The Atlantic Monthly

Waste Not

Ron Tang — Fri, 11 Apr 2008 07:24:00 -0400

Forty years ago, the steel mills and factories south of Chicago were known for their sooty smokestacks, plumes of steam, and throngs of workers. Clean-air laws have since gotten rid of the smoke, and labor-productivity initiatives have eliminated most of the workers. What remains is the steam, billowing up into the sky day after day, just as it did a generation ago.

The U.S. economy wastes 55 percent of the energy it consumes, and while American companies have ruthlessly wrung out other forms of inefficiency, that figure hasn’t changed much in recent decades. The amount lost by electric utilities alone could… more

God's Country

Ron Tang — Sat, 01 Mar 2008 00:00:00 -0500

It was an ordinary soccer pitch: sparse tufts of grass and reddish soil surrounded by cinder-block homes. The two candidates stood on opposite sides of the field as the people of Yelwa, a town of 30,000 in central Nigeria, lined up behind them one May morning in 2002 to vote. Whoever had more supporters would lead the town’s council. And whoever led the council would control the certificates of indigeneship: the papers certifying that Yelwa was their home, and that they had a right there to land, jobs, and scholarships. Between the iron goalposts milled ethnic Jarawa, principally Muslim merchants… more

The Atlantic Highlights Shannon Brownlee's Ideas on Health Reform

Communications — Wed, 12 Dec 2007 12:15:00 -0500

New America in the News:

In the next eight years, medical schools intend to increase enrollment in order to accommodate the medical needs of aging baby boomers and replace retiring doctors from that generation. But Shannon Brownlee, a senior fellow at the New America Foundation, writes that adding more doctors does not necessarily mean better care.

The Association of American Medical Colleges, which advises the federal government on how many medical residents to support, says that the country will be 100,000 doctors short by 2025 unless the average number of medical-school graduates rises. Ms. Brownlee says more than 12 new medical schools are now being constructed or considered, and many existing schools are expanding, with a goal of increasing the number of graduates from 16,000 a year to 21,000 a year.

Some experts are saying, however, that many doctors are choosing their location based on patients' wealth and quality of life. Ms. Brownlee says that doctors are in control of how much care their patients receive and that when there is an influx of doctors in one area, they can still keep their schedules busy, creating unnecessary expenses for the patients and sometimes putting them at risk. This attraction to heavily insured areas makes for shortages in parts of the country where more people lack insurance, such as rural areas.

Ms. Brownlee points to other ways in which too many doctors can have an adverse effect on the quality of care and drive up costs. In hospitals that have a high ratio of specialists to primary-care physicians, for example, having different doctors for the same patient can lead to mishaps such as duplicate tests, unwise prescriptions, and mistaken assumptions about care, she writes. Medical schools are graduating more specialists and fewer primary-care doctors, a trend that she believes could make such problems worse. ...

For the complete article, visit The Chronicle of Higher Education Online, which previewed The Atlantic Monthly article.

Overdose

adminn — Sat, 01 Dec 2007 00:00:00 -0500

When we look back on the health-care plans of the 2008 campaign, we may wonder that no one chose to face up to one of the most troubling recent developments in American medicine. Yes, various presidential hopefuls have put forth plans containing detailed provisions to cover the uninsured, bring down costs, and improve the astonishingly uneven quality of health care. But no candidate has discussed the most dramatic change now under way in our medical system, a change that may negate many of the benefits of the plans on offer: the flood of new doctors coming down the pipeline.

Over… more

If America Left Iraq

Articles — Thu, 01 Dec 2005 00:00:00 -0500

At some point -- whether sooner or later -- U.S. troops will leave Iraq. I have spent much of the occupation reporting from Baghdad, Kirkuk, Mosul, Fallujah, and elsewhere in the country, and I can tell you that a growing majority of Iraqis would like it to be sooner. As the occupation wears on, more and more Iraqis chafe at its failure to provide stability or even electricity, and they have grown to hate the explosions, gunfire, and constant war, and also the daily annoyances: having to wait hours in traffic because the Americans have closed off half the city;… more

The Long Hunt for Osama

Articles — Fri, 01 Oct 2004 03:00:00 -0400

When you fly over the icy peaks of the Hindu Kush, which march in serried ranks toward the Himalayas, dividing Central Asia from the Indian subcontinent, you get a sense of the scale of the problem: Osama bin Laden may be hiding somewhere out there. Wherever he is, bin Laden continues to give substantial ideological direction to jihadist movements around the globe -- and so American forces are scouring the Hindu Kush to find him.

The conventional wisdom now, of course, is that tracking bin Laden down won't make much of a difference to the larger war on terrorism… more

Radical Tax Reform

Articles — Tue, 20 Jan 2004 12:00:00 -0500

We have become accustomed to thinking that taxes, like hemlines, can only go up or down. This isn't true. Over the centuries changes in the form of U.S. taxes have been at least as dramatic as changes in the rate of taxation.

For instance, most federal revenues now come from personal and corporate income taxes, and from the payroll taxes that fund Social Security and Medicare. But most government revenues originally came from excise taxes on luxury items such as tobacco, spirits, and sugar, and throughout much of the nineteenth century the bulk of federal revenues came from tariffs on… more

The Real State of the Union: 2004

Articles — Tue, 20 Jan 2004 08:00:00 -0500

Are We Still a Middle-Class Nation? Michael Lind, Whitehead Senior Fellow

America's "Suez Moment" Sherle R. Schwenninger, Co-Director, Global Economic Policy Program and Director, Fellowship Program

The Tuition Crunch Jennifer Washburn, Fellow

Insurance Required Laurie Rubiner, Director, Universal Health Insurance Program

Information, Please Shannon Brownlee, Senior Fellow

Radical Tax Reform Maya MacGuineas, Director, Fiscal Policy… more

America's 'Suez Moment'

Articles — Tue, 20 Jan 2004 00:00:00 -0500

Despite its unchallenged military might, the United States has an Achilles' heel: its economy depends on foreign capital. Though hardly anyone acknowledges this publicly, China and Japan already hold so much American debt that, theoretically, each could exert enormous leverage on American foreign policy. So far, the economic dependence of these countries on American consumers has kept them from exercising such power. But what would happen if, for instance, Washington changed its one-China policy and officially recognized Taiwan? Or if the Bush Administration threatened to invade North Korea? Simply by dumping U.S. Treasury bills and other dollar-denominated assets, China --… more

The Tuition Crunch

Articles — Tue, 20 Jan 2004 00:00:00 -0500

A four-year college degree has become all but a necessity for getting ahead in the information age. Since the 1980s the average real income of workers with only a high school diploma has fallen, while salaries among those with at least a college degree have risen: they now earn 75 percent more than high school graduates. At the national level, having a highly educated work force is critical in order to sustain our technological edge in the global economy.

America's higher-education system ranks among its greatest achievements. But in the past two decades our commitment to equal opportunity in post-secondary… more