The Pasty Little Putz has decided to tell us all “What Health Insurance Doesn’t Do.” He tries to convince us that there are probably better ways to improve people’s lives. I’ll bet you two things: First, this little asshole isn’t about to give up his own health insurance and, second, he doesn’t read Krugman’s blog although he really should. (As an added bonus Putzy uses Megan “Can’t Keep Track of Decimal Points” McArdle and Slate as his authoritative links.) MoDo has a question in “In a Gaudy Theme Park Jay-Z Meets Jay-Gatz:” Why are we borne back ceaselessly to West Egg and Gatsby swag? Bread and circuses, that’s why. The Moustache of Wisdom also has a question in “This Ain’t Yogurt:” Just what would it take to put Syria on a path toward democracy? Beats the fck out of me, but I will tell you that we do not need to be meddling militarily in the region again. Mr. Bruni, in “Sexism and the Single Murderess,” says Amanda Knox’s story is just one example of our continued quickness to heap scorn and slurs on women seen as sexually bold. Here’s The Putz:
In one of the most famous studies of health insurance, conducted across the 1970s, thousands of participants were divided into five groups, with each receiving a different amount of insurance coverage. The study, run by the RAND Corporation, tracked the medical care each group sought out, and not surprisingly found that people with more comprehensive coverage tended to make use of it, visiting the doctor and checking into the hospital more often than people with less generous insurance.
But the study also tracked the health outcomes of each group, and there the results were more surprising: With a few modest exceptions, the level of insurance had no significant effect on the participants’ actual wellness.
Needless to say, experts have been arguing about what the RAND results mean ever since. But the basic finding — that more expensive health insurance doesn’t necessarily lead to better health — just received a major boost. The state of Oregon expanded its Medicaid program via lottery a few years ago, and researchers released the latest data on how health outcomes for the new Medicaid users differed from those for the uninsured. The answer: They didn’t differ much. Being on Medicaid helped people avoid huge medical bills, and it reduced depression rates. But the program’s insurance guarantee seemed to have little or no impact on common medical conditions like hypertension and diabetes.
As liberals have been extremely quick to point out, these findings do not necessarily make a case against the new health care law, which includes a big Medicaid expansion as well as subsidies for private insurance. After all, the first purpose of insurance is economic protection, and the Oregon data shows that expanding coverage does indeed protect people from ruinous medical expenses. The links between insurance, medicine and health may be impressively mysterious, but staving off medical bankruptcies among low-income Americans is not a small policy achievement.
This is true. But it’s also true that the health care law was sold, in part, with the promise (made by judicious wonks as well as overreaching politicians) that it would save tens of thousands of American lives each year. There was so much moral fervor on the issue, so much crusading liberal zeal, precisely because this was not supposed to be just a big redistribution program: it was supposed to be a matter of life and death.
But if it turns out that health insurance is useful mostly because it averts financial catastrophe — which seems to be the consensus liberal position since the Oregon data came out — then the new health care law looks vulnerable to two interconnected critiques.
First, if the benefit of health insurance is mostly or exclusively financial, then shouldn’t health insurance policies work more like normal insurance? Fire, flood and car insurance exist to protect people against actual disasters, after all, not to pay for ordinary repairs. If the best evidence suggests that health insurance is most helpful in protecting people’s pocketbooks from similar disasters, and that more comprehensive coverage often just pays for doctor visits that don’t improve people’s actual health, then shouldn’t we be promoting catastrophic health coverage, rather than expanding Medicaid?
Liberals don’t like catastrophic plans because, by definition, they’re stingier than the coverage many Americans now enjoy. But this is where the second critique comes in: If the marginal dollar of health care coverage doesn’t deliver better health, isn’t this a place where policy makers should be stingy, while looking for more direct ways to improve the prospects of the working poor? Some kind of expanded health security is clearly a good thing — but if we want to promote economic mobility as well, does it really make sense to pour about a trillion dollars into a health care system that everyone agrees is deeply dysfunctional, when some of that money could be returned to Americans’ paychecks instead?
There are a variety of ways this could be accomplished — a bigger child tax credit for struggling families, a payroll tax cut to boost workers, an expanded earned-income tax credit to raise wages at the bottom, health savings accounts that roll over money left unspent. In each case, the goal would be to help people rise by giving them more money and more options for what to do with it, rather than just expanding 1960s-vintage programs that pay medical bills and only medical bills.
It’s to the Republican Party’s great discredit that these policies and goals don’t have enough conservative champions at the moment. But it’s to liberals’ discredit that they remain wedded to the dream of a health care bureaucracy that pays and pays and pays, when in all likelihood we could be spending much less with similar results, and finding better ways to help the poor.
Yeah, Putzy, by all means let’s not let them have health insurance, because it doesn’t prevent illness. You stupid jackass. Here’s MoDo:
When I started out in journalism, I spent five long years as a reporter in Montgomery County, Md., a cosseted suburb of Washington.
I felt suffocated, as though I’d never escape to the blazing, gritty larger world I dreamed of covering.
Driving to work every day, I passed a small cemetery connected to St. Mary’s Catholic Church in Rockville. I would always look up and give a silent salute to F. Scott Fitzgerald, who was buried there in the Fitzgerald family plot. His modest headstone features the indelible final line of “The Great Gatsby”: “So we beat on, boats against the current, borne back ceaselessly into the past.”
There was something both incongruous and congruous in the final resting spot for the shimmering American chronicler of corrosive glamour and crushed dreams: next to a busy highway peppered with tacky strip malls.
When Fitzgerald died of a heart attack at 44 after a failed stint as a screenwriter, a losing struggle with alcoholism and a relationship with the Hollywood gossip columnist Sheila Graham, his Hollywood funeral attracted only 30 people, including his editor, Maxwell Perkins, and required hired pallbearers. For 35 years, Fitzgerald was buried in a Protestant cemetery two miles from St. Mary’s, until the Catholic Church got over the idea that his decadence precluded a Catholic burial and let him and Zelda in.
Surveying his own crushed dreams once, Fitzgerald — who sold the movie rights to “The Great Gatsby” for $16,666 in the 1920s, sparking a long succession of green lights for his enchanted green-light saga — famously said that there are no second acts in American life. For someone who wrote an iconic American novel (as Lionel Trilling observed, “Gatsby, divided between power and dream, comes inevitably to stand for America itself”) it was a bad miscalculation. Americans love sin and redemption and reinvention almost as much as they love stuff.
Fitzgerald is not only having a glittering second act, he’s having it in the third dimension.
All over Manhattan, in anticipation of the opening of Baz Luhrmann’s $104.5 million 3-D theme-park ride of a “Great Gatsby,” with its hip-hop-studded soundtrack and gorgeous Prada dresses, Fitzgerald is being celebrated with starry parties; Tiffany’s jazz-baby windows; Brooks Brothers boaters, bow ties and canes; and a Vogue cover of the latest Daisy Buchanan, Carey Mulligan, gleaming in diamonds and pearls, looking as if she would sound like money.
“She’s in her own TV show,” Mulligan said of her character. “She’s like a Kardashian.”
In this gaudy, blingy, frenzied version that puts the roaring in Roaring Twenties, gin bottles, bits of the novel’s text and Gatsby’s passel of pastel shirts come flying off the screen right at you.
“It will be interesting,” Robert Redford wryly told me, “to see how many in the audience grab for a shirt.”
The 3-D glasses, though, just get in the way of seeing the more subtle elements of Fitzgerald’s masterpiece: the decay of souls, the crumbling mythology and the dark side of social mobility.
Some at screenings last week muttered at how appalled they were that “Gatsby” was being treated like a Disney pirate movie. One woman said the dizzying kaleidoscope made her long to see a small black-and-white version of the film. But the Australian director argues that Fitzgerald was a modernist who was fascinated with new cinematic techniques and jazz when it was dangerous, so he would have been intrigued by 3-D and rap.
Luhrmann told The Wall Street Journal that when he met with Jay-Z about scoring the soundtrack and showed him a rough cut, that Jay, who started as Shawn Carter, immediately connected with the other Jay, who started as James Gatz: “Jay turns to me and goes, ‘It’s an aspirational film. You know, the thing about this story is that it’s not a question of how Gatsby made his money, it’s is he a good person or not? Is there meaning in his life? And all these characters, do they have a moral compass?’ ”
Robert Evans, the legendary producer, was running Paramount when the studio made the 1974 “Gatsby” for $6.4 million with Redford and Mia Farrow, a commercial success despite being pronounced “as lifeless as a body that’s been too long at the bottom of a swimming pool” by The Times’s Vincent Canby. Evans said he spent some time with Luhrmann before Baz started the film and warned him not to overcommercialize and overpublicize the movie. (In vain, given the movie’s high-end tie-ins and the swag online, including “I party with Jay Gatsby” tank tops, Dr. T. J. Eckleburg laptop decals, and green-light pendants.)
“The trouble we had with our ‘Gatsby’ was that everything was Gatsbyized from your toes to your hats, from your stockings to your pants,” Evans told me. “It took it away from a work of art to a work of commerce.”
He believes the movie was damaged by a 1974 Time cover on the hype involved in selling “Gatsby,” a story that started with this Evans quote: “The making of a blockbuster is the newest art form of the 20th century.”
The most successful rendering of the novel was the most literal, unadorned one: “Gatz,” the Public Theater’s seven-hour reading of the novel by actors.
John Collins, the director of “Gatz,” who says he has listened to the novel read more than 200 times, was generous about the “contemporary sensibilities” of the latest iteration, even big changes like having the narrator, Nick Carraway, end up in a sanitarium because of his “morbid alcoholism.” That’s where Luhrmann’s Nick writes the novel and narrates the movie.
“The movie is almost kind of a comic book idea of ‘The Great Gatsby,’” Collins said. “I don’t mean that in a pejorative way. It’s an imaginative project.”
Leon Wieseltier, the literary editor of The New Republic, understands that we’re drawn back to “Gatsby” because we keep seeing modern buccaneers of banking and hedge funds, swathed in carelessness and opulence. “But what most people don’t understand is that the adjective ‘Great’ in the title was meant laconically,” he said. “There’s nothing genuinely great about Gatsby. He’s a poignant phony. Owing to the money-addled society we live in, people have lost the irony of Fitzgerald’s title. So the movies become complicit in the excessively materialistic culture that the novel set out to criticize.”
He noted that Gatsby movies are usually just moving versions of Town and Country or The Times’s T magazine, and that filmmakers “get seduced by the seductions that the book itself is warning about.”
A really great movie of the novel, he argues, would “show a dissenting streak of austerity.” He thinks it’s time for a black Gatsby, noting that Jay-Z might be an inspirational starting point — “a young man of talents with an unsavory past consumed by status anxiety and ascending unstoppably through tireless self-promotion and increasingly conspicuous wealth.”
The problem with the “Gatsby” movies, he said, “is that they look like they were made by Gatsby. The trick is to make a Gatsby movie that couldn’t have been made by Gatsby — an unglossy portrait of gloss.”
All you really need to see are the promos for this POS on the TV to see that it will be crap. Now here’s The Moustache of Wisdom:
An Arab friend remarked to me that watching the United States debate how much to get involved in Syria reminded him of an Arab proverb: “If you burn your tongue once eating soup, for the rest of your life you’ll blow on your yogurt.”
After burning our tongues in Iraq and Afghanistan, and watching with increasing distress the aftermath of the revolutions in Libya, Tunisia and Egypt, President Obama is right to be cautious about getting burned in Damascus. We’ve now seen enough of these Arab transitions from autocracy to draw some crucial lessons about what it takes to sustain positive change in these countries. We ignore the lessons at our peril — especially the lesson of Iraq, which everyone just wants to forget but is hugely relevant.
Syria is Iraq’s twin: an artificial state that was also born after World War I inside lines drawn by imperial powers. Like Iraq, Syria’s constituent communities — Sunnis, Alawite/Shiites, Kurds, Druze, Christians — never volunteered to live together under agreed rules. So, like Iraq, Syria has been ruled for much of its modern history by either a colonial power or an iron-fisted autocrat. In Iraq, the hope was that once the iron-fisted dictator was removed by us it would steadily transition to a multisectarian, multiparty democracy. Ditto for Egypt, Libya, Tunisia and Yemen.
But we now see the huge difference between Eastern Europe in 1989 and the Arab world in 2013. In most of Eastern Europe, the heavy lid of communist authoritarian rule was suppressing broad and deeply rooted aspirations for democracy. So when that lid was removed, most of these countries relatively quickly moved to freely elected governments — helped and inspired by the European Union.
In the Arab world, in contrast, the heavy lid of authoritarianism was suppressing sectarian, tribal, Islamist and democratic aspirations. So, when the lids were removed, all four surfaced at once. But the Islamist trend has been the most energetic — helped and inspired not by the European Union but by Islamist mosques and charities in the Persian Gulf — and the democratic one has proved to be the least organized, least funded and most frail. In short, most of Eastern Europe turned out to be like Poland after communism ended and most of the Arab countries turned out to be like Yugoslavia after communism ended.
As I said, our hope and the hope of the courageous Arab democrats who started all these revolutions, was that these Arab countries would make the transition from Saddam to Jefferson without getting stuck in Khomeini or Hobbes — to go from autocracy to democracy without getting stuck in Islamism or anarchism.
But, to do that, they need either an external midwife to act as a referee between all their constituent communities (who never developed trust in one another) as they try to replace sectarianism, Islamism and tribalism with a spirit of democratic citizenship or they need their own Nelson Mandela. That is, a homegrown figure who can lead, inspire and navigate a democratic transition that is inclusive of all communities.
America, we all know, played that external referee role in Iraq — hugely ineptly at first. But, eventually, the U.S. and moderate Iraqis found a way back from the brink, beat back both Sunni and Shiite violent extremists, wrote a constitution and held multiple free elections, hoping to give birth to that Iraqi Mandela. Alas, they got Nuri Kamal al-Maliki, a Shiite who, instead of building trust with other communities, is re-sowing sectarian division. Decades of zero-sum politics — “I’m-weak-how-can-I-compromise/I’m-strong-why-should-I-compromise” — are hard to extinguish.
I believe if you want to end the Syrian civil war and tilt Syria onto a democratic path, you need an international force to occupy the entire country, secure the borders, disarm all the militias and midwife a transition to democracy. It would be staggeringly costly and take a long time, with the outcome still not guaranteed. But without a homegrown Syrian leader who can be a healer, not a divider, for all its communities, my view is that anything short of an external force that rebuilds Syria from the bottom up will fail. Since there are no countries volunteering for that role (and I am certainly not nominating the U.S.), my guess is that the fighting in Syria will continue until the parties get exhausted.
Meanwhile, wherever we can identify truly “good” rebels, we should strengthen them, but we should also be redoubling our diplomatic efforts to foster a more credible opposition leadership of reconciliation-minded Syrians who can reassure all of Syria’s communities that they will have an equitable place at a new cabinet table. (Never underestimate how many Syrians are clinging to the tyrannical Bashar al-Assad out of fear that after him comes only Hobbes or Khomeini.) That way, when the combatants get exhausted and realize that there can be no victor and no vanquished — a realization that took 14 years in Lebanon’s civil war next door — a fair power-sharing plan will be in place. Even then, Syrians will almost certainly need outside help to reassure everyone during the transition, but we can cross that bridge when we come to it.
Here’s the one alternative that won’t happen: one side will decisively defeat the other and usher in peace that way. That is a fantasy.
Lastly we have Mr. Bruni:
“Sex game gone wrong,” “sex game gone awry,” “sex-mad flatmate,” “sex-crazed killer.”
That’s from just the first three minutes of the ABC News special on Amanda Knox last week, a veritable drumbeat of sexual shaming that leaves no doubt about what elevated a college student accused of murder into an object of international fascination, titillation and scorn.
It wasn’t the crime itself. It was the supposed conspiracy of her libido, cast as proof that she was out of control, up to no good, lost, wicked, dangerous. A girl this intent on randy fun was a girl who couldn’t be trusted and got what was coming to her, even if it was prison and even if there was plenty of reason — as the eventual reversal of her initial conviction made clear — to believe that she might not belong there.
“Knox knew, it seemed, no boundaries, leaving a vibrator in a transparent washbag and enjoying one-night stands,” wrote Tobias Jones in a 2011 article in the British newspaper The Observer. One-night stands? How could she?!? Of course if a guy has one of those, it’s a triumph: all the pleasure, none of the commitment. And boys, after all, will be boys.
We’ll never know precisely what happened on the night in Perugia, Italy, in 2007 when Meredith Kercher, 21, was killed. Knox, her housemate, was found guilty, then acquitted and will soon, despite the profoundly flawed case against her, face another trial. The Italian judicial system works about as smoothly as the Italian government.
But we know this: the double standard concerning men’s versus women’s sexuality not only survives but thrives, manifest in the enduring notoriety of “Foxy Knoxy,” whose memoir was published on the same day last week that the ABC News special aired. Keep the rest of her story the same but make her a man in the midst of erotic escapades abroad. Are we still gawking? Is ABC trumpeting Diane Sawyer’s exclusive sit-down with the lascivious pilgrim?
Similar questions can be asked about Jodi Arias, 32, whose murder trial in Arizona was winding down last week. The Arias case hasn’t made quite the leap from the tabloids into the mainstream that Knox’s did. But HLN, the cable network on which Nancy Grace fulminates, has enjoyed a ratings bonanza with its saturation coverage of the courtroom proceedings.
Arias has admitted to stabbing, shooting and slashing the throat of a former lover: an act of self-defense, she unpersuasively claims. And while his death was certainly grisly enough to explain a baseline of media interest, the amount of attention it has received stems from the courtroom juxtaposition of the defendant, outfitted in nerdy eyeglasses and a frumpy hairstyle, and evidence of what a steamy, pliable playmate she was. It stems from pictures of her genitalia that she let her lover take, audiotapes of the phone sex that the two of them had — and that she recorded. It stems from the shock and censure of such potent female desire.
Knox and Arias aren’t just women accused of murder. They’re minxes accused of murder, sitting in their courtroom seats with scarlet letters emblazoned on their chests, no jury needed to pronounce them guilty of wantonness at the very least. For men, lust is a tripwire. For women, it’s a noose.
I’ve heard quite a bit lately about David Petraeus’s road to redemption. I’ve heard less about Paula Broadwell’s. Yes, he’s the more public figure, but the disparity also reflects the way their affair was often portrayed in the first place. He strayed; she preyed. He was weak; she was wily. He was the fly, she the spider.
Let’s bring a few other recent news stories into this. Let’s indulge in a few hypotheticals.
What if it had been Antonia Weiner who took to Twitter and there had been a different architecture to the image she tweeted? Would she be able even to entertain the idea of a political comeback? And would the spouse standing dutifully by her be seen as a brave and magnanimous stalwart, the way Huma Abedin is viewed in some quarters, or dismissed by one and all as a pitiable pushover?
Had a Southern governor named Marcia Sanford been entangled with a Latin lover when reputedly hiking the Appalachian Trail, would she today be her party’s nominee for an open Congressional seat? We know the answer, and we know that Wilhelmina Clinton and Newtina Gingrich wouldn’t have rebounded from their infidelities as robustly as Bill and Newt did.
Men get passes, women get reputations, and real, lasting humiliation travels only one way. The size and scope of that mortification, despite many decades of happy talk about dawning gender equality, are suggested by recent news stories of one teenage girl in California and another in Nova Scotia who hanged themselves after tales or cellphone pictures of their sexual violation circulated among peers. It’s impossible not to wonder if shame drove them to suicide, and it’s impossible not to ask what sort of world allows the victims of such assaults to feel more irredeemably branded — more eternally damned — than their accused assailants by all appearances do.
I’ll tell you what sort: a world in which there’s a cornucopia of synonyms for whore and slut and no comparably pejorative vocabulary for promiscuous or sexually rapacious men. A world in which Knox’s vibrator and the lingerie she was said to have bought in a Perugia store were presented not just as newsworthy but as germane to the charge of murder against her: referendums on her character, glimmers of her depravity, clues to precisely how a good girl went bad. A world in which her erotic appetite made her a “man eater,” as the Italian press wrote and as the rest of the world more or less parroted. A world in which her tally, scribbled on a sheet of paper in her prison cell, of seven sexual partners in all of her life was seen as sensational. A similar count for a guy in his early 20s would provoke not derision but disagreement: swordsman or slacker?
When we chart and lament the persistence of sexism in society, we look to the United States Congress, where women are still woefully underrepresented. We look to corporate boardrooms, where the glass ceiling hasn’t really shattered. But we needn’t look any further than how perversely censorious of women’s sex lives we remain, and how short the path from siren to slut and from angel to she-devil can be.