives. "All my doctors are in San Francisco," she says. "I live 20 minutes from San Francisco. In fact, it's more convenient for me to go to San Francisco than to the hospital here in Marin County."
Shore's experience doesn't surprise San Francisco-based insurance broker Susan Shargel, who's trying to sort out all the new ways insurers are contracting with doctors. Some health plans will have fewer doctors and hospitals. Blue Shield, for example, says it will have half the doctors and three-quarters of the hospitals next year as it has this year in the individual market.
Shargel thinks the changes aren't clear in the cancellation letters. "There isn't something that says: 'Alert. Be aware. Take action now to be sure this works for you or to be sure you know what's happening.' There needs to be a red alert," she says.
The health plan offered to Shore was a Blue Shield of California EPO plan. EPO stands for "exclusive provider organization." The company says it's offering these lower-cost plans for the first time next year to buyers on the individual market. Other insurers are offering similar plans.
Patrick Johnston, president of the California Association of Health Plans, notes that the federal Affordable Care Act requires more benefits than most insurance plans have provided up until now. That includes free preventive care, a limit on annual out-of-pocket spending and a ban on lifetime caps for medical expenses. So, to keep health plans affordable for buyers on the individual market, one of the few cost variables to work with is doctor contracts.
"In areas where there are a lot of hospitals, some more expensive than others, and a lot of doctors, it's only natural that a health plan will sign up some, but maybe not all," he says.
So Johnston says if you're buying your own insurance next year and want to keep your doctors, you may have to shop around. "Transitioning might mean looking or having difficulty signing up exactly the same doctors," he says.
Insurers are negotiating hard, according to Gerry Kominski, director of the Center for Health Policy Research at UCLA, saying to providers, for example: "We're willing to pay you $50 a visit. If you're not willing to do that, we know a doctors' group across the street that will accept that."
Kominski acknowledges the trend of narrowing provider networks pre-dates the Affordable Care Act, but has been speeding up under the law. And not just for individual policyholders; it's been happening for people who get insurance through work as well.
But, he's quick to add that it's necessary."If we want to keep health care from becoming completely unaffordable for everyone, at some point something has to give," he says. "And in this case what's giving is the ability to choose any doctor and any hospital."
And, he says, some of the plans may have a wider variety of doctor and hospital choices, but they are likely to cost more.
This story is part of a reporting partnership with NPR, Capital Public Radio and Kaiser Health News.
TO: Zack Snyder, Big Time Hot Shot Hollywood Director
FROM: Glen Weldon, Nerd
IN RE: Wonder Woman
Dear Zack Snyder:
I see you've cast The Fast and the Furious' Gal Gadot as Diana of the Amazons, aka Wonder Woman.
I see, also, that the internet has reacted as it can be counted upon to do, when such casting announcements occur. Namely, with fulsome, fulminating nerdrage.
I am here to tell you, Zack Snyder: Keep your head down. Ignore it. Make your movie.
And not because it's all just more of the tiresome, predictable, reflexive carping that has come to serve as the static hiss, the universal background radiation, of comics culture, though it is that. And I know whereof I speak, here, as the casting of Ben Affleck as Batman in the very same movie led me to tiresomely, predictably and reflexively carp about it in this space.
(Point of order: My hand-wringing in the Batfleck case was and is borne of my conviction that the past is prologue - that we've already seen the guy play a grim vigilante who haunts the shadows of the urban night — albeit one more given to red pleather than black Kevlar - and be hilariously, jaw-droppingly, savagely lousy at it.)
Gadot is different. We haven't seen her in a role similar to Wonder Woman, because the role of Wonder Woman is so singular. More on that in a second.
Much of the criticism directed at this casting choice - too much — has revolved around Gadot's physicality. She's too thin, too wispy, too short, goes the argument, when Wonder Woman is a badass. She's a kicker of butts, so you need someone with some meat on her bones and a proven track record of butt-kicking, like fellow Fast & Furious alumnae Michelle Rodriguez and ex-MMA fighter Gina Corano.
(Full disclosure: Ever since Joss Whedon's Firefly first aired back in 2002, I've been boring friends with my abiding conviction that Gina Torres was born for the role. And those who reacted to this casting announcement by noting that the mythical nature of Wonder Woman's ethnicity - Amazonian - means you ignored a perfect opportunity to put a woman of color in a landmark role? ... OK, yeah, they've got a point.)
But this focus on the musculature of the actor in question is a dead end, where Wonder Woman is concerned. Christian Bale bulked up for the role in Nolan's Batman, true, but Bruce Wayne's a mere mortal. We need to see that he's trained his body for his mission.
Diana, on the other hand, is creature of myth and fantasy. Her physical strength is an important aspect of her character, but it is not a function of her lean body mass. Whether or not Gadot will make an interesting, let alone convincing, Wonder Woman has nothing to do with the size of her biceps.
No, Wonder Woman is a presence, a figure of mingled strength and compassion. There's one and only one thing that Gadot needs to project, the moment she comes on-screen:
"I got this."
Call it gravitas, or regality, or plain old ordinary conviction. Wonder Woman may or not be large, but she's always, always, always in charge.
How Do You Solve a Problem Like Diana?
As you know, several factors have kept Wonder Woman off the big screen thus far, and one of them - the most-cited, in industry circles - is completely bogus: The notion that a female character can't open a blockbuster.
The era of studios being able point to the failures of Catwoman and Elektra as proof that female superhero properties are non-starters - as opposed to proof that Hollywood can make terrible movies - is over. It was always false, but now, in a post-Hunger Games reality, it's demonstrably so.
But there's another, deeper reason, and it has to do with who Wonder Woman is, at her core.
Her most essential self is an abiding contradiction, an oxymoronic riddle:
She is a Warrior ... for Peace.
She fights ... to stop us from fighting.
At first, it made sense. Because unlike Superman and Batman, who appeared before America entered World War II and who kept themselves Stateside throughout the conflict, Wonder Woman was created expressly to go toe-toe with the Axis threat. She served as America's star-spangled ally in the war against a great and unambiguous evil - an evil that, she avowed, must be defeated utterly, if there was ever to be peace.
Historically, her greatest foe has been the God of War (referred to variously as Mars or Ares) - a powerfully evil figure who glories in the violence and chaos of armed conflict, and who was depicted pulling the Nazis' strings.
Wonder Woman's patrons, on the other hand, have included the Goddess of Love (Aprhrodite/Venus) and, more recently, the Goddess Minerva/Athena, a deity of battlefield strategy and honor.
When the war ended, her driving principle - "Stop fighting or I'll beat you up!" - grew harder to sell. She's been many things, over the years - a depowered globe-trotting kung-fu adventuress/fashion boutique owner, a Goddess of Truth, an Amazonian ambassador (complete with a colorful embassy staff), dead.
But these have all felt to me like iterations, imitations, off-brand avatars of her true self, who will forever be most at home punching Nazis in their collective schnozz.
Lately, in the pages of DC's recently relaunched Wonder Woman comic, writer Brian Azzarello and artist Cliff Chiang have come up with a fresh take that's opening up new sides to the character. In their book, they've lifted her out of the superhero world and returned her to her mythic roots, as a woman caught up in the machinations of a fractious and violent mafia family fueled by bile, guile and long-nursed grudges - who just so happen to be Greek Gods. Think Bullfinch's Mythology by way of The Sopranos, and you begin to get the idea. I'd suggest, Mr. Snyder, that you read up on the version of the character in those pages, to get a sense of what I'm talking about.
(You can probably skip the more generic version of Wonder Woman now appearing in DC's Justice League book, and the book that chronicles her romance with Superman, for that matter.)
Anyway. I'll let you go, as you've got a lot of work to do, what with this sequel being rushed into production and all. If I had more time, I'd raise some of my concerns about your ability to understand and create compelling stories about women, but that would mean I'd have to bring up your film Sucker Punch, and ... well.
I don't want to talk about that. You don't want to talk that.
Yours in cautiously pessimistic hope, or its closest analogue,
Comic book lovers have a new paradise. It's not the Batcave or the Fortress of Solitude; it's a new cartoon library and museum, tucked into a nondescript building on the Ohio State University campus.
Jenny Robb loves comics and cartoons; it's in her job description. She's the curator of the new Billy Ireland Cartoon Library and Museum, named after the famed Columbus Dispatch cartoonist. With millions of pages of material in this free collection, Robb is in charge of geek heaven.
"I do think I have a pretty cool job, and we welcome all geeks and dorks," she says, laughing. "They're sort of taking over the world. I mean the movies, film, literature ... A lot of people are looking to the geeks and the dorks for guidance. So they're welcome here."
The library has row after row of Japanimation, political cartoons and every other possible type of illustration.
Comics and cartoons "reflect our society; they reflect our culture," Robb says. "It's a very powerful way to tell a story."
Although a few other colleges have similar libraries, Robb says this one is by far the largest. Visitors can find the most iconic issues of Superman and Spider-Man comics, and even the more obscure books.
Billy Mount came looking for Batman comics from the 1980s, before the iconic Frank Miller stories, and he was surprised to hear about the library's extensive Calvin and Hobbes collection.
"I actually named my cat after Hobbes growing up. That's awesome," Mount says.
The library also represents an emerging branch of academia. Christina Meyer, a researcher from Germany, traveled to study original copies of The Yellow Kid, a popular 19th-century comic strip.
"I had already black-and-white copies from microfilm, but now I could actually finally see them in color, which is so great and amazing and overwhelming," Meyer says.
The archives also house thousands of original sketches by Jim Borgman, the Pulitzer Prize-winning editorial cartoonist who later started the comic strip Zits. He attended the museum's grand opening last month.
"It just kind of brought tears to my eyes to think of what that would have meant to me as a young person beginning to sense a passion for expressing myself this way, to be standing in the middle of these great artists," Borgman says.
The library has also been a hit in the local comic scene. Jeff Stang, who manages the Laughing Ogre comic book store a few miles away, was also at the library's grand opening and says it's been the talk among customers.
"It was packed to the gills. It was incredible and everyone there was just really excited," Stang says. "All the hard work that everyone's put in — it's really finally starting to pay off. And then there's a lot of people coming up (to the store) from there ... It's nice to see people really getting excited about comics again."