Repo tells the tale of a distant dystopian future where the healthcare system is managed by the incredibly wealthy and innocent people die if they can't afford treatment...hmmm sounds familiar.
Gabe talks about how the film feels a bit too real in our pandemic worlds and Kat discusses the very real challenges and barriers around organ transplantation.
Sources in this episode: https://filmmakermagazine.com/4773-freak-show-by-andr-salas/#.YTeVAdNKjHB
https://film-cred.com/repo-the-genetic-opera/
https://www.cbr.com/repo-the-genetic-opera-whole-2020-mood/
https://unos.org/transplant/how-we-match-organs/
https://optn.transplant.hrsa.gov/learn/about-transplantation/how-organ-allocation-works/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3127035/
Ways to Help:
Read and give feedback on developing policy:
https://optn.transplant.hrsa.gov/governance/key-initiatives/
Attend regional meetings:
https://unos.org/community/regions/regional-meetings/
Volunteer of join a committee
https://optn.transplant.hrsa.gov/members/get-involved/
Sign up to be an organ donor:
https://www.donatelife.net/register/
Website that claims to help find affordable medicine and clinic access:
Media from this week's episode:
Repo! The Genetic Opera (2008) Director: Darren Luynn Bousman
Summary by IMDB: A worldwide epidemic encourages a biotech company to launch an organ-financing program similar in nature to a standard car loan. The repossession clause is a killer, however.
This Dystopia Looks a lot Like Ours: Repo! the Genetic Opera
by Gabe Castro
RED: Quotes, someone else's words.
Interesting concept -- organ repossession. Honestly, not too far fetched considering our current medical insurance industry. I can see the allure and why people would be drawn to a premise like that. If only this film actually covered this topic at all. It's also a rare goth-musical. I first watched this film in high school after a pirate told me about it at the flea market (I am from Florida so this all makes sense). I remember enjoying the aesthetics and angst of it all. Bousman created the piece thinking of the oddball kids I fancied myself to be at the time. In an interview in Filmmaker Magazine Bousman explained, "The movie appeals to the fringe, it appeals to the goth-y outside-the-box [crowd], the gay crowd, the theater crowd." In looking up articles and reviews, I found that the film has a strong cult-following and that many people are rediscovering the 2008 musical. Its tones and themes hit a bit harder in today’s dystopian world.
In an article on Film Cred, Repo! The Genetic Opera is the Hot Mess America Deserves Right Now, author Emma Ambrose hits the nail on the coffin, “The Repo Man is a pure personification of the terror of living in a state where insurance is given only at the behest of corporations and medical infrastructure is forgone in the name of overfunding an already bloated military and police budget. “None of us are free from this horror,” Zdunich continues, “because long ago we all fell into debt.” With this song, the Repo Man is presented as the inhuman slasher of predatory Capitalism. If you cannot pay in cash, you can pay in blood.”
My biggest gripe with the musical is that I wish this part of the story was more of the focus. It turns to focus on family drama. Others felt the same which is why I imagine the film, Repo Men with Jude Law was made. It’s the same rough idea but not a musical and maybe better? I haven’t watched it yet.
The song, 21st Century Cure sums up the idea pretty succinctly:
“Industrialization has crippled the globe
(Enjoy GeneCo's day and nighttime formula of Zydrate)
Nature failed as technology spread
(Ask a gentern if Zydrate is right for you)
And from this wake a market erected
(Buying Zydrate from an unlicensed source is illegal)
An entire city built on top of the dead!
And you can finance your bones
And your kidneys
For every market a submarket grows
But best you be punctual
With making your payments
Lest it be you on the concrete below”
Firstly, from a musical perspective - it clearly appeals to a certain audience. Looking online I found a few people who truly loved the soundtrack and even listened to it outside of the film! Apparently, there are die-hard fans of the musical that reenact the play every Halloween. We are not one of them. I will say, I can hear why this was interesting to me as a young human. This soundtrack isn’t too far from the terrible music I used to listen to! Also, listening to the soundtrack separately from the film -- it's not so bad. However, to Kat and I the songs are pure noise and annoyance now. Keys, rhythm, and motivation change several times per song. Also, people don’t sing every single word in a musical -- you are allowed to speak normally. This is not the case for Repo which never lets the audience breathe and instead continually assaults us with more terrible singing.
Bousman was buddies with James Wan (Saw, Conjuring) and Leigh Wannell (Invisible Man) who asked him to direct Saw 2, 3 and 4. Bousman originally wrote this musical as a play and it was performed in New York and Los Angeles. He financed 90% of the film. He had guerilla marketing techniques of handing out flyers to college students and eventually got the film out there. In that same interview with Filmmaker Magazine, Bousman discussed his promotion tactics. “Basically it’s myself and two other people doing it. We run the website, we print out flyers every night. Every single day I’m online on chat rooms talking to people about the movie. This isn’t Lionsgate doing it; this is us.”
With his limited budget, Bousman and co had to get creative which is why they implemented the comic book style work throughout to help tell the story. The world they built is so unique -- grungy and punk rock. As penny-pinching savvy filmmakers ourselves, I can give them a bit of credit for their creativity. The songs and plot may not be great -- but I did enjoy the costuming and overall vibe of the film. I certainly felt like I was in a post-apocalyptic grunge world where organs are repossessed!
“That’s why we went with the comic book look — we knew that we were not gonna have the money to do things real so we embraced being crazy and weird. We embraced looking cheesy...There’s a scene in the movie where Anthony Head is cutting someone who’s strapped to a chair and all these people around him are singing. Well, that set is plastic. We ran out of money, we had this big song to shoot and so the production designer said, “All I got, Darren, is plastic.” But it works for the movie that we’re in a plastic room. It looks cool.” Bousman explained in the interview.
The eclectic cast includes Paris Hilton, Alexa Vega (Spy Kids), Giles from Buffy the Vampire slayer, Sarah Brightman as Blind Mag (an actual performer) and a real punk rock star named Ogre of Skinny Puppy who plays Pavi, the face-stealing son of GeneCo’s Rotti.
The film follows this odd chorus of characters through the post-apocalyptic landscape. Alexa Vega’s Shilo inherited a nondescript blood disease from her mom (hence - genetic opera). She cries and rages against her teenage angst -- in remorse of her inherited condition. Her mother is long dead, died upon her birth, and her father, the head Repo-Man Giles, believes he killed her while trying to cure her. GeneCo’s creator Rotti is ill and dying. Even he can’t be saved. The film follows him as he is dismayed at the idea of any of his sh*tty children inheriting GeneCo. One is always angry, violent and murderous. Another is obsessed with stealing and wearing other faces (he looks like Handsome Jack from Borderlands). And lastly, Paris Hilton’s Amber Sweet is obsessed with surger (surgery) and by extension addicted to the drug, Zydrate that comes in a little glass vial. (A little glass vial? A little glass vial.)
In an article on CBR titled, Repo! The Genetic Opera Is a Whole 2020 Mood the author Brynna Cole draws some troubling comparisons to our present day woes. “Rotti Largo is also a charming but sinister businessman who has capitalized on tragedy to become famous, wealthy and powerful. He doesn't actually care about the people his company purports to help, but he's nonetheless convinced he's a beloved humanitarian worthy of respect. He's great at putting on a show for people to distract from the horror, chemical dependency, financial extortion and murder that his corporate regime enables even in the midst of a health crisis. He's also surrounded by his unqualified and demonstrably problematic children and an endless slew of yes-men willing to say and do whatever he wants, which is uncomfortably reminiscent of a certain political figure.”
I made the same connection when we were watching after seeing the campaign Rotti drew up for Amber Sweet. Felt very much like Ivanka Trump to me.
Cole goes on to highlight how Shilo’s quarantine hits a bit close to home nowadays. After over a year of Pandemic fears, the lyrics “I want to go outside, outside” feels a bit too real. She's standing at her window, staring out at the post-apocalyptic city around her. While months of quarantine are less severe than a lifelong quarantine, this year has been full of social distancing and isolation, the likes of which have taken a mental toll on many people. Standing at the window, watching things (some of them horrific) go on is a sight that many people are dealing with today.
SPOILERS!
Giles didn’t kill Shilo’s mom. GeneCo’s Rotti killed her because she used to be engaged to him so I guess that’s a reason. Anyway, if you think that means Giles can be redeemed and isn’t so bad despite his obvious joy from organ-reposession-murder you will be disappointed to find out he’s got a bad case of munchausen-by-proxy and has been poisoning Shilo since birth. This film is a lot of men trying to control women in some way or another. Blind Mag is indebted to GeneCo for giving her eyes. She has been blind since birth but since having eyes = sings good??? she has them on loan, she only needs to be their opera singer for her entire life. Steep price? Not for fame or the ability to see?? Also, brief aside, but how horrible is it to be named disability first? Like what? Also...she’s not blind anymore...she can see with her GeneCo eyes. What a mess. Amber Sweet is addicted to Zydrate is constantly following and catering to the Graverobber. All other women in this film are murdered -- including the absurd nurses - all women are expendable but enough of a catalyst to justify murder. The song in the credits alludes to Shilo becoming addicted to Zydrate too and having a questionable relationship with the Graverobber. It's a bit messy to say the least.
Organ Transplantation: Deciding Factors & Classist Limitations
by Kat Kushin
RED: Quotes, someone else's words.
The concept of this film is really interesting, in that it seems to critique capitalism and the commodification of the human body and it’s parts. I think the context that the film was made in and how it hits now is relevant in that it seems to be originally intended as a critique on the plastic surgery industry, big pharma, and the credit industry. Viewing it during a global pandemic however gave it a different feel for me, with the blatant exploitation of human bodies especially relevant and upsetting. A reality where human body parts are purchased and sold, the ever present threat of repossession is obviously horrific but doesn’t seem so farfetched. As I live in a society where the commodification of human bodies is relatively commonplace already, organs seem like a believable next step within this system that already values money more than human life. Considering how the service industry has been actively exploited for profit and for a sense of “normalcy” (for who?), where life saving medicine is held behind locked cabinets and price walls, I can easily imagine a world where human life is disregarded to the point that a repo man of organs would exist.
The ghouls have covered medical exploitation before in previous episodes, and the layers that exist in terms of how capitalism, the patriarchy, and racism work together to oppress people is as always, hella gross, and hella sad. The horrors that already surround the organ transplant industry provide our usual dose of “wow people are trash”. When looking at how Organ transplants are decided, red flags immediately stand out. The language used for how transplant recipients are decided is very vague, and seems to inherently, because of how the US exists, separate transplant access based on economic and racial terms. According to the United Network for Organ Sharing, organ allocation is decided based on the following factors:
These types are organized based on the preservation factors that exist for each kind of organ. Since certain organs lose transmissibility over time, location in proximity to the hospital seems like a large barrier for many.
There are obvious disparities that exist in the distribution of organs, specifically in the necessity for individuals receiving transplants to be located in close proximity to transplant hospitals. Essentially if hospitals are located closer to white neighborhoods, and further from BIPOC neighborhoods, there are obvious implications of inequity that would exist from this alone. Economic status also plays a role both in reference to location as well as access to insurance.
The data for organ transplants from dead donors, which is publicly available, unfortunately seems to support this claim. To date, White Americans have received 10,105 out of the 16,035 total available organs. Black Americans have received 2,705, Hispanic Americans 2,395, Asian Americans 563, American Natives 122, Pacific Islander 56 and Multiracial 88. This list spans the years 1988-2021. This data does not include live-kidney transplantation which holds different, but similarly disparaging data.
The amount of individuals in need of life saving organ transplants according to the US Department of Health and Human Services is over 120,000 people, who currently occupy the waitlist. In an article titled Ethnic Disparities in Liver Transplantation written by Nyingi Kemmer, the largest disparity is in access to insurance. The article states that “According to the National Healthcare Disparities Report, health insurance is the key barrier to healthcare access among Black and Hispanic patients.12 In a population-based study using the NIS database, black and Hispanic patients with cirrhosis were less likely to have private insurance—but more likely to be insured by Medicaid— than white patients.3 In a large cohort of potential liver transplantation candidates, Bryce and coworkers found a strong association between insurance status and the likelihood of referral or evaluation for liver transplanta-tion.13 In this study, potential candidates with commercial or private insurance were more likely to be referred and evaluated for liver transplantation. Although this study did not provide ethnic-specific data, it provides an insight into the critical role that health insurance plays in affecting access to liver transplantation.”
When it comes to live-donors of kidneys, an article from John Hopkins Medicine titled, Disparity Persists: Racial and Ethnic Minority Patients Still Less Likely Than White Patients to Get Live Donor Kidney Transplants written by Chanapa Tantibanchachai, they go through some of the factors that influence these disparities. The findings, published Jan. 2 in the Journal of the American Medical Association, are based on a study of 453,162 adult first-time kidney transplant candidates nationwide. Overall, the incidence of live donor kidney transplantation increased from 1995 to 2014 among white patients (from 7 percent to 11.4 percent) and among Asian patients (from 5.1 percent to 5.6 percent), but decreased over the same time period among black patients (from 3.4 percent to 2.9 percent) and Hispanic patients (from 6.8 percent to 5.9 percent).
This article goes on to outline the extensive need for live-kidney donation, as over 700,000 patients in the US have been diagnosed with end-stage kidney disease. With the need, there are factors that keep BIPOC candidates from both the recipient and donor pool, including diseases that would often make someone ineligible to become a live-donor - such as high blood pressure, diabetes and kidney disease that disproportionately affect Black and Hispanic populations. A large barrier to donor and recipient status also revolves around price as well as access to insurance. This extends both to the bill for care, as well as from inability to take days off from work to recover. Essentially both the pathway to receiving and donating organs are skewed to favor economically more well-off individuals with private insurance, and thus inherently discriminatory towards race because of the structure of the systems within our country.
A lot can be said about organs, but there are also disparities that exist just for access to care for basic health needs, such as medicine and specialists that operate behind pay and insurance walls. Thinking back to the high price of insulin, of inhalers, epipens, and other life sustaining medicines that exist behind pay and insurance walls. There is a huge disparity that exists just from capitalism alone that actively hurts people.