The Retire Advocate < Back to Table of Contents February 2025 Views from the Screen A Review of "A Real Pain" Randy Joseph Film Title: A Real Pain 2024, Directed by Jesse Eisenberg Cast: Jesse Eisenberg as David; Kieran Culkin, Golden Globe winner for his characterization of Benji. Also includes Will Sharpe, Jennifer Grey, Kurt Egyiawan, Liza Sadovy and Daniel Oreskes. Spoiler alert. But it doesn’t matter – this review may help. A good reader is a re-reader, says author and teacher Vladimir Nabokov in his “Lectures on Literature.” I believe the same goes for film. In anticipation of writing a few notes on the movie “A Real Pain” I watched it a second time at home – slowly. I took notes and was able to pause, rewind, and revisit scenes multiple times. A second viewing gave me the ability to hear the tender plaintive piano music of Polish composer Frederic Chopin, which gently holds us throughout the film – mirroring the energy and mood of the story. I loved the film the first time. But the second slow time gut-punched me with dialogue and nuance I originally missed while gulping down the plot. Wikipedia calls it a buddy comedy-drama. Are they kidding? I mean, yes…but no. This is a story about pain and love and loss and the unending human struggle. And a sad story about love between cousins who were like brothers and are now quite different and apart. And a yearn- ing for how things used to be. It is dead wrong to think this is a holocaust film or, as one reviewer quipped, a holocaust comedy. Yes, there is a tour of the Majdanek concentration camp outside of Lublin, Poland. Yes, there is a visit to a Jewish cemetery and poignant views of the Jewish neighborhoods that were once so vibrant with Yiddish conversation, commerce, theatre, poetry, and music. But that is a backdrop – a heartbreaking backdrop to the melody of the love and loss story of two cousins who have been bequeathed a visit to Poland to visit the childhood home of their grandmother, Dory. David and Benji had been very close as children. That is gone now and Da- vid, a nervous, anxious rule follower – successful in outward appearance with career and family – has found it very difficult to be around the chaotic, rebellious, angry, and often miserable yet charming, generous, and loving Benji. He loves him but can no longer tolerate the craziness. Benji deeply misses the closeness and the purpose in life he used to have protecting and soothing David. Their childhood love fuels the conflict and the plot. Benji is hard to describe. He can immediately connect to people and not only charm them but get to their core and bond at a deep emotional level. David’s social skills are much weaker, and he is often awkward and alone. As charming as Benji is, he can turn on those same people in a second with aggression, anger, mocking, and generally horrible alienating behavior. The two moods seem to be tied together push- ing and pulling inside of him. Clearly Benji is damaged in some fundamental way. We don’t get a good understanding of why, and I wouldn’t presume to diagnose. But the film questions whether their collective anxiety and misery is generational trauma, individual psychological differences, and/or simply the human condition. You come to learn just how lost and suffering Benji is. He has recently lost his beloved grandmother (“She was the only person that stuck with me – every- one else left me when I needed them most”), and he lost David a long time ago. He feels abandoned by David and tells the tour people how it used to be. How important he used to be in David’s life. Benji tells the group, “This is the guy I used to have all to myself. David cried for a week at overnight camp, and I held him in my arms soothing him with tales of his sweet mother.” “What happened to you David? You used to cry all the time.” David’s retort, “How is crying all the time a good thing?” David, on the other hand, has man- aged to corral his anxiety and pull a life together, partly by distancing himself from the difficult Benji. We watch as Benji becomes increasingly more difficult, blaming David for his own lateness, berating David for being a wimp back in the day and now. Daring David – almost forcing him – to hide on the train without a ticket and to break through doors that say Don’t Enter. It’s torture for David, yet exhilarating too. It always was. Benji becomes almost impossible to be around. He is A Real Pain. Yet at the same time, through his loud and unbearable truth telling, he enriches everyone’s experience on the tour. On the train to the camp, he completely freaks out and lambasts everyone for calmly eating fancy food and happily sitting in first class on the very same train tracks where their ancestors were thrown onto the trains almost naked, sick, and miserable. The problem with Benji is that he doesn’t just pose the question. He makes a huge scene shaming everyone and dramatically throws himself into third class. But it isn’t a performance. He is a truth teller, and he can barely stand what he sees as the complacency of the others who don’t have his deep feelings. Admirable in so many ways – but destructive. He loses people but has no control over his behavior. In a pivotal scene in a restaurant, the cousins talk about their grandmother, Dory, who always said she survived the Holocaust due to "a thousand miracles." Benji breaks down with grief, lashes out at everyone, and walks out of the restaurant loudly and repeatedly burping so the whole restaurant can hear. It’s David’s turn to break down. In what should have been an award- winning scene, David lets loose when a tour member says, “He’s clearly in pain.” David whips, “Isn’t everybody in pain? Look where our families came from – isn’t everybody wrought??” Another tour colleague says, “Well YOU seem ok David.” David sobs, “I’m NOT! I take pills for obsessive compulsive disorder, I jog, I meditate. I move forward because I know my pain is not exceptional. I don’t want to burden everybody with it (like Benji). David continues sobbing, “I am exhausted by Benji. I love him I hate him I want to kill him I want to BE him. He is so fucking cool and doesn’t give a shit what people think.” He then reveals to the group that Benji is only six months away from having attempted suicide. David is livid with grief and anger at the thought. “How did the product of a thousand miracles overdose on a bottle of sleep- ing pills. (crying) I don’t want to lose him.” The next day, alone with Benji, David tells him that he doesn’t want to lose him. He compares himself to Benji. “Do you see how people love you? When you walk into a room? I would give anything to know what that feels like. To have charm. You light up a room, and then you shit on everything inside it.” In the last scene we see the cousins in the New York airport at the end of their odyssey. They cling to each other. David leaves and reunites with his wife and child. Benji sits down in the crowd- ed airport alone. Isolated in his pain. The future for them is questionable. Watch this movie…Twice. Randy Joseph is a member of PSARA < Back to Table of Contents

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How To Make America Sick The Trump administration’s plan to “Make America Healthy Again” will make Americans’ health worse. Donald M. Berwick In the Advocate August 2025: Donald M. Berwick, MD. How To Make America Sick The Trump administration’s plan to “Make America Healthy Again” will make Americans’ health worse. Donald M. Berwick, MD. Reprinted from the Center for American Progress website. It might seem obvious that the United States, the wealthiest country on earth, would have the best health and health care. But we do not. Not even close. So when President Donald Trump, Secretary of Health and Human Services Robert F. Kennedy Jr., and their allies in Congress propose to “Make America Healthy Again,” it’s easy to get on board. The trouble is that their plan won’t work. In fact, it will make Americans’ health worse. They are currently proposing to cut Medicaid and Medicare, decimate public health structures, withdraw support for food security and other basic needs, and harm the environment all of which is dead wrong from a scientific viewpoint. There is no disputing that America’s health care system needs a dramatic overhaul. U.S. life expectancy ranks 49th globally at more than four years lower than that of the world’s healthiest countries. Our children’s health ranks 36th among the 38 richest nations. Not a single U.S. state has an average life expectancy longer than that of comparably wealthy nations. If the goal is to make America as healthy as other wealthy nations, it would be hard to do worse than we are doing right now. And for that terrible performance, the United States spends twice as much per capita on health care as the average wealthy country—with more than 110 million Americans struggling with medical debt. So, yes, by all means, let’s “make America healthy.” However, unlike how the Trump administration and RFK Jr. are going about it, doing so requires following the science. In 2015, the revered British epidemiologist Michael Marmot wrote “The Health Gap,” arguably the best playbook for making any country healthier. The book summarizes decades of research on why health varies enormously among places with ostensibly similar conditions. The gap in health outcomes can be between nations, between sub- groups within nations, and even across the tracks in a single city. For example, Black Americans had a lifespan six years shorter than that of white Americans in 2021; residents of west Chicago live 14 years less than residents of the Chicago Loop; and across the city of Boston, lifespan varies by more than two decades. Marmot sorts known causes of health gaps into buckets including early childhood experiences, education, workplace conditions, supports to the elderly, and community “resilience”; he also looks at the impact of attributes such as food security, housing security, transportation systems, clean air, compassionate criminal justice systems, and recreational opportunities. Through that lens, a scientifically guided plan for “making America healthy” is simple to devise: Invest in what drives health. This is why what RFK Jr. and the Trump administration are doing makes no sense. Watch the administration, and it would be hard to find a better way to “make America sick.” It’s like “opposite day”: Every single component of the Marmot playbook is being not only neglected but controverted through the administration’s actions. Let’s run the list. Kids Healthy societies tend to place their bets on safe perinatal care, strong supports for the early years—say, from birth to age 3—and school readiness, which means not only helping children but also their parents. Contrast that with the House-passed One Big Beautiful Bill Act that instead cuts food stamps by nearly $300 billion and enacts a historic $793 billion cut to Medic- aid and the Children’s Health Insurance Program, which cover 50 percent of the children in America. Education People in countries and regions with strong educational systems, especially those that include girls and women, tend to live longer. Overall, the U.S. education system ranks 31st in the world, and it varies widely, with many schools performing poorly and many students underachieving. This is neither the teachers’ fault nor the students’. It boils down to ensuring that all children and youth, regardless of where they live or how wealthy their families are, have access to the highest quality education. The proper response would be to pour resources into delivering on that promise. On the contrary, the Trump administration’s plan calls for slashing funding for the Department of Education, cutting support to K-12 programs, and eliminating federal subsidies for student loans. Workers Job security is also foundational to national health. Unionization, which has been backwatered in the United States, is one straight shot to improving worker power. So is raising the federal minimum wage far above its embarrassingly low level of $7.25 per hour, instituting stronger legal protections for workers’ rights, and establishing more equity in tax and compensation policies. The Trump administration, meanwhile, seeks to abolish the Consumer Financial Protection Bureau, hamstring the Department of Labor, reduce bargaining rights for federal workers, weaken worker protections, and cut the essential food assistance and health care programs that the working class relies on, all to give massive tax cuts to the wealthiest Americans. Seniors How a nation supports its aging and elderly population affects not only how long and well its older citizens live, but also the health and well-being of a country’s entire population. The Trump administration claims to want to protect Medicare—a mainstay of security for those age 65 and older in the country—but study the details of what the president and his congressional allies are doing so far, and you will find steadily weakening protections for coverage, reduced access to care, and thousands of dollars more in out-of-pocket costs. For example, Medicaid, which has been torpedoed by the Trump-signed reconciliation bill, is the primary payer for 63 percent of people in nursing homes. Where are the elderly Americans who rely on that care supposed to go? Communities Healthy communities help ensure access to nutrition, housing, safety, mobility, and opportunity for everyone. The Trump administration is already weakening every one of those things and is poised to damage them further. The administration is hurting public transportation systems and rolling back environmental controls for particulate air pollution. It is also publicly in favor of coal and against wind power, against public housing expansion, against mental health supports to help reduce violence, and has backpedaled on criminal justice reform. Conclusion President Trump and Secretary Kennedy can preach all they want about making us healthy again, but their rhetoric is no substitute for facts. The right way to “Make America Healthy Again” is to invest in the infrastructure, programs, and priorities that we know, based on scientific evidence, will actually improve health—the very same ones that the Trump administration seems intent on destroying. Donald M. Berwick, MD, is President Emeritus and Senior Fellow at the Institute for Healthcare Improvement, and a former Administrator of the Centers for Medicare & Medicaid Services (CMS). BACK TO THE ADVOCATE

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In the Advocate May 2025: Lisa Dekker North Olympic Peninsula 2025: Rural Resistance! Lisa Dekker Like the rest of Washington State, Clallam County and the Peninsula are reeling from the harms happening now – and those yet to come – from this corrupt regime and their flagrant refusal to follow the law. But we are not taking this lying down. Our residents and our leaders are determined to resist. Olympic National Park, just outside Port Angeles, gets thousands of visitors each year and is an economic engine for the region. It was already unable to meet basic maintenance needs, and reduced staffing will make it worse. In addition, although $80 million was al- ready allocated by Congress to replace the Hurricane Ridge Day Lodge that burned down in 2023, delivery of those dollars is now uncertain. For many years Port Angeles has been a gateway for Canadian visitors via the Coho/BlackBall Ferry that connects us to Victoria, B.C., just 12 miles away. But now, the absurd tariffs and territorial threats coming from #47 have resulted in an understandable backlash of Canadians deciding not to spend their tourist dollars here. This will have grave economic consequences for our restaurants, hotels, and small businesses this summer unless the tariffs are undone. Likely the most unconscionable harms to individuals here would be the drastic cuts to Medicaid in the current Republican budget. With 20 percent of our adults and more than 37 percent of our children dependent on Medicaid in Clallam County alone, the devastation would be felt by thousands here on the Peninsula. So how are we fighting back? There have been sizeable rallies in Port Ange- les, Sequim, and Port Townsend (Jefferson County) that have many new faces and an enthusiastic response from the community. Indivisible Sequim, first begun in 2016, has had a surge of new members and has backed several rallies. One of the largest gatherings in Port Angeles, and the one with the most young people, was a raucous and upbeat march supporting the Olympic National Park and Park staffers who had been abruptly laid off. Clallam Democrats have become re-energized. With the leadership of their Chair, PSARA member Ellen Menshew, they have hosted timely forums and promoted many rallies. With a new online newsletter, Clallam Democrats Rising, plus a blog, a presence on Substack and Blue Sky, and an events calendar, the Dems are keeping members informed and involved. Our three County Commissioners even did their bit with a letter to Senators Murray and Cantwell and Congresswoman Emily Randall, reminding them of the impacts being felt here and asking that they “do all that they can to support our community.” We don’t know what’s next, but here in the northwest corner, we saw that despair became righteous anger, then hope, and now resistance. We are determined to fight back. Lisa Dekker is PSARA's Co-VP for Outreach and a leader of PSARA's Clallam County organizing committee. BACK TO THE ADVOCATE

In the Advocate May 2025: Pam Crone Final Legislative Budget Overview Pam Crone The 2025 Washington legislative session ended on April 27. The information below reflects the final legislative budget. The Governor has until May 20 to sign the budget and exercise his veto authority. The budget does not be- come final until he acts. This overview was prepared before the Governor has taken action. As a reminder, the Governor has line-item veto power, meaning he can eliminate funding but cannot add new spending or shift dollars around. Over the final weeks of the session, the Legislature returned to the drawing board multiple times to draft a budget that included new revenue to navigate a $16 billion deficit projected over the next four years. Why did the Legislature have to return multiple times to the drawing board? The Governor repeatedly and consistently expressed opposition to a wealth tax, as well as concerns about relying too heavily on new revenue to balance the budget. As a result, the final budget includes more, and deeper, cuts. Another major concern is the potential impact of looming federal Medicaid reductions. Although these cuts are largely unpopular – effectively reducing healthcare access for many Americans while further lining the pockets of the wealthy – the Repub- lican-controlled House continues to move closer to a budget proposal that includes them. If these cuts are en- acted, the Governor is expected to call a special legislative session to address the resulting healthcare crisis. Current Budget Snapshot: Final operating budget: $77.8 billion Four-year outlook: $7 billion in total reductions New revenue (2025–2027): $4.3 billion New revenue (2027–2029): $4.4 billion Rainy Day Fund: $2 billion remaining Cash reserves: $225 million Investments in K–12 Education: $750 million for special education services $213 million for materials, supplies, and operating costs $200 million in local effort assistance for low-income school districts Investments in State Workers: Approximately $1 billion to fund and approve collective bargaining agreements for state employees Housing Investments: $605 million to the Housing Trust Fund $117 million in grants to local governments to offset lost document recording fee revenues Maintaining Core Services: $93 million for emergency food assistance organizations $27.9 million for senior nutrition programs $20 million to expand resources for crime victims Pam Crone is a retired lobbyist and Chair of PSARA's Government Relations Committee (GRC). BACK TO THE ADVOCATE

The Retire Advocate < Back to Table of Contents March 2025 SJM 8002 Hearing in Washington State Senate Tim Wheeler In a crowded hearing room in Olympia, WA, on Feb. 11, Sen. Bob Hasegawa (D-Seattle) introduced SJM-8002, addressed to President Trump and the US House and Senate. The Senate Joint Memorial 8002 urges the lawmakers in Washington D.C. to enact a law to halt Medicare Advantage overcharges and fraud and to “level the playing field” by adding benefits to traditional Medicare and capping out-of-pocket expenses. Hasegawa told fellow Senators and a crowd that included members of PSARA, “This memorial comes from the people themselves. They drafted this legislation.” Medicare was enacted in 1965 as a “public good,” Hasegawa added, “one of President Lyndon B. Johnson’s star programs” to benefit all senior citizens, paid for from a payroll tax on employees and employers. More than $1.6 trillion has accumulated in the Medicare Trust Fund, a target for runaway Wall Street greed. “Unfortunately, there is a move to privatize Medicare,” he continued, with Medicare Advantage permitted to pocket 15 percentof every Medicare dollar in administrative costs and profits. “No one has explained to me how Medicare Advantage provides more efficient healthcare while also collecting 15 percent in profits,” he said. Traditional Medicare administrative costs are under two percent. There are no profits. This Senate Joint Memorial 8002, if approved by the Washington State Legislature, demands that Congress enact and Trump sign a law to terminate Medicare Advantage profiteering and preserve original Medicare. Ed Weisbart, a retired physician and Vice President of Physicians for a National Health Program, hailed the Hasegawa measure. Speaking via Zoom from St. Louis, he stressed the importance of recouping the tens of billions – some estimates are as high as $140 billion – stolen from the Medicare Trust Fund by Medicare Advantage providers and using the money to help finance expanded Medicare benefits. Karen Richter, PSARA Co-President, told the hearing that PSARA strongly supports SJM-8002. “Leveling the playing field,” she said, “would scrub overcharging and fraud from the Medicare system while allowing Medicare beneficiaries a real choice about which program they would prefer." A level playing field will give traditional Medicare recipients the same benefits provided to Medicare Advantage enrollees –now just over half the 60 million Medicare recipients. Legislation is needed, said Richter, to restore Medicare “as the public good it was created to be in 1965 and to continue the tradition of Medicare being the lowest cost and most effective health care program in the United States.” Anne Watanabe, speaking for the PSARA Race and Gender Equity Committee, also endorsed SJM 8002. “Unsurprisingly, higher percentages of seniors of lower income and seniors of color enroll in private Advantage plans,” she said, because they can’t afford supplemental insurance to cover the 20 percent not covered by traditional Medicare. They discover too late “that their private advantage plans impose limits on coverage or limited networks, especially in rural areas. Medicare Advantage profiteers delay or deny treatment recommended by their doctors….” Ellen Menshew, a PSARA member from Clallam County, cited Olympic Medical Center (OMC) in Port Angeles, a public hospital that provides urgent care from Neah Bay on the Pacific coast to Quilcene near Hood Canal. “OMC is more than just a healthcare provider,” she said “It is a lifeline. As the largest employer in our county with 1,500 employees, OMC plays a crucial role in our local community. “The most glaring common denominator in the failure of rural hospitals is the impact of for-profit corporate insurance companies,” Menshew continued. These profiteers impose “delays, denials, and slow payments….leaving providers struggling to maintain financial stability and forcing hospitals into mergers or total acquisitions...” The result, she charged, is reduction in services, staff cuts, and ultimately “a decline in the overall health and well being of the community.” The presentations by PSARA leaders and allies both in oral and written testimony were compelling. Two days after the hearing, SJM 8002 was passed out of the Senate Health and Long-Term Care Committee with a “do pass” recommendation. The Republicans on the Committee voted against it. Now legislation goes to the Senate Rules Committee, this is empowered to send the bill to the floor of the Senate for a vote by the entire Senate. Here is the link to SENATE JOINT MEMORIAL 8002: https://lawfilesext.leg.wa.gov/biennium/2025-26/Pdf/Bills/Senate%20Joint%20Memorials/8002-Medicare.pdf#page=1 Tim Wheeler is a veteran activist and journalist, a member of PSARA's Executive Board, and a leader of PSARA organizing in Clallam County. < Back to Table of Contents