‘Elysium’ Wants To Be A Lacerating Movie About Health Care, But It Has No Idea Why Inequality Exists

Credit: Screencrush
Credit: Screencrush

This post discusses the plot of Elysium in detail.

I very much wanted to like Neill Blomkamp’s Elysium, a parable about access to health care, given how much I loved his previous directorial effort, the alien invasion drama District 9. The story, about a former convict named Max (Matt Damon), who is poisoned by radiation during an industrial accident, and enlists the help of a criminal-slash-political-leader named Spider (Wagner Moura) who helps desperately ill people try to get to an enclave for the very wealthy called Elysium that has exceptional health care resources to help him do the same, has promise. Blomkamp is a hugely inventive world-builder, and his characters, from Elysium’s Secretary of Defense Delacourt (Jodie Foster), to an augmented warrior named Kruger (Sharlto Copley) who works for her, to John Carlyle (William Fichtner), an industrialist who becomes embroiled in her schemes, to Frey (Alice Braga) have some nice grace notes and invite some strong performances.

But Elysium falls apart the more you think about it — and fails in its mission to speak truth to power — because of its inability to explain a simple question: why is health care scarce on Earth in the world of Elysium? The movie shows us many ways that life in Elysium is more comfortable and satisfying than life on earth, but Blomkamp focuses his camera narrowly on people on Earth who want to get to Elysium mainly for access to medical pods that can cure even grave illnesses with a single, quick scan. And at the conclusion of the movie, they get it. After Spider and Max download a program into the Elysium mainframe that makes everyone on Earth a citizen, and thus able to be scanned by the devices, shuttles full of the pods take off for Earth where people of all races, genders, and creeds flock to make use of them. It’s not as if there’s a medical device scarcity. There could be other reasons that health care is restricted, but it’s not particularly made clear in the movie what those motives might be.

The determination of whether you get access to the pods is, before Spider’s hacking of the citizenship rolls, whether you’re a citizen of Elysium or not. At the beginning of the film, citizenship is something you purchase, and access to a medical pod is part of a package of services you receive along with that designation. But use of the pod isn’t fee-based on a per-use basis. Maybe that’s because the costs of citizenship are so high that they cover unlimited use of the pods, but the surplus of the pods in reserve suggests that they aren’t prohibitively expensive to manufacture on a large scale. And it’s clear that they can be deployed quickly for intensive, free use, which suggests that they aren’t exceptionally delicate instruments that will break down or require intensive maintenance.


Even if these were fragile, expensive instruments, there’s something odd about Elysium’s decision to leave out the question of who manufactures and maintains the medical bays, and who profits from their sale and use. The movie spends a fair amount of time on the character of Carlyle, a wealthy defense contractor who owns the factor where Max works and is injured, and who becomes a pawn in Delacourt’s scheme to stage a coup in Elysium. But if health care is, in fact, one of the key engines of inequality between Elysium and Earth, wouldn’t it make sense that the Big Bad of the movie is whoever controls access to health care, and whoever profits off people’s access to it? In District 9, the South African military ended up having an interest in keeping an alien ghetto present so it could try to test existing alien weapons and learn how to adapt them for human use. But Elysium has a curious blank in that space instead, and the absence makes for a softer movie.

Another explanation could be that leaving human doctors and nurses to care for Earth’s injured and infirm is a way of creating work for Earth’s population even if robots could do their jobs better, just as Max’s job in the factory appears to be more a way to keep him occupied than the actual, maximally efficient way to manufacture law enforcement robots. But even that doesn’t quite make sense. If Earth’s population in the 22nd century hovers somewhere around 9 billion people, and that running an individual through a med pod takes a minute, which seems like a reasonable estimate, it would take more than 17,000 years to run the entire human population through the pods once. Even with a huge number of pods in operation, that’s a work program that could employ a whole lot of people to oversee the scans, not to mention the work of intake counselors, folks overseeing lines, and high-level doctors making decisions about priority access to the pods. If you want health care make-work as an employment program, the pods don’t eliminate that possibility. And in fact, setting up that system might be complicated, but it might provide a structure for the pod manufacturers to extract a regular stream of profit from a population that would have more opportunities to consume health care than they do in the present, dramatically over-stressed system.

In other words, there’s absolutely no good reason that the medical pods aren’t already on Earth at the beginning of Elysium. And given that access to health care is presented as the main reason that people try to get to fake citizenship and land shuttles on Elysium — the people of Earth seem remarkably uninterested in ripping off their wealthier counterparts, which is a rather saintly perspective on humanity from the man who made District 9 — that suggests that providing medical pods on Earth would remove the main exit pressure for immigration, however fleeting their stays there might be. If what the residents of Elysium want is to live their lives untouched by the desperately poor citizens of Earth, then why not ship down medical pods, eliminate the most pressing needs that are spurring citizens to challenge inequality, and bleed off enough political pressure to keep your segregated world intact and separate?

A much sharper version of Elysium might have ended with Delacourt doing precisely that, sending down medical pods, extending citizenship to Earth’s population while preserving a two-tiered structure within it, and cutting Spider’s nascent movement off at the knees by addressing its most pressing need. That would have been a powerful demonstration of how resilient economic inequality and the interests behind it really are. Or a sequel might deal with Spider’s gift becoming a curse and a force for social turmoil as the maker of the pods emerges, and demands payments on the kind of per-service basis that keeps health care costs so high in the U.S. now, or holds back parts that are needed to repair the pods as they begin to break down and need servicing.

But presenting the pods as a magical cure-all with no strings attached means that the only real explanation for denying them to Earth’s population is that Elysium’s leaders are both mean and stupid, that they enjoy watching the people of Earth suffer, but have no sense of how that suffering might ruin the sanctity of their new Eden. It’s satisfying to think of villains that way if you simply want to demonize them. But vicious and dumb is rarely combination that that describes the actual, rational cunning that people in power use to keep themselves there, and to keep themselves wealthy.