World

Romania’s State-Run Health-Care Disaster

Vlad Voiculescu in ‘Collective’, 2019. (Alexander Nanau Production/Magnolia Pictures)
Collective doesn’t quite bend the arc of history toward justice, but it does shine a light on the dysfunction and horrors of state-run medicine.

Far be it from me to suggest that journalists could conceivably, sometimes, be a little bit excitable about the wonderfulness of their profession, but their praise of the crusading-journo doc Collective is a bit overstated. Critics are comparing Romania’s entry for the Best International Film Oscar to thrilling newspaper dramas such as All the President’s Men, describing it as a stirring story of fiercely dedicated idealists bending the arc of history toward justice. To me it looks more like an unintentional slam of Romanian culture.

Collective is about the aftermath of a 2015 nightclub fire in Bucharest, Romania, that killed 27 people at a concert, plus 37 more who died of bacterial infections and other ailments they picked up in hospitals afterward. The film does a service in that it solidly confirms my priors about Romanian health care, which is almost entirely state-run, and the title of the film, which is simply borrowed from that of the nightclub (Colectiv), speaks to the nature of its failure. The everyday woes of this system, not the sensational facts uncovered by the crusading hero-journalists, provide the real meat here.

The film, directed by Alexander Nanau, unfolds largely from the viewpoint of an investigative reporter for a sports paper, Catalin Tolontan, who comes across as diligent but is expressionless and far too much of a cipher for viewers to forge a connection with. This is one of those ascetic fly-on-the-wall documentaries, supplying no narration or backstory, and so we learn nothing about Tolontan except that he’s been asking questions about why the death rate was so high in survivors. Dustin Redford he is not. Moreover, the big scoop happens off-camera, apparently before the film got started: A disinfectant solution used in more than 300 Romanian hospitals was being diluted to such a degree that it was useless. Surgical instruments were being “sterilized” with what might as well have been pond water.

So the villain of the piece is the Porsche-driving owner of the disinfectant manufacturer (already under surveillance by journalists at the start of this film), but we never get to meet him. We see him only in glimpses and he is never caught saying anything on camera. How did such a shabby excuse for a disinfectant win a place in so many hospitals? Kickbacks to the hospital managers. A national health minister is shown promising everyone that everything is fine in a bland press conference before resigning in disgrace, but as cinema these interludes don’t amount to much. Later he is replaced by an eager young technocrat (if his name is supplied in the film, I missed it, but it’s Vlad Voiculescu) who learns that the whole system is rotten and is consequently at a loss for where to start.

So where’s the surprise factor? We already knew Romania is corrupt. Surveys rank it below Rwanda, Cuba, Barbados, Butan, Saudi Arabia, and Cuba on that front. Another piece of information the film supplies is that you may not fare so well in a Romanian hospital. Okay, but there’s a reason “Romanian hospitals” is not exactly a brand on par with, say, Disney resorts or German automobiles. Voiculescu learns that the tainted products can’t be removed from hospitals except by the company that put them there — but that the company can’t do so because its bank accounts have been frozen by the courts. Such disclosures remind us that “Romanian governance” is unlikely to be the title of a Harvard school of government seminar, unless it’s a comedy-writing class.

One doctor notes without much surprise that there are actual maggots crawling around the ears of a burn patient who had not recently been bathed and that patients are dying because of botched blood transfusions. Nurses treat burn victims by covering their faces so as not to have to look at them, and apparently in Romania doctors bribe other doctors for plum assignments known to yield bribes from patients. “How the hell can all this be solved?” asks Voiculescu. How indeed. Let’s hear it for state-run health care!

Journalistic sleuthing about watered-down disinfectants is somewhat beside the point when the entire system is such a dumpster inferno. A reporter asks what Romania would do in the event of casualties from a bomb explosion, and the answer is: ask other countries to take them. “Even five burn patients would be a serious problem,” notes the health minister.

The most effective part of Collective is the footage taken inside the club as the band’s singer concludes a song and warns that he smells smoke. Within seconds, the fire is raging over the stage. A camera recording this apparently falls to the ground amid much shrieking and terror. Powerful stuff, but these two minutes supply almost the only dramatic images in this two-hour film about conferences and phone calls. A scene when a burn victim (apparently a celebrity, though we aren’t presented with much information about her) gets a mechanical new left hand is not supported by any context or storytelling whatsoever; it’s hard to become invested in the human story when you aren’t given the story of any particular human. And her sketchy tale is pretty much all we learn about the survivors.

A lengthy and strange digression is built around what seems to amount to a case of national hurt feelings over the lack of lung transplants done in Romania, which had no hospitals legitimately accredited for that purpose and consequently sent such patients to Vienna for the surgery. (Hands up, those of you who’d rather have a lung transplant in Romania than Austria.) Even the violent demise of one of the major players is presented so blandly that it has almost no dramatic impact. People shrug and move on.

The last act of the film is so naïve it comes across as a put-on. “The way a state functions can crush people sometimes,” Voiculescu notes toward the end. Just so, which is why I’d rather not give the state the opportunity to do so when I’m at my most vulnerable, in a hospital bed. The Social Democratic Party, which Voiculescu blames for the deaths resulting from the fire, ends up gaining even more power in a resounding election victory. He considers its success unconscionable, but since the film doesn’t explore what the voters were thinking, it’s impossible for the audience to come up with an informed opinion on the matter. One thing that’s pretty obvious, though, is that there’s not a lot of arc-bending toward justice going on here. My only takeaway from Collective is: Don’t get sick in Romania. Better yet, don’t go there in the first place. Which I wasn’t planning to do anyway.