November 23, 2015

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Today in Movie Culture: Creed Singer Reviews 'Creed,' U.S. Navy Parodies 'Star Wars: The Force Awakens' and More

Here are a bunch of little bites to satisfy your hunger for movie culture:

Movie Review of the Day:

Scott Stapp, frontman for the band Creed reviews the new movie Creed as if it was supposed to be about his group:

Franchise in Focus:

Speaking of Creed, Matt Singer of Screen Crush created a montage of Rocky movie training montages with commentary on the art of this franchise staple:

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Star Wars Trailer Remake of the Day:

The latest old Star Wars things to be recut to fit the style of the Force Awakens trailer is the Holiday Special:

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Star Wars Trailer Parody of the Day:

The U.S. Navy is now officially the coolest — and geekiest — of our military branches (via Live for Films):

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Prop Replicas of the Day:

Watch the blacksmiths and craftspersons of Baltimore Knife and Sword construct custom replicas of Drax’s knives from Guardians of the Galaxy in the latest episode of Man at Arms: Reforged:

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Fan Art of the Day:

Instagram user @greg_or_egan recently began watching a movie a day for a year and drawing its main character (or one or two of them) and posting the art online. Below is his piece for The Hunger Games: Mockingjay – Part 1, which he watched earlier this month. See his account for drawings for Back to the Future, They Live, Con Air and more (via Design Taxi).

A photo posted by @greg_or_egan on Nov 7, 2015 at 9:26pm PST

Character Supercut of the Day:

Whoispablo made a supercut of Batman getting ready:

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Iconic Shot of the Day:

For Fandor’s Keyframe, Jacob T. Swinney compiled a supercut of movies that pay homage to the doorway shot from The Searchers:

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Filmmaker in Focus:

For Every Frame a Painting, Tony Zhou looks at Buster Keaton‘s brilliance in the art of the gag:

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Classic Trailer of the Day:

Today is the 10th anniversary of the initial limited theatrical release of Syriana. Watch the original trailer for the drama, which earned George Clooney his first Oscar nomination and only win for acting, below.

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and

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Here Are The 2015 Medal Of Freedom Winners, In Their Own Voices

Baseball player Willie Mays, singer Barbra Streisand and politician Shirley Chisholm will all be awarded the Presidential Medal of Freedom this year.

Jed Jacobsohn/Kevin Winter/Hulton Archive/Getty Images

On Tuesday, President Obama will be handing out the Presidential Medal of Freedom, the highest civilian honor in the U.S. The list of winners this year brims with both household names and virtual unknowns — artists, athletes and activists of just about every stripe.

With 17 winners, there are 17 personal histories, 17 highlight reels of accomplishments — and 17 stories of service worth recognizing. Inspiring, sure, but also quite a bit of homework for the average American looking to learn more about the honorees.

So, NPR’s here to help. Click a name on the list below to find a brief introduction to the life and works that helped define a legacy — and more often than not, a conversation with the actual person. Because who better to tell you who these people are than the folks themselves?

Medal Of Freedom Winners

Yogi Berra
Bonnie Carroll
Shirley Chisholm
Emilio Estefan
Gloria Estefan
Billy Frank Jr.
Lee Hamilton
Katherine G. Johnson
Willie Mays
Barbara Mikulski
Itzhak Perlman
William Ruckelshaus
Stephen Sondheim
Steven Spielberg
Barbra Streisand
James Taylor
Minoru Yasui


Yogi Berra

Yogi Berra, during spring training in 1954, at the height of his career.

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Berra, that master of the bat and malapropisms, won 10 World Series championships — more than any other major league player — and spent four decades as a professional catcher, manager and coach. Born Lawrence Peter Berra, Yogi was also named league MVP three times in the course of his career. He died earlier this year at the age of 90.

He also was widely known for his twisty turns of phrase, which managed to mine wisdom from apparent nonsense — stuff like “it ain’t over till it’s over,” and “when you come to a fork in the road, take it.” He was also quite the conversationalist on the diamond, apparently, which wasn’t always appreciated by batters such as Ted Williams.

“Oh, he would get mad,” Berra told NPR’s Robert Siegel in 2003. “You know, I used to say, ‘Where you going tonight, Ted? What are you doing? When you going fishing?’ And he’d say, ‘Shut up … I’m up here to hit, not to talk about fishing or hunting.’ “

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Yogi Berra On ‘All Things Considered’ (2003)


Bonnie Carroll

In this 2012 photo, Bonnie Carroll, president and founder of the Tragedy Assistance Program for Survivors, known as TAPS, poses in her office in Washington, D.C.

Jacquelyn Martin/AP

Carroll, a retired major in the Air Force Reserve, founded the Tragedy Assistance Program for Survivors, or TAPS, an organization that provides support for those affected by the death of a loved one serving in the U.S. armed forces. Carroll started the group after her husband, Brig. Gen. Tom Charles Carroll, died in a plane crash in 1992.

Since its founding, TAPS has stepped in to help survivors cope with grief and feelings of guilt — and seeks to prevent suicide with therapy and mental health treatments.

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Bonnie Carroll’s TAPS on ‘All Things Considered’ (2010)


Shirley Chisholm

Rep. Shirley Chisholm, during her 1972 bid for the Democratic presidential nomination.

James Palmer/AP

Running behind the slogan “Unbought and Unbossed,” the New York Democrat won her first term in the House in 1968, becoming the first black woman elected to Congress. But she didn’t stop there: In 1972, Chisholm undertook a bid for the presidency. That campaign made her not only the first African-American woman, but the first African-American to run for a major-party presidential nomination in the U.S.

She lost her party’s nomination to Sen. George McGovern that year, but she continued to serve in Congress for another decade, during which she also became a founding member of the Congressional Women’s Caucus. Chisholm died in 2005.

Perhaps Chisholm described herself best when she told NPR’s Tavis Smiley, in 2003: “I was very outspoken, very articulate, and I wouldn’t take any guff from anybody.”

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Shirley Chisholm’s 1972 Presidential Candidacy Announcement, Rebroadcast On ‘Tell Me More’ (2008)


Emilio Estefan

Emilio Estefan, in Miami Beach, Fla., in February.

Sergi Alexander/Stringer/Getty Images

The multiple Grammy winner, who is married to fellow Medal of Freedom winner Gloria Estefan, built a music empire rooted in Miami. The founding member of the group Miami Sound Machine — which also featured Gloria — Estefan made his name as a producer and songwriter foremost. He also created his own label, Crescent Moon Studios.

“What Emilio Estefan has done in this country to promote Latin music is without dispute,” said Mauricio Abaroa, the executive vice president of the Latin Academy of Recording Arts & Sciences, in 2000. “As a producer, as a composer, as a manager, he is one of the greatest ambassadors we have ever had.”

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Gloria Estefan

Gloria Estefan, during a performance in Washington, D.C., on Memorial Day this year.

Paul Morigi/Getty Images

Gloria Estefan rose to prominence at the head of Emilio Estefan’s band, the Miami Sound Machine. By the ’80s and ’90s, the singer was in the vanguard of the booming Latin music scene. Now, decades and dozens of albums later, Estefan is still performing and recording.

But at the start, Gloria Estefan told NPR’s Rachel Martin in 2013, it wasn’t so easy.

“They would say you’re too American for the Latins; you’re too Latin for the Americans; lose the drums; lose the percussion; change your name,” Estefan said. “And the fact that we had this fresh, different sound, and that we stuck to it, is the reason we had success. So, we were very happy that we were our own cheerleaders.”

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Gloria Estefan On ‘Weekend Edition’ (2013)


Billy Frank Jr.

Billy Frank Jr. walks along the Nisqually River near Olympia, Wash., in 2005.

Ted S. Warren/AP

Born on a Nisqually reservation in Washington state, the Native American activist resisted state fishing regulations in the 1960s and early ’70s, arguing that the imposed laws violated 19th-century treaties signed between the U.S. and Native Americans. Frank was arrested numerous times, and his argument was eventually upheld by the Supreme Court in the mid-’70s.

In the decades after, he continued to help lead efforts for Native Americans’ rights and environmental conservation in the Pacific Northwest — efforts for which he was recognized with the Albert Schweitzer Award and the Martin Luther King Jr. Distinguished Service Award for Humanitarian Achievement.

Frank died last year at the age of 83. At the time, The Seattle Times put together an interactive timeline of Frank’s life — including his efforts during the “salmon wars” in the ’60s and ’70s.

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Lee Hamilton

Rep. Lee Hamilton speaks during the release of a Bipartisan Policy Center report in Washington, D.C., in 2013.

Rep. Lee Hamilton speaks during the release of a Bipartisan Policy Center report in Washington, D.C., in 2013. Saul Loeb/AFP/Getty Images hide caption

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Hamilton spent decades in public service. First elected to Congress in 1964, the Indiana Democrat served in the House until 1999 — including a notable stint in the ’80s as chairman of the Select Committee to Investigate Covert Arms Transactions with Iran, otherwise known as the Iran-Contra committee. After retiring, he kept going: Hamilton was vice chairman of the 9/11 Commission in the wake of the 2001 terrorist attacks.

Still, despite his decades in government as a widely respected voice in foreign policy, Hamilton told NPR’s Steve Inskeep in 2010 that one thing, especially, left an impression on him:

“I think that you come filled with ambition and drive and energy and wanting to accomplish great things, and you find the system is very hard to move, to make it work,” he said. “And I think what has impressed me over the years is the sheer complexity and difficulty of governing this country.”

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Lee Hamilton On ‘Morning Edition’ (2010)


Katherine G. Johnson

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A research mathematician for NASA in its earliest years, Johnson worked on projects such as calculations for interplanetary trajectories. Her calculations were behind the space flight of Alan Shepard — a first for America — and the Earth Resources Satellite.

“Early on, when they said they wanted [Shepard’s] capsule to come down at a certain place, they were trying to compute when it should start,” Johnson told NASA’s news service in 2008. “I said, ‘Let me do it. You tell me when you want it and where you want it to land, and I’ll do it backwards and tell you when to take off.’ That was my forte.”

Throughout her career with NASA, Johnson helped pave a path for African-American women in the space program. She is 97.

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Willie Mays

Willie Mays, on the field before a World Series game in San Francisco, in 2012.

Doug Pensinger/Getty Images

The Say Hey Kid was an outfielder for the New York and San Francisco Giants for more than two decades. The Hall of Famer’s feats on the baseball diamond — including one legendary catch in the 1954 World Series — provided ample fodder for photographers and plenty of entries in the record books.

Though some question whether he could have owned even more records if he hadn’t spent two years in the military during the middle of his career, Mays told NPR’s Bob Edwards in 2000 that he doesn’t have any regrets about it.

“I’m not a type of guy that look back and says, ‘Boy, if I had this, or if I could have did that, I would have been ahead of guys.’ I’m fine with what I have, you know,” Mays said.

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Willie Mays On ‘All Things Considered’ (2010)


Barbara Mikulski

Sen. Barbara Mikulski, D-Md., speaks to the media in May 2015, in Baltimore.

Drew Angerer/Getty Images

When Mikulski was elected to the Senate in 1986, she roared, “We elected a Democratic woman named Barbara and somebody named Mikulski, and the Senate won’t be the same from now on!”

It set the tone for the energetic Mikulski, who was the first Democratic woman to serve in both houses of Congress, the first woman to win a statewide senatorial election in Maryland — and, eventually, the longest-serving woman in Congress, before announcing her retirement earlier this year.

“I am a fighter,” she told NPR’s Renee Montagne in March. “And when you’re going to fight, you have to be specific. You have to be tenacious. You have to be insistent and persistent. And that’s what it takes to get the job done.”

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Barbara Mikulski On ‘Morning Edition’ (2015)


Itzhak Perlman

Itzhak Perlman performs during the annual national Hanukkah menorah lighting ceremony on the White House Ellipse in 2010.

Mandel Ngan/AFP/Getty Images

Perlman has been playing the violin since he was 3 years old — which means, for those following along at home, that he’s been a violinist for more than 67 years. So Perlman, who was paralyzed by polio at an early age, has decades of material to delve into — including a performance at President Obama’s second inauguration and a stop by the set of Sesame Street.

“I always say that my goal is to not be bored by what I do,” Perlman told NPR’s Steve Inskeep this week. “The only way that I cannot be bored by what I do is if I play something and it’s all new to me.”

Happily, NPR’s Tom Huizenga put together a reel of Perlman’s many highlights — such as his first appearance on The Ed Sullivan Show at the age of 13.

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Itzhak Perlman On ‘Morning Edition’ (2015)


William Ruckelshaus

William Ruckelshaus, the first administrator of the Environmental Protection Agency, poses for photos in 2009 at his office in Seattle.

Ted S. Warren/AP

Picked by President Nixon in 1970 to be the first head of the Environmental Protection Agency, Ruckelshaus steered the EPA through the passage of the Clean Water and Clean Air acts in the early ’70s. Later, as acting director of the FBI, Ruckelshaus refused an order from Nixon to fire the Watergate special prosecutor, choosing instead to resign in protest. He even returned to the EPA in the mid-’80s, at the request of President Reagan, to help guide the agency during a time of upheaval.

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Stephen Sondheim

Stephen Sondheim talks with Adam Gopnik during the New Yorker Festival in October 2014, in New York City.

Thos Robinson/Getty Images for The New Yorker

He held the pen behind Sweeney Todd, Into the Woods and A Funny Thing Happened on the Way to the Forum. He had a hand in Gypsy and West Side Story. He’s won Grammys, Tonys, an Oscar and a Pulitzer. And he’s at it still, lending his advice and encouragement to the Broadway smash of the moment, Hamilton.

In between performances of his songs such as “Send in the Clowns,” Sondheim told Marian McPartland of Piano Jazz a lesson he learned along the way: “That’s the whole point, is to keep the listener surprised.”

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Stephen Sondheim On ‘Piano Jazz’ (2001)


Steven Spielberg

Steven Spielberg arrives for a screening of Bridge of Spies in Berlin on Nov. 13, 2015.

John MacDougall/AFP/Getty Images

Jaws, Raiders of the Lost Ark, E.T.: the Extra-Terrestrial, Jurassic Park, Schindler’s List, Saving Private Ryan — even if, by some fluke of fate, you haven’t heard of Steven Spielberg, you know his movies. The director and producer has won Academy Awards, founded a movie studio — and, remarkably, managed never to be interviewed on NPR’s airwaves.

So, I’ll just leave this to NPR’s Bob Mondello, who recently celebrated the 40th anniversary of Jaws, the film that he says “put Spielberg on the map.”

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NPR’s Bob Mondello On Spielberg’s ‘Jaws’ (2015)


Barbra Streisand

Barbra Streisand speaks on stage during the Women in the World Summit held in New York City, in April 2015.

Andrew Toth/Getty Images

The acclaimed singer and star of Yentl and Funny Girl began her career as a performer at a nightclub in 1961. The headliner of Broadway hits has since won Oscars, a Tony and plenty of Grammys and Emmys. It’s been a long and eventful career, but as she told Fresh Air’s Terry Gross in 2012, Streisand is still wondering what comes next.

“You reach a certain age and you wonder, well, do I give it up? Do I retire? Or do I get more in before my time is up?” she asks. “I could just travel around the world. But then I think I’d get bored and I’d need to create. I need to be creative, and time is going so fast.”

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Barbra Streisand On ‘Fresh Air’ (2012)


James Taylor

James Taylor performs at the iHeartRadio Theater in June 2015, in New York City.

Cindy Ord/Stringer/Getty Images

Taylor released his first album in 1968, but it wasn’t until Sweet Baby James came out in 1970 that his popular success caught up with his critical acclaim. Since then, he’s put out more than a dozen albums and earned Grammys — but “Fire and Rain,” the single off that second album, remains one of his best-known works.

Back in 2000, Taylor broke down the song for NPR’s Noah Adams.

“It was a great relief. That song relieved a lot of sort of tension. There was things that I needed to get rid of or at least get out of me or get in front of me or at least have some other relationship than feeling them internally, either by telling somebody else or by just putting them out in a form in front of me so that I could say, ‘There they are’ — you know, externalizing it somehow.

“And that part was hard, having the feelings that needed to be
expressed in that way. But it was actually a relief, like a laugh or a sigh.”

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James Taylor On ‘World Cafe’ (2015)


Minoru Yasui

At the height of World War II, the U.S. government forcibly placed more than 100,000 Americans of Japanese descent in internment camps and pursued other discriminatory policies such as race-based curfews — out of fear that the Japanese-American population could prove a threat.

Minoru Yasui, then a recent law school graduate, violated the curfew in order to get his case heard in court. “I walked these two or three or four times, as I recall that evening, trying to get arrested,” Yasui said — and finally, he had to walk down to the local police department to turn himself in.

That’s when his case began. As NPR’s Michel Martin reports:

“Ultimately, the case made it all the way to the U.S. Supreme Court, where Yasui lost. Despite that, he continued to work on civil rights cases throughout his life on behalf of Native Americans, Latin Americans, wherever he found injustice. Minoru Yasui died in 1986, too soon to witness a victory he had sought for decades when the U.S. granted reparations to interned Japanese-American families in 1988.”

Now, a new recognition of his efforts will be handed down Tuesday — a reminder that it’s never too late to honor hard-fought victories.

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NPR’s Michel Martin On Minoru Yasui

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Pharmaceutical Companies Pfizer, Allergan To Merge In $160 Billion Deal

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U.S. drug giant Pfizer and its rival Allergan have agreed to merge in order to lower its corporate taxes, creating the world’s largest pharmaceutical company by sales.

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ARI SHAPIRO, HOST:

One of the largest mergers of the year may turn out to be the most controversial. It’s being criticized as a huge corporate tax dodge. New York-based Pfizer announced today that it is buying Allergan, which is based in Dublin, Ireland. The deal is valued at a $160 billion. NPR’s John Ydstie reports.

JOHN YDSTIE, BYLINE: There’s no doubt this merger will reduce Pfizer’s U.S. tax bill significantly, says international tax expert Tim Larson.

TIM LARSON: Suffice it to say, it would at least be cut in half.

YDSTIE: Larson, who is a partner at Marcum LLP, an international accounting and advisory firm, says that could easily mean annual tax savings for Pfizer of more than $100 million. That’s because under the deal, Pfizer would move its corporate citizenship from the U.S. to Ireland and its lower tax rates. Under the deal, the company’s operational headquarters would remain in New York City, but its principal executive offices would be in Ireland.

LARSON: Basically pushing a large portion of its non-U.S. revenues outside the existing U.S. tax net.

YDSTIE: And, Larson says, that can be done without any significant change in Pfizer’s current operations. Larson says research and production could remain in the U.S., and the company’s executives could even continue to live and work in the New York area at the company’s current headquarters.

LARSON: You’ve just pinpointed why Treasury and the IRS really want to put a halt to these altogether because there’s tax benefits to be gained without meaningful and substantial business operational change.

YDSTIE: The U.S. Treasury is trying to stop these kinds of mergers which Wall Street calls corporate inversions. The administration says they’re costing the U.S. billions of dollars in tax revenue. President Obama has called the inversions, which have become popular in recent years, unpatriotic. Treasury has tried to stop the flood of inversions by issuing new interpretations of tax rules. Larson says they may slow them down, but only legislation from Congress will stop them. Pfizer’s CEO, Ian Read, has argued the current U.S. tax system, which officially taxes corporate profits at 35 percent, makes U.S. firms compete globally with the one hand tied behind their backs. Of course, many large U.S. firms pay far less in corporate taxes due to tax breaks and loopholes. In announcing the deal today, Pfizer’s CEO deflected the criticisms by touting other benefits of combining Pfizer and Allergan.

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IAN READ: Together, we’ll be even better positioned to make more medicines and more therapies available to more people around the world.

YDSTIE: The merger will add Allergan’s Botox to Pfizer’s large, popular drugs like Viagra. And merging with Allergan provides other benefits for Pfizer.

(SOUNDBITE OF ARCHIVED RECORDING)

READ: Allergan expands our leadership position by bringing very strong franchises in aesthetics, dermatology, eye care, GI, women’s health, urology and anti-infectives.

YDSTIE: And the two firms say the deal will achieve more than $2 billion in annual cost savings. John Ydstie, NPR News, Washington.

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Mendocino Coast Fights To Keep Its Lone Hospital Afloat

Mendocino, Calif., lures vacationing tourists and retirees. But the lone hospital on this remote stretch of coast, in nearby Fort Bragg, is struggling financially.
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Mendocino, Calif., lures vacationing tourists and retirees. But the lone hospital on this remote stretch of coast, in nearby Fort Bragg, is struggling financially. David McSpadden/Wikimedia hide caption

toggle caption David McSpadden/Wikimedia

Board meetings for the Mendocino Coast District Hospital are usually pretty dismal affairs. The facility in remote Fort Bragg, Calif., has been running at a deficit for a decade and barely survived a recent bankruptcy.

But finally, in September, the report from the finance committee wasn’t terrible. “This is probably the first good news that I’ve experienced since I’ve been here,” said Dr. Bill Rohr, an orthopedic surgeon at the hospital for 11 years. “This is the first black ink that I’ve seen.”

The committee erupted in applause, even a few cheers. But the joy was short-lived. By the next month, the hospital was back in the red.

Things first started going badly for the hospital in 2002, when the lumber mill in Fort Bragg closed down. Many people lost their jobs — and their health insurance, which had paid good rates to the hospital. Today, about 7,000 people are left in the blue-collar town, and the economy is propped up by tourists who come to the rugged Mendocino coastline to hike or fish. Visiting the hospital does not usually make it onto their itinerary.

By 2012, the hospital had declared bankruptcy. Now it’s barely hanging on. And some locals are worried that the only hospital in the area might close for good.

If The Hospital Fails, So Goes The Community

“Nobody can live here without that hospital,” says Sue Gibson, 78, a Mendocino resident. “I mean, the nearest hospital is an hour and a half away on treacherous mountain roads.”

It’s not only her family’s health and the community’s that Gibson is concerned about. She’s afraid the local economy would be wrecked. The hospital is the largest employer.

“It has probably the best-paying jobs, and if they close that, all of that income would go away,” she says.

That means less money spread around to the local bait shops and seafood restaurants. Also, Gibson says, the property values of businesses and homeowners would plummet.

Across the country, rural communities share similar fears. Small rural hospitals everywhere have been struggling to survive. Many people who live in these areas are older or low income — not a great customer base for a hospital that needs to make money.

The government used to pay these small critical access hospitals extra to account for that. Medicare reimbursed them 101 percent of their reasonable costs. But after the recession, the government trimmed payments to 99 percent of costs. Medicaid pays much less, sometimes just half the cost of providing the care.

At the Mendocino Coast Hospital, more than 80 percent of patients are covered by Medicare or Medicaid.

“The general health care reimbursement environment is to do more with less,” says Bob Edwards, the hospital’s CEO. “And I would even go so far as to say, it’s a starvation model.”

Plus, the government excludes a lot of expenses from its cost calculation, like doctors’ fees or janitorial services, says Wade Sturgeon, the hospital’s chief financial officer. Medicare basically tells the hospital what it will pay.

“So it’d be like going in to Safeway and saying, ‘Hey, there’s a jug of milk. I really want that jug of milk; I’ll give you $2,’ ” Sturgeon explains. “But the price says $3.50. ‘You’re only going to get $2.’ Often times, that’s what happens to us.”

The upshot: Many hospitals that never had to worry about controlling costs now do. They have to learn to compete in an open market, just like other hospitals, just like many other profit-driven businesses.

Some hospitals have planned ahead and adapted. Down the long, winding road from Fort Bragg, the Frank R. Howard Memorial Hospital in Willits just finished a $64 million renovation, complete with modern technology and a full organic garden that supplies the hospital cafeteria.

But some hospitals haven’t adapted. In the past five years, 57 rural hospitals in the United States have closed, according to data from the Rural Health Research Program at the University of North Carolina. Others have declared bankruptcy, like the Mendocino Coast District Hospital.

Battles Over How To Keep Hospital Afloat

The financial failure led to a lot of finger-pointing in this small town. Administrators blame the policy changes and payment reforms. Some doctors blame the administrators.

“It was economic mismanagement, to put a single label over all these things,” says Dr. Peter Glusker, a neurologist based in Fort Bragg for 37 years. “Because of people who just didn’t know any better.”

The public hospital is governed by a five-member board of directors, elected from and by the community. Glusker says some past directors knew nothing about finance or nothing about health care. Some just stopped caring.

So he and another doctor ran their own campaign, promising to shake things up on the board and change things. They were elected last year.

“There’s a segment of the population that says, ‘Oh good, it’s about bloody time,’ ” Glusker says. “But there’s another segment of the population, in the institution, that says, ‘Hey, you’re rocking the boat and this is bad.’ “

Glusker’s running mate and ally on the board is Rohr, the steely orthopedist, who wears his gray hair long, tied back in a tight ponytail. He spent many years in the corporate world and vowed to bring the kind of financial discipline he learned there to the tiny public hospital in Fort Bragg. A lot of people are afraid of him.

“Look, this is not about being ruthless,” Rohr says. “It’s about keeping this business alive, and it’s only alive if it makes money, OK.”

A lot of his sentences are punctuated like this, with a sometimes impatient “OK,” which seems aimed at making sure you don’t miss his point. Like when he’s giving a presentation at a finance committee meeting, staring daggers at the CEO.

“We keep saying $870,000 loss,” Rohr says. “Not acceptable, OK.”

Edwards, the current CEO, has been on the job six months. He’s the hospital’s fourth chief executive in a year. His right-hand man is Sturgeon, the brand-new CFO, who started in September.

On days the financial committee meets, Sturgeon wears a mint-green shirt and a tie with a $100 bill on it. He says things like, “Do the math.”

Right now, the hospital administrators and the doctors on the board are pitted against each other in a battle over how to keep the hospital doors open — a battle that is echoed at small hospitals across the nation.

Cut costs or raise prices? Board members disagree on best approach

CFO Sturgeon and CEO Edwards say the hospital should focus on increasing revenues. It should find more patients to come to the hospital, maybe develop new services to attract then.

“If you’re not growing, you’re dying,” Sturgeon says.

He says the hospital should also charge more money for services provided to patients who have private insurance — currently about 15 percent of the hospital’s patients.

“Anytime we don’t raise prices, we’re leaving money on the table,” he says.

But Rohr says that would put an unfair burden on the small-business owners in town, the ones who typically buy their own private insurance.

He and Glusker say the hospital should be focused on controlling costs.

“It’s obviously an expense problem,” Rohr says. “And you can come to that conclusion very quickly, just by looking at the data.”

The hospital is going to have to make some very difficult decisions to balance its budget, Rohr says. He offers this analogy: “There’s 20 people in the water about to drown. And there’s a rowboat there, but the rowboat can only hold 10,” he says. “If 11 people get in that rowboat, it sinks and all die, OK.”

At the hospital, this means choosing between a cardiologist and an ophthalmologist, a cafeteria and a new X-ray machine.

“It’s horrible to make the decision that 10 are going to drown,” he says. “But I’ve got to pick the 10. OK.”

One area Rohr thinks could be ripe for trimming? Administrative positions.

“I walk into the hospital to do rounds in the morning, and there are more people standing around with clipboards than with stethoscopes,” he says, “and that doesn’t feel like the right formula to me.”

But CFO Sturgeon says there’s not enough management. “Physicians always think there’s too much management,” he says. “You have some people with 50 direct reports. Does that make sense?”

There are some cuts both sides agree on. All say there needs to be some serious culling of the health benefits for hospital staff. Years ago, the nurses union negotiated to have the hospital pay full health benefits for any full-time or part-time nurse and their entire families. Nurses pay nothing toward their monthly premiums.

“Do the math. How many people are we paying for to have full family coverage?” Sturgeon says. “I’ve never worked in a hospital that provided the type of health insurance benefits that we have at this facility.”

Meanwhile, Need For New Hospital

To understand exactly how dire the financial situation is, one need only walk into the lobby of the hospital itself. It’s like stepping back into 1971. The main patient floor is lined with drab brown carpets. The smell of Salisbury steak spills out of patient rooms.

“I’ve been in Third World countries. This is pretty basic, OK,” Rohr says, walking by the operating suite.

Through the maternity ward and the emergency room, Rohr says the flooring is layered with asbestos. The concrete isn’t strong enough to hold the weight of modern CT scanners and MRI machines. On top of all that, in 2030 new state requirements kick in for earthquake readiness.

It all points to one conclusion. “We’re going to have to build a new hospital,” Rohr says.

So, not only is the hospital struggling to maintain a balanced budget through normal hospital operations but it also has to come up with tens of millions of dollars to replace itself in 15 years.

It’s an especially tall order for a hospital that just posted its first monthly profit in a decade, then slipped into the red again right away.

If you ask the Washington policymakers in charge of payment reform, some will say it’s just a harsh reality that some hospitals will have to close. Some previous local administrators have predicted that the Fort Bragg hospital will one day be replaced by a helicopter landing pad. People will be airlifted out for heart attacks and other emergencies. For other planned surgeries, like hip replacements, people will have to drive “over the hill” to another hospital.

But the people who live in Fort Bragg and Mendocino don’t like that scenario. Gibson has been hosting community meetings in her living room, where people spread out on the pink Victorian sofas to talk about how to save the hospital.

She’s rallying support for a possible solution, and it’s one the administrators and doctors are united around: a new tax on homeowners. Local residents will very likely vote on that in November 2016.

“The only way we’re going to be able to save this place, really, is with a parcel tax,” she says. “But they can’t even think about that until they clean up their act.”

After the Wall Street meltdown, banks were too big to fail. The feeling here is that the local hospital is too important to fail. And the residents will be tapped to fund the bailout.

This story comes from a reporting partnership of NPR, KQED and Kaiser Health News.

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