Time 15 01 19 [美] by ohao

JANUARY 19, 2015

WHAT I LEARNED FROM MY $190,000 OPEN-HEART SURGERY BY STEVEN BRILL THE SURPRISING SOLUTION FOR FIXING OUR HEALTH CARE SYSTEM

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vol. 185, no. 1 | 2015

6 Editor’s Desk 8 Conversation

THE CULTURE

60 Books

A survey of the best young-adult literature of all time, including Top 10 lists of the best books for preteens and tweens and recommendations from Gillian Flynn, Michael Lewis and more

BRIEFING

13 Verbatim 14 LightBox

A capsizing cargo ship is run aground near the Isle of Wight 16 World

A deadly terrorist attack targets a satirical newspaper’s ofﬁce in Paris

Plus, novelist Meg Wolitzer on taking inspiration from Sylvia Plath’s The Bell Jar

18 World

Foreign-affairs columnist Ian Bremmer maps global conﬂicts brewing for 2015

68 The Awesome Column

20 Nation

A new lawsuit revives a high-proﬁle sexcrime case

The U.S.’s total health care bill for 2014 was $3 trillion, bolstered by fees for MRIs, CT scans and X-rays. Photo-illustration by Ann Elliott Cutting

Joel Stein tries out hosting America’s Funniest Home Videos

22 Health

Is the prevention of most cancers out of our control? 25 Milestones

Bill Clinton remembers Mario Cuomo COMMENTARY

30 Viewpoint

Walter Isaacson on building a safer Internet

OY E L O W O : PA R A M O U N T P I C T U R E S

on the cover: Time photo-illustration. Medical tray: Fuse/ Getty Images

FEATURES

Fixing Obamacare How letting hospitals run their own insurance companies can bring down health care costs for everyone by Steven Brill 34

44 Strange Bedfellows Instability across the Middle East has prompted promising conversations among Israeli and Arab ofﬁcials by Joe Klein 52 Marching On A timely ﬁlm brings Martin Luther King Jr.’s civil rights struggle in Alabama to the screen by Daniel D’Addario Plus: A review of Selma by Richard Corliss

David Oyelowo as Martin Luther King Jr. in Selma, page 52

TIME (ISSN 0040-781X) is published weekly, except for two issues combined for one week in January, May, July, August, September and December, by Time Inc. Principal Office: Time & Life Building, Rockefeller Center, New York, NY 10020-1393. Periodicals postage paid at New York, NY, and at additional mailing offices. Canada Post Publications Mail Agreement No. 40110178. Return undeliverable Canada addresses to: Postal Stn A, P.O. Box 4322, Toronto, Ont., M5W 3G9. GST #888381621RT0001 © 2015 Time Inc. All rights reserved. Reproduction in whole or in part without written permission is prohibited. TIME and the Red Border Design are protected through trademark registration in the United States and in the foreign countries where TIME magazine circulates. U.S. subscriptions: $49 for one year. Subscribers: If the Postal Service alerts us that your magazine is undeliverable, we have no further obligation unless we receive a corrected address within two years. Postmaster: Send address changes to P.O. Box 62120, Tampa, FL 33662-2120. CUSTOMER SERVICE AND SUBSCRIPTIONS—For 24/7 service, please use our website: time.com/customerservice. You can also call 1-800-843-TIME or write to TIME, P.O. Box 62120, Tampa, FL 33662-2120. Mailing list: We make a portion of our mailing list available to reputable firms. If you would prefer that we not include your name, please call, or write us at P.O. Box 62120, Tampa, FL 33662-2120, or send us an email at privacy@time.customersvc.com. Printed in the U.S. ◆◆◆◆◆◆◆

time January 19, 2015

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Editor’s Desk America’s Bitter Pill

LIGHTBOX James Nachtwey was moved to become a photojournalist by the searing images of America’s civil rights movement, so his recent undertaking— photographing scenes on the set of Selma for Paramount (see one above)—was stirring. “There were moments when I felt I had traveled back in time,” he says, yet “many of the emotions that fueled the historical event were still very much alive.” To see Nachtwey’s images, as well as a video interview with Selma’s director and star (right), visit time.com/selma.

Selma director Ava DuVernay, left, and lead actor David Oyelowo

LIFE

NOW ON TIME.COM

In an exclusive interview with TIME.com, Ford CEO Mark Fields says the world is not yet ready for self-driving cars—despite advances in technology and a proliferation of newly announced options from other automakers. Read more at time.com/ fordinterview.

The Consumer Electronics Show, which this year featured Bluetooth-equipped baby paciﬁers, has come a long way from its earlier incarnation as the International Gadget and Invention Show. See images from LIFE’s coverage of the 1958 exhibition, including this foot-propelled hammock, at time.com/gadgets1958.

Nancy Gibbs, editor

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Customer Service and Change of Address For 24/7 service, please use our website: time.com/customerservice. You can also call 1-800-843-8463 or write to TIME at P.O. Box 62120, Tampa, FL 33662-2120. Back Issues Contact us at help.single@customersvc .com or call 1-800-274-6800. Reprints and Permissions Information is available at the website time.com/time/reprints. To request custom reprints, email TimeIncReprints@ parsintl.com or call 1-212-221-9595, ext. 437; for all other uses, contact us by emailing timereprints_us@timeinc.com. Advertising For advertising rates and our editorial calendar, visit timemediakit.com. Syndication For international licensing and syndication requests, email syndication@timeinc.com or call 1-212-522-5868

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time January 19, 2015

L I G H T B O X : J A M E S N A C H T W E Y— PA R A M O U N T P I C T U R E S; L I F E : T H E L I F E P I C T U R E C O L L E C T I O N/G E T T Y I M A G E S

this week’s cover story marks the culmination of Steve Brill’s extraordinary journey through the landscape of American health care. He first launched this expedition for the 2013 story that became one of our bestselling covers, “Bitter Pill,” a riveting and often infuriating autopsy of hospital costs. In subsequent stories, he explored the terrain as a reporter—but took a harrowing detour as a patient, winding up in New York–Presbyterian Hospital for open-heart surgery to correct a potentially deadly aneurysm. Steve’s discoveries now come together in his new book, America’s Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System, from which this week’s story is adapted. The Affordable Care Act, he argues, is a case study of a dysfunctional government trying to take on a dysfunctional health care system. “The more I looked behind the point I made at the tail end of the first Time article— that Obamacare didn’t seem to do much about all the pricing abuses I had identified—the more I realized that this was the overarching story of how Washington really works,” he says. “We have become a country where money seems to govern almost everything in Washington, and those interests that enjoy the most power and money, often abusively, will be able to protect their positions.” His experience as a patient brought the vast, submerged forces in this debate to the surface: namely the power of fear and emotion when it comes to a health crisis. You can have a deep belief in the efficiency of markets and still doubt whether your own health, or the health of someone you love, is suited to negotiation or bargain hunting. Steve proposes a solution that does not require a change in human nature or the current state of U.S. democracy. Let that be the start of the next national conversation: Now that coverage has been expanded, what would it really take to control the costs?

BECAUSE SOMEDAY

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Conversation What You Said About ... “A guy’s gonna go up in space for a year— why?” asked Joe Scarborough on Morning Joe in a discussion of Time’s Dec. 29–Jan. 5 cover story on an upcoming NASA mission that will send Scott Kelly into space for a year—the longest period ever for an American—while his identical twin Mark is monitored at home on Earth. On Chicago radio, writer Jeffrey Kluger addressed the experiment’s possible physical and mental strain, including “third-quarter effect,” or the fatigue and depression that can set in before the end of such an arduous period of relative isolation. Readers were impressed. “I salute both of these intrepid men,” wrote Mike Moore of Warsaw, Mo. But Thomas McGugan of Jacksonville Beach, Fla., thought NASA could do better by the astronaut: “I was shocked and a bit saddened to see the condition of Scott Kelly’s suit, including rust on the helmet lock ring and connectors that belong on a ’63 Rambler.” TWIN SPACE PIONEERS

THE TOP 100 PHOTOS OF 2014 TIME’s picks reflected a “wide spectrum of emotion,” according to Today.com, including Derek Jeter’s jubilant leap after his game-winning last at bat at Yankee Stadium against the Baltimore Orioles (second row, right) and a haunting closeup of a young Afghan refugee (second row, left). BBC News, in particular, was taken by Massimo Sestini’s “astonishing” aerial photo of migrants crossing the Mediterranean Sea in a jam-packed boat (top left): “From a distance it looks like a fish, with colorful scales. But look closely and you see that it is a boat—packed so tightly with people looking up that you cannot actually see the boat ... like when a child sprinkles a piece of cardboard with glitter.” Meanwhile, on MSNBC, panelist Ayman Mohyeldin called out a lighter entry—the now famous Oscar selfie—and debated the merits of selfies with TIME’s Belinda Luscombe. “Is it cheating to use a selfie stick?” he asked. To see the full list, visit time.com/photos2014

The Kentucky Senator’s Time.com essay celebrating the Obama Administration’s recent moves toward engagement with Cuba sparked heated debate—not least between Paul and fellow GOP star Marco Rubio, who critiqued Paul as a “cheerleader for Obama’s foreign policy.” On Time.com, commenter MatthewKilburn supported incremental steps toward engagement but wrote that “the manner in which the President—and apparently, Rand Paul—is so willing to wash away any restriction on that country, and in doing so enrich the current authorities while emptying our current tool kit of any future available carrots, is foolish.” RicardoRivera disagreed: “We must move

RAND PAUL ON CUBA

B O AT: P O L A R I S; O B A M A , F E R G U S O N : R E U T E R S; J E T E R , E L L E N S E L F I E , R E F U G E E : A P ; PA U L , R O O S E V E LT, S W I M M E R S : G E T T Y I M A G E S

away from outdated policy that harms the Cuban people more than it will harm those in charge of Cuban politics.” THE TEDDY AWARDS Joe Klein’s annual shout-outs for the politicians who showed the most courage included President Obama for his “moderate, sane and humane” policies (despite some considerable missteps). Critics pounced. “What an ugly 8 years this will have been!” wrote D. Wymard of Fort Lauderdale, Fla. “In his own words (‘needless unforced errors,’ ‘negligent foreign policy’) Klein castigates Obama, and yet turns around and awards the Teddy. Rather hypocritical!”

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THE WEEK

Briefing ‘We have just been hit at the heart of our liberty.’

TERROR CAME TO PARIS

Brisket Prices for the barbecue meat have surged amid rising demand and a cattle shortage

‘HE SOMETIMES CALLS ME “BRO.”’ DAVID CAMERON, British Prime

GOOD WEEK BAD WEEK

Minister, describing his close relationship with U.S. President Barack Obama

C A M E R O N , D E B L A S I O : R E U T E R S; H I D A L G O, B R I S K E T, W I L L I A M S : G E T T Y I M A G E S; M C N U G G E T S : M C D O N A L D ’ S ; I L L U S T R AT I O N B Y B R O W N B I R D D E S I G N F O R T I M E (2)

ANNE HIDALGO, mayor of Paris,

after gunmen killed at least 12 people at the ofﬁces of the satirical newspaper Charlie Hebdo, in a terrorist attack on Jan. 7 that shook France

2,400

McNuggets

46 million The number of people Starbucks says received gift cards for the coffee chain during the holidays, about 1 in 7 Americans

The number of new Cardinals chosen by Pope Francis, none from the U.S., as he diversiﬁes Catholic Church leadership

‘They were disrespectful to the families who lost their loved ones.’

Sales in Japan were halted after vinyl was found in one of the McDonald’s chicken bites

BILL DE BLASIO,

New York City mayor, on the police ofﬁcers who turned their backs on him during funerals for slain colleagues. De Blasio has feuded with cops who say he failed to support them during protests against the use of force

The number of miles (3,900 km) traveled by a lost Seattle puppy named Penny, who ended up in Pennsylvania before her microchip was scanned and her owners located

SERENA WILLIAMS,

‘I just asked them to get me a shot of espresso.’

tennis player, on the cup of “miracle coffee” she requested after losing, 6-0, the ﬁrst set of a match at the Hopman Cup in Australia. Williams went on to win the next two sets and the match

‘I am very proud of all the employees ... who stood up against some of the extortionist efforts of the criminals.’ K AZUO HIRAI, Sony CEO, speaking for the ﬁrst time about the devastating hack of Sony Pictures Entertainment that prompted the studio to pull, but then eventually release, The Interview following threats of 9/11-style attacks on theaters that screened the movie

time January 19, 2015

WorldMags.net Sources: New York Times (2); Daily Mail; ESPN; Reuters; Wall Street Journal; AP

Brieﬁng

LightBox A Tactical Tilt The cargo ship Hoegh Osaka, which was carrying 1,400 cars, was deliberately grounded on a submerged sandbank near the Isle of Wight in England on Jan. 3 in order to keep it from capsizing. All 25 crew members were rescued overnight. Photograph by Peter Macdiarmid—Getty Images FOR PICTURES OF THE WEEK, GO TO lightbox.time.com

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World An Attack Foretold French

RĂ¨FLDOV ZHUH concerned even EHIRUH WZR JXQPHQ VWRUPHG D 3DULV QHZVSDSHU BY VIVIENNE WALT/PARIS

DeďŹ ant Thousands of Parisians gathered in the Place de la RĂŠpublique on the evening of the attack

else too: it was an act foretold. For months, French ofďŹ cials have expressed concerns that the country was becoming increasingly vulnerable to a terrorist attack. Last month their nervousness appeared well justiďŹ ed, when two separate drivers rammed their cars into Christmas crowds in the provincial cities of Nantes and Dijon, injuring dozens of people, while a third attacker wielded a knife, shouting, â&#x20AC;&#x153;Allahu akbar,â&#x20AC;? or â&#x20AC;&#x153;God is great.â&#x20AC;? Those car rammings now seem amateurish and opportunisticâ&#x20AC;&#x201D;more the work of lone-wolf terrorists acting without support. In contrast,

the men who mounted the Jan. 7 massacre worked like a well-drilled cell primed to inďŹ&#x201A;ict maximum damage. Their target was clear: Hardline Islamists have threatened Charlie Hebdo for years for publishing countless caustic

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commentaries and cartoons directed at extremist Muslims (as well as ultra-religious Jews and conservative Catholics). In 2011 Muslims ďŹ rebombed Charlie Hebdoâ&#x20AC;&#x2122;s previous ofďŹ ce building in Paris amid widespread protests after the paper published an issue purportedly edited by the Prophet Muhammad, with a cartoon lampooning him. French people quickly assumed that the assault had been an act of retaliation against the paperâ&#x20AC;&#x2122;s antireligious stance. The attackâ&#x20AC;&#x2122;s ruthless efďŹ ciency shocked Parisians as much as the result. Arriving at the very moment Charlie time January 19, 2015

T H I B A U LT C A M U S â&#x20AC;&#x201D; A P

the french, who have seen two devastating world wars and a revolution on their soil, are known for keeping cool heads in the face of tragedy and violence. Yet little could have prepared them for the gruesome events of Jan. 7. It seemed a gray, rainy Wednesday like any other, until two gunmen wearing black ski masks stormed into the ofďŹ ces of the satirical weekly newspaper Charlie Hebdo just before midday, in Parisâ&#x20AC;&#x2122; congested 11th district, and let loose a fusillade of bullets. Outside on the street they shot dead a police ofďŹ cer and ďŹ&#x201A;ed in a black car driven by a third manâ&#x20AC;&#x201D;a horrifying sequence of events ďŹ lmed by a witness and seen around the world. The men killed 12 people in the attack, among them three of Franceâ&#x20AC;&#x2122;s best-known cartoonists, the paperâ&#x20AC;&#x2122;s top editor and two police ofďŹ cers. Rushing to the scene, President FranĂ§ois Hollande stood ashen-faced on the chilly sidewalk, some 3 miles (about 5 km) from his grand ElysĂŠe Palace, and appealed for the French to â&#x20AC;&#x153;show we are a united country.â&#x20AC;? â&#x20AC;&#x153;This was an act of exceptional barbarity,â&#x20AC;? he said, and declared the attack â&#x20AC;&#x153;a terrorist operation.â&#x20AC;? The massacreâ&#x20AC;&#x201D;Franceâ&#x20AC;&#x2122;s worst terrorist attack in memoryâ&#x20AC;&#x201D;was something

Brieﬁng

Hebdo’s journalists were in their weekly editorial meeting—the only time the entire staff gathers in the building—the two assailants sprang from their vehicle carrying automatic riﬂes and wasted no time killing as many people as they could. “They were well equipped, they had military weapons, they had probably bulletproof vests,” French terrorism consultant Jean-Charles Brisard told the BBC after watching video footage from a closed-circuit security camera outside the building. “These individuals were well trained.” The attackers are precisely the sort of terrorists the French

government has most feared. With more than 5 million Muslims, France has the largest Islamic population in all of Europe. Many French Muslims emigrated from French-speaking North Africa or were raised as children of immigrants from those countries. Their communities have been hard hit by years of recession as France struggles with record-high unemployment now nearing 11%. Some young French Muslims, disillusioned by the economic hardship and what they see as a French population increasingly hostile to outsiders, have looked abroad for direction and meaning, to the jihadist groups fighting in Syria and Iraq. French police believe about 1,200 French citizens have joined Islamist groups in Syria and Iraq since 2011—by far the most fighters to have joined the jihadists from any Western country. French officials now fear that those filtering home might return with professional military skills and a desire—or even instructions—to harm France. In response to the attack, Hollande quickly ordered France’s security threat raised to its highest level in years, while Interior Minister Bernard Cazeneuve vowed to hunt down the attackers “so they can be punished with the severity that their barbarous acts are worthy of.” Those words sound reassuring—for now. And as darkness fell on Jan. 7 Parisians came together in mass gatherings to show their sympathy for the dead and to insist on their right to express themselves free of the threat of violence. But citizens and security officials alike know that unity will not necessarily deter future attacks.

Figures Who Were Literally Irreplaceable ǎHUH V QR RQH LQ

)UDQFH ZKR FDQ oOO WKHLU UROH BY CL AIRE BERLINSKI

I’m a journalist but was only by chance in the vicinity of the massacre at the French satirical newspaper Charlie Hebdo. I was en route to visit a friend. This took me past the paper’s office and thus put me at the heart of the bloodiest attack France has seen in the past 50 years. On my approach, it was immediately obvious that there had been a massive terrorist attack. Such attacks have a characteristic signature. Swarms of ambulances. Police vehicles and mobile labs. Grimfaced cops. Crime-scene tape stretching for blocks. A very particular expression on the faces of dazed and bewildered onlookers. I asked the first cop I saw what had happened. She was in no mood to explain: “You’ll see it on the news.” “How bad is it?” “Grave.” Not quite translatable, but “as bad as it gets” will do. France is in shock. The attack killed 12 people and injured several others critically, as of press time. The number of fatalities may rise. Masked gunmen attacked the paper’s office. But their object was not merely to terrorize. This is obvious, and let no one tell you otherwise. This was an attack on France. It was an outright declaration of war. It was an attack on press freedom in particular— on journalists, writers, cartoonists and intellectuals who were as well known here as Jon Stewart and Stephen Colbert are to Americans. They were known above all for their willingness to say whatever they damn well pleased—no matter whom they offended or how many death threats resulted. While their publication was best known for its parodies of Muslim

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extremists, they were more than happy to say whatever they pleased about Jews and Catholics too—and never were that respectful, either. But only radical Islamists thought the proper rejoinder was simply to kill them all. In December 2011, the magazine’s office was firebombed following an issue it claimed was “guest edited” by the Prophet Muhammad. Shortly before the latest attack, it tweeted a mildly amusing cartoon of the leader of the Islamic State of Iraq and Greater Syria. The cartoonists who died—Charb, Cabu, Tignous, Wolinski—were household names. Bernard Maris, known as Uncle Bernie, was an economist to whom the French have listened every Friday morning on the radio since the 1990s. Le Monde, Radio France and France Télévisions have lent their staff to keep Charlie Hebdo going, but France is not a big enough country to replace such figures readily. They were literally irreplaceable. This is true of every human being, of course, but they in particular filled a role no one else in France can fill. In 2012, in an interview with Le Monde, Stéphane Charbonnier, Charlie Hebdo’s director, was asked if he was tempted to tone down the publication’s inclination toward the inflammatory. “It may sound pompous,” he replied, “but I’d rather die standing than live on my knees.” It hardly sounds pompous at all. Especially given that this is precisely what he did.

Berlinski, an American journalist and biographer, lives in Paris 17

Brieﬁng

World

Sea of Troubles ǎH 1HZ <HDU KROGV XQFRPPRQ ULVNV +HUH DUH RI WKH PRVW ZRUULVRPH RQHV

By Ian Bremmer

every january, eurasia group, the political-risk consultancy I founded and oversee, publishes a roundup of the most crucial geopolitical trends of the coming year. The ranking reflects our forecast of which global story lines will rise to the forefront over the next 12 months, which will have the biggest impact on the markets and on politics—and where we can expect surprises. As 2015 dawns, political conflict among the world’s great powers is at a higher pitch than at any time since the end of the Cold War. U.S. relations with Russia are now fully broken. China’s powerful President Xi Jinping is creating a new economy, and the effects will be felt across East Asia and around the rest of the world. Geopolitical uncertainty has Turkey, the Gulf Arab states, Brazil and India hedging their bets. International finance will be weaponized—and that could backfire on the U.S. But the year’s top risk is found in once placid Europe, where an increasingly fractious political environment is generating new sources of conflict.

1. THE BROKEN POLITICS OF EUROPE European economics aren’t as bad as they were at the height of the euro-zone crisis in 2012, but the politics of Europe are now far worse. Within key countries like Britain and Germany, anti-E.U. political parties continue to gain popularity, undermining the ability of governments to deliver on painful but needed reforms. Friction will grow among European states as peripheral governments come to increasingly resent the inﬂuence of a strong Germany unchecked by a weak France or an absent Britain. Finally, an angry Russia and the aggressive Islamic State of Iraq and Greater Syria (ISIS) will add to Europe’s security worries. 2. RUSSIA Sanctions and lower oil prices have weakened Russia enough to infuriate President 18

Vladimir Putin—but not enough to restrain him. Moscow will continue to put pressure on Ukraine, and as a result, U.S. and European sanctions will tighten. As Russia’s economy sags, Putin’s approval ratings at home will increasingly depend on his willingness to confront the West. Western companies and investors are likely targets—on the ground and in cyberspace.

3. THE EFFECTS OF CHINA’S SLOWDOWN China’s economic growth will slow in 2015, but it’s all part of Xi’s plan. His historically ambitious economicreform efforts depend on transitioning his country to a consumer-driven economic model that will result in levels of growth that are lower but ultimately more sustainable. The continuing slowdown should have little impact inside China. But

U.S. percentage of global GDP

22%

Percentage of global trade finance conducted in U.S. dollars

81%

Graphic sources: Eurasia Group; Swift via Bloomberg

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countries like Brazil, Australia, Indonesia and Thailand, whose economies have come to depend on booming trade with a commodity-hungry China, will feel the pain.

4. THE WEAPONIZATION OF FINANCE For the moment, the U.S. public has had enough of wars and occupations, but the Obama Administration still wants to exert significant influence around the globe. That’s why Washington is turning finance into a weapon. It is using carrots (access to capital markets) and sticks (various types of sanctions) as tools of coercive diplomacy. The advantages are considerable, but there is a risk that this strategy will damage U.S. companies caught in the cross fire between Washington and targeted states. Transatlantic relations could suffer for the same reason.

Brieﬁng

World

Fallen star Turkey’s Erdogan is one of a number of incumbent leaders who will face strong rivals at home in 2015

Zuma, Nigeria’s Goodluck Jonathan and Turkey’s Recep Tayyip Erdogan will each face determined opposition and formidable obstacles as they struggle to enact their political agendas.

E D O U — G E T T Y I M A G E S R E P O R TA G E

5. ISIS, BEYOND IRAQ AND SYRIA ISIS faces military setbacks in Iraq and Syria, but its ideological reach will spread throughout the Middle East and North Africa. It will grow organically by setting up new units in Yemen, Jordan and Saudi Arabia, and it will inspire other jihadist organizations to join its ranks— Ansar Beit al-Maqdis in Egypt and Islamists in Libya have already pledged allegiance to ISIS. As the militant group’s inﬂuence grows, the risk to Sunni states like Saudi Arabia, the United Arab Emirates and Egypt will rise. 6. WEAK INCUMBENTS Feeble political leaders, many of whom barely won re-election last year, will become a major theme in 2015. Brazil’s Dilma Rousseff, Colombia’s Juan Manuel Santos, South Africa’s Jacob time January 19, 2015

Past approval rating Dilma Shinzo Rousseff, Abe, post-2010 2013 peak Recep Tayyip Barack Erdogan, Obama, 2011 post-2012 peak 79% 71% 67% 57%

Brazil Turkey Japan U.S.

Current approval rating Abe, 2014

Rousseff, 2014 Erdogan, 2014

56%

51%

Obama, 2014

44% 43%

Brazil Turkey Japan

U.S.

7. THE RISE OF STRATEGIC SECTORS Global businesses in 2015 will increasingly depend on risk-averse governments that are more focused on political stability than economic growth, supporting companies that operate in harmony with their political goals—and punishing those that don’t. We’ll see this trend in emerging markets, where the state already plays a more significant role in the economy, as well as in rogue states searching for weapons to fight more powerful governments. But we’ll also see it in the U.S., where national-security priorities have inflated the militaryindustrial complex, which now encompasses technology, telecommunications and financial companies. 8. SAUDI ARABIA VS. IRAN The rivalry between Shi‘ite Iran and Sunni Saudi Arabia is the engine of conflict in the Middle East. Washington and other outside powers are increasingly reluctant to intervene in the region, while both countries struggle with complex domestic politics and rising anxiety about the ongoing negotiations over Iran’s nuclear program.

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Expect Tehran and Riyadh to use proxies to fuel trouble in more Middle Eastern countries than ever in 2015.

9. TAIWAN/CHINA Relations between China and Taiwan will deteriorate sharply in 2015 following the opposition Democratic Progressive Party’s landslide victory over the ruling Nationalist Party in Taiwanese local elections this past November. If China decides that its strategy of economic engagement with Taiwan has failed, it might well backtrack on existing trade and investment deals and signiﬁcantly harden its rhetoric. The move would surely provoke public hostility in Taiwan and inject even more anti-mainland sentiment into the island’s politics. Any U.S. comment on relations between China and Taiwan would quickly increase tensions between Beijing and Washington. 10. TURKEY Lower oil prices helped, but President Erdogan used election victories in 2014 to try to sideline his political enemies—of whom there are many—while remaking the country’s political system to tighten his personal hold on power. But he’s unlikely to win the authority he wants this year, creating more disputes with his Prime Minister, weakening policy coherence and worsening political unpredictability. Given the instability near Turkey’s borders, where the war against ISIS rages, that’s bad news for everyone. Refugees from Syria and Iraq are bringing more radicalism into the country and adding to economic hardship. 19

Brieﬁng

Nation Settling Old Scores

A new lawsuit could revive a KLJK SURoOH VH[ case BY MICHAEL SCHERER

From top: Prince Andrew, Alan Dershowitz and Jeffrey Epstein

lowed Epstein to plead guilty in 2008 to two state felonies, including soliciting a minor for prostitution. He was required to register as a sex offender and sentenced to 18 months in prison, of which he served 13. As part of the deal, prosecutors agreed to try to keep the settlement details off the public record. Several of the victims, including those like Roberts who later settled civil lawsuits against Epstein, were bothered by the leniency of the deal. “This stinks to high heaven,” says Cassell. Two victims sued the Justice Department for violating the 2004 Crime Victims’ Rights Act, which was meant to ensure that victims are given a voice in criminal proceedings. In the Dec. 30 ﬁling, Roberts and another victim asked to join the case. If Cassell is successful, the lawsuit could eventually overturn the initial settlement and change the way the Justice Department handles pretrial negotiations. “It’s a big case,” says Meg Garvin, director of the National Crime Victim Law Institute. In ﬁlings, the Justice Department has argued that Epstein’s alleged victims had no right to consultation, since the case was settled before criminal charges were brought. After the lawsuit began, Attorney General Eric Holder issued new guidelines, directing prosecutors to “make reasonable efforts” to make such consultations anyway. Cassell considers that a small victory but says he hopes his case “will send the message that federal prosecutors can’t keep victims in the dark.”

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The Rundown GAY MARRIAGE

In the latest sign of the nation’s growing acceptance of same-sex marriages, Florida became the 36th state to allow them on Jan. 6. The newly lifted statewide ban was enacted just six years ago with 62% of the vote.

CORRUPTION Former Virginia governor Bob McDonnell was sentenced Jan. 6 to two years in prison after being convicted on federal corruption charges. The onetime GOP rising star had been considered a potential presidential candidate. His wife Maureen, who was also found guilty of corruption, will be sentenced on Feb. 20. DRUGS

300% The approximate increase in seizures of methamphetamine at the CaliforniaMexico border from 2009 to 2014. Authorities say the rise is the result of tighter U.S. laws that have restricted domestic access to meth’s key ingredients, leading more people to manufacture the drug south of the border. HISTORY

The contents of a package that Samuel Adams and Paul Revere buried in a cornerstone of the Massachusetts State House in 1795 were revealed by the Boston Museum of Fine Arts on Jan. 6. Thought to make up what could be one of the oldest time capsules in the U.S., the box included ﬁve newspapers, 24 copper and silver coins, a seal of the Commonwealth and a silver plate possibly made by Revere. The most recent coins are from 1855, when the items were ﬁrst discovered, placed in a brass box and reburied.

time January 19, 2015

P R I N C E A N D R E W, D E R S H O W I T Z , M C D O N N E L L : G E T T Y I M A G E S; E P S T E I N : A P

the 13-page legal filing landed at a Florida courthouse on Dec. 30 with a bang. As part of a lawsuit accusing the Justice Department of botching a major sex-crime prosecution, attorneys Bradley Edwards and Paul Cassell, a former federal judge, laid out the shocking claims of their latest client, Jane Doe #3, who has been named elsewhere as Virginia Roberts. She said she had been kept as a teenage “sex slave” by the wealthy American financier Jeffrey Epstein. Cassell’s suit has the potential to both reopen the long-closed case and force the Justice Department to change the way it deals with crime victims during plea negotiations. In the recent filing, Roberts said Epstein arranged for her to have sex with his friend Prince Andrew, the Queen of England’s second son, and trafficked her to “numerous prominent American politicians,” “a well-known Prime Minister” and others, including noted Harvard professor Alan Dershowitz, one of Epstein’s attorneys. Buckingham Palace strongly denied the allegations, which had first been hinted at in a civil lawsuit in 2009 and later in press reports that included a photograph of Prince Andrew with his arm around a teenage Roberts. Dershowitz

declared the accusations false and libelous and vowed to seek the disbarment of Cassell and Edwards. Cassell and Edwards, in turn, have sued Dershowitz for defamation. A representative for Epstein dismissed the accusations as old and discredited. The truth of the claims has never been litigated before a court. That fact still motivates Cassell, a victim-rights advocate and law professor. Beginning in 2005, police and the FBI uncovered evidence that Epstein recruited an expansive network of underage girls, allegedly including Roberts, for paid sex. Prosecutors al-

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Brieﬁng

Health Most Cancer Is Out of Our Control Random DNA changes

are usually to blame

BY ALICE PARK

Source: Science

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GLIOBLASTOMA

The cells that cause this cancer divide often, making many errors

BASAL-CELL CARCINOMA

The most common skin cancer is triggered by exposure to UV rays

LUNG

Smoking, and the carcinogens in tobacco smoke, are the main drivers of lung cancer

MELANOMA

Because skin cells divide so frequently, this cancer is among the deadliest

PANCREATIC

This cancer is strongly affected by random mutations as opposed to lifestyle factors

LIVER

Risk of this cancer increases with age and heavy alcohol use

OVARIAN GERM CELL

A hard-to-treat cancer, it’s mostly the result of stemcell DNA-copying errors

OSTEOSARCOMA

Bone cells are actively dividing, leading to many chances for tumorcausing mistakes

time January 19, 2015

I L L U S T R AT I O N B Y T O D D D E T W I L E R F O R T I M E

we think we know what causes cancer: smoking, the sun’s UV rays, tumor-causing genes we inherit from Mom and Dad. But these factors alone can’t explain why cancer in its many forms is poised to edge out heart disease as America’s No. 1 killer within the next few years. That rise has sparked a spate of research into how much of cancer is within our control and how much of it is simply a roll of the genetic dice. Now, in an eye-opening study published in Science, researchers report that the majority of cancer types are the result of pure chance, the product of random genetic mutations that occur when stem cells—which keep the body chugging along, replacing older cells as they die off—make mistakes copying the cells’ DNA. Cristian Tomasetti and Dr. Bert Vogelstein at the Sidney Kimmel Comprehensive Cancer Center of Johns Hopkins University School of Medicine found that the more stem cells there are in certain kinds of tissues and the more often they divide, the more likely that tissue is to develop cancer over a person’s lifetime. About 65% of cancers are the result of these DNA mistakes made by stem cells. Only a small proportion of a tissue’s cells are stem cells, which are essentially templates for making more tissue. The catch is that this kind of DNA copying is also the process behind cancer, which is triggered by cells that pick up mutations in their genes when they divide. The element of chance does not, however, mean you should stop wearing sunscreen or take up smoking. “My biggest fear is that people will do nothing. The opposite is true,” says Tomasetti, who stresses that while we may not be able to prevent all tumors, we can focus on early detection and taking advantage of lifesaving treatments like chemotherapy and radiation, among other things. “We need to do everything we did before, but we want to do it even more than before.”

LIFESTYLE OR BAD LUCK? IT DEPENDS ON THE CANCER

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Brieﬁng

Milestones

Mario Cuomo, who died Jan. 1 at 82, at a New York hotel in 1986 DIED

Mario Cuomo New York governor,

presidential hopeful, liberal lion

ARTHUR GR ACE—ZUMA

By Bill Clinton

Mario Cuomo’s life story—the proud son of immigrants who raised him to believe in faith, family and work and to use his own gifts to enter public service and reach the pinnacle of New York politics— will always be inspiring. But it is especially important to us today because he believed that every American, native-born or immigrant, should have the same chance he’d had, and that that could only happen in a strong community with a compassionate, effective government. He deplored winner-take-all economics and winner-take-all politics. He believed to the end that our country could give anyone the chance to rise without pushing others out or down, and that at its best, the essential role of government is to give everyone a fair chance to rise. He never believed government could replace strong families and individual initiative. The beautiful family he and Matilda created and the lives their time January 19, 2015

children have lived are more than enough proof of that. He simply believed that without a “hand up” government, too many people would be left behind and our country would be diminished. Once an avid and able baseball player, Mario said in an interview for Ken Burns’ Baseball series, “You find your own good in the good of the whole. You find your own individual fulfillment in the success of the community.” Everything Mario Cuomo did was part of his passionate determination to strengthen the bonds of community, from his early efforts to address AIDS, to his support for mentoring and health care programs for children who needed them, to his initiatives to create more economic opportunities in upstate New York. For him the struggle to solve particular problems was not interest-group politics but community building, making the weak links stronger.

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He believed that he could do his part to build the “more perfect union” of our founders’ dreams. He did it with a politics like Lincoln’s—whom he so admired and wrote about—based on the better angels of our nature. He had a fine mind, competitive drive and unsurpassed eloquence. While he loved to debate, often fiercely, with reporters and opponents, he wanted his adversaries to have a fair chance to make their case. That was never more clear than in 1993, when his thorny critic, the New York Post, hit hard times. As the Post graciously said on Jan. 1, “Mario Cuomo stepped in and heroically performed a one-man rescue mission ... because he was convinced it was in New York’s best interests, not necessarily his own.” As all the political world knows, I owe a great debt to Mario Cuomo—for declining to run for President in 1992, then electrifying our convention with his nomination speech for me. I later wanted to nominate him for the Supreme Court, but he declined. I think he loved his life in New York and was content to be our foremost citizen advocate for government’s essential role in building a strong American community, living and growing together. In all the years since, Mario Cuomo never stopped believing that, in our hearts, Americans don’t want to be divided, driven by resentment and insecurity. He saw problems and setbacks as a part of the human condition, mountains to be climbed and opportunities to be seized—together. Mario Cuomo’s America of community, compassion and responsibility will live as long as there are people who believe in it as strongly as he did, who define our success by the chances we give to others who have dreams and the determination to chase them. In his keynote address to the 1984 Democratic Convention, Mario said, “We still believe in this nation’s future ... It’s a story ... I didn’t read in a book, or learn in a classroom. I saw it and lived it ... Please, make this nation remember how futures are built.” That memory is Mario Cuomo’s lasting gift to us. Clinton is the 42nd President of the United States

COMMENTARY

Walter Isaacson

Time to Build a More Secure Internet

Yes, anonymity is empowering. But escalating hacks and scams show that we need a safer alternative the internet was designed in a way that would allow it to withstand missile attacks. That was cool, but it resulted in an unintended side effect: it made it more vulnerable to cyberattacks. So now it may be time for a little renovation. The roots of the Internet’s design come from the network built by the Pentagon’s Advanced Research Projects Agency to enable research centers to share computer resources. The ARPANET, as it was called, was packet-switched and looked like a ﬁshnet. Messages were broken into small chunks, known as packets, that could scurry along different paths through the network and be reassembled when they got to their destination. There were no centralized hubs to control the switching and routing. Instead, each and every node had the power to route packets. If a node were destroyed, then trafﬁc would be routed along other paths.

40 MILLION Number of Americans who have had personal information stolen by cybercriminals

T $100 BILLION Loss to the U.S. economy in 2013 as a result of cybercrime

he vener able requests-for- comments process is already plugging away at this. RFCs 5585 and 6376, for example, spell out what is known as DomainKeys Identified Mail, a service that, along with other authentication technologies, aims to validate the origin of data and verify the sender’s digital signature. Many of these techniques are already in use, and they could become a foundation for a more robust system of tracking and authenticating Internet traffic. Such a parallel Internet would not be foolproof. Nor would it be completely beneficial. Part of what makes the Internet so empowering is that it permits anonymity, so it would be important to keep the current system for those who don’t want the option of being authenticated. Nevertheless, building a better system for verifying communications is both doable and, for most users, desirable. It would not thwart all hackers, perhaps not even the ones who crippled Sony. But it could tip the balance in the daily struggle against the hordes of spammers, phishers and ordinary hackers who spread malware, scarf up credit-card data and attempt to lure people into sending their bank-account ■ information to obscure addresses in Nigeria.

Isaacson, a former managing editor of Time, is the author of The Innovators

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time January 19, 2015

I L L U S T R AT I O N B Y B R O W N B I R D D E S I G N F O R T I M E

hese ideas were conceived in the early 1960s by a researcher at the Rand Corp. named Paul Baran, whose motive was to create a network that could survive a nuclear attack. But the engineers who actually devised the trafﬁc rules for the ARPANET, many of whom were graduate students avoiding the draft during the Vietnam War, were not focused on the military uses of the Net. Nuclear survivability was not one of their goals. Antiauthoritarian to the core, they took a very collaborative approach to determining how the packets would be addressed, routed and switched. Their coordinator was a UCLA student named Steve Crocker. He had a feel for how to harmonize a group without centralizing authority, a style that was mirrored in the distributed network architecture they were inventing. To emphasize the collaborative nature of their endeavor, Crocker hit upon the idea of calling their proposals Requests for Comments (RFCs), so everyone would feel as if they were equal nodes. It was a way to distribute control. The Internet is still being designed this way; by the end of 2014, there were 7,435 approved RFCs. So was the Internet intentionally designed to survive a nuclear attack? When Time wrote this in the 1990s, one of the original designers, Bob Taylor, sent a letter objecting. Time’s editors were a bit arrogant back then (I know, because I was one) and refused to print it because they said they had a better source. That source was Stephen Lukasik, who was deputy

HACK ATTACKS

director and then director of ARPA from 1967 to 1974. The designers may not have known it, Lukasik said, but the way he got funding for the ARPANET was by emphasizing its military utility. “Packet switching would be more survivable, more robust under damage to a network,” he said. Perspective depends on vantage point. As Lukasik explained to Crocker, “I was on top and you were on the bottom, so you really had no idea of what was going on.” To which Crocker replied, with a dab of humor masking a dollop of wisdom, “I was on the bottom and you were on the top, so you had no idea of what was going on.” Either way, the Net’s architecture makes it difﬁcult to control or even trace the packets that dart through its nodes. A decade of escalating hacks raises the question of whether it’s now desirable to create mechanisms that would permit users to choose to be part of a parallel Internet that offers less anonymity and greater veriﬁcation of user identity and message origin.

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NATION

What I Lea My $190,00 Photo-illustration by Ann Elliott Cutting

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arned From 00 Surgery By Steven Brill WorldMags.net

NATION | HEALTH CARE

i usually keep myself out of the stories i write, but the only way to tell this one is to start with the dream I had on the night of April 3, 2014. Actually, I should start with the three hours before the dream, when I tried to fall asleep but couldn’t because of what I thought was my exploding heart. Thump. Thump. Thump. If I lay on my stomach, my heart seemed to push down through the mattress. If I turned over, it seemed to want to burst out of my chest. When I pushed the button for the nurse, she told me there was nothing wrong. She even showed me how to read the screen of the machine monitoring my heart so I could see for myself that all was normal. But she said she understood. A lot of patients in my situation imagined something was going haywire with their heart when it wasn’t. Everything was fine, she promised, before giving me a sedative. All might have looked normal on that monitor, but there was nothing fine about my heart. It had a time bomb appended to it. It could explode at any moment—that night or three years later—and kill me almost instantly. No heart attack. No stroke. I’d just be gone, having bled to death. That’s what had brought me to the fourth-floor cardiacsurgery unit at New York–Presbyterian Hospital. The next morning I had open-heart surgery to fix something called an aortic aneurysm. Editor’s note: In 2013, Steven Brill wrote Time’s trailblazing special report on medical bills. His subsequent book, America’s Bitter Pill—a sweeping inside account of how Obamacare happened and what it does, and does not do, to curb the abuses Brill chronicled in Time—was published Jan. 5. This article is adapted from that book.

It’s a condition I had never heard of until a week before, when a routine checkup by my extraordinarily careful doctor found it. And that’s when everything changed. Until then, my family and I had enjoyed great health. I hadn’t missed a day of work for illness in years. Instead, my view of the world of health care was pretty much centered on a special cover story I had written for Time a year before about the astronomical cost of care in the U.S. and the dysfunctions and abuses in our system that generated and protected those high prices. For me, an MRI had been a symbol of profligate American health care—a high-tech profit machine that had become a bonanza for manufacturers such as General Electric and Siemens and for the hospitals and doctors who billed patients billions of dollars for MRIs they might not have needed. But now the MRI was the miraculous lifesaver that had found and taken a crystal-clear picture of the bomb hiding in my chest. Now a surgeon was going to use that MRI blueprint to save my life. A week before, because of the reporting I had done for the Time article, I had been like Dustin Hoffman’s savant character in Rain Man—able and eager to recite all varieties of statistics on how screwed up and avaricious the American health care system was. We spend $17 billion a year on artificial knees and hips, which is 55% more than Hollywood takes in at the box office. America’s total health care bill for 2014 was $3 trillion. That’s more than the next 10 biggest spenders combined: Japan, Germany, France, China, the U.K., Italy, Canada, Brazil, Spain and Australia. All that extra money produces no better, and in many cases worse, results. There are 31.5 MRI machines per 1 million people in the U.S. but just 5.9 per 1 million in the U.K. Another favorite: We spend $85.9 billion trying to treat back pain, which is as much as we spend on all of the country’s state, city, county and town police forces. And experts say that as much as half of that is unnecessary. We’ve created a system in which 1.5 million people work in the health-insurance industry while barely half as many doctors provide the actual care. And all those high-tech advances—pacemakers, MRIs, 3-D mammograms—have produced an ironically upside-down health care marketplace. It is the only industry in which technological advances have increased costs instead of lowering them. When it comes to medical care, cutting-edge products are irresistible and are used—and priced—accordingly. I could recite from memory how the incomes of industry

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Photograph by Peter Larson for TIME

The Cleveland Clinic Model The vast network of hospitals, clinics and doctors’ practices in Ohio draws patients from all over the world

Delos “Toby” Cosgrove The Cleveland Clinic CEO was a celebrated heart surgeon before becoming one of the savviest hospital executives in the world

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NATION | HEALTH CARE

executives continued to skyrocket even during the recession and how much more the president of the Yale New Haven Health System made than the president of Yale University. I even knew the outsize salary of the guy who ran the supposedly nonprofit hospital where I was struggling to fall asleep: $3.58 million. Which brings me to the dream I had when I finally got to sleep. As I am wheeled toward the operating room, a man in a finely tailored suit stands in front of the gurney, puts his hand up and orders the nurses to stop. It’s the hospital’s CEO, the $3.58 million-a-year Steven Corwin. He, too, had read the much publicized Time article, only he hadn’t liked it nearly as much as Jon Stewart, who had had me on his Daily Show to talk about it. “We know who you are,” the New York–Presbyterian CEO says. “And we are worried about whether this is some kind of undercover stunt. Why don’t you go to another hospital?” I don’t try to argue with him about gluttonous profits or salaries or the possibility that he was overusing his MRI or CT-scan equipment. Instead, I swear to him that my surgery is for real and that I would never say anything bad about his hospital. In real life, I could have given hospital bosses like him the sweats, making them answer questions about the dysfunctional health care system they prospered from. Their salaries. The operating profits enjoyed by their nonprofit, non-tax-paying institutions. And most of all, the outrageous charges—$77 for a box of gauze pads or hundreds of dollars for a routine blood test—that could be found on something they called the chargemaster, a massive menu of list prices they used to soak patients who did not have Medicare or private insurance. How could they explain those prices, I loved to ask, let alone explain charging them only to the poor and others without insurance, who could least afford to pay? But now, in my dream, I am the one sweating. I beg Corwin to let me into his operating room so I can get one of his chargemasters. If one of the nurses peering over me as he stopped us at the door had suggested it, I’d have bought a year’s supply of those $77 gauze pads.

1. Why U.S. Health Care Is So Hard to Fix health care is america’s largest industry by far, employing a sixth of the country’s workforce. And it is average Americans’ largest single expense, whether paid out of their pockets or through taxes and insurance premiums. So the story of how our country spent years trying to overhaul this vast portion of the economy—and still left the U.S. with a broken-down jalopy of a health care system—is an irresistible tale. The story of how what has come to be called Obamacare happened—and what it will and will not do—is about politics and ideology. In a country that treasures the marketplace, how much do we want to tame those market forces when trying to cure the sick? And in the cradle of democracy, or swampland, known as Washington, how much taming can we do when the health care industry spends four times as much on lobbying as the No. 2 Beltway spender, the much feared military-industrial complex? 38

It’s about the people who determine what comes out of Washington—from industry lobbyists to union activists, from Senators tweaking a few paragraphs to save billions for a home-state industry to Tea Party organizers fighting to upend the Washington status quo, from turf-obsessed procurement bureaucrats who crashed the government’s most ambitious Internet project ever to the selfless high-tech whiz kids who rescued it, and from White House staffers fighting over which faction among them would shape and then implement the law while their President floated above the fray to a governor’s staff in Kentucky determined to launch the signature program of a President reviled in their state. But late in working on the book from which this article is adapted, on the night of that dream and in the scary days that followed, I learned that when it comes to health care, all that political intrigue and special-interest jockeying play out on a stage enveloped in something else: emotion, particularly fear. Fear of illness. Or pain. Or death. And wanting to do something, anything, to avoid that for yourself or a loved one. When thrown into the mix, fear became the element that brought a chronically dysfunctional Washington to its knees. Politicians know that they mess with people’s health care at their peril. It’s the fear I felt on that gurney, not only in my dream but during the morning after the dream, when I really was on the gurney on the way into the operating room. It’s the fear that continued to consume me when I was recovering from my operation. The recovery was routine. Routinely horrible. After all, my chest had just been split open with what, according to the website of Stryker, the Michigan-based company that makes it, was a “Large Bone, Battery Powered, Heavy Duty Sternum Saw,” which “has increased cutting speed for a more aggressive cut.” And then my heart had been stopped and machines turned on to keep my lungs and brain going. It’s about the fear of a simple cough. The worst, though routine, thing that can happen in the days following surgery like mine, I found out, was to cough. Coughing was torture because of how it assaulted my chest wounds. I developed a cough that was so painful, I blacked out. Not for a long time; there was a two-two count on Derek Jeter just before one of the episodes, and when I came to, Jeter was about to take ball four. However, because I could feel it coming but could do nothing about it, it was terrifying to me and to my wife and kids, who watched me seize up and pass out more than once. In that moment of terror, I was anything but the wellinformed, tough customer with lots of options that a robust free market counts on. I was a puddle. There were occasions during those eight days in the hospital when the non-drug-addled part of my brain wondered, when nurses came in for a blood test twice a day, whether one test was enough and what the chargemaster cost for both was going to look like. But most of the time the other part of my brain took over, the part that remembered my terror during those blackouts and the overriding fear, reprised in dreams that persisted for weeks, that lingered in someone whose chest had been

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time January 19, 2015

There are 31.5 MRI machines per 1 million people in the U.S. There are 5.9 per 1 million in the U.K.

sawed open and whose heart had been stopped. As far as I was concerned, they could have tested my blood 10 times a day if they thought that was best. They could have paid as much as they wanted to that nurse’s aide with the scale or to the woman who flawlessly, without even a sting, took my blood. The doctor who had given me an angiogram the afternoon before the surgery and then came in the following week to check on me became just a nice guy who cared, not someone who might be trying to add on an extra consult bill. In the days that I was on my back, to have asked that nurse how much this or that test was going to cost, let alone to have grilled my surgeon—a guy I had researched and found was the master of aortic aneurysms—about what he was going to charge, seemed beside the point. It was like asking Mrs. Lincoln what she had thought of the play. When you’re staring up at someone from the gurney, you have no inclination to be a savvy consumer. You have no power. Only hope. And relief and appreciation when things turn out right. And you certainly don’t want politicians messing around with some cost-cutting schemes that might interfere with that result. That is what makes health care and dealing with health care costs so different, so hard. The Obamacare story is so full of twists and turns—so dramatic—because the politics are so treacherous. People care about their health a lot more than they care about health care policies or economics. That’s what I learned the night I was terrified by my own heartbeat and in the days after when I would have paid anything for a cough suppressant to avoid those blackouts. It’s not that this makes prices and policies allowing— indeed, encouraging—runaway costs unimportant. Hardly. My time on the gurney notwithstanding, I believe everything I have written and will continue to write about the toxicity of our profiteer-dominated health care system. But now I also understand, firsthand, the meaning of what the caregivers who work in that system do every day. They achieve amazing things, and when it’s your life or your child’s life or your mother’s life on the receiving end of those amazing things, there is no such thing as a runaway cost. You’ll pay anything, and if you don’t have the money, you’ll borrow at any mortgage rate or from any payday lender to come up with the cash. Most of the politicians, lobbyists, congressional staffers and others who collectively wrote the story of Obamacare had some kind of experience like that, either directly or vicariously through a friend or loved one. Who hasn’t? The staffer who was more personally responsible than anyone else for the drafting of what became Obamacare had a mother who, in the year before the staffer wrote that draft, had to take an $8.50-an-hour job as a night-shift gate agent at the Las Vegas airport. She worked every night, not because she needed the $8.50—her semiretired husband was himself a doctor—but because a pre-existing condition precluded her from buying health insurance on the individual market. That meant she needed a job, any job, with a large employer. Her daughter’s draft of the new law prohibited insurers from stopping people with pre-existing conditions from buying insurance on the individual market. And then there was Senator Edward Kennedy, for 50 years the champion of extending health care to all Americans. Be-

yond his brothers’ tragic visits to two hospital emergency rooms, Ted Kennedy’s firsthand experience with health care began with a sister’s severe mental disabilities, was extended by a three-month stay in a western Massachusetts hospital following a near fatal 1964 plane crash and continued through his son’s long battle with cancer. Everyone involved in the writing of the Affordable Care Act similarly saw and understood health care as an issue that was more personal and more emotionally charged than any other. Accordingly, they struggled with one core question: How do you pay for giving millions of new customers the means to participate in a marketplace with inflated prices— customers with a damn-the-torpedoes attitude about those prices when they’re looking up from the gurney? Is that possible? Must the marketplace be tamed or tossed aside? Or must costs be pushed aside, to be dealt with another day? Even the seemingly coldest fish among politicians—the cerebral, “no drama” Barack Obama—drew on his encounters with people who desperately needed health care to frame, and ultimately fuel, his push for a plan. “Everywhere I went on that first campaign, I heard directly from Americans about what a broken health care system meant to them—the bankruptcies, putting off care until it was too late, not being able to get coverage because of a pre-existing condition,” Obama would later tell me. should we be embarrassed and maybe even enraged that, as my book chronicles, the only way Obama ended up being able to reform health care was by making backroom deals with the industry interests who wanted to make sure that reform didn’t interfere with their profiteering? Of course. We’ll be paying the bill for that forever. But should we blame Obama for making those deals? I don’t think so. Obamacare gave millions of Americans access to affordable health care, or at least protection against being unable to pay for a catastrophic illness or being bankrupted by the bills. Now everyone has access to insurance and subsidies to help pay for it. That is a milestone toward erasing a national disgrace. But the new law hasn’t come close to making health-insurance premiums and out-of-pocket costs low enough so that health care is truly affordable to everyone, let alone affordable to the degree that it is in every other developed nation. Worse, it did little beyond some pilot projects and new regulations to make health care affordable for the country. Instead, it provided massive government subsidies so that more people could buy health care at the same inflated prices that so threaten the U.S. Treasury and our global competitiveness. The Obama Administration trumpeted Obamacare as a modern innovation that would force another hidebound industry to be more competitive. expedia for health insurance was a winning political bumper sticker in an age when even Democrats were wary of being accused of anything that could be labeled as income redistribution. But the real bumper sticker might have read money for the poor and middle class so they can get insurance to buy the same product everyone else does at the same price that makes everyone in the health care industry so rich.

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2. How To Fix It: Let the Foxes Run the Henhouse is there something we can now do to fix that ? how can we go beyond Obamacare? That’s the puzzle I was struggling with before my operation, so when I was able to move around afterward, I went back to New York–Presbyterian to talk to its top executives. We discussed the aggressive chargemaster bills I had gotten following my surgery—totaling more than $190,000—and the fact that the hospital’s brand name was so strong, it had to offer only a 12% discount off those exorbitant prices ($451 for each of the eight times a portable X-ray machine took a picture of my battered chest) to my insurer, UnitedHealthcare. I then discovered that for massive hospital systems like New York–Presbyterian—a product of the merger of New York City’s two most prestigious hospitals—this kind of leverage over even the largest insurers, like United, was not unusual. But we also talked about how the kind of care I received wasn’t an accident. For example, only a third of CEO Corwin’s annual bonus (which accounts for about half his annual pay) is based on the hospital’s ﬁnancial results. The rest is based on an elaborate patient-satisfaction survey and an even more elaborate set of metrics related to patient care. It was then that my idea for how to ﬁx Obamacare and American health care gelled: Let these guys loose. Give the most ambitious, expansion-minded foxes responsible for the chargemaster but also responsible for providing stellar care of the kind Corwin gave me even more free rein to run the henhouse—but with conditions that would cut costs and, in fact, kill the chargemaster. Several months before, I had begun toying with the same thought after encountering other leaders of high-quality hospital systems who were fast expanding their footprints and in the process gaining leverage over insurers. At one event, I had been intrigued by Delos “Toby” Cosgrove, CEO of the Cleveland Clinic, a vast network of hospitals, clinics and doctors’ practices that dominated northeast Ohio and had such a good reputation that patients traveled there from all over the world. Cosgrove, a celebrated heart surgeon, had built the Cleveland Clinic’s heart program into one of the world’s best. He was also regarded as one of the savviest hospital executives in the world, widely admired for the way he ran what he had propelled into a $6 billion, 75-facility enterprise. I had watched Cosgrove blanch while participating in a program about health care reform when another panelist implied that he dominated his market. “Not possible,” he said. “If we expand too much, the FTC will be all over us.” Should the Federal Trade Commission really want to stop a guy like Cosgrove from dominating health care in Cleveland? I wondered. But then I remembered Jeffrey Romoff, CEO of the University of Pittsburgh Medical Center (UPMC), who had long been enmeshed in litigation over whether he had conspired to control his market. By buying up doctors’ practices, clinics and other hospitals, Romoff truly did dominate health care in and around Pittsburgh. Furthermore, he once told me that he saw any attempts to hold him back as “impediments” he needed to overcome. 40

By now, UPMC had settled litigation with, and was about to complete a divorce from, Highmark Insurance—the Blue Cross Blue Shield company it had been accused of conspiring with to control the provider and insurance markets, respectively, in western Pennsylvania. Through 2014, UPMC was filling the Pittsburgh area airwaves and every billboard not already taken by Highmark with touts for its own insurance company as the one that patients could use to get full access to its facilities—because, beginning in 2015, UPMC would no longer recognize Highmark insurance. At the same time, Romoff was fighting a lawsuit from the city of Pittsburgh that might have embarrassed other hospital executives. The city charged that UPMC’s prices and profits were so high and its salaries, including Romoff’s—which by then was more than $5 million— were so exorbitant that it did not deserve nonprofit taxexempt status and should therefore be subject to the city’s payroll tax. That would mean a lot to Pittsburgh, because UPMC was the biggest nongovernment employer in Pennsylvania. UPMC’s first defense was that it didn’t have any employees; only its subsidiaries did. By the summer of 2014, a state judge would agree. He dismissed the case, though the city would be allowed to file the same action against the various subsidiary hospitals. Nonetheless, the suit highlighted UPMC’s status as perhaps the world’s most tough-minded, profit-oriented nonprofit. So to put it charitably, Romoff, who is not a doctor, didn’t seem to be the kind of hospital leader that Corwin or Cosgrove was. Yet it was when I went to see Romoff (once I was able to travel) that the idea I had begun playing with after those talks with Corwin and other hospital leaders became fully formed. Sitting in front of a window in his suite atop the U.S. Steel Tower, overlooking his city’s football and baseball stadiums, Romoff laid out a vision for health care that put it all together for me. We spent much of the time talking about his UPMC insurance company and its competition with Highmark. By then, Highmark’s insurance market share in the Pittsburgh region had shrunk from 65% to 45%. Romoff calculated that with all the business he was taking away with his own insurance company, plus the inroads made by other insurers with whom he had signed network deals, Highmark’s share would be 25% by the end of 2014 and still sinking. He expected that his insurance company would end up the leader in the market—and he was going to do everything he could to get to 100%. Would he be worried about being so successful that he would drive out all the other insurance companies? I asked. “Of the things that keep me up at night, that is not one of them,” Romoff answered with a smile. He was unabashedly trying to become the dominant insurer. And he was already by far the dominant provider through his 20 hospitals and hundreds of clinics, labs and doctors’ practices. In other words, like the Geisinger Health System in Pennsylvania, only on a much larger scale and with little

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Photograph by Peter Larson for TIME

The UPMC System Romoffâ&#x20AC;&#x2122;s UPMC is now touting its own insurance company, creating a system of health care without a middleman

Jeffrey Romoff The University of Pittsburgh Medical Center CEO bought practices, clinics and other hospitals to dominate health care in Pittsburgh

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NATION | HEALTH CARE

competition in the market, Romoff could sell me health insurance, which would cover me when I used Romoff’s hospitals, clinics, doctors and labs.

there would be no middleman. no third-party insurance company. To me this was a hugely appealing idea, despite UPMC’s record of high prices and its take-no-prisoners approach to competition. Why? Because it was the structure that made sense, not the particulars of Romoff and UPMC. The insurance company would have not only every incentive to control the doctors’ and hospitals’ costs but also the means to do so. It would be under the same roof, controlled by Romoff. Conversely, the hospitals and doctors would have no incentive to inflate costs or overtreat, because their ultimate boss, Romoff, would get the bill when those extra costs hit his insurance company. As Romoff put it, “All the incentives are aligned the right way. It’s the beauty of being the payer and provider at the same time. The alignments of interest are just so pure.” “When the incentives are not aligned,” he added, supplying a quote that could easily be read the wrong way, “it’s why seniors dying of cancer get chemo when they should just get hospice care.” Maybe, but how could we know that those cancer patients—who would have no place to go in and around Pittsburgh except to UPMC if Romoff had anything to say about it—wouldn’t be denied chemotherapy that they actually needed if Romoff-employed doctors were the ones holding the prescription pads? Wasn’t Romoff’s interest the one that was the most purely aligned of all? That’s where doctor-leaders like Corwin and Cosgrove come in—along with strong oversight and regulation. Hospitals are already consolidating. It is happening all over the country, including in Corwin’s New York City and Cosgrove’s Cleveland. Let’s let them continue. More important, as they continue, let’s encourage them to become their own insurance companies, à la Romoff, so they can cut out the middleman and align those incentives. Let’s harness their ambition to expand, rather than try to figure how and when to contain their ambition. Why shouldn’t I be able to buy Cosgrove’s Cleveland Clinic health insurance? What a great brand! I would know that I could use all his facilities and doctors, and he would know that his incentive—which, he says, has always been the same—was to provide good care, not expensive care full of unnecessary and overpriced CT scans and blood tests. And I would know that doctors whom I could hold accountable would determine the nature of that care, not insurance companies. But let’s ensure that accountability by insisting on tight regulation, mostly through the smarter use of federal antitrust law and state regulatory authority, in return for giving doctor-leaders the freedom to expand and also the freedom to become their patients’ insurance companies. The first regulation would require that any market have at least two of these big, fully integrated provider–insurance 42

Cutting out middleman insurance companies would cut administrative costs, which now account for 15% to 20% of private health care costs

3. Cutting Out the Middleman

company players. There could be no monopolies, only oligopolies, as antitrust lawyers would call them. The larger markets, such as New York City, Los Angeles and Chicago, might have to have four, five or even more players to make the competition real and to make sure that, with accompanying regulatory requirements, their footprints were big enough and their marketing plans robust enough to serve patients throughout their regions, not just in the wealthier areas. That would mean the hospital and all the doctors it controlled would be subject to pricing and service-delivery standards that liberal reformers have sought since the mid– 20th century. Health care in the U.S. would finally be treated as a public good, not a free-market product. However, the change would have come jujitsu-style, not by a government takeover. It would have come because the private players had driven it to that state. These fully integrated brands could pursue recent innovations that offer less expensive, more consumer-friendly health care, such as storefront urgent-care centers that are smart alternatives to expensive, time-wasting hospital emergency rooms. These urgent-care centers are now being opened piecemeal by for-profit and often lightly regulated companies. Why not put them under the banner and branded accountability of the big hospital systems? In fact, Cosgrove’s Cleveland Clinic has already opened a dozen urgent-care and express-care (for more routine needs) centers. I’d rather pay him to care for me than pay a walk-in center owned by a private-equity fund. The second regulation would cap the operating profits of what would be these now-allowed dominant market players, or oligopolies, at, say, 8% a year, compared with the current average of about 12%. That would force prices down. Better yet, an excess-profits pool would be created. Those making higher profits would have to contribute the difference to struggling hospitals in small markets. A third regulation—which, again, the hospital systems would have to agree to in return for their being allowed to achieve oligopoly or even monopoly status—would prevent hospital finance people from playing games with that profit limit by raising salaries and bonuses for themselves and their colleagues (thereby raising costs and lowering profits). There would be a cap on the total salary and bonus paid to any hospital employee who did not practice medicine full time of 60 times the amount paid to the lowest salaried full-time doctor, typically a first-year resident. (Under that formula, Corwin’s and Cosgrove’s salaries would stay about the same but Romoff in Pittsburgh would take a big cut.) A fourth regulation would require a streamlined appeals process, staffed by advocates and ombudsmen, for patients who believed they were denied adequate care or for doctors who claimed they were being unduly pressured to skimp on care. A fifth regulation would require that any governmentsanctioned, oligopoly-designated integrated system have as its actual chief executive (not just in title) a licensed physician who had practiced medicine for a minimum number of years. Sorry, Mr. Romoff. The culture of these organizations needs to be ensured, even if that means choosing leaders based on something in addition to their business acumen and stated good intentions.

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Sixth, any sanctioned integrated oligopoly provider would be required to insure a certain percentage of Medicaid patients at a stipulated discount. Wait a minute, I can hear my readers thinking. These guys generate thousands of those obscene chargemaster bills a year. Now you’re going to put them in charge? Which brings me to my final regulation: These regulated oligopolies would be required to charge uninsured patients no more than what they would charge competing insurance companies whose insurance they accepted, or else a price based on their regulated profit margin if they didn’t accept other insurance. In other words, no more chargemaster. All of this may seem complicated, but the rules required to set up this structure would be a drop in the bucket compared with the thousands of pages of laws and millions of pages of rules and regulations that are now on the books. And it is certainly more realistic than pining for a public single-payer system that is never going to happen. Combining the work that the Corwins and Cosgroves of the world do with Romoff’s plan boils down to this: Allow doctor-leaders to create great brands that both insure consumers for their medical costs and provide medical care. Let them act on their ambitions. Let them compete with other legitimate players in their markets, or even with one another if they want to expand. That kind of competition is already happening. But as things stand now, an employer who wants to get health care for his workers, or an individual who is shopping on the Obamacare exchanges, has to figure out which insurance company has which hospitals and doctors in its network and what discounts it has negotiated. This change would create a new, clearer competitive process. Instead of hoping for the best with UnitedHealthcare, I could just go on the exchange and pay Corwin to use all of his New York–Presbyterian doctors and facilities to keep me healthy. Period. Full stop. There would be total clarity about which facilities and doctors are in my network. Or my employer could pay him after negotiating the price. It would be insurance the way it’s supposed to work— the risk associated with the cost of my heart surgery would be spread across a pool of premiums that Corwin collected from tens or hundreds of thousands of New Yorkers, most of whom won’t have the kind of medical mishap I had. If Corwin and his integrated system charged too much or didn’t do a good job, either my employer or I (if I were in the individual market) could switch to another competitive New York City brand like Mount Sinai Hospital or NYU Langone Medical Center. And all that competition would be fortified by advances in data transparency that would make each competitor’s quality ratings for various types of care readily available. Corwin’s high price for my open-heart surgery would truly be tested in the market, because he would be competing with other high-quality health systems to capture all of my business or my employer’s business. He and his network of hospitals, clinics and doctors would insure me not only against heart surgery but for routine treatment and X-rays in case I twisted my ankle or got the flu. time January 19, 2015

4. Hundreds of Billions in Savings i bet that with this plan, we could cut 20% off the two-thirds of our health care bill not paid by Medicare or Medicaid. Here’s a sketch of how the math could work: First, administrative costs for insurance—including vetting claims, paying bills, paying managers and executives and distributing profits to shareholders—account for 15% to 20% of private health care costs. Couldn’t half or more be saved by cutting out middleman insurance companies? Corwin or Cosgrove would still have to employ managers, actuaries, accountants and salespeople on the insurance side of their integrated operations, but surely not to the extent that an insurance company responsible for paying bills from multiple third-party hospitals and other providers would. Nor would they have to deliver profits to shareholders. Let’s say we could save 10% by eliminating middlemen. Second, on the provider side of the equation, the main culprit in driving costs up—the incentive for overtreating and overtesting that comes with billing for each patient encounter and procedure instead of billing for overall treatment—would be eliminated. And the general incentive to maximize revenue would be tamped down by the new regulation capping operating profit at 8%. That could likely save another 10%. The total, then, could be 20% of nongovernment health care costs, or $400 billion a year, and maybe $100 billion more saved by allowing Medicare and Medicaid to pay those integrated providers this way. That would go a long way toward bringing American health care costs as a percent of our gross domestic product closer to those of the countries we compete with. One of Corwin’s competitors, the giant North Shore–LIJ Health System, is now selling its own insurance. Corwin told me that although he is more comfortable being on the provider side of the street, he would consider doing the same if he thought his hospital system were big enough to provide that full spectrum of quality care and if he needed to do it in order to be competitive. “The first thing we can agree on about the health care system in the United States,” the Cleveland Clinic’s Cosgrove said, “is that it is not a system at all. It’s just a collection of disparate providers. So, yes, we are consolidating,” he continued, noting that although the number of hospital beds in the U.S. had declined in recent years from 1 million to 800,000, “there is still only 65% occupancy.” Doctors, said Cosgrove, have consolidated their practices, often under the umbrella of hospital systems like his, “because medical knowledge doubles every two years. So you continually need to specialize still more to keep up. And the more you consolidate, the more you can specialize. The more you specialize and do a lot of just one or two things, the better you are at them and the more cost-effective you are. That’s why they call it ‘practicing’ medicine.” Would integrating insurance into that system be the next logical step beyond consolidation? “That seems right,” Cosgrove said. In fact, he added, “we recently applied for an insurance license.” The momentum for the consolidation I have in mind is clearly there. We just need to seize it rather than resist it, and then control it and push it in the right direction. ■

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WORLD

THE PATH TO PEACE Chaos in the Middle East is sowing the seeds for an unlikely alliance between Israel and the Arab states BY JOE KLEIN

Out of ashes A Palestinian man

prays in a Gaza neighborhood destroyed during the war last year between Hamas and Israel

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Photograph by Peter van Agtmael for TIME

WORLD | MIDDLE EAST

Armed and anonymous A Hizballah ﬁghter, left, in Beirut. An image of ISIS militants in Syria, right, that was put on an extremist site

Brotherhood leaders in 2013. (Al-Sisi won a largely uncontested presidential election last year.) But these are not sentiments that have often been uttered publicly by Arab leaders before. And then, the very next day, the Times of Israel reported that Israeli Foreign Minister Avigdor Lieberman and exiled Palestinian leader Mohammed Dahlan had met privately in Paris. Dahlan has made no secret of his desire to replace Palestinian Authority President Mahmoud Abbas; Lieberman is a conservative who has fallen out with Netanyahu and wants to be part of a coalition to replace him. So what on earth were Dahlan and Lieberman talking about? All of this may add up to nothing. But there seems to be a growing impatience with the perpetual status quo in the region. There is a new generation of leaders pushing for power in Israel and Palestine. There are dangerous new threats like ISIS. There is concern about the U.S.—the possibility of a nuclear deal with Iran, the waning need for Middle East oil. There is the memory of the Arab Spring, which ultimately produced chaos instead of democracy.

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The established powers in the region, like Israel, Saudi Arabia and Egypt, have found in recent years that they have increasingly aligned foreign policy interests. The Israelis and Saudis have been sharing intelligence for the past few years, according to regional sources. The Israelis and Egyptians are cooperating on security efforts in Sinai and in Gaza, where Hamas— the Palestinian branch of the Muslim Brotherhood—is a common enemy. There are private talks going on between Israeli and Saudi Arabian ofﬁcials. “It might be called mushroom diplomacy,” an Israeli told me. “It can only grow in the dark.” Most Israeli and Arab officials I spoke with during a December tour of the region acknowledge the mushrooms and hope that the burgeoning relationships—especially the acceptance of Israel as a de facto ally—can be brought to light in time. There are, of course, all the usual roadblocks, including the eternal one: nothing can happen publicly without an Israeli-Palestinian peace settlement. The Saudis and the Arab League promised to recognize Israel in 2002 if such a deal were made, but the Arab terms—a return to 1967 borders, with Palestinians’ right of return to their former lands in Israel— were unacceptable to the Israelis. Now those terms may be changing. Prince

P R E V I O U S PA G E S : M A G N U M P H O T O S; T H E S E PA G E S , F R O M L E F T: M O I S E S S A M A N — M A G N U M P H O T O S; A P

n may 26, 2014, an unprecedented public conversation took place in Brussels. Two former high-ranking spymasters of Israel and Saudi Arabia—Amos Yadlin and Prince Turki al-Faisal—sat together for more than an hour, talking regional politics in a conversation moderated by the Washington Post’s David Ignatius. They disagreed on some things, like the exact nature of an Israel-Palestine peace settlement, and agreed on others: the severity of the Iranian nuclear threat, the need to support the new military government in Egypt, the demand for concerted international action in Syria. The most striking statement came from Prince Turki. He said the Arabs had “crossed the Rubicon” and “don’t want to fight Israel anymore.” The Turki-Yadlin dialogue was not “official,” but it sent a clear message. Saudi Arabia’s King Abdullah had personally approved the meeting, intending it as an olive branch to the Israelis. But Israeli Prime Minister Benjamin Netanyahu decided not to reciprocate—at least not openly. It was too dangerous politically. Crucial components of Netanyahu’s coalition, especially his supporters among right-wing Jewish settlers in the West Bank, oppose any deal with Palestinians. And yet, in the months after he decided against a public gesture to the Saudis, Netanyahu was suggesting at private meals with editors and influential figures at the U.N. General Assembly meetings last September that an alliance with the Arabs was not only possible but perhaps the best way to resolve the Palestinian problem. Other odd things have been happening recently in the gridlocked Middle East. On New Year’s Day, Egyptian President Abdul Fattah al-Sisi made an interesting speech, challenging Islamic radicalism and calling for a Muslim reformation. “It’s inconceivable that the thinking that we hold most sacred,” he said, “should cause the entire umma [Islamic world] to be a source of anxiety, danger, killing and destruction for the rest of the world. Impossible!” The sentiments were not unexpected, since al-Sisi had come to power by overthrowing the country’s democratically elected Muslim

Turki described the proposal as a “framework,” which implies room to maneuver. Is it possible that the Middle East has become so unstable that an Arab-Israeli peace is no longer unthinkable? The ISIS Effect as 2015 begins, the middle east seems to be a greater mess than it ever was— especially when it comes to the conﬂict between Israel and the Palestinians. The deterioration began with Israel’s 50-day war in Gaza last summer, which increased the popularity of Hamas in the West Bank and has led Abbas to take a series of steps toward the unilateral declaration of Palestinian statehood. In recent weeks, the Palestinian Authority applied for membership in the International Criminal Court—a red ﬂag to the Israelis because the Palestinians would presumably use membership to bring war-crimes charges against Israel. In return, the Israelis have cut off the monthly payment of taxes they collect for the PA, which represent almost 80% of the government’s $160 million monthly budget. It is possible that the Palestinians could retaliate by suspending government operations in the West Bank—schools, health care and, especially, security. Chaos would be the likely result. time January 19, 2015

In the rest of the region, the sectarian split between Sunni and Shi‘ite has become more dangerous, even as it has become more confusing. The Sunni Arab nations—which include Saudi Arabia, Egypt, Jordan and the Gulf states—have worried for a decade that the U.S. demolition of Saddam Hussein’s ugly but stable dictatorship in Iraq has created a power vacuum in a broad swath of the region that the Iranians are exploiting. They call it the “Shi‘ite crescent,” a sphere of inﬂuence stretching from Hizballah-controlled southern Lebanon and President Bashar Assad’s Alawite regime in Syria, to Iraq and Iran, right up to the border of the Eastern province of Saudi Arabia, a majorityShi‘ite area where most of the country’s oil is produced. But the old Sunni-Shi‘ite conﬂict has been complicated by a new threat in the region: ISIS, a Sunni radical military force vastly more competent and frightening than al-Qaeda. ISIS began in Iraq but made its mark in the rebellion against Assad’s government in Syria. Assad isn’t well liked by his Sunni neighbors—and some of them, like Qatar and perhaps private sources in Saudi Arabia, gave surreptitious support to ISIS and other Sunni militias in the early days of the rebellion. The lightning march ISIS made

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through Iraq last year changed the equation. An ISIS-controlled Iraq would be a threat not only to Iran but also to some of the Sunni royal families in the region, as well as Egypt. The Jordanians—already overwhelmed by refugees from Iraq, Syria and Palestine—are vulnerable. The Saudis, governed by an increasingly feeble gerontocracy—the 90-year-old Abdullah was hospitalized with pneumonia at the start of the new year—are worried too. The Egyptians are fighting ISIS-style terrorists in Sinai and are threatened by Libyan militias, which may also be loosely affiliated with ISIS. In response, a heterodox alliance has gathered to make war with ISIS. Iranianbacked militias, like Hizballah, are the most ardent fighters in this war, along with the Kurds. But they are now joined by U.S. airpower—as well as pilots from Sunni powers like Saudi Arabia and Jordan. Another potentially major change in the region: the Israelis, Iranians, Saudis and Egyptians are increasingly concerned about Turkey, which sees the ISIS threat somewhat differently from its neighbors. Turkey has allegedly allowed thousands of militants to cross its border and join ISIS because the group is fighting Assad and militant Kurdish groups like the Kurdistan Workers’ Party (PKK), which the Turks see as a permanent threat in the south and east of their country. (Turkey has acknowledged that its border with Syria is porous but has denied accusations that it purposefully allows militants to cross.) “Why aren’t you Americans making more of a fuss about Turkey’s support for ISIS?” a prominent Egyptian official asked me. “I read a lot more about our humanitarian problems in the American press than I do about the Turks who are allowing terrorists to cross their border and behead Americans.” Of course, the “humanitarian problems” in Egypt are very real, as al-Sisi’s forces have led a brutal suppression of the Muslim Brotherhood. But the Egyptians have become sensitive to the point of paranoia about the changing U.S. role in the region. I had dinner in Cairo with a group of prominent leaders. One of them, a banker, asked seriously, “Is it true that there is a secret alliance between Obama and the 47

WORLD | MIDDLE EAST

Muslim Brotherhood to destabilize the existing Sunni governments in the region?” I started to laugh, but none of the Egyptians at the table were smiling. They didn’t buy the banker’s conspiracy theory, but they laid out an array of charges, ranging from the (pre-Obama) Iraq invasion to the President’s support for the overthrow of former President Hosni Mubarak to the Administration’s recent slow walk of military supplies, especially spare parts, to the al-Sisi government. “Doesn’t he want us to be fighting ISIS in Sinai?” asked the banker. The Obama Administration maintains that all al-Sisi has to do is free some political prisoners—especially those who are American and three jailed journalists from al-Jazeera who were accused, implausibly, of joining a terrorist group and broadcasting “false news”—and the military support will flow again. The Administration argues that its overall policy—steering clear of neocolonial adventurism like the 2003 invasion of Iraq and working to bring Iran back into the international community—has been more effective than George W. Bush’s neoconservatism. Obama aides also point out that there are two U.S. naval ﬂeets in the region, plus U.S. bases in Qatar, Abu Dhabi and Djibouti. “Does that sound like disengagement?” one of them asked me. “We’re not going anywhere.” From Washington, the region seems a jigsaw puzzle ruled by anarchic moving pieces—a disproportionate source of concern that leaches attention from growing problems in Russia and East Asia. From Cairo and Riyadh and Jerusalem, though, the U.S. seems a ﬁckle ally that can’t decide whether its policy is to support stability or the naive hope for democracy in a region that isn’t ready for it. The modern Middle East was stabilized, in a toxic but effective way, by the Cold War, when partnership with superpowers provided security and economic aid. In the 21st century, the USSR is gone and the U.S. no longer has the incentive, or the money, to lavish vast aid packages on local clients. But the nations of the Middle East have been unable to wean themselves from their dependency on outside forces. “Whenever we’re in trouble we dial 911,” 48

an Arab diplomat told me. “But it is illogical to think the U.S. was created to protect the Sunnis.” With few other options, the Arabs have returned to an old idea, which was mostly bluster in the past—that they must unite to protect themselves. And any serious conversation about security and economic development has to include the one nation in the region that has succeeded at both: Israel. There is no love for the Israelis, but there is respect. And so there is a hope—a conversation that is occurring across the Arab states—that perhaps the only alternative is to bank on the regional forces of stability to create a security alliance against the extremist threat of both Shi‘ite and Sunni militias. Even if that means partnering with Israel. Strange Bedfellows is such an alliance even vaguely possible? History says no, vehemently. But in the days before Netanyahu’s government collapsed in December, Israeli intelligence sources—usually the most skeptical people in the country—were allowing tiny shreds of hope to creep into their calculations. The common security interests with the Arabs were compelling, several of them told me, and might lead to new arrangements in the region. It was not impossible that the Arabs could help broker a peace deal with the Palestinians. The Egyptians could help provide security; the Saudis and Gulf states could provide funds for Palestinian economic development. For that to happen, though, Israel would need to make changes of its own. “These governments can’t be seen to be cooperating with Israel as long as there isn’t a deal with the Palestinians,” said one intelligence expert, who spoke on the condition of anonymity. “ISIS can turn the Arab street, especially their young people, against them. It’s bad enough that [the U.S.] is dropping bombs on Sunnis in Iraq and Syria. That strengthens [ISIS] on the street as well.” At the heart of this conundrum stands Benjamin Netanyahu. The Israeli Prime Minister may have been selling an alliance with the Arabs in New York, but he’s been selling intransigence back home. That includes a new law that would make

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Israel a “Jewish” state—with the implication of second-class citizenship for its 1.7 million Arab citizens. His insistence on pushing that law resulted in the collapse of his government, as moderate parties led by Tzipi Livni and Yair Lapid refused to support the legislation. Netanyahu is no longer very popular in Israel, but no one is betting against him in the March election. Given his political skills, the absence of a charismatic mainstream challenger and the steady tattoo of terrorist incidents—stabbings, shootings, cars running over pedestrians—most observers assume that Netanyahu will prevail somehow, though he might even struggle to maintain control of his Likud Party. The rising tide seems to be with the settler-movement leader Naftali Bennett, whose party might well outpoll Likud in March. It is also possible that the moderate-liberal coalition of the Labor Party and the splinter party of Livni’s supporters will challenge Likud for ﬁrst place in the March election and the right to attempt to form a government of its own. The real negotiations begin after the election. Netanyahu will try again to cobble together a centrist coalition. The big question is whether he will have to include Bennett in a government; if so, there will be no hope of Israel’s negotiating a deal with the Palestinians—and no hope of closer public ties with its Sunni Arab neighbors. But there are other possibilities as well. If Labor-Livni polls strongly and is joined by Lapid’s centrist party, they may ﬁnd a partner in Avigdor Lieberman. The Foreign Minister and leader of the Israel Beitenu party ran a crass, anti-Arab campaign last time. “But Lieberman plays a different game inside the government than he does outside,” says Shai Feldman, director of Brandeis University’s Crown Center for Middle East Studies. “As Foreign Minister, he’s had to deal with the leaders of other countries. He’s more of a realist now.” But he’s also less of a political force, as recent polls show support for his party waning dramatically because of renewed corruption charges against Lieberman. “It is absolutely impossible to predict how this election is going to turn out,” Feldman says. time January 19, 2015

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WORLD | MIDDLE EAST

The last stand Kurds in Turkey watch air

strikes in Kobani. The Syrian town is a symbol of Kurdish resistance against ISIS

an alliance with a Palestinian leader currently sitting in an Israeli prison. Marwan Barghouti, 55, is considered a folk hero by both Hamas and Fatah. He was a prominent leader of the ﬁrst and second intifadehs before he was arrested by the Israelis in 2002 and sentenced to ﬁve continuous life terms for murder. Barghouti’s wife has already announced her support for a movement to draft him for President. Dahlan’s vision is that Barghouti would be the titular head of the PA from inside prison and Dahlan himself would be the handson guy, running the show from Ramallah, while former Palestinian Prime Minister Salam Fayyad, widely considered Palestine’s most effective bureaucrat, would administer the West Bank. Netanyahu has long lamented the fact that he doesn’t have a “strong” partner on the Palestinian side. Abbas has never had the support among his people to cut a deal, and his predecessor Arafat had little desire to do so. But a government led by Barghouti or Dahlan could hardly be considered weak, and a Barghouti-Dahlan coalition would be formidable. The question of what to do with Barghouti—whether

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time January 19, 2015

P E T E R VA N A G T M A E L— M A G N U M P H O T O S

The New Generation netanyahu has been at the center of Israeli politics for nearly 25 years. Abbas has been a force in Palestinian politics even longer. But a new generation of leaders is rising, which is why the LiebermanDahlan meeting in Paris was noteworthy, at the very least. One thing the two men have in common, despite their wildly divergent politics, is that both believe the Netanyahu-Abbas era is coming to a close. Dahlan is perhaps the most skilled of the next generation of Palestinian leaders, although he developed a well-deserved reputation as a thug when he led the Palestinian security services in Gaza. He is a young-looking 53, a protégé of Yasser Arafat’s and a native Gazan. He’s also the sworn enemy of Abbas, who accused Dahlan of corruption and convicted him in a show trial; Dahlan has been living in Abu Dhabi since 2011. He has already announced that he will run for President of the PA against Abbas—who is supremely unpopular—should Abbas ever call the Palestinian election that has been long delayed. But Dahlan’s strategy is more expansive than a one-on-one ﬁght with Abbas. His hope is to create a new coalition that would appeal to people across the Palestinian political spectrum, from Hamas to Fatah. How could he manage that? By forming

to release him or not—has been discussed by Netanyahu’s inner circle. At this point, Barghouti’s political views are a mystery; he has been described as “Mandela-esque” and utterly unrepentant. Dahlan has been meeting with Arab leaders across the region. He is close to Sheikh Mohamed bin Zayed Al Nahyan, the crown prince of Abu Dhabi, and also to Egypt’s al-Sisi. His aspirations parallel Netanyahu’s: that the Arab states could be brought into the talks as intermediaries. Dahlan hopes the Arabs will nudge the Israelis to make concessions; Netanyahu hopes that the Arabs will nudge the Palestinians to make concessions. But the bottom line is the same: visions of commercial cooperation that transforms ports in Gaza and Haifa into Middle Eastern Singapores; visions of a security alliance strong enough to fend off Islamic radicalism, both Shi‘ite and Sunni. The only thing preventing all this is what usually gets in the way in the Middle East—reality. Here is what might also happen in 2015: Israel might elect a rightwing government that wants nothing to do with the Arabs. The West Bank may fall into chaos as the PA struggles without the funds necessary to keep its security forces in operation. The U.S. might make a nuclear deal with Iran, with unforeseen consequences for the region. The U.S. might not make a nuclear deal with Iran, with unforeseen consequences for the region. King Abdullah might pass away in Saudi Arabia. The moderate Jordanian government might be overwhelmed by the tide of Syrian, Iraqi and Palestinian refugees. Bashar Assad might fall, or survive, with consequences for the Kurds, the Turks and the Lebanese. Libyan militias might find common cause with ISIS. The rickety new government in Iraq might collapse. Any of these events is more likely to occur than a peace deal between the Israelis and Palestinians, brokered by the Arabs. But the fact that the conversation is taking place—between Prince Turki and Amos Yadlin, between Mohammed Dahlan and Avigdor Lieberman, secretly at the U.N. and in capitals across the region—means that peace, the most unlikely Middle East ■ result, is no longer off the table.

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On the march

Director Ava DuVernay and actor David Oyelowo, photographed in New York City

Photograph by Peter Hapak for TIME

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CULTURE

A vivid new ﬁlm about Martin Luther King Jr. couldn’t come at a better time

MAKING

SELMA HISTORY BY DA N IEL D ’A DDA R IO

the most surprising thing about the history of Hollywood and Martin Luther King Jr. is that there isn’t one. There are no good King movies. There are no bad King movies. There are simply a handful of cameos in biopics about other people, such as Ali and Lee Daniels’ The Butler. Nearly 50 years after King’s death in 1968, Selma—which was released in selected cities Dec. 25 and opens nationwide on Jan. 9—is the ﬁrst full-length ﬁlm to take a deep look at King or make him the main character. Directed by Ava DuVernay and starring David Oyelowo, it examines a pivotal period in the last four years of King’s life, the three votingrights marches he organized from Selma to Montgomery, Ala., that ultimately led to the passage of the landmark Voting Rights Act in 1965. King’s absence from theaters is “a jaw dropper,” says DuVernay. “Let’s not even list the biopics that we’ve had,” she says,

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CULTURE | FILM

King (Oyelowo) and his wife Coretta (Carmen Ejogo) ﬂanked by marchers

A Long March the cast and crew of selma began breaking boundaries even before the film was released. DuVernay is the first black woman to be nominated for the Best Director prize at the Golden Globes; expectations are high that she will break the same barrier when nominations are announced on Jan. 15 for this year’s Academy Awards. Oyelowo, who appeared last year in supporting roles in Interstellar and A Most Violent Year, was one of only two black actors nominated for the 30 movie-acting slots at this year’s Golden Globes. (The other was Annie’s Quvenzhané Wallis.) The Screen Actors Guild’s 20 nominees were all white. DuVernay and Oyelowo both toiled in relative obscurity before Selma. The director spent many years as a publicist, marketing awards-ready movies—often made by white directors—to the black community, including Invictus, The Help and Dreamgirls. She directed the sensitive Middle of Nowhere (2012), co-starring Oyelowo, about a young woman dealing with her husband’s incarceration, which won her a Best Director prize at Sundance. But her film was overshadowed that year by Beasts of the Southern Wild, a fantastical tale about black life in the South. It was only after Lee Daniels dropped out of a long-gestating King biopic that DuVernay came aboard, on Oyelowo’s recommendation. DuVernay, who reshaped screenwriter Paul Webb’s script before production began, says she was still rewriting in Decem-

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ber 2013. “Less than a year from script to theaters is a little accelerated,” she says. That Selma came together at all after years on hold is remarkable. But it’s all the more impressive that the movie denies easy gratiﬁcation. It has more to say about the messy business of political organization than it does about King. And its time frame—the early months of 1965—means there’s no triumphant “I Have a Dream” moment. King gave that speech at the March on Washington 18 months earlier, and though he would later reprise elements of it, his tone in Selma is far less optimistic. Oyelowo, a trained Shakespearean actor, found an advantage in skipping King’s most famous refrain. “It’s like doing ‘To be

‘WE WERE NOT DOING A SAINTED VERSION OF HIM OR AN OVERCORRECTED, ANTIHERO VERSION OF HIM.’ —ava duvernay

J A M E S N A C H T W E Y— PA R A M O U N T P I C T U R E S (3)

“but not one about one of the most famous and influential Americans who changed the way we all behave and live. Films with African-American protagonists are not first on the list of things to do.” Selma addresses King’s legacy not by putting him on a pedestal but by showing him frustrated and beleaguered. While his obvious opponents were whitesupremacist voters and politicians, he also faced challenges from erstwhile allies, including the Student Nonviolent Coordinating Committee, which had grown impatient with his tactics, as well as a complicated presidential partner in Washington. The film’s tight focus on the Selma marches—with their climax on “Bloody Sunday,” when 600 marchers assembled on the Edmund Pettus Bridge and were met with the nightsticks, tear gas and charging horses of Sheriff Jim Clark and his deputies—allows it to closely follow tactical debates among King’s uneasy collaborators and between King and Lyndon Johnson (Tom Wilkinson), who urges the civil rights leader to proceed with greater caution, insisting that change would come incrementally. “We were not doing a sainted version of him or an overcorrected, antihero version of him—both of which are scripts that have floated around,” DuVernay says. “We wanted to stay close to what happened—a dynamic leader who was at times depressed and let his ego get in control.”

“Bloody Sunday,” which turned public opinion in favor of voting rights

Marchers cross the Alabama River on the Edmund Pettus Bridge

or not to be,’” he says. “Not to denigrate the speech, but it’s a bit like doing a karaoke song. What you want, in playing a character like Dr. King, is something revelatory. Otherwise, go watch a documentary.” He had been hesitant to dig into the project, he says, until the director “put so much meat on the bone,” challenging him to create an original character rather than ventriloquize an icon. In one gripping sequence, King’s marital tensions come to the fore when the FBI sends his wife Coretta (Carmen Ejogo) a tape of her husband, apparently with another woman. “I knew it was something we had to handle,” says DuVernay. Oyelowo’s voice echoes King’s familiar intonations but, directed at individuals rather than projected to a crowd, lacks its preacherly openness. Audiences will hear a more intimate side of King. “Most Americans don’t know Dr. King’s conversational voice,” DuVernay says. “They haven’t seen interviews or heard him laugh. They know the ‘I Have a Dream’ speech and then that he was killed. There’s a lot in between.” Reliving History king’s achievements were legion, but they’re under threat. The Voting Rights Act—the signature accomplishment won in the Selma marches—was weakened by a 2013 Supreme Court ruling. The arguments over what sort of resistance is acceptable and what goes too far could as easily have taken place a month ago, durtime January 19, 2015

ing nationwide protests against police brutality toward unarmed people of color. The images of tear gas look all too familiar. “If there’s one thing that Selma shows,” says Oyelowo, “it’s that things haven’t changed enough. There’s things in our film that show how far we need to go and means by which we can get there.” The film’s most stirring scene comes early, when Annie Lee Cooper (played by Oprah Winfrey, one of the film’s producers) attempts to register to vote, having brought ample documentation, and is faced with an unpassable political-IQ test. The challenges the Selma protesters faced, the movie suggests, weren’t rooted in the sort of racism that could be argued away when rhetoric makes people see reason. They were baked into the political system. Selma has already ignited controversies of its own. DuVernay has earned praise for her nuanced portrayal of King, but in showing Johnson as a President who was opposed to the marches and had to be manipulated into proposing the Voting Rights Act, she blurred the facts, according to some historians and an aide who worked in the White House at that time. While Johnson did want to advance his Great Society agenda first, they argue, he had already prepared voting-rights legislation that he could present to Congress. Furthermore, the President was happy that King’s Selma protests were making Southern bigots look bad; he knew the news footage would build support among sympathetic whites.

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Critics also question a key plot point involving Johnson, the FBI and its director, J. Edgar Hoover, who tells the President he’d be happy to smear King in retaliation. At first, Johnson rejects the idea and decries Hoover’s methods, but later he asks a secretary to connect him with Hoover. We then see King’s wife opening a parcel that holds a recording of King in bed with another woman, along with a threat that he must stop his activity in Selma or face further revelations. It’s true that King was a notorious womanizer, but it was actually Robert F. Kennedy who had approved Hoover’s mud gathering, years earlier. And though the FBI did send such a recording of King, it was mailed the previous year. “We knew we were bugged,” former King aide Andrew Young, who is portrayed in the film, told MSNBC. “But that was before LBJ.” Others, including writer Gay Talese, who covered the marches for the New York Times, have defended DuVernay’s portrayal of events. And most historians agree that the claim made by Johnson’s aide that the Selma marches were the President’s idea is overstated. DuVernay responded to the criticism with a tweet: “Bottom line is folks should interrogate history. Don’t take my word for it or LBJ rep’s word for it. Let it come alive for yourself.” With King finally getting the kind of big-screen treatment he has always deserved, it is appropriate that he once again ■ stirs deep argument. 55

CULTURE | FILM

F I L M OF T H E Y E A R : 1965 OR 2014? Ava DuVernay’s Selma shows how much we still have to learn from Dr. King’s message BY R IC H A R D C OR L IS S

Marching in Selma for the human dignity of all races

Paul Webb, is all about realpolitik in the service of social idealism. King must woo Johnson (Tom Wilkinson), preoccupied with the War on Poverty, even as he and his Southern Christian Leadership Conference cohorts negotiate with the younger, more restless leaders of the Student Non-Violent Coordinating Committee.

KING WAS A REALIST. AND SELMA IS ABOUT REALPOLITIK IN THE SERVICE OF SOCIAL IDEALISM WorldMags.net

DuVernay, taking the reins of the Selma project after Lee Daniels (Precious) moved on to direct The Butler, worked on Webb’s script, sheared the budget to a manageable $20 million and impressively shepherded a huge cast with dozens of speaking roles and hundreds of extras. No less than King, she proved herself a wizardly community organizer. Given that King’s children withheld permission to quote their father’s speeches, Oyelowo wisely avoids mimicking the tremulous cadences of King’s oration. This is a ﬁlm set not on great lawns but mostly in back rooms, where a forceful whisper can have more effect than a pulpit homily. Oyelowo gives a warm, acute performance and lends King a presence that makes everyone from his wife Coretta (Carmen Ejogo) to LBJ feel the power of his argument, the singe of his soul. Selma should be a time-capsule relic— a clue to how well we heeded the preacher’s words and how far we have advanced. Instead it is a reminder that the “American problem” has yet to be solved. ■ time January 19, 2015

J A M E S N A C H T W E Y— PA R A M O U N T P I C T U R E S

“there is no negro problem. there is no Southern problem. There is no Northern problem. There is only an American problem.” President Lyndon Johnson spoke these words in a nationally televised address to Congress on March 15, 1965, just eight days after the “Bloody Sunday” confrontation in Selma, Ala. The naked brutality of this assault spurred LBJ to propose the Voting Rights Act, which passed that August. Today that act, which Johnson signed with Martin Luther King Jr. and other civil rights leaders at his side, has been effectively gutted by the Supreme Court. The past six months have seen demonstrations, violent and nonviolent, protesting the death of unarmed black men at the hands of police. So Ava DuVernay’s Selma, a vivid restaging of King’s three historic marches from Selma to Birmingham, carries a message of heroic, tragic relevance. If not quite in quality, then certainly in import and impact, this is the film of the year—of 1965 and perhaps of 2014. If it can overcome critiques from Johnson historians who have challenged part of its narrative, Selma could be a favorite for the Academy Award. To cite it for Best Picture—along with Best Actor for David Oyelowo as King and Best Director for DuVernay—would testify to the Oscar voters’ political consciences as well as to the film’s undeniable power. The members would be voting yes for the hallowed memory of Dr. King and no for the unjustified killings of unarmed blacks. King would appreciate that conundrum: that violence can be a goad to good. Civil rights had advanced with images of decent black folks clubbed by angry white cops. Alabama promised fertile ground for telegenic confrontation, with its segregationist Governor George Wallace, and Sheriff Jim Clark’s police force primed to be rough on pacifists with dark faces. King knew: If it bleeds, it leads. He wasn’t a cynic; he was a political realist. And Selma, from a cogent script by

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SUMMARY NOTICE OF PENDENCY OF CLASS ACTION AND NOTICE IN CONNECTION WITH SETTLEMENT If You Purchased Certain Products—Carpet Cushion, Bedding Products (for example, mattresses or pillows), or Upholstered Furniture—Containing Polyurethane Foam, a Class Action Lawsuit and Settlement May Affect Your Rights. Si usted compró Cojín Alfombra, Ropa de cama (por ejemplo, colchones o almohadas), o muebles tapizados que Contiene espuma de poliuretano, una demanda colectiva y solución puede afectar sus derechos. Para una notificación en Español, llamar o visitar nuestro website. A lawsuit called In re Polyurethane Foam Antitrust Litigation, Index No. 10-MD-2196 (JZ) is pending in the United States District Court for the Northern District of Ohio in Toledo. The case is about whether certain manufacturers of polyurethane foam (which is used in carpet cushion, bedding products (such as, mattresses or pillows), and upholstered furniture) conspired to raise the prices of polyurethane foam. On April 9, 2014, the Court decided that this lawsuit could proceed as a class action on behalf of a “Class” or group of people and entities that may include you. Defendants petitioned for leave to appeal that decision and on September 29, 2014, the Sixth Circuit Court of Appeals denied Defendants’ request. Additionally, a partial settlement has been reached with two of the Defendants: Valle Foam Industries, Inc. and Domfoam International, Inc. (the “Settling Defendants”). The litigation is continuing against all other defendants (the “Non-Settling Defendants”). The Court has not decided who is right or wrong and nothing in this Notice or the Court’s order permitting this case to proceed as a class action expresses any opinion by the Court as to whether the Class will ultimately be successful on their claims or whether Defendants are in any way liable to the Class. Instead, the Court has ordered this notice to provide information so you may make an informed decision regarding your legal rights. This notice summarizes your rights and options before an upcoming trial against the Non-Settling Defendants and related to the proposed Partial Settlement. More information is contained in a detailed notice available at the website below. What Is This Case About? The lawsuit claims that the Defendants engaged in a conspiracy to increase prices of polyurethane foam, which is used in carpet cushion, bedding products (like mattresses and pillows), and upholstered furniture, and to allocate customers. Plaintiffs contend that Defendants’ actions violated antitrust and consumer protection laws in numerous states. The parties have vigorously litigated the suit for several years, including many motions and an interlocutory appeal. The Non-Settling Defendants deny that they did anything wrong and/or that they are liable to the Class. The Court has not decided who is right. If this case goes to trial, the lawyers for the Class will have to prove their claims with the Non-Settling Defendants at a trial. Are You Affected? If you purchased, not for resale, carpet cushion, bedding products (for example, mattresses or pillows), or upholstered furniture containing polyurethane foam made by Carpenter Co., Domfoam International, Inc., FFP Holdings LLC (f/k/a/ Flexible Foam Products LLC and f/k/a Flexible Foam Products, Inc.), FXI-Foamex Innovations, Inc., Future Foam, Inc., Hickory Springs Manufacturing Co., Mohawk Industries, Inc., Leggett & Platt, Incorporated, Scottdel Inc., Valle Foam Industries, Inc., Vitafoam Products Canada Limited, Vitafoam, Inc., Woodbridge Foam Corporation, Woodbridge Sales & Engineering, Inc., or Woodbridge Foam Fabricating, Inc., in AL, AZ, CA, CO, DC, FL, HI, IL, IA, KS, ME, MA, MI, MN, MS, MO, NE, NV, NH, NM, NY, NC, ND, OR, RI, SD, TN, VT, WV, WI during the period January 1, 1999 to the present, then you are a member of the Class. You are included in the Class if you purchased polyurethane foam “indirectly,” meaning that you did not purchase polyurethane foam directly from any of the Defendants, but instead bought a product from a company other than one of the Defendants that incorporated polyurethane foam made by one of the Defendants. What Does the Partial Settlement Provide? A Partial Settlement has been reached with the Settling Defendants: Valle Foam Industries, Inc. and Domfoam International, Inc. No money is being paid by Valle Foam Industries, Inc. and Domfoam International, Inc., but they have agreed to provide substantial assistance to the Class in the prosecution of their claims. Who Represents You? The Court has appointed Marvin A. Miller of Miller Law LLC to represent the Class. The lawyers for the Class will have to prove their claims with the remaining Defendants at a trial. No date has been set for when the trial will begin. What Are Your Options? If you are included in the Class, you will need to decide whether to: (1) stay in the Class or (2) ask to be excluded from the Class. To stay in the Class, you do not need to do anything at this time. You will be legally bound by all orders and judgments of the Court, and you won’t be able to sue, or continue to sue, the Defendants as part of any other lawsuit for conspiring to fix prices or allocate customers of polyurethane foam or polyurethane foam products which contain polyurethane foam manufactured by Defendants. If you do not want to participate in this lawsuit or the Partial Settlement, you may request to exclude yourself from the Class. If you exclude yourself, you will not be bound by or benefit from any court orders, jury verdicts, or settlements approved by the Court, but you keep your right to sue or otherwise resolve your claims, if any, with Defendants on your own. Requests to Exclude must be in writing and received by March 13, 2015. You can obtain more information at www.PolyFoamClassAction.com. The Court will hold a hearing on April 2, 2015, at 9:00 a.m. at the Carl B. Stokes U.S. Court House, 801 W. Superior Avenue, Cleveland, Ohio 44113 to consider whether to approve the proposed Partial Settlement with Valle and Domfoam. If you stay in the Class, you may object or comment on the Partial Settlement by March 13, 2015. You or your own lawyer may, but are not required to, ask to appear and speak at the hearing at your own cost. The Court may change the date, time or location of the hearing. To obtain the most up-to-date information regarding the hearing date and location, please visit www.PolyFoamClassAction.com or call 866-302-7323. If you have questions or want a detailed Notice or other documents about this lawsuit and your rights, go to www.PolyFoamClassAction.com or call 866-302-7323. Para una notificación en Español, llamar o visitar nuestro website.

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AUTHOR APPROVED!

The Culture CURTIS SITTENFELD Author of Sisterland

George and Martha by James Marshall “These tales of two hippo BFFs are wonderfully irreverent and full of both misbehavior and compassion.”

Books

OUR ALL-TIME FAVORITE BOOKS FOR YOUNG READERS The best illustrated and chapter books; Meg Wolitzer on a transformative teen novel; “grownup” authors recall beloved classics

INSIDE:

Illustrations by Tomi Um for TIME

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We’re living in a golden age of young-adult literature, when books ostensibly written for teens are equally adored by readers of every generation. In the likes of Harry Potter and Katniss Everdeen, they’ve produced characters and conceits that have become the currency of our pop-culture discourse—and inspired some of our best writers to contribute to the genre. To honor the best books for young adults and children, Time compiled this survey in consultation with respected peers such as U.S. Children’s Poet Laureate Ken Nesbitt, children’s-book historian Leonard Marcus, the National Center for Children’s Illustrated Literature, the Young Readers Center at the Library of Congress, the Every Child a Reader literacy foundation and 10 independent booksellers. With their help, we’ve created two all-Time lists of classics: 100 Best Young-Adult Books and 100 Best Children’s Books. The top 25 in each category are presented here; for the full lists, visit time.com/youngreaders.

MARTIN AMIS Author of The Zone of Interest

Goodnight Moon by Margaret Wise Brown (author) and Clement Hurd (illustrator) “I must have read Goodnight Moon to my children several thousand times, and I was never bored by it. The book has its own soporiﬁc poetry—and it quite often worked.”

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GILLIAN FLYNN Author of Gone Girl

The Westing Game by Ellen Raskin “It completely charmed me as a kid: the clever mystery, the complex characters (especially the grownups—who knew they had lives too?) and the nasty, fantastic TabithaRuth Wexler. I still read it once a year.”

The Culture

Books

TOP 10: YOUNG ADULT AGES 12 AND UP

1 The Absolutely True Diary of a Part-Time Indian Sherman

Alexie’s coming-of-age novel (illustrated by Ellen Forney) illuminates family and heritage through young Arnold Spirit, torn between his life on a reservation and his largely white high school. The speciﬁcs are sharply drawn, but this novel, with its themes of selfdiscovery, speaks to young readers everywhere. 2 Harry Potter (series) What more can be said about J.K. Rowling’s iconic franchise? How about this: seven years after the ﬁnal volume was published, readers young and old still go crazy at the slightest rumor of a new Potter story. 3 The Book Thief For many

young readers, Markus Zusak’s novel provides their ﬁrst in-depth contemplation of the Holocaust. Although terror surrounds Liesel, a young German girl, so too does evidence of friendship, love and charity—redeeming lights in the darkness. 4 A Wrinkle in Time Mad-

eleine L’Engle’s surrealist adventure has provided generations of children with their first-ever mindblowing experiences, as Meg travels across the fifth dimension in search of her father. But the sci-fi also has a message: Meg learns self-sufficiency and bravery in the process. 62

5 Charlotte’s Web Read-

ers are still drawn to the simplicity and beauty of arachnid Charlotte’s devotion to her pig pal Wilbur. Though family farms may be less common than they were in 1952, E.B. White’s novel remains timeless for its enduring meditation on the power of friendship and of good writing. 6 Holes Louis Sachar’s sto-

ry of a family curse, fancy sneakers and poisonous lizards moves forward and backward through time, telling of how Stanley Yelnats IV ended up in a juvenile prison camp. It’s an introduction to complex narrative, suffused with fun, warmth and a truly memorable villain. 7 Matilda With apologies to the lovable Charlie and the Chocolate Factory, this may be Roald Dahl’s most compelling read for young

MICHAEL LEWIS author of Flash Boys

The Hardy Boys by Franklin W. Dixon “As a kid I lived on a steady diet of The Hardy Boys and Archie comic books, without the slightest sense there was anything better I might be doing with my time.”

people. Poor Matilda feels thwarted and ignored by her family—a sense that many preteens share. They don’t share her magical powers, but that’s the enduring appeal of this escapist frolic. 8 The Outsiders Published when author S.E. Hinton was just 18, this comingof-age novel offers proof that even the youngest writer can provide valuable insight. Her striking look at Ponyboy and gang life in the 1960s has resonated for decades with readers of all kinds, whether they identify more with the Greasers or the Socs. 9 The Phantom Tollbooth In a witty, sharp fairy tale that illuminates language and mathematics through a picaresque story of adventure in the Kingdom of Wisdom, Jules Feiffer’s whimsical drawings do as much as Norton Juster’s plain-language interpolations of complex ideas to carry readers through Digitopolis and the Mountains of Ignorance. 10 The Giver Lois Lowry’s

tale of self-discovery in a dystopian society has a memorable central character, Jonas, and an indelible message—that pain and trauma have an important place in individual lives and in society, and to forget them is to lose what makes us human. —daniel d’addario

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AND 15 MORE

Are You There God? It’s Me, Margaret Judy Blume To Kill a Mockingbird Harper Lee Roll of Thunder, Hear My Cry Mildred D. Taylor

Anne of Green Gables (series) L.M. Montgomery The Chronicles of Narnia (series) C.S. Lewis Monster Walter Dean Myers

The Golden Compass Philip Pullman

Looking for Alaska John Green

The Diary of a Young Girl Anne Frank

The Curious Incident of the Dog in the Night-Time Mark Haddon

From the Mixed-Up Files of Mrs. Basil E. Frankweiler E.L. Konigsburg

Little House on the Prairie (series) Laura Ingalls Wilder

The Miraculous Journey of Edward Tulane Kate DiCamillo Wonder R.J. Palacio The Once and Future King (series) T.H. White

CONTRIBUTING BOOKSELLERS: BOOK PEOPLE (AUSTIN); BOOKS AND BOOKS (CORAL GABLES, FL A.); ELLIOT T BAY BOOK COMPANY (SE AT TLE); POLITICS AND PROSE (WASHINGTON, D.C.); POWELL’S BOOKS (PORTL AND, ORE.); PRAIRIE LIGHTS (IOWA CIT Y ); SK YLIGHT BOOKS (LOS ANGELES); SQUARE BOOKS (OXFORD, MISS.); THE TAT TERED COVER (DENVER); THE STR AND (NE W YORK CIT Y )

FOR THE COMPLE TE LIST, GO TO time.com/ youngreaders

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Photograph by Andrew B. Myers for TIME

The Culture

Books

YOUNG ADULT AT HEART BY MEG WOLITZER

When novelist Meg Wolitzer began writing Belzhar, her ﬁrst book for a YA audience, she turned to Sylvia Plath and The Bell Jar he first time i read Sylvia Plath’s autobiographical novel The Bell Jar, it was an emotional, chaotic experience. Her narrator has a nervous breakdown while a college student and attempts suicide, as Plath had. The story is so viscerally real and imaginable that I, then a teenager, was immersed. Plath, who recovered from her breakdown but committed

suicide at age 30, left behind one powerful novel, many brilliant poems, a good deal of short ﬁction and voluminous journals. But it was in The Bell Jar that she used the detailed landscape of a novel to look bravely at her illness, and she compelled readers to look with her. Flash-forward several decades. I had embarked upon writing a young-adult novel

in which The Bell Jar plays a part. Belzhar (pronounced bel-jhar, a play on Plath’s title) is about a troubled girl, Jam Gallahue, who tragically loses her boyfriend and is sent to a therapeutic boarding school where she’s placed in a class that reads only one writer over the whole semester. This year, the teacher has decided they will read Plath. Plath told the truth in The Bell Jar—I don’t mean only the autobiographical truth, though that was part of it— but also a larger truth about how emotional suffering can

Plath (left, circa 1957) and Wolitzer (pictured during her college years) both studied at Smith College. Both have written about women’s struggles to deﬁne themselves

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P L AT H : B E T T M A N N/C O R B I S; W O L I T Z E R : C O U R T E S Y M EG W O L I T Z E R

make people feel isolated under their own airless glass jars. Because of this truth, young readers like me were deeply affected and in some ways transformed. Had Plath been a famous suicide but not such a fine writer, her reputation would likely have fizzled out after her death. But she was uncommonly good, so she stuck. Teenagers read her when I was that age, and I sense that many teenagers still read her now. And so, for research purposes, I read Plath again. But now, instead of responding only to the young narrator’s detachment and despair, as I had long ago, I also found myself, to my surprise, responding to the woman Sylvia Plath would never become. The writer who would never continue to mature with age. The mother who would never see her children off into the world. The person who wouldn’t have the chance to live a long life. Younger me tended to take the short view, feeling everything along with the narrator as it happened and never thinking about that nebulous thing called the future. But now, as a middle-aged woman, I definitely took the long view. It occurs to me that not only readers but also writers often fall into the habit of taking either the short or the long view when they work. I’m a novelist whose fiction has mainly been for adults; my most recent adult book, The Interestings, lavishes a lot of time on its characters when they’re young. Then it keeps going, following them from age 15 all the way into their 50s—an age I can time January 19, 2015

relate to well these days, as my children have left home, and I must remind myself to schedule my yearly mammogram. But Belzhar, a novel about adolescents written for adolescent readers (although these days plenty of adults read YA too), takes place over the course of only one semester at boarding school. And while The Interestings is told from multiple points of view, Belzhar hews close to its narrator, letting her tell her story in a particularly close-grained way. Jam is someone who needs to talk, who is breathless and single-minded; making her a ﬁrst-person narrator

JESMYN WARD Author of Men We Reaped

The Hero and the Crown by Robin McKinley “When I was around 8, I discovered this book at my local book fair. I charmed one of my cousins into buying it for me, and then I devoured it. The heroine is an illegitimate princess who hunts dragons in an attempt to ﬁnd a place for herself in her father’s kingdom. The heroine is tough, stubborn and smart, taking on a world bent on making her less than she is. I empathized.”

struck me as the best way to convey her voice, her neediness, her absolutely certain convictions about what had happened to her. I couldn’t help but think, when writing this novel, of the two versions of me who had read The Bell Jar. Maybe there were two versions of me who should be writing Belzhar: one who was still close to the intensity of adolescence, for whom everything felt fresh and raw. That version, which still exists inside of me, took care of the parts in which I needed to drag up feelings buried in the overstuffed dresser drawer that is adolescence: What it’s like to make ﬁrst-time emotional, romantic, even sexual decisions. What it’s like to manage the overwhelming new sensations and thoughts that invade you. What it’s like to feel rejected. What it’s like to realize that everyone is essentially on their own. But then the older version of me had to put the whole thing into context, to remember that circumstances can change if you give them enough time, even if my narrator can’t know it. I wanted the older me to be somewhere in the mix of this YA book, though not to give Jam a goody-goody artiﬁcial voice of reason. Books aren’t morality plays; they don’t all need lessons. But given that Belzhar takes place in a special class at a special boarding school, it seemed appropriate that there would indeed be some kind of essential lesson conveyed. And that’s the point at which Mrs. Q stepped in: Jam’s

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elderly teacher, a woman who knows quite a bit about how things can change. Without realizing it at first, I became part Jam and part Mrs. Q, shuttling between someone who takes the short view and someone who takes the long. At book readings, audience members often ask how writers create characters. People want to know: Have writers actually experienced what their characters experienced? And if not, where do their ideas come from? My best, though incredibly vague, answer is that ideas come about through the long, slow process of living. Even if a character’s experiences aren’t your own, you are citizens of the same world, and you’ve had your experiences and witnessed other people’s too. While all that’s been going on, empathy has quietly been forming; it’s almost a chemical process. And if you’re a writer, you’ve also been reading. A lot. And while Belzhar isn’t a ripoff or a retelling of The Bell Jar, it reflects on Plath’s novel and owes a debt to it. It’s not that you want to imitate the book you admire; you just want to do your version of what that writer did: you want to tell the truth, fiction-style. There are quite a few of us former teenagers—women in the middle of their lives (and some men, for sure)—who have never forgotten what it felt like to read The Bell Jar for the first time. So what are we supposed to do with all that leftover feeling? Me, I decided to write a book. ■ 65

The Culture

Books

TOP 10: CHILDREN AGES 3–11

1 Where the Wild Things Are

Maurice Sendak’s adventure has inspired generations of children to let out their inner monsters, showing how imagination allows for an escape from life’s doldrums. It’s also a moving testament to family love: when young Max returns from his reverie, his mother has saved him a hot dinner.

instructive read for any kid who’s ever felt a bit like a wild animal, or parents who’ve ever felt like they’re raising one. 5 Little Bear (series) Else

Holmelund Minarik wrote these stories, which convey a young cub’s yearning for his absent father, but it’s Sendak’s illustrations that catch the eye and allow for endless imaginings of life among woodland critters.

2 The Snowy Day The journey of Peter through a snowbound New York City made for a milestone: as a successful children’s story focused on a black protagonist, it broke down barriers many white editors may have never noticed. But Ezra Jack Keats’ book is memorable too for the sheer beauty of its collage illustrations.

6 Owl Moon Many young bird watchers likely owe their passion to Jane Yolen, whose story of a father-daughter trip to ﬁnd the elusive great horned owl takes ﬂight thanks to John Schoenherr’s evocative woods-atnight illustrations.

3 Goodnight Moon Some-

7 The Giving Tree It’s hard

where a child is being put to sleep right now to Margaret Wise Brown’s soothing, repetitive cadences. While the lines may be etched in every parent’s memory, Clement Hurd’s illustrations, with their quirky hidden jokes, provide amusement on the thousandth reading.

to imagine a story more poignant than Shel

4 Blueberries for Sal Robert

McCloskey’s block-printed illustrations show just how similar families of different species can be, as child Sal and a baby bear covet Maine blueberries on a berry hunt with their respective mothers. It’s an 66

DAVE EGGERS Author of The Circle

Adèle & Simon and Adèle & Simon in America by Barbara McClintock “McClintock’s artwork is ridiculously beautiful, and because readers are asked to ﬁnd objects that Simon has lost during various trips— including turn-of-thecentury Paris and the USA—the books reward very close attention.”

Silverstein’s tale of a tree that gives its life for a boy turned self-centered young man. It’s been interpreted along environmentalist and religious lines, but all can agree on the beauty of its underlying theme of generosity. 8 The True Story of the Three Little Pigs Jon Scieszka and

Lane Smith’s ironic, witty book, which revises the story of the pigs as an exculpatory memoir by the wolf—who claims he’s not so big and bad at all!— is a welcome corrective to more saccharine tales. It also introduces young readers to the notion of dueling perspectives. 9 Tuesday Who needs

text? Not illustrator David Wiesner, who also “wrote” the very few words that make up his tale. His stunning, propulsive watercolors show ﬂying frogs on a surreal adventure. Reading may be fundamental, but here the pictures do almost all the talking. 10 Where the Sidewalk Ends

Silverstein wasn’t just good at tales of leafy selfsacriﬁce. His loopy poems have been speaking to kids’ concerns and sparking their imaginations for decades. Any child who’s ever fantasized about playing “hug o’ war” instead of tug-of-war will ﬁnd a kindred spirit in these pages. —d.d.

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AND 15 MORE

Harold and the Purple Crayon Crockett Johnson (author and illustrator) Make Way for Ducklings Robert McCloskey (author and illustrator) Olivia (series) Ian Falconer (author and illustrator)

Madeline (series) Ludwig Bemelmans (author and illustrator)

Click, Clack, Moo Doreen Cronin (author), Betsy Lewin (illustrator)

Annoâ&#x20AC;&#x2122;s Journey Mitsumasa Anno (author and illustrator)

The Story of Ferdinand Munro Leaf (author), Robert Lawson (illustrator)

Frog and Toad (series) Arnold Lobel (author and illustrator)

Donâ&#x20AC;&#x2122;t Let the Pigeon Drive the Bus! Mo Willems (author and illustrator) The Lorax Dr. Seuss (author and illustrator) Corduroy Don Freeman (author and illustrator)

I Want My Hat Back Jon Klassen (author and illustrator) Miss Rumphius Barbara Cooney (author and illustrator)

Alexander and the Terrible, Horrible, No Good, Very Bad Day Judith Viorst (author), Ray Cruz (illustrator) FOR THE COMPLE TE LIST, GO TO time.com/ youngreaders

Brave Irene William Steig (author and illustrator)

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Photograph by Andrew B. Myers for TIME

THE AWESOME COLUMN

JoelStein

Hey Baby, Can I Get You a Beer?

What I learned about making people laugh on the set of America’s Funniest Home Videos when i was in second grade, I asked my parents what the Vice President did. They told me that the second most important person in the country didn’t have any responsibilities whatsoever. For the next ﬁve years, I told people that when I grew up, I wanted to be the Vice President. So when Tom Bergeron announced he was stepping down as the host of ABC’s America’s Funniest Home Videos (AFV) after 14 years, I applied. I could be on network TV every week, introducing a few clip packages while making tons of money and getting invited to lots of parties— many of which, admittedly, would have guest lists consisting of cats or men with ice packs on their groins. I walked onto the AFV stage feeling surprisingly nervous, so I asked Bergeron for advice on how to be funny when hosting a family show. “Relax, have fun and remember your role is to service the videos. Which sounds dirtier than I intended,” he said. In other words: make jokes that sound edgy but are actually safe because they don’t make sense.

Vin Di Bona, the show’s creator and executive producer, told me he’s leaning toward hiring someone famous and talented. Still, he said, while I was unpolished, I had some of that Bergeron magic, compared with the blunter skills of previous host Bob Saget. “He had to have laughter to know it was right,” he said. “You didn’t need that. You just presented and moved on.” Yes. That is exactly what I was trying to do. I was not just being quiet because all the jokes I could think of with a ﬂy, a penguin and a leprechaun were racist.

To prepare, I watched Bergeron tape a

Di Bona, however, thought I might be a better ﬁt as a writer. So a few weeks later I spent an afternoon working for head writer Todd Thicke, who has been with the show since 1989. He has the same good looks and deep voice as his brother Alan Thicke and nephew Robin Thicke and, I’m guessing, other Thickes. I sat at a table with three other writers, looking at walls covered with index cards, on which were written things like “A boy comments on how to impress the ladies in the car. Then suddenly screams in a panic when he sees a spider” and “A dog shows its teeth and growls while a woman rubs its butt with her foot indoors.” This was going to be easy. We stared at a screen and watched the very best 10% of submitted videos, as culled by screeners who I’m assuming

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The writers had an amazing ability to

predict, within just a few seconds, what would happen in the clips we watched, all of which provided me with valuable life lessons: don’t wear socks on kitchen tile; don’t run near the buttocks of an obese woman; use extreme caution when weight lifting at home alone; don’t leave ﬂour in an area accessible to toddlers. Since AFV is a family show, the writers can’t use a lot of the best stuff, like a baby smiling widely after tasting a beer. “You can barely give a monkey a cigarette, no less a baby a beer,” said Erik Lohla. “The world has changed,” agreed Jordan Schatz. So to make the clips seem more exciting, they combine them using clever frames like “Failed football entrances vs. babies knocked over by sneezes.” Thicke also set us to work creating alternative meanings for NSFW besides “not safe for work” that he could print below clips. At ﬁrst I tried to write for clips we’d seen, such as “nice sprinkler fart, wanker” for the guy with the sprinkler stuck in his pants and “new style feline wevenge” for the cat who attacked a dog, but the other writers simply searched for new topics in their 25-year database of clips. They found me lots of guys falling off stripper poles for “never strip for women,” but Thicke thought that it wasn’t in great taste. And they didn’t seem excited about my suggestion that we take absolutely any clip anyone submitted and just write “no sense from within.” It’s been several months, and I haven’t heard back about either job. Luckily, I have some pretty adorable footage of my son that I’m sure will win $10,000. ■ time January 19, 2015

I L L U S T R AT I O N B Y T O M A S Z W A L E N TA F O R T I M E ; G E T T Y I M A G E S (3)

show, during which I noticed many surprising details, like the fact that the show is an hour long. It turns out I’d never actually seen America’s Funniest Home Videos, which made me even more anxious. When the show ended, I walked out to great applause, which—along with the bright lights and my loud, distracting heartbeat—made it hard to remember which cameras to look at, though I’m pretty sure there wasn’t one in my shoes. Then I brought two audience members up for a game called “Pick the Real Video!” in which I asked them if I was about to show a clip of a houseﬂy stuck to a frozen hot dog, a penguin swimming in a hotel fountain or a leprechaun falling down an escalator. One of the contestants picked the leprechaun. The show is not called America’s Smartest Home Video Watchers.

work in Chinese prison camps. And they were still insanely boring—just cute pets, cute babies and uncute tweens dancing in their bedrooms. It took 90 minutes before we saw the ﬁrst guy get hit in the testicles, which was the ﬁrst time we laughed. “It’s weird,” I said. “As soon as someone gets hurt, people laugh.” Writer Mike Palleschi looked around the room and said, “I think that’s our fault.”

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THE KEYS TO A NEW HOME OPEN A NEW ERA.

Twenty years after the end of apartheid, the path to wealth through property ownership is still closed to many South Africans. International Housing Solutions, a global private equity ﬁrm, is determined to change that. Their idea: a fund to build safe, affordable housing for rising middle class families. Citi’s early support and expertise has helped the fund grow to ﬁnance 27,000 housing units across South Africa. Its success is being used as a model throughout the continent. For over 200 years, Citi’s job has been to believe in people and help make their ideas a reality.

citi.com/progress

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