The Week in Movie News: Scott Derrickson to Direct ‘Doctor Strange 2,’ New ‘Godzilla: King of the Monsters’ Trailer and More

The Week in Movie News: Scott Derrickson to Direct ‘Doctor Strange 2,’ New ‘Godzilla: King of the Monsters’ Trailer and More

Need a quick recap of the past week in movie news? Here are the highlights:

BIG NEWS

Doctor Strange 2 holds on to director Scott Derrickson: Marvel is moving forward with a sequel to 2016’s Doctor Strange with a planned 2021 release. The original’s director, Scott Derrickson, will take the helm again with stars Benedict Cumberbatch and Benedict Wong returning on screen. Read everything we know so far here.

 

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Scott Derrickson to Direct ‘Doctor Strange’ Sequel; Here’s Everything We Know

Scott Derrickson to Direct ‘Doctor Strange’ Sequel; Here’s Everything We Know

There was a time when the Marvel Cinematic Universe was publicly planned out years in advance, but currently, we still don’t know many confirmed titles, let alone their release dates for anything post-Avengers: Endgame next May.

There’s Spider-Man: Far From Home in July for sure, and then what? At some point we expect to see Black Panther 2, Guardians of the Galaxy Vol. 3, Black Widow and Eternals. Now comes word that Doctor Strange 2 is also on the way.

At the moment, the…

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Graham O’ Brien Is the Breakout Companion of ‘Doctor Who’ Series 11

It’d be reasonable to suggest that any incarnation of the Doctor is only as strong as their companions – especially when they’re first starting out. Throughout the years, TV’s greatest time traveller has played host to robot dogs, pansexual con men from the 51st century, and even a few so-called “impossible” girls able to do such extraordinary things as absorb the Tardis’s time vortex, or implant multiple versions of themselves across the Doctor’s timeline. With all this in mind, who’d have thought that one of the most memorable companions in recent years would turn out to be a middle-aged bus driver from Essex? But that’s the power of Bradley Walsh’s Graham O’Brien.

Introduced alongside the Thirteenth Doctor’s other two new chums, Yaz and Ryan, Graham has spent most of this recent season with one of the most emotional character arcs. Usually, a companion is thought of as a surrogate in which audiences can experience these fanciful flights of escapism when embarking on the next interdimensional adventure, but it’s in Graham O’Brien where the show manages to stay relatively grounded and relatable – if only for the humanity he brings via his humour and grieving.

Many were sceptical of Bradley Walsh’s casting heading into this new series, wondering how he would fit. But, boy, has he exceeded all our expectations. Here’s why we love Graham O’Brien.

Optimism Amid Great Loss


Giant spiders and mud monsters won’t stop Graham from looking up.

Right from the off, Graham’s reasoning for joining the crew once the Doctor regains control of her Tardis at the end of “Arachnids in the UK” is an honest one. Following the heroic death of his wife, Grace (played by Sharon D. Clarke) during the climax of the season opener, Graham looks to use this call for adventure as his primary coping mechanism. It isn’t unusual for the Doctor’s companions to be running away from something, but this is usually something as trivial as the monotony of everyday life – here, it’s the death of a loved one.

This has led Bradley Walsh to play Graham throughout the season with a consistent sense of faint vulnerability, as he once again is forced to ponder what he deems important in life. Despite these terrible circumstances Graham always does his best to stay strong and optimistic, whether it’s in the way he defends his fellow companions against the ongoing racial discrimination of 1955 Alabama in “Rosa” or how it’s revealed he always packs an emergency sandwich in the chilling “It Takes You Away“.

Against all odds, Graham has been gradually growing stronger following his wife’s death, slowly finding the value in life after loss. Optimism has been an overarching theme of Jodie Whittaker’s initial season of Doctor Who: Bradley Walsh embodies this perfectly, and often, beautifully.

Laughing in the Face of Adversity


What other Doctor Who companion needs to stay aware of their blood sugar levels?

To think that Graham O’Brien would be pitched solely as Doctor Who Series 11’s comic relief character may have been wrong, but that doesn’t mean he’s not funny. In fact, he’s hilarious. The character has been a replete dispenser of ‘grandad jokes’ throughout the series – always ready to defuse the tension of the scary scenarios our Tardis crew find themselves in with a bout of regular-Joe jokes. This once again feeds into the emotional journey the character finds himself on, as he continually attempts to find ways to turn his state of anguish into positivity. Even when confronted by 17th-century mud monsters and the maniacal shopping robots of an off-brand Amazon.

I’m Dreading Christmas Without ‘Doctor Who’

One of our favourite running gags so far comes from his constant seeking of grandparent legitimacy. Where, on more than one occasion, Graham has raised his hand for a fist bump to Ryan in true ‘I’m down with the kids’ fashion, only to be left hanging. Despite how “uncool” Ryan might deem it currently, we remain confident that this deal will eventually be sealed by the end of the series finale – if not then, the New Year’s Day special.

It soon becomes clear that Graham is far from the old codger the average passer-by might initially presume him to be, despite him needing to stay conscious of his low blood sugar. When Ryan suggested a bit of Bradley Walsh’s real-life friend, Stormzy, to grant the mutant spiders’ passage to safety in “Arachnids in the UK” he appeared more than willing, and made a rather convincing Steve Jobs when having to think on his feet in the face of a discriminative law enforcement officer. And how could we forget, he is now best mates with Banksy (the Doctor)?

The Voice of Reason


The Tardis team can always look to Graham for advice.

It’s only been passingly mentioned in the show, but as a retired bus driver in remission from cancer, Graham’s vast life experience as the Tardis crew’s most senior human member has rendered him the voice of reason on more than one occasion. This most often comes as a result of him seeking to adequately fulfil the grandad role for Ryan, one that he feels the implicit need to step-up to given the loss of Grace, Ryan’s nan. His 21st-century point of view means he is able to stay level-headed and understand Yas and Ryan’s perspective, particularly on history, alongside the Doctor.

This approach of his was indicated early on in the season when, in ‘The Woman Who Fell to Earth”, Graham’s ‘bish, bash, bosh’ attitude and general advice to simply “ask a bus driver” proved crucial in tracking down the menacing Tim Shaw. It’s since continued to feed through into episodes like “Rosa”, “Demons of the Punjab“, and even “The Witchfinders“, where characters feel comfortable in confiding in the middle-aged retiree whenever the question their own beliefs, or what is good and right.

All this contributes to how remarkable Doctor Who’s most seemingly unremarkable companion has turned out to be, pretty much right from the off. Bradley Walsh’s Graham O’Brien is a multi-faceted character we hope will continue to be part of Team Tardis for many future adventures, even if his strong emotional through-line looks to be coming full circle by this season’s end.

Bradley Walsh’s Best Lines in the ‘Doctor Who’ Series 11 Premiere

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A ‘smart’ toilet could stop us from flushing away our most valuable health information, says doctor

Both doctors and patients could benefit if we figure out a way to stop flushing away some of our most vital health information, argues Dr. Sameer Berry, a third-year resident physician at Cedars-Sinai Medical Center in Los Angeles.
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5 Cutest ‘Doctor Who’ Monsters

Whatever your opinion is of Season 11 of Doctor Who thus far (and I’m going with ‘I’m unquestionably a big fan of the Thirteenth Doctor, but I’m more than ready for an episode where she’s not ‘just’ another character in it’), few Whovians would say that they weren’t extremely taken with the debut of the Pting, the energy-scoffing creature from last weekend’s episode, “The Tsuranga Conundrum”.

To recap, the Pting is a small bipedal creature, a little bit like a reptilian Beanie Baby or an extremely old dinner lady who has been left in the wash. It feeds off pure energy, even going as far as to munch on the Doctor’s sonic screwdriver in the aforementioned episode. It’s immortal too. And it’s completely adorable. Word has it that the BBC has been inundated with requests for Pting toys to be made in time for Christmas (we’ll take two please, thanks).

Much is made of Doctor Who’s ability to leave viewers hiding behind the settee, and with good reason. But the show is no stranger to bringing us creatures more “aww!” than “eww!” And so, we thought now was as good a time as any to see how the following Doctor Who cuties compare to the Pting. It’s going to be a close-run thing…

ADIPOSE

First appearance: “Partners In Crime“, 2008

Inspired by a stuffed toy that then-showrunner Russell T. Davies owned, this vaguely humanoid creature takes its name from ‘adipose tissue’, the scientific name for body fat. You know them. They look like happy Tic Tacs or andromorphic marshmallow, and the year they debuted, they were the only Christmas gift any Doctor Who fan wanted. The Pillsbury Doughboy was another frame of reference for their creation, although the creatures’ signature central fang didn’t come about until acclaimed post-production team The Mill (they made the groovy title sequence in the RTD era) came to work on the project.

How cute are they compared to the Pting? Probably cuter. But there are loads of them and (that we’ve seen) only one Pting, so it’s not really fair.

TERILEPTILS

First appearance: “The Visitation“, 1982

Despite being war-loving space reptiles – albeit ones who were huge fans of art and beauty, going so far as to consider conflict itself part of that last category – there was always something about the Terileptils that slightly resembled an elongated Cabbage Patch Kid. Of course, the CDT homework nature of many old Doctor Who creatures neutered how scary they were intended to be, to some extent. But never more than in the case of these guys, who despite being a dangerous foe for the Fifth Doctor, really did look like, on some level, they’d stop all this warmongering if they just had a nice hug.

How cute are they compared to the Pting? The Pting wins, despite the Terileptils ruffles. BUT IMAGINE A PTING WITH RUFFLES!

TIVOLIANS

First appearance: “The God Complex“, 2011

On one hand, these gopher-like-humanoids are cute, in the sense they’re, y’know, gopher-like humanoids. On the other, they’re so cowardly – their species desperate to be a conquered and enslaved – that how supremely irritating they are does a lot to negate how much you’d like to spend any significant time with them. Beneath the prosthetics, that’s David Walliams from terrifyingly problematic, early noughties sketch-comedy sensation Little Britain. Although the only reason we draw attention to this is to say, “HE’S A GOPHER!”

How cute are they compared to the Pting? They’re too snivelling to be truly cute. That they made their debut in an episode with a giant Minotaur in it means they perhaps appear more cute comparatively than they would have if they hadn’t.

QUARKS

First appearance: “The Dominators“, 1968

It’s no secret that the Quarks came about as a result of the BBC desperately trying to recapture the popularity of the Daleks, who at the time were due some downtime, as they have been, if we’re being really honest, throughout the entirety of the show’s history. Then-producer Peter Bryant approached writers Mervyn Haisman and Henry Lincoln and asked if they could create an adversary to the Doctor with a view to replicating the merchandising opportunities that had arisen via the success of Skaro’s most exterminatory upturned dustbins. This is what they came up with.

Okay… You need to watch the Quarks to really see how badly Hausman and Lincoln delivered on their brief, or at least hear them, the surprisingly tiny robots sounding a bit like someone whose boffed helium trying to talk underwater. To be fair, an argument over edits to Haisman’s and Lincoln’s original designs resulted in the pair walking away acrimoniously from Doctor Who (the episode they appear in is written by ‘Norman Ashby’, a pseudonym), so they could have been imagining something different. Let’s hope so.

How cute are they compared to the Pting? It’s close. It’s really, really close. But the sheer fact that we think hugging a Quark would feel a bit like hugging a washing machine means that the Pting wins out.

SLITHEEN CHILD

First appearance: Okay, we’re cheating a little bit. This little guy turns up in the ninth and tenth episodes of Season 1 of Doctor Who spin-off, The Sarah Jane Adventures, in 2008 (RIP Elizabeth Sladen, you are forever missed…).

There comes a point in all creature design, where, no matter what other menacing physical attributes your creature might possess, you’ve made the eyes slightly too big and it ends up looking cute. Try it. Take out a copy of the paper. Find yourself a politician or other rotter doing their best to make the world a meaner place, take out your pen, apply it to the paper, and make their eyes really big, and full, and wide — and you’ve got yourself an adorable monster!

How cute are they compared to the Pting? It’s a clear win for the Pting. Although. We. Can’t. Stop. Looking. Into. Those. Lovely. Eyes. Of. His.

Spiders Have Been Spinning Their Intricate Webs in ‘Doctor Who’ for Years

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The New ‘Buffy’ Can Learn A Lot From the Thirteenth Doctor

The new Buffy the Vampire Slayer show is looming large on the horizon. We don’t know much so far, but as a massive fan, my nerdy heart has been doing cartwheels since confirmed showrunner Monica Owusu-Breen announced that the new show will likely showcase a new Slayer (and a new group of Scoobies).

Honestly, a Buffy reboot makes sense: The story of the Slayer has always been about passing the mantle on to a new generation. But Buffy isn’t the only series getting a fresh start. The first Doctor Who episode featuring Jodie Whittaker’s Thirteenth Doctor premiered on October 7, and it was everything a huge Who fan like me could want. While watching the new Doctor in all her glory, something recently dawned on me: Buffy and the Doctor deal with similar problems, but in very different ways.


Buffy the Vampire Slayer Doctor Who

Both heroes regularly deal with non-human enemies who threaten their friends and home. But while Buffy stab-stabs her foes, the Doctor tries to understand them. If this most recent season of Doctor Who proves anything, it’s that there’s room in the supernatural landscape to explore problem-solving in a more measured manner than Buffy did back in the ’90s.

Slayer vs. Doctor

Buffy and the Doctor are more alike than you might think. Both characters play a specific role that’s been filled by a long line of people before them – the Slayer’s powers are passed from young girl to young girl after death, and the Doctor is the same being who’s reborn with a new body and personality after regeneration (a kind of overall reset button). They both encounter fantastical monsters (demons or aliens) that work in either weekly stand-alone episodes or whole season arcs. But they differ greatly in how they approach those monsters.


Buffy the Vampire Slayer Scoobies

For starters, Buffy has found a family in her friends, the Scoobies (a group that grows and shrinks over the seasons, but always consists of Willow, Xander, and Giles), who ground her combative nature with good old-fashioned research — more often than not, even after Buffy’s friends provide her with historical context and intellectual preparation to face her foe, Buffy still stabs. She’s the arm muscle; she’ll shoot a bazooka at her ex-boyfriend without hesitating. She has a concrete support system to welcome her back once the fight is over. Conversely, the Doctor has had multiple beloved companions over the most recent 11 seasons, none are permanent fixtures in her life. Like the Doctor’s physical form, her companions also change with time; part of her tragedy is that she has no permanent family.


Buffy the Vampire Slayer bazooka

Perhaps because of her solitary nature, the Doctor takes a different approach to conflict: She asks questions, explores her enemies’ motivations, and tries to understand them both physically and emotionally before resorting to bazookas. The Doctor considers most aliens and robots she comes across as capable of change until proven otherwise. The slaying is exciting, no doubt, but as I get older, I wonder if that’s the best approach to take regarding all creatures unknown.

We Need More Adults in the Room

Buffy was chosen, against her will, to be a warrior. The Doctor made the decision to defy expectation and fix what ails the universe one corridor at a time.  It makes sense that the Doctor’s a more naturally diplomatic hero than Buffy. The Slayer is, by nature, a teenager; her young age is built into the show’s DNA. The Doctor is older than most sentient beings can comprehend, has taken multiple forms, and traveled across galaxies.


Doctor Who Thirteen

I was a teenager when Buffy premiered back in 1997, and I liked the exciting stabby-stabby of it all. I was younger and the world was different then. I’m not a teenager anymore — but many of the new Buffy fans will be. When approaching a new young audience, is “slay first, ask questions later” the core message we want to send? As I get older and my worldview begins to align more closely with the Doctor’s, I wonder if we should tread more lightly, more carefully, like the Doctor. Adults use their words, not their Mr. Pointy stakes. And what the world desperately needs right now is more adults in the room.

Buffy Can Learn From Thirteen

One of Buffy’s key character components is her rebellious streak. From the very beginning of the show, she absolutely refused to conform to the Watchers Council’s archaic traditions. The Doctor has always been similarly rebellious. But with Thirteen, the Doctor isn’t just rebelling against what it means to be a Time Lord; she’s rebelling against ingrained audience expectations. Thirteen differs greatly than past Doctors in her physical form (she’s the first woman Doctor), her creators (this is the first season to feature scripts by writers of color), and her new adventures.

A typical episode of Doctor Who, like most sci-fi stories, is an allegory for societal ills — the most obvious being the Doctor’s genocidal foes, the Daleks. But Thirteen’s series is more literal. In Episode 3, the Doctor and her new team meet Rosa Parks, Martin Luther King, Jr., and Fred Gray, then become an integral part of American Civil Rights history. It’s less a metaphor and more a clear political statement. And these days, we’re all hungry for heroes who aren’t afraid to make a statement.


Doctor Who Rosa Parks

The creative staff of Doctor Who trusted that the audience was mature enough for a new kind of Doctor, and it’s paying off (both narratively and in numbers). Buffy is being given a similar opportunity. The Slayer’s fan base has grown up, but can the show mature with us? Maybe the stabby-stabby is just who Buffy is, and that’s fine. But maybe she can change and evolve with us. After all, one of the Slayer powers is natural leadership — and good leaders know that violence is always a last resort.

Why ‘Doctor Who’ Series 11 Could Be the Best Yet

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Doctor: Ironic that Pittsburgh suspect is being treated by Jewish staff

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Readers And Tweeters: Are Millennials Killing The Primary Care Doctor?

Letters to the Editor is a periodic feature. We welcome all comments and will publish a selection. We edit for length and clarity and require full names.


Health Care Wasted On The Young

I feel Sandra Boodman’s thesis is inadequate without a historical comparison to how young people accessed health care five, 10 or 20 years ago (“Spurred By Convenience, Millennials Often Spurn The ‘Family Doctor’ Model,” Oct. 9). As a family medicine doctor practicing for 33 years, my experience is that healthy young people use medical services only for urgent care and pregnancy until they develop chronic conditions. And, as a society in general, we have become more demanding about receiving services “now.”

Why should medical care not change as our expectations change? Certainly we have the technological ability to provide a portable health record one could take from site to site to improve continuity. We also have the ability to have a single electronic medical record or shared information hub so one’s health info can be accessed by any provider anywhere.

However, demanding “now” care at any convenient site does not allow one provider to get to know a person in a way to better inform them of how that individual’s situation (emotional-social-economic) impacts their health. So, convenience has its price.

— Dr. Kevin Walsh, Ellensburg, Wash.


Family physician Ajoy Kumar of Florida led a lively debate on Twitter and, in a series of tweets, emphasized how important it is to build doctor-patient relationships early because “nobody is young and healthy forever.”

— Dr. Ajoy Kumar, St. Petersburg, Fla.


It’s not so much the new generation as it is the age group. I didn’t have a primary care physician from the time I entered university until I was 42. I also only went to the doctor when I had a particular problem to deal with. Even back then (25-30 years ago), a $ 200 deductible meant I could pay for insurance but could not afford to use it for anything other than a dire emergency. Of course, back then almost everything was traditional indemnity, so we all paid full-freight unless you were covered by one of the nascent HMOs (which often controlled costs by denying care).

— Brenda F. Bell, North Plainfield, N.J.


Another primary care doctor bemoaned the trend as part of a larger move away from generalized medicine:

— Dr. Holly Mitchell, Amarillo, Texas


As long as we are talking about new models for medicine, here’s a plea for “human-centered design thinking”:

— Julie Schilz, Northglenn, Colo.


Laryngitis On The Campaign Trail?

It isn’t surprising that health care is a priority issue for voters (“Health Care Tops Guns, Economy As Voters’ Top Iissue,” Oct. 18). After all, the chief cause of personal bankruptcy is medical bills. Nor is it surprising that voters have not heard much about health care from midterm election candidates, who know the future success or failure of the health system and their political futures depend on how they respond to voters’ top concerns. It is much safer for our political leaders to leave the administration of the health system to the insurance companies.

But, so far, private insurers have shown they are more concerned with shareholders’ concerns than patients’. The result is a fragmented, impersonal health system overrun by multiple insurance plans, each with different copays, deductibles and insurance panels — where doctors are held captive by insurers’ regulations. If we vote people into office because we believe they will respond to our needs, why are so many of them so quiet on health care?

— Dr. Edward Volpintesta, Bethel, Conn.


Metrics Show Medicaid Is True To Its Mission

Both Medicaid enrollees and taxpayers see real results from Medicaid health plans — despite contrary claims (“As Billions In Tax Dollars Flow To Private Medicaid Plans, Who’s Minding The Store?” Oct. 19). Medicaid plans are held to high standards by the states, improving health, quality and savings for millions of Americans, including children, veterans, seniors and people with disabilities.

Medicaid plans run many programs to improve patient health — driving quality, coordinating care, and helping patients stay compliant with treatment. The vast majority of every Medicaid dollar pays for care, while Medicaid plan profit margins average less than 2 percent.

Medicaid plans report metrics that are made public. Results show that insurance providers saved states about $ 7 billion in 2016 alone — helping states realize the highest value for their Medicaid investment. Research shows that Medicaid enrollees have access to care that is similar to those who have coverage through their jobs, and are satisfied with their coverage.

Medicaid serves nearly 75 million Americans. Insurance providers know that Medicaid must work for those who rely on it — and the hardworking taxpayers who pay for it. We are committed to working together to ensure that Medicaid is effective, affordable and accountable.

— Matt Eyles, president and CEO of America’s Health Insurance Plans (AHIP), Washington, D.C.


A tweeter reading the same story noted the outsize level of Medicaid oversight compared with that of corporate America.

— Fran Quigley, Indianapolis


Imagine No Big Pharma

I know that we are all supposed to think the pharmaceutical industry is the savior of our country and that without them life itself would not be possible. What if we instead began to think of them as just the manufacturers of medication? What if we did our own drug research (maybe researching medication to treat millions instead of medication to make millions) and collected bids from every drug manufacturer for production only? What if we used tax dollars to pay for the manufacturing of the medications, and patients had to pay only a token pharmacy fee? I wonder what that would look like.

— Dr. David Herring, Staunton, Va.


Unamusing Cartoon

The publication by Kaiser Health News of a Nick Anderson cartoon with the caption “Inadequate Mental Health Services” above a picture of a prescription bottle reading “RX for Violence” from which bullets spill forth, is both surprising and deeply disappointing (‘Alternative Treatment’? Oct. 18).

How easy it is to imply that gun violence, indeed violence of any type, is largely attributable to untreated or undertreated, mental health conditions. But the facts, which I and millions of readers have come to expect from KHN, say otherwise. Mass shootings, the thought of which this cartoon invokes, account for less than 1 percent of gun violence, and for which mental health is a factor in but a small minority of cases. And while suicides are in fact increasing, and 85% of completed suicides involve guns, this too is only a small fraction (about 2%) of gun violence in the U.S.

It would be expected that KHN editors would be familiar with the oft-cited statistic that only about 4% of all violence may be attributed to people with serious mental illness, and the fact people with mental health conditions are far more likely to fall victim to violence than to perpetuate it against others.

As a trusted source of factual news, it is shocking that Kaiser would perpetuate and reinforce the erroneous, albeit widely held belief, that mental illness (treated or not) equates to gun violence.

— Debbie Plotnick, vice president for mental health and systems advocacy, Mental Health America, Alexandria, Va. 


I appreciate the perspective that inadequate mental health services can lead to negative consequences for the individual and, ultimately, for society. However, the implied connection between mental illness and violence is unfairly stigmatizing and not supported by evidence. In addition, the use of a prescription bottle seems to suggest that medication is the prescription for “adequate mental health services,” which vastly oversimplifies the need for a range of services that should be included in an effective, comprehensive system of care. I hope that you will consider removing this cartoon from your website, as it is harmful to engaging and truly supporting people with mental health needs.

— Jenifer Urff, Northampton, Mass.


A Call For Deeper Reporting

I was disappointed by Phil Galewitz’s reporting on the negative aspects of Medicare Advantage HMOs (“Medicare Advantage Plans Shift Their Financial Risk To Doctors,” Oct. 8), although it was nice that he quoted me and that you incorporated “risk shifting” into the headline. Galewitz cites a Health Affairs report but should have mentioned years of reports by the Government Accountability Office and the Medicare Advisory Payment Commission detailing overpayments and risk analysis and overpayments. There is a big dark side to Medicare Advantage plans that patients/consumers do not understand. They think it’s all about “free” care. It is hard to sue these HMOs for medical malpractice and failure to coordinate and manage care — which is what they promise to do. Medicare Advantage needs more critical reporting.

—Dr. Brant S. Mittler, San Antonio, Texas


For a Georgia reader, the story raised more questions:

— Colleen Mahaney, Woodstock, Ga.


On Shooting Down Sky-High Bills …

We in Montana were frustrated in our process to address the balance billing issues for air ambulance, with little success (“Will Congress Bring Sky-High Air Ambulance Bills Down To Earth?” Sept. 27). But the issue arises from insurance companies inserting a coverage cap in the policy, stacking deductibles for in- and out-of-network carriers. Much about this issue is aimed at air companies. They are solely responsible for their charge practices. But insurers also share the responsibility for their decisions to put those who are insured at risk as they seek to constrain premiums by policy design.

— Bob Olsen, Helena, Mont.


… And Missing The Mark?

The Oct. 19 Facebook Live broadcast (“Facebook Live: What About Those Sky-High Air Ambulance Bills?”) failed to note critical facts and provided misinformation. Alarmingly, this may cause patients to question whether they should board an air medical flight even when their physicians or first responder requests the transport based on patient need. We’d like to set the record straight.

1. Insurance Coverage

FACT: Dr. Naveed Kahn’s insurer’s payment was far lower than the actual bill, and air medical services, like all health care providers, are required by federal law to “balance bill” the patient the remainder. Dr. Kahn’s insurance company failed to adequately cover his bill.

[Editor’s note: KHN’s coverage did not focus on the mechanics of “balance billing,” but rather the prohibitive amount of the original bill.]

2. State Regulation

FACT: States can and do regulate air ambulances. Court decisions and Department of Transportation opinions have reaffirmed states’ authority to regulate all medical aspects of air medical transportation. This includes standards and coordination of patient care, including protocols controlling which air medical operator is called to a scene. Air medical operators never self-dispatch; they are called by trained first responders and medical personnel, operating under state authority.

3. Medicare Fee Schedule

FACT: The implementation of the Medicare Fee schedule did not increase rates for air ambulance services; it changed the way air ambulances are reimbursed, increasing the rates for some and dramatically decreasing the rates for others. While the data demonstrates the industry has grown over the last 37 years, according to “An Economic Analysis of the U.S. Rotary Wing Air Medical Transport Industry”, 22 of those growth years occurred before the implementation of the Medicare Fee Schedule.

Industry growth, over a 30-year period, reflects growth in demand for air medical transport services in response to continued closures of rural hospitals and trauma centers. Air ambulances are filling that gap — more aircraft means better coverage and better outcomes.

— Carter Johnson, SOAR (Save Our Air Medical Resources) Campaign, Washington, D.C.

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The Latest Thing Millennials Are Killing? The Primary Care Doctor

Millennials are killing everything from car ownership to home ownership to beer to vacations to the institution of marriage itself, if the headlines are to be believed. (Full disclosure: I am a millennial.) So why not add another victim to the list? In this case, the primary care doctor.

A Kaiser Family Foundation (KFF) survey and followup analysis by Kaiser Health News found that 26% of 1,200 respondents said they didn’t have a go-to primary care physician. But, digging a bit deeper, the survey found sharp generational shifts fueling that trend: Nearly half (45%) of 18-to-29 year olds said they didn’t have a primary care doctor. That figure fell to 28% for Americans aged 30 to 49 and just 18% and 12%, respectively, for people in the 50-to-64 and 65-plus cohort.

Some of this can likely be explained by a divergence of needs. It’s not implausible to think that, the older you get, the more you may want to have the security of a personal medical professional versed in your health history.

But it also represents a sea change in thinking likely fostered by an increased emphasis on convenience (and, perhaps, increasingly transitory lifestyles), according to some experts. A same-day telehealth appointment in a stranger could prove more valuable to some than a long-standing relationship with a doctor who may not be available at the click of a button.

The broader question is: What long-term effects will this shift have on public health? People with chronic conditions, for instance, may benefit from the stability of a primary care doctor who can provide continuous (and, theoretically, more personalized) care. At the same time, Americans who live in the numerous areas with a shortage of doctors may have entirely understandable reasons for pursuing more transitory medical relationships.

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Fortune

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