Puncture (7/10)

by Tony Medley

Run time 99 minutes.

Not for children.

Based on a true story, co-director (with his brother Adam) Mark Kassen co-stars with Chris Evans in this thriller as personal-injury attorneys trying to take on the health care industry to crusade for safer hypodermic needles. From a good script by Chris Lopata and a story by Paul Danziger and Ela Thier, the title comes from an ER nurse, Vicki (Vinessa Shaw), who receives a deadly puncture from an HIV-infected needle at the beginning of the film.

Vicki goes to Attorneys Mark Weiss (Evans) and Paul Danziger (Kassen) to get them to help her friend, Marshall Bell, who has invented "Safety Point" syringes, to get them into 2,000 hospitals to protect health care workers from what happened to Vicki. They find that a corrupt "Group Purchasing Organization" (GPO), which purchases supplies for lots of hospitals, keeps good, innovative new products from being purchased because it might cause their major suppliers to lose a lucrative market. They are quickly thrust into a huge antitrust case and find themselves over their collective heads.

Danziger wants to drop the case but Weiss insists they continue. As they proceed, what happens is familiar to anybody who has ever had any connection with litigation and courts.

There is a lot of nudity and pervasive drug use, but that's a part of the plot since Weiss is a serious addict. Other than his crusade on behalf of safe needles, he has virtually no redeeming personal values as his wife has left him and he spends most of his off time in the company of prostitutes. Evans gives a compelling performance as this lowlife, drug-addled lawyer facing enormous odds fighting the good fight.

The film paints a startlingly frank picture of the corruption of the American system of civil justice. There is a particularly effective scene in which Evans is trying to get an obviously corrupt judge to allow discovery to get evidence of the bad guys' malfeasance.

Highlighting the indictment of the civil justice system is the performance of Brett Cullen as Nathaniel Price, the enormously wealthy, smooth, smarmy, well-connected, defense attorney. Price epitomizes the legal system at its worst. Supremely confident, he overwhelms the two protagonists and controls the litigation until the very end. Cullen deserves a Best Supporting Actor Oscar® nomination for his portrayal.

This movie isn't just about a corrupt system of civil justice. It's main point is akin to the muckracking work of Ida Tarbell and Lincoln Steffens at the turn of the 20th Century. This movie can introduce millions to what's going on with GPOs.

GPOs negotiate contacts for tens of billions of dollars annually for thousands of hospital. Despite its title, in a 1986 law (the Medicare antikickback law) Congress allows GPOs to receive a fortune in kickbacks in return for which their suppliers receive preferential, exclusive treatment by the buyers. In virtually every other industry, the type of arrangement would be criminal. This means that doctors and nurses have no say in what supplies are purchased. Those decisions are totally in the hands of the purchasing agents.

That's bad, but even worse is that a report by Navigant Consulting showed that these kickbacks increase annual healthcare costs by almost $40 billion, including almost $20 billion in federal outlays (taxpayer money) for Medicare and Medicaid.

This movie is not only an entertaining thriller, it's an eye-opener in more ways than one.