David Gately

Archive for 2016|Yearly archive page

President-elect Trump on global health and HIV

In Africa, AIDS, David Gately, Health, HIV, PEPFAR, President Trump, Worlds AIDS Day 2016 on December 1, 2016 at 4:54 pm
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Secretary of State John Kerry hosts a high-level meeting on global AIDS with PEPFAR partners at the United Nations General Assembly in 2013.

Today is World AIDS Day. A new Republican administration convenes in January. So it’s a good time to look at what the next four years means for American-led global-health programs, particularly efforts to combat the HIV crisis. The U.S. and the world are watching.

Will President-elect Trump make changes to PEPFAR, the President’s Emergency Plan for AIDS Relief? The U.S. initiative is a multilateral global commitment to saving lives and achieving an AIDS-free future. The prospect of Trump making cuts to the program has many health experts fearful.

In a November 9 Council on Foreign Relations online letter, Laurie Garrett, senior fellow for global health, noted that the British journal Lancet created a website tracking the U.S. elections and its impact on global health.

“Terrific detail can be found there,” said Garret, about the website. “Though in fairness to Republicans it is clear the Lancet folks were not enamored” with Trump.

The signs are worrisome, according to Mitchell Warren, executive director of the AIDS Vaccine Advocacy Coalition, a New York-based organization founded in 1995 by nine HIV treatment activists.

“During the U.S. election campaign, plenty was said about emails and sexual harassment,” said Warren, in a November 25 article on (DW), the German broadcaster Deutsche Welle’s website. “But there was little or no talk on global health or HIV.”

President George W. Bush signed PEPFAR into law in 2003, with strong bipartisan support from the U.S. Congress.

“HIV/AIDS is one of the greatest medical challenges of our time, said President Bush, when signing the PEPFAR bill. “The legislation launches an emergency effort that will provide $15 billion over the next five years to fight AIDS abroad.”

Thirteen years later and many experts consider PEPFAR a success. However, there have been challenges. A studypublished in the May 2016 issue of Health Affairs found that abstinence programs in Sub-Saharan Africa have failed.

Despite roadblocks, PEPFAR’s achievements since 2003 have been dramatic, with more than:

  • 68.2 million people receiving HIV testing and counseling, including 14.7 million pregnant women,
  • 1 million babies born HIV-free,
  • 9.5 million men, women and children receiving life-saving antiretroviral treatment,
  • 8.9 million men receiving voluntary medical circumcision, and
  • 5.5 million orphans and vulnerable children receiving care and support.

Today, PEPFAR is a generous $57 billion global-health juggernaut. (Add the United States Leadership Against HIV/AIDS, Tuberculosis and Malaria Act, and total funding exceeds $72 billion.)

“Thanks to a spate of scientific advances, this decade could be the beginning of the end of the HIV/AIDS epidemic,” reported STAT News in July.

President Obama marks World AIDS Day in 2011 by announcing plans to boost U.S. efforts to fight AIDS at home and aboard.

President Obama continued to support PEPFAR, and, despite eight tough years of partisan wrangling on Capitol Hill, his administration pushed through many advances in global health and development. The Pentagon led an international military mobilization against Ebola, and the Obama administration strengthened the Global Health Security Initiative and launched the Global Health Security Agenda, which coordinates the global effort to standardize disease surveillance and response spelled out in the International Health Regulations.

For 2017, PEPFAR’s budget request is $5.2 billion. Will a President Trump, bolstered by renewed conservative GOP armor in both houses of Congress, maintain the initiative’s staggering momentum? It’s vital that he does, not only for the benefit of its recipients overseas, but for American workers as well.

Though estimates are scarce, PEPFAR employs–either directly or indirectly, in both the public and private sector–tens of thousands Americans.

The State Department implements the program. Key agency coordinators include the U.S. Agency for International Development, the Department of Health and Human Services, the Center for Disease Control and Prevention, the departments of defense, commerce, and labor, and the Peace Corps.

Add to that list the National Institutes of Health, the Health Resources and Services Administration, the Food and Drug Administration, and the Substance Abuse and Mental Health Services Administration–and decreases to PEPFAR’s labor requirements by Trump could impact scores of American workers.

However, some health experts choose to focus on small nuggets of hope in Trump and his Vice President-elect Mike Pence, the deeply conservative and devotedly religious Indiana governor.

“Politics is cyclical,” said Naomi Seiler, an associate research professor at George Washington University, at a World AIDS Day 2016 panel at GW’s Milken Institute School of Public Health.

Democrat or Republican, its normal for policies to be renegotiated, realigned and reaffirmed with every new presidential administration, said Seiler.

HIV/AIDS care delivery and awareness was an exception to the rule in the 1980s and early 90s, said panelist Dr. W. David Hardy, senior director at the Whitman Walker Clinic. But today, said Hardy, the American public is more accepting of the public health model championed by HIV/AIDS that’s shown that effective funding and resources can beget worthy results.

One panelist even finds optimism in Pence.

In 2015, when an HIV outbreak sprung seemingly out the blue among intravenous drug addicts in small, rural and poor Scott County, Indiana, Governor Pence, said Dr. Richard J. Wolitski, director of the Office of HIV/AIDS and Infectious Disease Policy, (eventually) responded admirably.

Pence’s first reaction to the endemic was to pray, according to an August 2016 article in the New York Times. But in short order, Pence approved a needle exchange program, along with drug therapy and aggressive outreach, slowing “the flood of new HIV cases to a trickle.”

But as the AIDS Vaccine Advocacy Coalition’s Warren indicated about the 2016 presidential campaign, there is little indication of what Trump will do about global health or HIV.

However, at an October 2015 press briefing in New Hampshire, when a college student asked Trump whether he would support PEPFAR, he seemed to suggest he wouldn’t make changes. The student, whose name was not revealed, began his question to Trump by saying how successful PEPFAR has been.

“Would you commit to doubling the number of people on treatment to 30 million by the year 2020?” asked the student.

Though candidate Trump did not particularly reference PEPFAR in his response, he mentioned AIDS and seemed to commit to PEPFAR in a general way. “Well, I like committing to all those things. Those are great things–Alzheimer and AIDS–but the answer is yes. I believe so strongly in that. And we are going to lead the way.

A clinic on the outskirts of Kampala, Uganda, that receives money from the United States through PEPFAR for AIDS prevention. (Photo: Rodney Muhumuza, Associated Press)

One year later, will President-elect Trump stick to his word?

Even as Trump’s views rotate toward conservative GOP ideology the closer we get to inauguration day, he has altered his positions on domestic healthcare a number of times, both pre- and post-election. In April, the Washington Postreported that Trump changed his position on abortion five times in just three days.

And what of the Affordable Care Act, or Obamacare, the health reform law that Republicans have demonized ever since it was enacted in 2010? Trump and his fellow 2016 GOP presidential candidates, together with Republicans in Congress, have made it clear that repealing the law will be one of their first initiatives in 2017. Now Trump is not so sure.

“Either Obamacare will be amended, or repealed and replaced,” he told CNNfour days after the November 8 election, acknowledging that it was Obama, who met with Trump in the Oval Office for 90 minutes, who encouraged him to reconsider. “I told him I will look at his suggestions, and out of respect, I will do that.”

If ACA is repealed, an estimated 22 million people, many of them poor and older, will lose their health insurance, according to a November 28 New York Times editorial. After his meeting with President Obama, Trump seems open to compromise. The key word is “seems.”

And if Trump so easily flips-flops on domestic healthcare policies like abortion and ACA, what can be expected on the global HIV crisis? Which brings us back to World AIDS Day.

Absent a crystal ball into Trump’s HIV/AIDS global plans, today is a day for action. Whether partnering with the ONE initiative to empower women to take action, or working with the International Medical Corps to relieve suffering, or volunteering with the CDC to rally a domestic response, World AIDS Day inspires small and large acts of hope every December 1, and throughout the year, for achieving an AIDS-free future.

 

8 Health Insurers in 7 States Allegedly Discriminate Against HIV Patients

In David Gately, Health, HIV on October 23, 2016 at 4:04 pm
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HIV medications

Cambridge, MA – A Harvard University healthcare advocacy group recently filed complaints against seven health insurers in eight states, claiming that they discriminate against HIV patients by making vital medications they need either too expensive or by not covering the drugs at all, according to Kaiser Health News.

The complaint was filed in September by the Center for Health Law and Policy Innovation of Harvard Law School (CHLPI) with the Department of Health and Human Services’ Office of Civil Rights (OCR).

CHIPL argues that plans by Anthem Blue Cross Blue Shield, Cigna, Community Health Choice, Highmark, Humana, Independence Blue Cross, and UPMC Health Plan, in Alabama, Georgia, Illinois, Louisiana, Pennsylvania, Tennessee, Texas and Wisconsin, circumvent federal health care law, which profits insures from discriminating against people based on medical condition.

The result not only renders essential treatments unaffordable and unavailable for people living with HIV in those states, it’s alleged to violate both their health care rights guaranteed under the Affordable Health Care (ACA) and their civil rights protections under the Americans with Disabilities Act (ADA).

“What’s most important to us is that there’s a robust enforcement mechanism around the promises … in the ACA and its regulations, especially the anti-discrimination provisions,” said Kevin Costello, director of litigation at CHLPI.

The Harvard center, along with AIDS groups in seven states, examined silver-level–plans, where insurance companies pay 70%, and patients pay 30% and have lower out-of-pocket premiums–available on the Marketplace, to determine whether the plans cover six treatment regimens that are the current standards of care for treating HIV.

CHIPL says the insurers bypass the ACA and its regulations by refusing to cover single-tablet drug regimens that are often tied to better compliance because a number of effective medicines are combined in one pill.  Alternatively, the insurers place most or all of the drugs in the higher gold and premium cost tiers, with patients having to shell out higher monthly premiums, according to the complaint.

CHIPL found, for example, that Anthem silver plans in Wisconsin cover only four of the 16 drugs or combination products that are recommended to meet the current standard of care, and they fail to cover any single-tablet regimens.  In Illinois, the center charged that Humana’s silver plans place 16 of the 24 most commonly prescribed HIV drugs in the highest cost-sharing tier, which requires patients to pay 50 percent of the cost.

With estimated monthly costs ranging from $377 to $684 for different drug regimens, enrollees in the Illinois Humana plans would have to pony up between 8 and 14 percent of their average monthly income, according to the Harvard center.

Costello said although the complaints are addressing HIV drugs, the center hopes the complaint speaks to the larger issue of patients with chronic illnesses difficulty in accessing drugs.

Ben Stiller says an early PSA test (and surgery) saved his life

In David Gately, Health, prostate cancer, prostate caner, PSA on October 11, 2016 at 9:04 am

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Actor Ben Stiller revealed last week that he is cancer-free after a controversial screening test diagnosed him with prostate cancer in June 2014. He credits his good health today on early detection and surgery to remove the tumor three months later.

Stiller, 50, made the announcement on Howard Stern’s Sirius XM radio and in an essay posted on the website Medium with the bold title “The Prostate Cancer Test That Saved My Life.”

“Taking the PSA test saved my life,” Stiller wrote in the essay.

The trouble is Stiller’s doctor tested his baseline prostate-specific antigen (PSA) levels when he was 46, and he choose to have surgery at 48, much too early according to many in the medical community.

The American Cancer Society recommends men begin PSA screening at age 50. And the U.S. Preventative Services Task Force (USPSTF), a group of independent medical experts that issue medical guidelines for doctors to follow, declared in 2012 that no man of any age should have the PSA test to screen for prostate cancer unless he has urologic symptoms.

PSA tests detect an enzyme that is released by prostate cells. Elevated levels of PSA could indicate cancer. In many cases, however, the cancers would progress so slowly that it would not threaten a man’s health or life.

Stiller said his doctor started monitoring his PSA levels after a year and a half of “rising PSA numbers.” He went for an MRI and biopsy and after learning he had a “mid-range aggressive cancer,” he elected to have his prostate removed.

But sometimes the surgery may not be worth taking.

“PSA tests find a whole lot of prostate cancers that will never kill people,” urological surgeon Dr. Peter Albertsen of the University of Connecticut Health Center told STAT  – a national publication focused on telling compelling stories about health, medicine, and scientific discovery – in 2015.

USPSTF’s 2012 recommendation was partly based on evidence that 90% of men with PSA-detected prostate tumors opt for treatment — biopsy, surgery and chemotherapy — but at least 20% of them will have adverse effects such as erectile dysfunction or incontinence.

Stiller wrote, “If he (his doctor) had followed the US Preventive Services Task Force guidelines, I would have never gotten tested at all, and not have known I had cancer until it was way too late to treat successfully.”

The good news is that prostate cancer diagnoses seem to have declined slightly. But a 2015 editorial in the Journal of the American Medical Association worried that fewer PSA tests would lead to more men dying from prostate cancer.

“I think men over the age of 40 should have the opportunity to discuss the test with their doctor and learn about it, so they can have the chance to be screened,” Stiller wrote. “After that an informed patient can make responsible choices as to how to proceed.

Evil Garden: An American family’s foray into Nazi Germany

In David Gately on September 17, 2016 at 9:43 pm

Dateline: BERLIN, Germany, 1933 – a simmer of dire portents.

Extremists prosper as calls for a defense of the Aryan race echo throughout the county, and Jews are blamed for the nation’s ills. In January, as Adolf Hitler is sworn in as chancellor, whispers of the country’s escalating racist ideology ricochet throughout Europe and across the pond.

Seven months later, during a blistering hot summer, a new U.S. Ambassador arrives, thrust into the fermenting milieu. His name is William E. Dodd, a mild-mannered University of Chicago professor, and his ambassadorship brims with fascinating personalities, among them his sexually coquettish daughter Martha.

Seventy-five years later, Dodd’s tenure (1933-37) makes for a captivating read in Erik Larson’s “In the Garden of Beasts: Love, Terror and an American Family in Hitler’s Berlin.”

Larson’s one of the few contemporary American writers exceptionally deft at crafting an imaginary work of novelistic history. “Beasts” certifies another well-conceived work of nonfiction that breathes life into a previously obscure tale. It’s familiar literary territory for him, as best-selling author (and winner of a National Book Award) for “The Devil in the White City.”

“White City” brilliantly animated the mind-boggling events surrounding the 1893 Chicago World’s Fair (White City refers to the Fair’s white stucco buildings, which, in comparison to the brick and mortar Chicago, seemed illuminated.)

It unfolded the bizarre tale of two men: Daniel H. Burnham, the great American architect responsible for the fair’s construction, and a serial killer masquerading as a charming doctor. The effect: an engrossing account of the delightful charm and shockingly sinister side of 19th-century Chicago.

“Beasts” brilliantly illuminates not just the dark side of Nazi Germany but also the delicate scale of human relationships in international politics. Larson’s nimble writing humanizes the whirlwind of escalating cruelty and panic against a backdrop of U.S-German relations leading up to World War II.

Dodd, who prefers to go to bed early each night with a bowl of peaches and warm milk, bumbles his way through dicey diplomacy as a supporting yet key player in the early 20th century nightmare now stamped Nazi Germany.

He met Hitler several times before becoming strongly anti-Hitler and eventually refusing to meet with him. He spoke out vehemently against the regime, warning of war ahead. His remarks angered his State Department bosses, who wondered how an ambassador not on speaking terms with his host government could be effective.

Dodd’s time in Berlin serves as focal point for the horrifying rise of Adolf Hitler and the Third Reich, as the city becomes the site of a glittering social life, secret affairs and political meetings that take place within lavish homes and embassies scattered throughout the city.

Martha, a journalist wannabe, becomes totally smitten by the allure of Berlin’s capricious setting, flagrantly sleeping with members of the diplomatic corps, the SS, the Gestapo and several high-profile American reporters and authors, Thornton Wilder and Carl Sandburg among them.

Though not a comparative study of 1930s antisemitism in Germany verse America, where antisemitism has always been less prevalent, “Beasts” also excels in revealing – through Dodd and his daughter’s prolific journal and letter writing, as well as official State Department dispatches – America’s own struggles with racial and religious intolerance.

“I accepted the attitude that Jews were less socially desirable,” writes Martha from Berlin. In Washington, President Franklin Roosevelt grapples with how to respond to a letter from Hitler calling out America’s hypocrisy in shaming Germany for bigotry when African-Americans – who made up approximately 12 percent of U.S. population vs. a 3 percent Jewish population in Germany in the 1930s – lack voting and other civil liberties.

The narrative of “Beasts” climaxes with “The Night of the Long Knives,” a weekend in June 1934 when Hitler rounded up most of his political opponents and had them executed. It is then that Martha finally sees the cautionary light and accepts the evil of the Nazis.

Dodd survived his ambassadorship in Berlin, an assignment he loathed, retiring to his Virginia farm only to die three years later in 1940. Until Larson’s research, history painted Dodd a weak and ineffective ambassador.

“Beasts,” which takes its name from Tiergarten (Animal Garden), the park across the street from Dodd’s Berlin residence, recasts Dodd an everyday man under unimaginable pressure to maintain personal moral compass serving a thankless job in an immoral environment.

Strange Brew: A toxic blend of master and follower

In David Gately on August 3, 2016 at 7:16 am

Since 1993’s Cigarettes and Coffee, writer-director Paul Thomas Anderson has charmed us with idiosyncratic films that pit extraordinary complexities in human temperament against fascinating history. Consider his three Oscar-nominated movies: Boogie Nights (naive nightclub dishwasher inhabits 70s golden age of porn), Magnolia (misogynist self-help guru antagonizes 90s vacuous San Fernando Valley) and There Will Be Blood (gold miner-turned-oilman lords over early 1900s frontier).

His latest, The Master, is another cinematic outlier. Here we have the promise of post-War World II America beguiling two extremely flawed men: one a reckless alcoholic drifter, the other a manipulative cult leader. Both are looking for a fix.

Freddie Quell (Joaquin Phoenix), the drunk, needs help. Lancaster Dodd (Philip Seymour Hoffman), an L. Ron Hubbard-like leader of a Scientology-like congregation called The Cause, needs someone to repair.

The story opens at end of WWII. Freddie, a sailor onboard a U.S. Navy ship, lies alone, passed out on top of the ship’s engine, staring blindly into what’s most likely a South Pacific sky. Something about him whispers unhinged misfit. He’s a drink mixologist, adept at concocting a grain-alcohol blend of paint-thinner, bread and sugar. Devoid of this brew, he drains (and drinks) either fuel or incendiary liquid from a bomb.

On a beach with other sailors, Freddie gulps alcohol from coconuts and mimics sex with a busty sand sculpture of a woman. Trapped and frustrated in his hyper-sexualized fantasy, he wanders to the ocean’s edge to masturbate. Later, when a shrink presents him with a Rorschach test, he sees only “pussy” and “cock” in the inkblots.

At war’s end, Freddie’s in San Francisco, aimless and showing signs of colossal post-traumatic stress disorder.

Enter Dodd, onboard a yacht at a San Francisco wharf, cajoling his flock of followers. He’s readying the herd, including his wife Peggy (Amy Adams), for a long, spiritual journey to New York, via the Panama Canal. Something about him says charismatic huckster. Freddie, drunk again and wandering the docks, stumbles onto Dodd’s boat and passes out. When the boat’s at sea, Freddie wakes, and Dodd summons him for a meeting.

In Freddie, Dodd sees a “protégé and guinea pig,” someone he can cure and offer to doubters as shining proof of his ideology’s veracity. The elder gentleman wields his smarts and paternal authority to manipulate Freddie’s vulnerabilities. He’s also looking for a comrade who knows how to make a stiff drink, he tells Freddie, which furthers his mixed-message seduction. In Dodd, Freddie sees the only person in his small world who cares and may have the answer to his desperation.

The Master’s cinematic peak – and the scene that will no doubt screen at the Oscars next year when Phoenix, Hoffman and Thomas Anderson are nominees – has Dodd “processing” Freddie. [Thomas Anderson admits borrowing from Scientology for The Master, and similar to L. Ron Hubbard, Dodd believes he can cure sickness through a Q&A session similar to Scientology’s auditing, by recalling and exorcising demons from childhood and past lives.] Here, Phoenix and Hoffman’s artistic sparring and Thomas Anderson’s camerawork showcase a master class in film making.

Phoenix’s physicality throughout The Master recalls Brando and De Niro. Rarely in modern cinema do we get to witness such a stunning method of inhabiting a character.

Hoffman is just as agile. His outbursts of rage, childishness and violence are brilliantly tempered with grace and charm. His Dodd is a prideful shaman, weakened by the weight of his own make-believe world.

Eventually, Freddie and Dodd run an inevitable course toward toxic rivalry, between philosophical contempt and brotherly love. But like all affection built on lies and deception, the pathology eventually breaks the bond. Neither can fix the other.

The movie presents a surreal story based on facts that are at once lucid, a bit confusing and thoroughly engaging. Its power – and perhaps source of both its appeal and ambiguity – relies on questioning what’s on scene:  who’s setting up whom, and more pointedly, what dialogue and imagery are real, and what scenes only reflect Freddie and Dodd’s psychotic imaginations?

With The Master, Thomas Anderson – one of America’s few, young (he’s 42), outside-the-lines writer-directors – presents a tour de force in human character study and semi-conscious disquiet.

John Brown’s Body: Revisiting a rebel’s raid

In David Gately on June 15, 2016 at 9:29 am

As America recognizes the sesquicentennial of its Civil War, John Brown and his role in sparking that war remain a mystery to many.

Ask, and you’ll likely hear an assortment of reactions toward the man. Abolitionist. Agitator. Hero. Lunatic. You could get a simple: “who’s John Brown?” Or you may hear the hymn of the infamous Union battlefield march:

“John Brown’s body lies a-mouldering in the grave,
His soul’s marching on.
He’s done to be a solider in the army of the Lord,
His soul’s marching on.”
 

Brown is often a footnote in American history books, relegated to a fuzzy heliographic engraving of a crazed dissenter who staged the botched, blood-spattered raid on Harper’s Ferry, Va., in October 1859, in protest of slavery.

But read Tony Horwitz’s “Midnight Rising: John Brown and the Raid That Sparked the Civil War,” and a fresh supposition surfaces.

In Horwitz’s fluid, engaging narrative, Brown is rebaptized a proud American, passionate humanist and suffragette of social ills. He may have been a woefully flawed, madcap anarchist, but he was fundamentally a good-hearted husband, father (to 20 children) and citizen, organically revolted by the imorality of American slavery.

The Brown of “Midnight Rising” is a self-anointed insurgent, a nineteenth-century forerunning rebel-rouser, feverishly devoted to committing suicidal violence to spark a moral crusade against injustice.

Brown didn’t die in the raid, but 16 of his men did, including two of his sons. Another died while waiting trial for treason against the Commonwealth of Virginia, and six men, including Brown, were eventually hanged for their involvement.

In Horwitz’s account, Brown’s path to Harper’s Ferry seeded early as his Calvinist parents preachly loudly against America’s sins – slavery, foremost – while turning their Ohio home into a stop on the Underground Railroad. When he witnessed the whipping of a slave boy, young John Brown was deeply sickened. A mini abolitionist emerged.

Born in 1800, Brown by his 20s was a fledgling figurehead in the growing national debate on slavery’s abhorrence and antithesis to equality, a founding principle. By the 1830s and ‘40s, he was travelling the country speaking to noted abolitionists, including Fredrick Douglas.

Brown’s half-baked Harper’s Ferry scheme plotted a rally of mutinous soldiers – anti-slavery whites, as well as free- and runaway-slaves – to steal guns and ammunition from the federal armory and to turn those weapons on slaveholders in the South. His actions drastically altered Abraham Lincoln’s philosophy on slavery during his 1860 presidential run and ultimately led to the start of the Civil War a year later.

Reading “Midnight Rising” post-9/11, through the lens of a newly Occupied world, offers an intriguing glimpse into the mind of a civil aggressor.

Horwitz, a Pulitzer Prize-winning journalist, is a nimble writer. As a best-selling author of books like “Confederates in the Attic: Dispatches from the Unfinished Civil War,” his “Midnight Rising” is part history, part biography, but mostly fascinating to read. It’s John Brown: humanized, demystified and maybe not so lunatic after all.

As the war began to fracture of the country in 1861, Henry David Thoreau called Brown “the most American of us all.” He added, “They called him crazy then; who calls him crazy now?”

Take Me Out to the Numbers Game: “Moneyball”

In David Gately on February 26, 2016 at 2:58 pm

Let’s hear it for smart Hollywood movies. For “Moneyball,” a new film about statistics in baseball staring Brad Pitt, is a nimble one.

The movie is based on the 2003 best-seller by Michael Lewis, “Moneyball: The Art of Winning an Unfair Game.” Pitt plays Billy Beane as the innovative general manager of the Oakland Athletics during the 2001-02 season.

Beane was a young baseball protégé drafted out of high school by the New York Mets. Then, for no clear reason, particularly to Beane, his abilities calcified. He was no longer the sure-shoot wunderkind. He bounced from team to team to team and ended up playing for the A’s, until the day he walked off the field and into the front office and declared he’d make a better scout than a ballplayer. Eight years later he’s G.M. of the small-market, losing team.

With the A’s minuscule purse-strings, Beane goes onto use sabermetrics (baseball statistics) to build a solid team of undervalued players that can compete with the bloated Goliaths of the league – the Yankees, Red Sox and Phillies, primarily. His quirky number crunching propels the A’s into multiple playoffs over the next several seasons. He forever changes conventional wisdom in baseball.

If baseball is the every-man’s sport, “Moneyball” is the thinking-man’s movie. The dialogue is chiseled and clever. The triumphant cast – of Pitt, Jonah Hill and Phillip Seymour Hoffman – is terrific. There’s even early Oscar buzz for Pitt.

The director, Bennett Mill, directed Seymour Hoffman’s Oscar-winning performance in “Captoe.” His “Moneyball” captivates from the get-to, a smoothly seamed stitch of narrative, which, refreshingly, doesn’t rely on a nostalgic soundtrack for transition. Under a lesser hand, “Moneyball” could have wound up overtly honeyed and hackneyed.

The script is co-written by Aaron Sorkin and Steven Zaillian, two of Hollywood’s current It-writers. Sorkin, of course, is the Oscar-winning screenwriter of last year’s “The Social Network.” He cut his lexicologically dexterous teeth on “A Few Good Men,” “Malice” and TV’s West Wing.

Zaillian won a best adapted screenplay Oscar for “Schindler’s List” and co-wrote screenplays for “American Gangster” and “Gangs of New York.” He also wrote the screenplay of the much-anticipated American take on one of the wildly popular books in Stieg Larsson’s Millennium series, “The Girl with the Dragon Tattoo,” which drops December 21, and is directed by “The Social Network’s” Oscar-nominated David Fincher.

Sorkin and Zaillian are high-octane gifted TV-movie writers in the vein of Paddy Chayefsky (“Network”), Reginald Rose (“12 Angry Men” and TV’s Boston Legal) and Alan Ball (“American Beauty” and TV’s Six Feet Under and True Blood). They are uber-smart, egotistical and (rumored to be) difficult-to-work-with Hollywood big-shoots. In the age of vapid, recylced Hollywood movies like “I Don’t Know How She Does It” and “Shark Night 3D,” movie-going America should thank them for that.

In Sorkin’s own words, “‘Moneyball’ is no more a movie about baseball than ‘The Social Network’ is about Facebook.'” And therein lie its smartness – and its beauty.

I know nothing more about baseball statistics than I do about computer algorithms. I do know, however,  that unlocking the mysteries of either – like unearthing the reasons for the final battle on the moon Endor, with its natural inhabitants, the Ewoks – can begat creation and destruction, wisdom and foolishness, beatitude and sorrow, adulation and reprehension – all of which make for compelling and timeless storytelling, and great movies.

In his new memoir, “Life Itself,” Pulitzer Prize-winning film critic Roger Ebert pines for the days when Hollywood movies were more than mediocre. He says, “Hollywood dialogue was once witty, intelligent, ironic, poetic and musical. Today it is flat.”

Not “Moneyball.” And you can thank Sorkin and Zaillian for it.

“MONEYBALL” TRAILER

Drive: What Motivates Us?

In David Gately on January 31, 2016 at 10:49 am

Let’s say you’re the head of a U.S. automaker. Your last quarter was very strong, but once again your company sheepishly claims the second-most-popular spot in world of auto sales.

Though all market indicators are on your side to crown you the new number one automaker – your technology is top-notch, your employees are uber-creative and productive, driving trends are in your favor – you just can’t seem to break through an illusive glass showroom ceiling that keeps stitching on your vehicles’ leather steering columns a big scarlet R: runner-up.

Is there anything you can do maneuver into first place? What about shifting your productivity gear into overdrive?  How about a cash incentive to inspire your employees to create a break-through in auto innovation: the next must-have car?

That’ll work. Everyone responds to a reward, especially a monetary one. It’s the textbook gold-standard in employee motivation. You’ll soon out prius the Prius.

But not so fast. If Daniel H. Pink were advising you he’d likely say – think again.

Pink’s popular book “Drive: The Surprising Truth About What Motivates Us,” currently number 23 on the paperback nonfiction New York Times Best Sellers List, cautions that the truths we’ve long held about extrinsic rewards, especially in the workplace, are not so valid anymore.

In fact, Pink says “rewards can form a weird sort of behavioral alchemy: They can transform an interesting task into a drudge. They can turn play into work. And by diminishing intrinsic motivation, they can send performance, creativity and even upstanding behavior toppling like dominoes.”

Pink, author of 2006’s New York Times best-seller “A Whole New Mind: Why Right-Brainers Will Rule the Future,” is quickly becoming a go-to literary guru in attempting to understand ourselves and our behaviors in a contemporary world, including the workplace. His writing is crisp, breezy and absorbing.

“Drive” outlines the transition of human nature from basic survival, through a period of “seek reward, avoid punishment,” to where we are today, in a period dominated by what Pink defines as three new basic elements: autonomy, creativity and purpose. Though money was more of a people motivator in the manufacturing 20th century, in today’s global information environment, ingenuity trumps routine.

Through well-documented and widely reported psychological surveys and testings, like the Soma puzzle and solving the “candle problem” – securing a candle to a wall using only matches and a box of tacks – Pink shows us how our “algorithmic” and “heuristic” activities have evolved.

An algorithmic task, like bagging groceries at the supermarket, is when you follow a set of established rules to a single conclusion. “A heuristic task is the opposite,” says Pink. “Precisely because no algorithm exists for it, you have to experiment with possibilities and devise a novel solution. Creating an ad campaign is mostly heuristic. You have to come up with something new.”

“Drive”  proves that for many people (most of us), the joy in life and at work is found in the intrinsic. Drudgery is out. Engagement is in.

There’s a good slogan for the next Prius. In scarlet red please.