This is preposterous

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A review of Zeke Emanuel’s new book comparing health systems across the world has as good a description of the American maze as I’ve seen.


Britain is so lucky to have the NHS; I find it literally impossible to explain to people here how the system doesn’t have to be this way.

By contrast, the US health care system—if one can call it that—excludes more people, provides thinner coverage, and is far less affordable. It combines socialized medicine practiced by the Department of Veterans Affairs, four-part federal Medicare (A, B, C, D) for the elderly and disabled, state-by-state Medicaid for the poor, health coverage provided by employers, and policies bought privately through an insurance agent or an Affordable Care Act exchange—all of which still leave 10 percent of the population unprotected. Among the biggest problems, says Emanuel, is that Americans are baffled by their health care: uncertain of the benefits they’re entitled to, the providers that will accept their insurance, the amount of their deductibles and copays, and the accuracy of the bills they receive. It is a system, moreover, in which people are regularly switching insurers out of choice or necessity—a process known as churning. “The United States basically has every type of health financing ever invented,” Ezekiel adds. “This is preposterous.”

Rate my room, Swiss hoarding edition

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We’re all spending a lot more time on Zoom these days. Hangouts with friends are a lot like work meetings are a lot like coffee chats are a lot like calls to family.

And we’re all spending a lot more time thinking about—and commenting on—our Zoom backgrounds. Room rating is a thing.

I wonder how the developmental psychologist Jean Piaget would have gotten along with it all.

Famous messy scientists - History of Science and Mathematics Stack Exchange

I mean, I don’t think he’d have cared very much at all. But still.

Weeks 38-40

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Silence, as usual, means a heavy workload. Closing an upcoming issue of the magazine, pushing along another large project with lots of moving parts, and helping corral our election coverage has been intense—that’s on top of the day to day business. Next up the election, which I suppose is my third or fourth time around, depending on how you count it. We moved to America shortly before the 2008 Obama victory, which I think skewed my perception of what American presidential races and outcomes were like. The never-ending chaotic evil spin cycle of US politics is enough to leave anyone brain damaged.

I’ve managed to properly read just a couple of books in between, but not much. The Death of Vivek Oji by Akwaeke Emezi I liked well enough, despite feeling a little contrived. And, due to popular demand from the 8-year-old, The Golden Compass by Philip Pullman, which I thought was good for a kid’s book and certainly light years ahead of most of its peers in terms of sheer quality of the written word.

There have been so many exciting new projects from friends that I will make separate posts for them.

The reverse Chotiner

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Britain’s left is riddled with anti-trans views in a way that continues to disappoint me. This interview with Judith Butler in the New Statesman is a great example of that, and of how to think about representation and poisonous discourse. We see a journalist trying to prod a certain kind of answer out of a thinker, and the thinker responding by rejecting the premises of questioning in an artful and coherent way.

I confess to being perplexed by the fact that you point out the abuse levelled against JK Rowling, but you do not cite the abuse against trans people and their allies that happens online and in person. I disagree with JK Rowling’s view on trans people, but I do not think she should suffer harassment and threats. Let us also remember, though, the threats against trans people in places like Brazil, the harassment of trans people in the streets and on the job in places like Poland and Romania – or indeed right here in the US. So if we are going to object to harassment and threats, as we surely should, we should also make sure we have a large picture of where that is happening, who is most profoundly affected, and whether it is tolerated by those who should be opposing it. It won’t do to say that threats against some people are tolerable but against others are intolerable.

Zombie news

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For nearly as long as there has been newspapers and magazines, there have been people who use publications to launder their own reputations or advance their own agendas. Press barons were a real thing before fake news, and media ownership is still a great way for the powerful to access even more power. PR folks, meanwhile, take great pains to try and place op-eds by, or positive stories about, their clients in the pages of prestigious and not-so-prestigious publications.

But the gutting of news media over the past 20 years, driven by a storm of competition, disintermediation and greed, has led to some slightly different beasts emerging from this hellscape.

One is the fake news outlet: something that looks and behaves like a genuine publication but is really just propaganda dressed in a costume of real publishing.

Now we have the “zombie magazine”—the formerly prestigious publication that uses the reputation it gained in the past to launder bad ideas. Prime candidate? Newsweek, which let its pages be used as the starting pistol for a racist conspiracy theory about Kamala Harris.

As Alex Shephard puts it in The New Republic:

Newsweek’s opinion section… has become a clearinghouse for right-wing nonsense. But it also points to a larger crisis in journalism itself: The rise of the zombie publication, whose former legitimacy is used to launder extreme and conspiratorial ideas.

Even by the volatile standards of journalism in the twenty-first century, Newsweek’s recent problems are extraordinary. There are the usual issues: a sharp decline in print subscribers, Google and Facebook, the difficulty of running a mass-market general interest news magazine in an age of hyperpartisanship. But Newsweek has also been raided by the Manhattan district attorney’s office (a former owner and chief executive pleaded guilty to fraud and money laundering charges in February) and has been accused of deep ties to a shadowy Christian cult, amid many other scandals.

Zombie magazines are different from more traditional places that propagate conspiracies under the guise of legitimate news—say, the Wall Street Journal‘s often rabid op-ed pages or the New York Times‘ recent Tom Cotton debacle— because the value is in the gap between public perception and current reality (that is, the folks who buy into the Harris spew likely recognize Newsweek as a voice with a little bit of historical authority even if the publication is clearly a long, long way from what it once was.) It’s also different because everybody involved seems so totally fucking desperate.

The canonical story on this turmoil at Newsweek is probably Daniel Tovrov’s CJR story on “dropshipping journalism,” which is prominently credited in Shephard’s piece. But I thought it was interesting to see this piece appear in The New Republic, because for a while I was pretty sure that TNR was going to become exactly the same kind of zombie magazine itself.

And perhaps that’s the thing to recognize from this sad tale: we can all end up there if we aren’t careful.

Week 36, 2020

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SIX MONTHS OF LOCKDOWN. We passed the milestone without even realizing, it just kind of came and went. (It was the same when we hit 100 days back in week 26.) Of course, “lockdown” is not exactly lockdown. Sometimes when the word crosses my lips, I feel like a character from this McSweeney’s jab: “Another dull quarantine weekend at home, Target, Chipotle, Home Depot, and our niece’s graduation party.” Your lockdown might not look the same as mine. We leave the house once or twice a day, go to the local shops or for a stroll. We get takeout food. Some weekends we have a socially-distanced drink with a couple of friends in our back garden, although I can’t think of the last time we visited other people. We haven’t done outside dining or drinking, which are now allowed in San Francisco, and the only shops I’ve been inside are supermarkets and pet stores. Our risk balance is being spent on childcare, basically: a covid-vetted summer camp here and there. School is back, but only virtually, for now—maybe October, they’re saying. The rest of the time we’re staying home. That’s now been fully half a year. And you only have so many days, right?

Books I read: Just one completed this week. Fever Dream by Samanth Schwelbin (translated from Spanish), which lived up to its name and had me in dread from the very beginning right through to the end.

PORTLAND, OR - AUGUST 22: Right wing groups, left, and Portland anti-police protesters face off in front of the Multnomah County Justice Center on August 22, 2020 in Portland, Oregon. For the second Saturday in a row, right wing groups gathered in downtown Portland, sparking counter protests and violence. (Photo by Nathan Howard/Getty Images)

Stories I worked on: Our magazine ridealong podcast Deep Tech looks at India’s history of using internet shutdown to stifle protest, with Sonia Faleiro. A study suggesting covid-19 tracing apps can have significant impact even if not everybody uses them; Joan Donovan walks through the emergence of right wing “riot porn” online; elsewhere what political databases know about you and, relatedly, what Facebook’s political ad ban gets wrong.

A prayer for life

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According to a Tina Brown essay I read recently, Vanity Fair‘s breakthrough editorial moment came when she published Dominick Dunne’s 1984 heartbreaker about the murder of his daughter and the trial of her killer. Since Conde Nast relaunched the magazine in 1983, it had been destroyed in the market, hadn’t found its footing, and had been lined up to get shut down. When Brown took the job at the start of 1984 it was almost a goner.

But you take a great writer, telling a terrible, tragic and personal story that somehow touches everybody, and it can do strange things.

Brown says Dunne’s essay (“Justice”) was a turning point for the magazine in the 80s; the moment its voice began to click. (She also noted that newsworthy covers and glamour helped, too.)

That context brought a different layer to this terrific, desolate piece by Jesmyn Ward on the death of her husband at the beginning of a year of utter turmoil. It’s a dramatically different piece, but she weaves together the terrible, the tragic, the individual and the universal. Ward brings into a single place the very personal grief she endured, the widespread hurt caused by covid-19, and the collective grief that led to the latest eruptions of Black Lives Matter protests.

Two days after our family doctor visit, I walked into my son’s room where my Beloved lay, and he panted: Can’t. Breathe. I brought him to the emergency room, where after an hour in the waiting room, he was sedated and put on a ventilator. His organs failed: first his kidneys, then his liver. He had a massive infection in his lungs, developed sepsis, and in the end, his great strong heart could no longer support a body that had turned on him. He coded eight times. I witnessed the doctors perform CPR and bring him back four. Within 15 hours of walking into the emergency room of that hospital, he was dead. The official reason: acute respiratory distress syndrome. He was 33 years old.

The parallels between the stolen breaths of black murder victims—Eric Garner, George Floyd—and the virus taking away people’s breath have been noticed by other writers, but no one has done it this vividly or devastatingly.


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Been thinking a lot about the long view recently, both in work and in life. Everything’s awful and urgent and yet the past six months have felt so momentously slow that it’s creating a huge amount of internal dissonance: make-it-happen-now has to sleep in the same bed as when-this-is-all-over. And that’s presuming it will ever be over, of course.

I’m placing high value on every little moment that breaks out of the immediate, every long view and every. That’s not because it distracts me from the everyday sense of turmoil, but in fact because it puts the everyday into a new focus. The long haul is always there. Your task is to stay concentrated on each part of the pathway to get to wherever we’re going.

Fans watch the chord change

One of those moments came this week when I read about John Cage’s As Slow As Possible. It’s an organ composition he wrote in 1987, five years before he died. Performances typically last around an hour, but the play comes from extending the limit—hours or more. In fact, there is one particular ongoing performance that is slated to last 639 years and it changed chord this week for the first time since 2013.

The piece started playing on September 5, 2001. That was a week before the twin towers fell, a generation ago—a moment that has shaped life for many of us, one way or another, but is now a piece of history the same way as the Second World War was to my parents. When this particular performance of ASAP ends, it will be the year 2640.