Apple TV+’s eight-part series on Benjamin Franklin does a bang-up job of depicting chess-like political maneuvering and landmark bargaining sessions that helped shape the course of history.

But “Franklin” doubly serves as a warning that democratic systems like the one the series namesake helped create are under attack across the globe.

At least that’s how Michael Douglas, who brings decades of acting prowess to the series’ titular role, views it.

Douglas adds another quiver to his impressive acting cap as the nimble-witted, immensely quotable inventor, author, publisher and founding father. “Franklin” hones in on how the publisher of the annual “Poor Richard’s Alamanack” voyaged to France in 1776 where he served as the pivotal dealmaker who shrewdly convinced France to join the Colonies’ fight for independence against the British.

“I think that it really shares with us the fragility of a democracy and just how fragile this concept is, and how it has to be nourished and protected,” said the award-winning actor and producer during an interview to promote “Franklin,” which debuts on Apple TV+ on April 12.

“That becomes clear and evident (during the series) and has echoes of what’s going on in our contemporary times,” Douglas added. “For democracies are endangered species. They are being overrun by autocracies around the world. And I think (democracies are) an extraordinary system. And when you get into a show like this and realize how brilliant this concept was, it’s something that we should be protecting.”

The final episode of this intelligently scripted series from screenwriters Kirk Ellis (“John Adams”) and Howard Korder (“Boardwalk Empire”) particularly coalesces around that theme.

“Franklin” was adapted from the 2005 nonfiction book “The Great Improvisation: Franklin, France, and the Birth of America,” by Pulitzer Prize winner Stacy Schiff. The book covers an oft-overlooked chapter from American history.

Tim Van Patten directed all eight episodes, and the 79-year-old Douglas served as an executive producer along with Schiff and others. Three episodes of the miniseries drop April 12 with one episode following every Friday through May 17.

Douglas admits he was in the dark about the critical role that Franklin played in wooing France to help fund, arm and fight for the fledgling United States’ freedom. Franklin stayed in France for eight years and was joined part of that time by the more stern John Adams (Eddie Marsan), with whom he sparred often, but who also played an instrumental role in making the Treaty of Paris of 1783 happen.

“Unbelievably,” Douglas added, “I was not aware of the most important part, which was after all that Franklin accomplished, at 70 years old, he goes over to France to really save America because we we were in a war with the British and we didn’t have any weapons’ or money or army … nothing. So he went over to this monarchy to try to talk them into it, with all the intrigue and spies. I didn’t know that part and found it really fascinating and ultimately realized that if it weren’t for France we would not have an America.”

While in France, Franklin dodged double agents while receiving a celebrity greeting — due, in part, to his experiments with electricity — and wooed women all around him, as he known to do.

Douglas was joined in this interview by co-star Noah Jupe (“A Quiet Place” and its sequel) who portrays Franklin’s ambitious grandson Temple in the miniseries. He knew zip about Franklin.

“I’m from the U.K.,” the 19-year-old actor explains. “In my high school history class, we didn’t even talk about the American Revolution. So for me, I had a big learning curve in the sense of learning about the entire history of America.”

Temple gets swept up in his grandfather’s mission and while in France served as his secretary. His father was a British loyalist, and estranged from Benjamin Franklin.

Jupe hopes “Franklin” encourages more people into becoming involved in striving for the common good.

“As a society today, I think we’re all very comfortable in our lives and it’s very difficult to change the way things are. I think that this (series) really shows how much work and bravery you have to put in to make things change and to stand for what you believe in and make your country or the world a better place … . That’s important and rare in today’s world.”

Jupe was impressed by Temple’s youth and how he participated in something monumental.

“You’re getting on a ship for 60 days sailing across the sea to a world where everyone speaks a different language (and) everyone is dressing in a different way. Temple’s there for the purpose of America and that’s the priority. But also he’s trying to grow up.”

Douglas grew up as the son of the late Hollywood legend Kirk Douglas. The actor turned heads and won hearts — especially in the Bay Area — as homicide inspector Steve Keller in the hit 1972-77 series “The Streets of San Francisco.” His career caught fire from there. But it was as producer on 1975’s “One Flew Over the Cuckoo’s Nest,” with Jack Nicholson and the late Louise Fletcher, that nabbed him his first of two Oscars — as a producer.

He also took home the best actor Oscar for his unscrupulous moneymaker Gordon Gekko in 1987’s “Wall Street.” Numerous other iconic roles have bookended his long career, which have included him even appearing in Marvel superhero films. In addition to his Oscars, he’s won five Golden Globes, an Emmy and has received the Cecil B. DeMille Award and the AFI Lifetime Achievement Award.

“Franklin” marks a bit of a change for Douglas — an historical period piece. He enjoyed this new direction.

“I think there’s been a big shift to historical pieces,” Douglas said. “I think a lot of it had to do with ‘Bridgerton’ quite honestly.”

To research his role, Douglas dove into Schiff’s biography as well as Walter Isaacson’s 2003 “Benjamin Franklin: An American Life.”

Both Jupe and Douglas appreciate how this story gets told in a series not a stand-alone film.

“It’s accessible all over the world on this platform,” Jupe said.

Douglas sees the length as being beneficial to the intricacies of the material.

“It’s a story to be told in eight hours, not just two hours,” he said, adding he’s proud of the production design and Van Patten’s direction.

“It takes place over eight years and it needs that amount of time,” he said.

Judith Graham | (TNS) KFF Health News

Susanne Gilliam, 67, was walking down her driveway to get the mail in January when she slipped and fell on a patch of black ice.

Pain shot through her left knee and ankle. After summoning her husband on her phone, with difficulty she made it back to the house.

And then began the runaround that so many people face when they interact with America’s uncoordinated health care system.

Gilliam’s orthopedic surgeon, who managed previous difficulties with her left knee, saw her that afternoon but told her “I don’t do ankles.”

He referred her to an ankle specialist who ordered a new set of X-rays and an MRI. For convenience’s sake, Gilliam asked to get the scans at a hospital near her home in Sudbury, Massachusetts. But the hospital didn’t have the doctor’s order when she called for an appointment. It came through only after several more calls.

Coordinating the care she needs to recover, including physical therapy, became a part-time job for Gilliam. (Therapists work on only one body part per session, so she has needed separate visits for her knee and for her ankle several times a week.)

“The burden of arranging everything I need — it’s huge,” Gilliam told me. “It leaves you with such a sense of mental and physical exhaustion.”

The toll the American health care system extracts is, in some respects, the price of extraordinary progress in medicine. But it’s also evidence of the poor fit between older adults’ capacities and the health care system’s demands.

“The good news is we know so much more and can do so much more for people with various conditions,” said Thomas H. Lee, chief medical officer at Press Ganey, a consulting firm that tracks patients’ experiences with health care. “The bad news is the system has gotten overwhelmingly complex.”

That complexity is compounded by the proliferation of guidelines for separate medical conditions, financial incentives that reward more medical care, and specialization among clinicians, said Ishani Ganguli, an associate professor of medicine at Harvard Medical School.

“It’s not uncommon for older patients to have three or more heart specialists who schedule regular appointments and tests,” she said. If someone has multiple medical problems — say, heart disease, diabetes, and glaucoma — interactions with the health care system multiply.

Ganguli is the author of a new study showing that Medicare patients spend about three weeks a year having medical tests, visiting doctors, undergoing treatments or medical procedures, seeking care in emergency rooms, or spending time in the hospital or rehabilitation facilities. (The data is from 2019, before the covid pandemic disrupted care patterns. If any services were received, that counted as a day of health care contact.)

That study found that slightly more than 1 in 10 seniors, including those recovering from or managing serious illnesses, spent a much larger portion of their lives getting care — at least 50 days a year.

“Some of this may be very beneficial and valuable for people, and some of it may be less essential,” Ganguli said. “We don’t talk enough about what we’re asking older adults to do and whether that’s realistic.”

Victor Montori, a professor of medicine at the Mayo Clinic in Rochester, Minnesota, has for many years raised an alarm about the “treatment burden” that patients experience. In addition to time spent receiving health care, this burden includes arranging appointments, finding transportation to medical visits, getting and taking medications, communicating with insurance companies, paying medical bills, monitoring health at home, and following recommendations such as dietary changes.

Four years ago — in a paper titled “Is My Patient Overwhelmed?” — Montori and several colleagues found that 40% of patients with chronic conditions such as asthma, diabetes, and neurological disorders “considered their treatment burden unsustainable.”

When this happens, people stop following medical advice and report having a poorer quality of life, the researchers found. Especially vulnerable are older adults with multiple medical conditions and low levels of education who are economically insecure and socially isolated.

Older patients’ difficulties are compounded by medical practices’ increased use of digital phone systems and electronic patient portals — both frustrating for many seniors to navigate — and the time pressures afflicting physicians. “It’s harder and harder for patients to gain access to clinicians who can problem-solve with them and answer questions,” Montori said.

Meanwhile, clinicians rarely ask patients about their capacity to perform the work they’re being asked to do. “We often have little sense of the complexity of our patients’ lives and even less insight into how the treatments we provide (to reach goal-directed guidelines) fit within the web of our patients’ daily experiences,” several physicians wrote in a 2022 paper on reducing treatment burden.

Consider what Jean Hartnett, 53, of Omaha, Nebraska, and her eight siblings went through after their 88-year-old mother had a stroke in February 2021 while shopping at Walmart.

At the time, the older woman was looking after Hartnett’s father, who had kidney disease and needed help with daily activities such as showering and going to the bathroom.

During the year after the stroke, both of Hartnett’s parents — fiercely independent farmers who lived in Hubbard, Nebraska — suffered setbacks, and medical crises became common. When a physician changed her mom’s or dad’s plan of care, new medications, supplies, and medical equipment had to be procured, and new rounds of occupational, physical, and speech therapy arranged.

Neither parent could be left alone if the other needed medical attention.

“It wasn’t unusual for me to be bringing one parent home from the hospital or doctor’s visit and passing the ambulance or a family member on the highway taking the other one in,” Hartnett explained. “An incredible amount of coordination needed to happen.”

Hartnett moved in with her parents during the last six weeks of her father’s life, after doctors decided he was too weak to undertake dialysis. He passed away in March 2022. Her mother died months later in July.

So, what can older adults and family caregivers do to ease the burdens of health care?

To start, be candid with your doctor if you think a treatment plan isn’t feasible and explain why you feel that way, said Elizabeth Rogers, an assistant professor of internal medicine at the University of Minnesota Medical School.

“Be sure to discuss your health priorities and trade-offs: what you might gain and what you might lose by forgoing certain tests or treatments,” she said. Ask which interventions are most important in terms of keeping you healthy, and which might be expendable.

Doctors can adjust your treatment plan, discontinue medications that aren’t yielding significant benefits, and arrange virtual visits if you can manage the technological requirements. (Many older adults can’t.)

Ask if a social worker or a patient navigator can help you arrange multiple appointments and tests on the same day to minimize the burden of going to and from medical centers. These professionals can also help you connect with community resources, such as transportation services, that might be of help. (Most medical centers have staff of this kind, but physician practices do not.)

If you don’t understand how to do what your doctor wants you to do, ask questions: What will this involve on my part? How much time will this take? What kind of resources will I need to do this? And ask for written materials, such as self-management plans for asthma or diabetes, that can help you understand what’s expected.

“I would ask a clinician, ‘If I chose this treatment option, what does that mean not only for my cancer or heart disease, but also for the time I’ll spend getting care?’” said Ganguli of Harvard. “If they don’t have an answer, ask if they can come up with an estimate.”

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(KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs of KFF — the independent source for health policy research, polling and journalism.)

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