Ïîïóëÿðíûå ñîîáùåíèÿ

среда

"To me it was hollow," he says, "and I think it was hollow for my father, though he would not have ever brought that to his conscious mind. He totally loved cowboys and so did most of the cowboys he worked with and that got him through his life. But he knew perfectly well that it wouldn't last another generation ... it just was not going to last."

In his new book, The Last Kind Words Saloon, McMurtry creates an unvarnished picture of one of the heroes of Western myth: Wyatt Earp and his sidekick, Doc Holliday. Over the years Earp has been portrayed as legendary lawman but McMurtry says it's a reputation he doesn't deserve.

"Wyatt didn't do much of anything except drink and pester his wife and run around," he says. "He didn't do anything remarkable his whole life, ever."

McMurtry strips Earp down to a guy who doesn't talk much, hits his wife and gets people killed for no particularly good reason. Earp and Holliday spend a lot of time doing nothing. At one point they try, unsuccessfully, to become stars in Buffalo Bill's Wild West show. The duo's adventures culminate in the infamous shoot out at the O.K. Corral.

More With Larry McMurtry

Books

McMurtry's 'Literary Life': Not Simple, But Practical

Veterans Affairs Secretary Eric Shinseki tells NPR that he's determined to "get to the bottom" of allegations that veterans may have died at a Phoenix Veterans Affairs hospital while waiting for care.

The accusations of extended delays in providing health care at the Phoenix Veterans Affairs Health Care system surfaced last month. The facility reportedly kept two lists of veterans waiting for care, one it shared with Washington and another secret list of wait times that sometimes lasted more than a year.

"Allegations like this get my attention," Shinseki tells All Things Considered. "I take it seriously and my habit is to get to the bottom of it.

"If allegations are substantiated, we'll take swift and appropriate action," he tells host Robert Siegel.

Last week, Shinseki announced that three officials had been placed on leave at the facility in Phoenix, where up to 40 patients reportedly may have died while on a wait list for care.

The VA has acknowledged that 23 patients have died as a result of delayed care in recent years, according to The Associated Press. At one clinic at a Fort Collins, Colorado, the VA's inspector general says officials were instructed on how to falsify appointment records. Other problems have occurred in Pittsburgh, Atlanta and Augusta, Georgia, according to the AP.

On Tuesday, Senate Minority Leader Mitch McConnell (R-Ky.) called the problems "an embarrassing period for the VA." Three GOP Senators, John Cornyn of Texas, Jerry Moran of Kansas and Richard Burr of North Carolina, have called for Shinseki to resign.

The VA's inspector general has been tasked with investigating the Phoenix hospital. Asked if the allegations are substantiated whether he'd step down, Shinseki said "Let's see what the inspector general comes back with."

The retired U.S. Army four-star general and former Army chief of staff says that the question of resignation is "a hypothetical.

"But what's not a hypothetical is that I serve at the pleasure of the president," he tells NPR. "I signed on to do this to help him make things better for veterans in the near term, as quickly as possible, but also to put in place for the long term those changes to this department that will continue to help veterans well into this century."

Shinseki, who was unanimously confirmed by the Senate to the Veterans Affairs post in 2009, has pledged to clear up the backlog of disability claims and to end the problem of homeless veterans, says he's confident that the numbers showing progress in those two areas are solid.

"In the case of disability claims, that's a number we can see because the claims are in the system and we can measure decisions going out the door, so that's one I am very confident of," he said. On the question of homelessness, "I am confident that we have taken veterans off the street."

Can corporations shift workers with high medical costs from the company health plan into online insurance exchanges created by the Affordable Care Act? Some employers are considering it, say benefits consultants.

"It's all over the marketplace," said Todd Yates, a managing partner at Hill, Chesson & Woody, a North Carolina benefits consulting firm. "Employers are inquiring about it, and brokers and consultants are advocating for it."

Health spending is driven largely by a few patients with chronic illnesses, such as diabetes, and those who need expensive treatments, such as organ transplants. Since most big corporations are self-insured, shifting even one high-cost worker out of the company plan could save the employer hundreds of thousands of dollars a year — while increasing the cost of claims absorbed by the marketplace policy by a similar amount.

And the health law might not prohibit it, opening a door to potential erosion of employer-based coverage.

"Such an employer-dumping strategy can promote the interests of both employers and employees by shifting health care expenses on to the public at large," wrote two University of Minnesota law professors in a 2011 paper that basically predicted the present interest. The authors were Amy Monahan and Daniel Schwarcz.

It's unclear how many companies, if any, have moved sicker workers to exchange coverage, which became available only in January. But even a few high-risk patients could add millions of dollars in costs to those plans. The costs could be passed on to customers in the form of higher premiums and to taxpayers in the form of higher subsidy expense.

Here's how it might work. The employer shrinks the hospital and doctor network to make the company plan unattractive to those with chronic illness. Or, the employer raises copayments for drugs needed by the chronically ill, also rendering the plan unattractive and perhaps nudging high-cost workers to look at other options.

At the same time, the employer offers to buy the targeted worker a high-benefit plan in the marketplaces. A so-called platinum plan could cost $6,000 or more a year for an individual. But that's still far less than the $300,000 a year that, say, a hemophilia patient might cost the company.

The employer might also give the worker a raise to buy the policy directly.

The employer saves money. The employee gets better coverage. And the health law's marketplace plan —required to accept all applicants at a fixed price during open enrollment periods — takes on the cost.

"The concept sounds to[o] easy to be true, but the ACA has set up the ability for employers and employees on a voluntary basis to choose a better plan in [the] Individual Marketplace and save a significant amount of money for both!" says promotional material from a company called Managed Exchange Solutions (MES). "MES works with [the] reinsurer, insurance carrier and other health management organizations to determine [the] most likely candidates for the program."

Consultant Benefit Controls, based in Charlotte, N.C., produced the Managed Exchange Solutions pitch last year. But Matthew McQuide, a vice president with Benefit Controls, said the company ultimately decided not to offer the strategy to its clients.

"Though we believe it's legal" as long as employees agree to the change, "it's still gray," he said. "We just decided it wasn't something we wanted to promote."

Shifting high-risk workers out of employer plans is prohibited for other kinds of taxpayer-supported insurance.

For example, it's illegal to induce somebody who is working and over 65 to drop company coverage and rely entirely on the government Medicare program for seniors, said Amy Gordon, a benefits lawyer with McDermott Will & Emery. Similarly, employers who dumped high-cost patients into temporary high-risk pools established by the health law are required to repay those workers' claims to the pools.

"You would think there would be a similar type of provision under the Affordable Care Act" for plans sold through the marketplace portals, Gordon said. "But there currently is not."

Moving high-cost workers to a marketplace plan would not trigger penalties under the health law as long as an employer offered an affordable company-wide plan with minimum coverage, experts said. (Workers cannot use tax credits to help pay premiums for an exchange plan in such a case, either.)

Half a dozen benefits experts said they were unaware of specific instances of employers shifting high-cost workers to exchange plans. Spokesmen for AIDS United and the Hemophilia Federation of America, both advocating for patients with expensive, chronic conditions, said they didn't know of any, either.

But employers seem increasingly interested.

"I have gotten probably about half a dozen questions about it in the last month or so from our offices around the country," says Edward Fensholt, director of compliance for the Lockton Companies, a large insurance broker and benefits consultant. "They're passing on questions they're getting from their customers."

Still, Fensholt said, "We just don't think that's a good idea. That needs to be kind of an under-the-radar deal, and under-the-radar deals never work." Plus, he added, "it's bad public policy to push all these risks into the public exchange."

Hill, Chesson & Woody isn't recommending it either.

"Anytime you want to have a conversation with an employee in a secretive, one-off manner, that's never a good idea," Yates said. "Something smells bad about that."

Next week, the broadcast networks — ABC, NBC, CBS, Fox and the CW — will make their upfront presentations in New York. (There are some scattered cable ones too, like ESPN and TNT/TBS.) This is where they present their new shows, in the form of clips and sizzle reels, to advertisers. From a business perspective, it's really important in the same way that any sales pitch is really important: they sell ads, they make money, and when they get the advertising people excited, a show becomes a presumed frontrunner before it even premieres. (This happened a couple of years ago with 2 Broke Girls.)

But it's become the collective moment in which we seem to decide we are looking ahead to next season, and while that's perfectly fine, I beg you: do not take this week too much to heart.

There are people who are gangbusters at writing up the business side of all this, who understand scheduling and executive shuffles and love to dive into who's making money and who's not and why, who have an encyclopedic knowledge of producers and players. (My favorites are Joe Adalian at Vulture and Lacey Rose and Lesley Goldberg at The Hollywood Reporter.) They're a lot of fun to pay attention to about now, because they're dealing with this as the Hollywood inside baseball that it is.

For critics, though, there's a sort of imperative to treat this as the official Preview Of What We'll All Be Talking About For The Next Six Months, and that's unnecessary for a few reasons.

First of all, the fact that this is a broadcast-centric event means that while it does provide a list of some of what will be on offer, it doesn't do so with any particular thoroughness. What five networks do in September has less and less of a stranglehold on the entire idea of television, both because things premiere all year and because everybody from The Weather Channel to Netflix to XBox is making shows. It's not at all uncommon for the highest viewership numbers on a particular night to be a motley mix of network shows and cable shows, and so few people are pulling in television over the air at this point that for your average person with at least basic cable, it's fair to ask who really cares about this particular constellation of folks?

Furthermore, it's so early in the creative development of all these projects that nobody really knows what they might turn into. What the networks are going to show during their official presentations aren't even pilots — they're just sizzle reels, which is a more finger-guns-shooting way of saying "trailers," which is in turn a more cinematic way to say "long commercials." You cannot tell literally anything from the vast majority of sizzle reels, except that in some cases, you can tell that comedies are thus far terrible and not funny. It's like trying to judge a house by the doorknob; you can try to extrapolate, but it's an awful lot of effort for minimal reward.

And finally, so much of this stuff is going to disappear so quickly that the minutes you spend even developing the pre-awareness of its existence that networks are trying to drum into you beginning right now is going to be largely wasted. There will be countless critics — including me! — making recommendations later about what to try and what not to try, but at this point ... well, let's put it this way: two years ago right now, Fox was very into The Mindy Project, but also The Mob Doctor and Ben And Kate. (These were television shows.) Last year at this time, We Are Men was a going concern. Not even! It was a concern yet to come. Remember Back In The Game? Welcome To The Family? Betrayal? Lucky 7? Blair Underwood in a remake of Ironside? There are, in fact, things that were announced last year at upfronts, were previewed by critics, have yet to air, and have already been canceled.

I'm not saying don't check out the rundowns from critics you like, or don't let buzz seep into your soul; there are times when it turns out to be right, and heaven knows that curating for yourself is enough work at this point that you need all the help you can get. We'll talk about upfronts here, too — it's what we do.

Just don't get too attached to anything. Don't get emotionally invested. This is very much a production of Ye Olde Television Model, which — don't get me wrong — remains the way most people watch much of their television, but which is only a teeny piece of the picture of the conversations that will be going on six months from now.

Be advised.

Blog Archive