The issue: James Cameron's interpretation of the future of healthcare
The vocab: Health insurance coverage for veterans
The protagonist is Jake Sully, a former Marine who was paralyzed from the waist down (which is presumably a war injury). Jake had agreed to travel to the distant planet Pandora and gather information on Pandora's indigenous people for the U.S. military unit stationed there - in return for his intel, the unit's Colonel promised to pay for spinal surgery that would enable Jake to use his legs again. Being the good public health student (read: dork) that I am, I turned to my friend sitting next to me and exclaimed:
"So James Cameron is saying that in 150 years, even though the technology had been invented to reverse paralysis, an injured war vet doesn't get enough health insurance coverage for spinal surgery???"
OK, yeah, the point of the movie is to blow you away with the visuals and submerge you in the blatant environmental commentary - but I got preoccupied for a while with this insurance coverage bit. But then I realized, I don't actually know what the current state of health coverage is for those on active duty and veterans.
When someone is on active duty, they receive insurance through the Military Health System. Those who are honorably discharged are then shuffled over to Veteran's Affairs insurance (or to their employer's or private insurance, if they opt). According to the Veteran's Affairs benefits site, there are two types of benefits: ones for service-connected disabilities (i.e., those that occurred during active duty), and ones for nonservice-connected disabilities. Sully was a victim of the former. He'd definitely be getting some monthly compensation, somewhere between $123 and $2,673, depending on what his "level of disability" was assessed to be. But I can't figure out from the VA's website if his insurance would cover expensive spinal surgery several years after the injury was suffered.
I suppose that's an interesting weakness to point out in and of itself - it's pretty impossible for the average person to easily scroll through veterans' benefits package and actually understand what to expect. For example, the site states that veterans receive a monthly stipend based on percent disability, but it doesn't explain (or link to a site that explains) how percent disability is determined. Part of the Senate's proposed health bill calls for the creation of an Internet site that clearly lists healthcare options and comparisons of benefits packages. Maybe the VA should set an example.
Speaking of health reform, let's look into how the recent healthcare overhaul talks could affect veterans - are we dooming our nation's future vets to unaffordable healthcare services and inadequate coverage for vets with service-related disability? Are we setting the stage for Jake Sully's predicament?
Probably not. First of all, I'd like to think that if doctors in the future are able to reverse paralysis, the VA would be extremely eager to help vets with war injuries (and I'd bet that taxpayers would gladly help share the costs). And secondly, according to The White House Blog, Obama's 2010 budget includes "the largest single-year increase in funding for the Department of Veterans Affairs in three decades, and significantly expands coverage, extending care to 500,000 more veterans who were previously excluded."
So do I buy James Cameron's depiction of a future where a disabled war veteran can't get paralysis-reversing surgery?? Nah. I don't think Congress or taxpayers would stand for it. And I don't think the VA will ever shrink the benefits package - it can really only grow. While the movie is grounded in fantasy and science fiction and imagination, it's simply not believable that Jake Sully wouldn't have health coverage in a non-Cameronsian (read: possible) future.
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