August 9th, 2012
arvindsuguness
Super-sizing Medicine
Writing for The New Yorker, Atul Gawande argues that emulating the standardization of chain restaurants like The Cheesecake Factory can help fix our health care system:

“It is unbelievable to me that they would not manage this better,” Luz said. I asked him what he would do if he were the manager of a neurology unit or a cardiology clinic. “I don’t know anything about medicine,” he said. But when I pressed he thought for a moment, and said, “This is pretty obvious. I’m sure you already do it. But I’d study what the best people are doing, figure out how to standardize it, and then bring it to everyone to execute.”

This is not at all the normal way of doing things in medicine. (“You’re scaring me,” he said, when I told him.) But it’s exactly what the new health-care chains are now hoping to do on a mass scale. They want to create Cheesecake Factories for health care. The question is whether the medical counterparts to Mauricio at the broiler station—the clinicians in the operating rooms, in the medical offices, in the intensive-care units—will go along with the plan. Fixing a nice piece of steak is hardly of the same complexity as diagnosing the cause of an elderly patient’s loss of consciousness. Doctors and patients have not had a positive experience with outsiders second-guessing decisions. How will they feel about managers trying to tell them what the “best practices” are?

Read the full article here.
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Super-sizing Medicine

Writing for The New Yorker, Atul Gawande argues that emulating the standardization of chain restaurants like The Cheesecake Factory can help fix our health care system:

“It is unbelievable to me that they would not manage this better,” Luz said. I asked him what he would do if he were the manager of a neurology unit or a cardiology clinic. “I don’t know anything about medicine,” he said. But when I pressed he thought for a moment, and said, “This is pretty obvious. I’m sure you already do it. But I’d study what the best people are doing, figure out how to standardize it, and then bring it to everyone to execute.”

This is not at all the normal way of doing things in medicine. (“You’re scaring me,” he said, when I told him.) But it’s exactly what the new health-care chains are now hoping to do on a mass scale. They want to create Cheesecake Factories for health care. The question is whether the medical counterparts to Mauricio at the broiler station—the clinicians in the operating rooms, in the medical offices, in the intensive-care units—will go along with the plan. Fixing a nice piece of steak is hardly of the same complexity as diagnosing the cause of an elderly patient’s loss of consciousness. Doctors and patients have not had a positive experience with outsiders second-guessing decisions. How will they feel about managers trying to tell them what the “best practices” are?

Read the full article here.

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July 17th, 2012
erickstoll

Civil War In Afghanistan

For The New Yorker, Dexter Filkins discusses how Afghanistan’s political landscape has been altered by the invasion, and what to expect when NATO leaves. 

After eleven years, nearly two thousand Americans killed, sixteen thousand Americans wounded, nearly four hundred billion dollars spent, and more than twelve thousand Afghan civilians dead since 2007, the war in Afghanistan has come to this: the United States is leaving, mission not accomplished. Objectives once deemed indispensable, such as nation-building and counterinsurgency, have been abandoned or downgraded, either because they haven’t worked or because there’s no longer enough time to achieve them. Even the education of girls, a signal achievement of the NATO presence in Afghanistan, is at risk. By the end of 2014, when the last Americans are due to stop fighting, the Taliban will not be defeated. A Western-style democracy will not be in place. The economy will not be self-sustaining. No senior Afghan official will likely be imprisoned for any crime, no matter how egregious. And it’s a good bet that, in some remote mountain valley, even Al Qaeda, which brought the United States to Afghanistan in the first place, will be carrying on.

Read the full article here. 

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July 10th, 2012
atomvincent

(Re)Joyce!

For The New Yorker, Louis Menand writes on the life, brilliance, and eccentricities of that most-famed Irish export, James Joyce.

Joyce didn’t use actual people and places because he was settling scores, or because he was writing disguised autobiography, or because he lacked invention. The relation between his world and his fiction is much stranger than that. In November, 1921, he wrote to his aunt Josephine, in Dublin, to ask if she could tell him whether it was possible “for an ordinary person to climb over the area railings of no 7 Eccles street, either from the path or the steps, lower himself from the lowest part of the railings till his feet are within 2 feet or 3 of the ground and drop unhurt.” He had seen it done, he told her, but by someone with an athletic build; he wanted to make sure that an ordinary man could do it. He needed the information because he was editing the “Ithaca” chapter of “Ulysses,” in which Leopold Bloom, who has forgotten his latchkey, enters his house, at 7 Eccles Street, by this method. He had made up Bloom. Why couldn’t he just make up the height of the railings?

In 1932, two young Americans, Dwight Macdonald and George Morris, recent Yale graduates with an interest in modern literature and art, were in Paris, where they bought a copy of “Ulysses,” still outlawed in the United States, at the English-language bookstore Shakespeare and Company. They got into a conversation with the owner, Sylvia Beach, the woman who had published “Ulysses,” and she arranged for them to meet Joyce. They showed up at Joyce’s apartment and plied him eagerly with questions about his work. He was unresponsive. “It was like trying to open a safe without the combination,” Macdonald later said. Finally, one of them made a remark about people not knowing what to do with their lives. Joyce suddenly perked up. He gestured toward the window. “There are people who go walkin’ up and down the street,” he said, “and they don’t know what they want.”

Read the full article here.

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July 3rd, 2012
erickstoll
The Fight For Guadalajara
For The New Yorker, William Finegan explores the escalating drug war in Guadalajara, Mexico, a city that had until recently had not seen the worst of the violence. 

Its Guadalajara chieftain, Ignacio (Nacho) Coronel Villarreal, became known as the King of Crystal. He lived in the city’s wealthiest neighborhood but ran his operations without flamboyance. The profits were apparently fabulous. Then, in July, 2010, Coronel was killed in an Army raid on his home. Speculation was rife. Armchair warriors wondered if El Chapo had set up his old friend Nacho, out of concern that his Jalisco kingdom was becoming too independently powerful. In any event, everyone said that taking Coronel alive was out of the question. The “gentleman narco,” as I heard him called in Guadalajara, knew who in the Army was on whose payroll. That was why the Army sent a hundred soldiers to attack the house where he had lived, more or less openly, for many years.
“That was when things changed in Jalisco,” a bookstore clerk on Avenida Chapultepec told me. “That was the end of the peace.” The Zetas, who reportedly know nothing about cooking meth but are old hands at the hostile takeover of going concerns, started making more aggressive alliances with disaffected local gangsters.
“Heating up the plaza” is the term of art for what’s happening in Guadalajara, mainly in the poor barrios and in the badlands on the outskirts, the places absorbing the city’s wild recent growth. Tlajomulco de Zuñiga, a big, shapeless municipio (the rough equivalent of a county) on the city’s southern edge, has seen its population quadruple in a decade, to almost half a million. The PRI’s candidate for governor recently described the area as “a dumping ground for corpses.” Bad guys dropped their victims in local ditches. The Army conducted raids on local meth labs. In February, the Army announced that it had seized, in a “historic” bust, in Tlajomulco, fifteen tons of methamphetamine. The street value of that much meth was, by the Army’s figuring, some four billion dollars. If true, that would indeed make it the largest meth bust in history. But was it true?

Read The Full Article Here. 
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The Fight For Guadalajara

For The New Yorker, William Finegan explores the escalating drug war in Guadalajara, Mexico, a city that had until recently had not seen the worst of the violence. 

Its Guadalajara chieftain, Ignacio (Nacho) Coronel Villarreal, became known as the King of Crystal. He lived in the city’s wealthiest neighborhood but ran his operations without flamboyance. The profits were apparently fabulous. Then, in July, 2010, Coronel was killed in an Army raid on his home. Speculation was rife. Armchair warriors wondered if El Chapo had set up his old friend Nacho, out of concern that his Jalisco kingdom was becoming too independently powerful. In any event, everyone said that taking Coronel alive was out of the question. The “gentleman narco,” as I heard him called in Guadalajara, knew who in the Army was on whose payroll. That was why the Army sent a hundred soldiers to attack the house where he had lived, more or less openly, for many years.

“That was when things changed in Jalisco,” a bookstore clerk on Avenida Chapultepec told me. “That was the end of the peace.” The Zetas, who reportedly know nothing about cooking meth but are old hands at the hostile takeover of going concerns, started making more aggressive alliances with disaffected local gangsters.

“Heating up the plaza” is the term of art for what’s happening in Guadalajara, mainly in the poor barrios and in the badlands on the outskirts, the places absorbing the city’s wild recent growth. Tlajomulco de Zuñiga, a big, shapeless municipio (the rough equivalent of a county) on the city’s southern edge, has seen its population quadruple in a decade, to almost half a million. The PRI’s candidate for governor recently described the area as “a dumping ground for corpses.” Bad guys dropped their victims in local ditches. The Army conducted raids on local meth labs. In February, the Army announced that it had seized, in a “historic” bust, in Tlajomulco, fifteen tons of methamphetamine. The street value of that much meth was, by the Army’s figuring, some four billion dollars. If true, that would indeed make it the largest meth bust in history. But was it true?

Read The Full Article Here. 

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May 22nd, 2012
arvindsuguness
How Corporations Became People
Writing for The New Yorker, Jeffrey Toobin recounts how conservative Justices on the Supreme Court were able to turn a narrow case, originally argued only over whether campaign finance law applied to video on demand services, into one that overturned decades of precedent, remaking how our elections are run:

Through artful questioning, Alito, Kennedy, and Roberts had turned a fairly obscure case about campaign-finance reform into a battle over government censorship. The trio made Stewart—and thus the government—take an absurd position: that the government might have the right to criminalize the publication of a five-hundred-page book because of one line at the end.
…
On June 29, 2009, the last day of the term, the Court shocked the litigants—and the political world—by announcing, “The case is restored to the calendar for reargument.” The parties were directed to file new briefs. In plain English, the Court’s order told the parties that the Justices were considering overruling two major decisions in modern campaign-finance law. Most important, the Court was weighing whether to overturn its endorsement of McCain-Feingold in the McConnell case of 2003. As every sophisticated observer of the Court knew, the Court did not ask whether cases should be overruled unless a majority of the Justices were already prepared to do so.

Read the full article here.
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How Corporations Became People

Writing for The New Yorker, Jeffrey Toobin recounts how conservative Justices on the Supreme Court were able to turn a narrow case, originally argued only over whether campaign finance law applied to video on demand services, into one that overturned decades of precedent, remaking how our elections are run:

Through artful questioning, Alito, Kennedy, and Roberts had turned a fairly obscure case about campaign-finance reform into a battle over government censorship. The trio made Stewart—and thus the government—take an absurd position: that the government might have the right to criminalize the publication of a five-hundred-page book because of one line at the end.

On June 29, 2009, the last day of the term, the Court shocked the litigants—and the political world—by announcing, “The case is restored to the calendar for reargument.” The parties were directed to file new briefs. In plain English, the Court’s order told the parties that the Justices were considering overruling two major decisions in modern campaign-finance law. Most important, the Court was weighing whether to overturn its endorsement of McCain-Feingold in the McConnell case of 2003. As every sophisticated observer of the Court knew, the Court did not ask whether cases should be overruled unless a majority of the Justices were already prepared to do so.

Read the full article here.

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May 1st, 2012
chasewhiteside

What Good is Wall Street?

On this May Day, which has seen thousands of Occupy Wall Street and labor-related strikes and protests in cities across the country, we present this 2010 essay for the New Yorker, wherein John Cassidy argues that much of what investment bankers do is not beneficial to society:

In effect, many of the big banks have turned themselves from businesses whose profits rose and fell with the capital-raising needs of their clients into immense trading houses whose fortunes depend on their ability to exploit day-to-day movements in the markets. Because trading has become so central to their business, the big banks are forever trying to invent new financial products that they can sell but that their competitors, at least for the moment, cannot. Some recent innovations, such as tradable pollution rights and catastrophe bonds, have provided a public benefit. But it’s easy to point to other innovations that serve little purpose or that blew up and caused a lot of collateral damage, such as auction-rate securities and collateralized debt obligations. Testifying earlier this year before the Financial Crisis Inquiry Commission, Ben Bernanke, the chairman of the Federal Reserve, said that financial innovation “isn’t always a good thing,” adding that some innovations amplify risk and others are used primarily “to take unfair advantage rather than create a more efficient market.”

Despite all the criticism that President Obama has received lately from Wall Street, the Administration has largely left the great money-making machine intact. A couple of years ago, firms such as Citigroup, JPMorgan Chase, and Goldman Sachs faced the danger that the government would break them up, drive them out of some of their most lucrative business lines—such as dealing in derivatives—or force them to maintain so much capital that their profits would be greatly diminished. “None of these things materialized,” Altman noted. “Reforms and changes came in, but they did not have a transformative effect.”

Read the full article here.

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April 23rd, 2012
erickstoll

The Real Romney

In The New Yorker, Louis Menand looks past the Republican primary posturing to examine what Mitt Romney really believes. 

Romney’s program is logical (which doesn’t mean that it’s practical). He believes that if freedom is to be fostered and preserved around the world the United States needs a stronger military. For the United States to have a stronger military, it has to grow economically. For the nation to grow economically, American companies must become more productive. And, for American companies to become more productive, business has to be allowed to do business. This means that Americans have to tolerate, to appreciate, even to encourage what Romney calls (using a phrase borrowed from Joseph Schumpeter) “creative destruction.”

It’s a strange slogan for a politician to adopt at a time of high unemployment and economic uncertainty, but Romney invokes it in his book and he uses it in interviews, because it’s precisely what he means by business. To make the future, we have to be willing to destroy some of the present. “It takes a leap of faith for governments to stand aside and allow the creative destruction inherent in a free economy,” as Romney puts it. We can’t be sentimental. And everything can be thought of in this way, from the production of microchips to the education of children. If we want cheaper chips or better schools, we have to be willing to pay the transaction costs. The unwillingness to do so is what’s holding us back.

Read the full article here. 

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April 18th, 2012
erickstoll
Is Procreation Immoral?
For The New Yorker, Elizabeth Kolbert reviews several new books examining the ethical quandaries of reproduction. 

…lots of people offer the notion that parenthood will make them happy. Here the evidence is, sadly, against them. Research shows that people who have children are no more satisfied with their lives than people who don’t. If anything, the balance tips the other way: parents are less happy. In an instantly famous study, published in Science in 2004, the Nobel Prize-winning psychologist Daniel Kahneman asked nine hundred working women to assess their experiences during the preceding day. The women rated the time they’d spent taking care of their kids as less enjoyable than the time spent shopping, eating, exercising, watching TV, preparing food, and talking on the phone. One of the few activities these women found less enjoyable than caring for their children was doing housework, which is to say cleaning up after them.
But none of this really matters. Procreation for the sake of the parents is ethically unacceptable. “To have a child in order to benefit oneself is a moral error,” Overall writes.

Read the full article here.
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Is Procreation Immoral?

For The New Yorker, Elizabeth Kolbert reviews several new books examining the ethical quandaries of reproduction. 

…lots of people offer the notion that parenthood will make them happy. Here the evidence is, sadly, against them. Research shows that people who have children are no more satisfied with their lives than people who don’t. If anything, the balance tips the other way: parents are less happy. In an instantly famous study, published in Science in 2004, the Nobel Prize-winning psychologist Daniel Kahneman asked nine hundred working women to assess their experiences during the preceding day. The women rated the time they’d spent taking care of their kids as less enjoyable than the time spent shopping, eating, exercising, watching TV, preparing food, and talking on the phone. One of the few activities these women found less enjoyable than caring for their children was doing housework, which is to say cleaning up after them.

But none of this really matters. Procreation for the sake of the parents is ethically unacceptable. “To have a child in order to benefit oneself is a moral error,” Overall writes.

Read the full article here.

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March 23rd, 2012
erickstoll

Turkey’s Deep State

Since Turkey’s secularization in 1923, many have alleged of a “deep state”, a presumed clandestine network of politicians and military officers who conspire to uphold the secular order by any means necessary. For The New Yorker, Dexter Filkins explores whether Prime Minister Erdoğan’s efforts to dismantle the deep state have been sincere, or have been a cover to suppress political opposition.  

Friends and colleagues say Erdoğan worried that the deep state would never allow him to govern. But, to the surprise of many, he has pulled Turkey closer to the West, opening up the economy and becoming a crucial go-between for the West with Palestine, Iran, and Syria. 

But Erdoğan’s rule has another, darker side, which the West seems intent on ignoring: an increasingly harsh campaign to crush domestic opposition. In the past five years, more than seven hundred people have been arrested, including generals, admirals, members of parliament, newspaper editors and other journalists, owners of television networks, directors of charitable organizations, and university officials. Some fifteen per cent of the active admirals and generals in the Turkish armed forces are now on trial for conspiring to overthrow the government.

Read the full article here. 

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