This week, a more America-centric set of recommendations than usual, covering: the gargantuan crisis of America’s “health-care-industrial” complex, which is literally killing the nation with galactically inflated prices and substandard healthcare; the Alice-in-Wonderland nature of America’s “sequestration” debacle; how the “personalized” Internet experience created by user profiling and content filtering actually delivers up two different Internets for the rich and the poor; the problem with a huge self-help industry that actually has no idea what a “self” is or how to help it; the personal and societal downside of the much-prized elite university education, which inculcates an all-dominating sense of privilege, specialness, and entitledness while grooming new generations of leaders to be just like the old ones; and a lovely essay exploring and honoring the East Texas roots of the recently deceased Van Cliburn.
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Bitter Pill: Why Medical Bills Are Killing Us
Steven Brill, Time, February 26, 2013
[EDITOR’S NOTE: Can you say “Pulitzer Prize,” anyone? This major report in Time magazine — clocking in at an astonishing 25,000 words — is simply brilliant. And infuriating and galling.]
What are the reasons, good or bad, that cancer means a half-million- or million-dollar tab? Why should a trip to the emergency room for chest pains that turn out to be indigestion bring a bill that can exceed the cost of a semester of college? What makes a single dose of even the most wonderful wonder drug cost thousands of dollars? Why does simple lab work done during a few days in a hospital cost more than a car? And what is so different about the medical ecosystem that causes technology advances to drive bills up instead of down?
. . . . Taken as a whole, these powerful institutions and the bills they churn out dominate the nation’s economy and put demands on taxpayers to a degree unequaled anywhere else on earth. In the U.S., people spend almost 20% of the gross domestic product on health care, compared with about half that in most developed countries. Yet in every measurable way, the results our health care system produces are no better and often worse than the outcomes in those countries.
. . . . The health care industry seems to have the will and the means to keep it that way. According to the Center for Responsive Politics, the pharmaceutical and health-care-product industries, combined with organizations representing doctors, hospitals, nursing homes, health services and HMOs, have spent $5.36 billion since 1998 on lobbying in Washington. That dwarfs the $1.53 billion spent by the defense and aerospace industries and the $1.3 billion spent by oil and gas interests over the same period. That’s right: the health-care-industrial complex spends more than three times what the military-industrial complex spends in Washington.
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We are through the sequestration looking glass here, people
Chris Cillizza, The Washington Post, March 1, 2013
[EDITOR’S NOTE: The following piece was published several hours before sequestration went into effect here in the U.S. It provides a useful (un)reality check for those who wonder just how strange this situation really is, and just how much stranger it may well become.]
Sequestration becomes a reality at midnight tonight. That, in and of itself, is somewhat remarkable to consider — given that Washington created the sequester as a this-is-so-bad-even-we-will-have-to-act device. The fact that President Obama, Speaker John Boehner and everyone else involved in sequestration never thought this day would come makes the post-sequester world absolutely fascinating. Starting at midnight, we are in uncharted territory.
. . . . We’ve not been in this place before. No one who signed off on sequestration in 2011 thought it would ever come to pass and, as a result, there was little long-range thinking about what might happen if it did. Now that the impossible in on the verge of happening, no one really knows what comes next.
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The Rich See a Different Internet Than the Poor
Michael Fertik, ZNet, February 20, 2013
Imagine an Internet where unseen hands curate your entire experience. Where third parties predetermine the news, products and prices you see — even the people you meet. A world where you think you are making choices, but in reality, your options are narrowed and refined until you are left with merely the illusion of control.
This is not far from what is happening today. Thanks to technology that enables Google, Facebook and others to gather information about us and use it to tailor the user experience to our own personal tastes, habits and income, the Internet has become a different place for the rich and for the poor. Most of us have become unwitting actors in an unfolding drama about the tale of two Internets. There is yours and mine, theirs and ours.
. . . . 99 percent of us live on the wrong side of a one-way mirror, in which the other 1 percent manipulates our experiences. Some laud this trend as “personalization” — which sounds innocuous and fun, evoking the notion that the ads we see might appear in our favorite color schemes. What we are talking about, however, is much deeper and significantly more consequential.
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The Self in Self-Help
Kathryn Schultz, New York Magazine, January 6, 2013
TEASER: We have no idea what a self is. So how can we fix it?
The noted self-help guru Saint Augustine identified this problem back in the fourth century A.D. In his Confessions, he records an observation: “The mind gives an order to the body and is at once obeyed, but when it gives an order to itself, it is resisted.” I cannot improve upon Augustine’s insight. . . . [S]uch acts of auto-insubordination happen all the time. They go some way toward explaining the popularity of the self-help movement, since clearly we need help, but they also reveal a fundamental paradox at its heart. . . . This is where the cheerfully practical and accessible domain of self-help bumps up against one of the thorniest problems in all of science and philosophy. In the 1,600 years since Augustine left behind selfhood for sainthood, we’ve made very little empirical progress toward understanding our own inner workings. We have, however, developed an $11 billion industry dedicated to telling us how to improve our lives. Put those two facts together and you get a vexing question: Can self-help work if we have no idea how a self works?
. . . . Let us call it the master theory of self-help. It goes like this: Somewhere below or above or beyond the part of you that is struggling with weight loss or procrastination or whatever your particular problem might be, there is another part of you that is immune to that problem and capable of solving it for the rest of you. In other words, this master theory is fundamentally dualist. It posits, at a minimum, two selves: one that needs a kick in the ass and one that is capable of kicking.
. . . . When it comes to solving that problem — which is the problem — all self-help literature offers is a kind of metaphysical power of attorney for our putative better halves. But if you identify with the above-mentioned Oreo-eater or healthy-relationship saboteur or procrastinator, you yourself are evidence that this is a nonsolution. If giving your better half executive control by fiat could change your life, sales of self-help material would plummet overnight. It is a somewhat beautiful fact that the underlying theory of the self-help industry is contradicted by the self-help industry’s existence.
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The Disadvantages of an Elite Education
William Deresiewicz, The American Scholar, Summer 2008
It didn’t dawn on me that there might be a few holes in my education until I was about 35. I’d just bought a house, the pipes needed fixing, and the plumber was standing in my kitchen. There he was, a short, beefy guy with a goatee and a Red Sox cap and a thick Boston accent, and I suddenly learned that I didn’t have the slightest idea what to say to someone like him. So alien was his experience to me, so unguessable his values, so mysterious his very language, that I couldn’t succeed in engaging him in a few minutes of small talk before he got down to work. Fourteen years of higher education and a handful of Ivy League degrees, and there I was, stiff and stupid, struck dumb by my own dumbness. “Ivy retardation,” a friend of mine calls this. I could carry on conversations with people from other countries, in other languages, but I couldn’t talk to the man who was standing in my own house.
. . . . There is nothing wrong with taking pride in one’s intellect or knowledge. There is something wrong with the smugness and self-congratulation that elite schools connive at from the moment the fat envelopes come in the mail. From orientation to graduation, the message is implicit in every tone of voice and tilt of the head, every old-school tradition, every article in the student paper, every speech from the dean. The message is: You have arrived. Welcome to the club. And the corollary is equally clear: You deserve everything your presence here is going to enable you to get. When people say that students at elite schools have a strong sense of entitlement, they mean that those students think they deserve more than other people because their SAT scores are higher.
. . . . Before, after, and around the elite college classroom, a constellation of values is ceaselessly inculcated. As globalization sharpens economic insecurity, we are increasingly committing ourselves — as students, as parents, as a society — to a vast apparatus of educational advantage. With so many resources devoted to the business of elite academics and so many people scrambling for the limited space at the top of the ladder, it is worth asking what exactly it is you get in the end — what it is we all get, because the elite students of today, as their institutions never tire of reminding them, are the leaders of tomorrow.
. . . . The world that produced John Kerry and George Bush is indeed giving us our next generation of leaders. The kid who’s loading up on AP courses junior year or editing three campus publications while double-majoring, the kid whom everyone wants at their college or law school but no one wants in their classroom, the kid who doesn’t have a minute to breathe, let alone think, will soon be running a corporation or an institution or a government. She will have many achievements but little experience, great success but no vision. The disadvantage of an elite education is that it’s given us the elite we have, and the elite we’re going to have.
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In Search of Van Cliburn
Prudence Mackintosh, Texas Monthly, February 28, 2013
[EDITOR’S NOTE: The timing of Van Cliburn’s recent death was personally synchronistic for me, since lately I’ve been spending a lot of my daily commute time listening to a disc of his beautifully rendered performances of various “favorite” (by popular reputation) classical piano pieces, and have had him in the back of my mind as I’ve gone about my regular habit of playing and practicing various classical piano pieces at home for my own enjoyment. This essay in Texas Monthly comes off as a particularly sensitive and insightful journalistic epitaph, written by a fellow East Texan who never met Van Cliburn but always longed to.]
TEASER: He was a world-renowned piano prodigy whose romanticism and technical virtuosity inspired thousands and famously helped thaw the Cold War. But as a visit to his hometown of Kilgore made clear to me, he was also a Texan, a Southerner, a Baptist, a patriot, and a man who loved black-eyed peas as much as I do.
Van, who remained a Baptist his entire life, usually saw his faith get brief mention in the national press. Twice I read that he neither drank nor smoked (untrue), as if abstinence could be the sum total of his religious experience. Central to his life and career, according to several friends I spoke with, was his belief in the transcendence of music and a Baptist notion of stewardship; he had received a gift from God and was obligated to develop it and use it for the purest and highest motives. His upbringing followed him to New York, where he became a member of the Calvary Baptist Church on West Fifty-seventh and annoyed some of his fellow Juilliard students by inviting them to attend Billy Graham crusades with him. Later, after his first visit to Moscow, he even contributed to the support of the Moscow Baptist church. (The Soviet Union initially encouraged Protestant proselytizing in hopes of weakening the hold of the Russian Orthodox Church.) “Van would be classified as a spiritual man even if he were not aligned with a denomination,” said Tom Stoker, the former minister of music at Broadway Baptist, Van’s church in Fort Worth. Music’s invisibility lends itself to mystery. When Van gave the commencement address at the Cleveland Institute of Music in May 2012, he spoke of musicians as missionaries for music, who devote themselves to a higher power.
. . . . “Van is always Van,” I heard over and over as I spoke to the people who knew him well. He performed for the opening of the Meyerson Symphony Center in Dallas, and he performed for the public library in Marshall. He accepted an award from the East Texas Women in Communications with the same humility that he received a National Medal of Freedom at the White House. He worked with the greatest orchestras and conductors of the twentieth century, and yet he also admitted his nervousness before performances to the young musicians preparing for the competition that bears his name. His passionate romantic renditions made women faint in Russia; my cousin Betty Sue Flowers almost fainted in Abilene. “I remember my mother taking me to hear him soon after he won the Tchaikovsky competition,” she wrote in an email. “I felt faint until I realized that the music was so beautiful that I had been holding my breath. I think of that Van Cliburn concert as my first experience of artistic beauty.”