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Facing unbearable heat, Qatar has begun to air condition the outdoors

By Steven Mufson
Facing unbearable heat, Qatar has begun to air condition the outdoors
The skyline in Doha, Qatar, in July 2019. MUST CREDIT: Washington Post photo by Salwan Georges

DOHA, Qatar - It was 116 degrees Fahrenheit (46.7 degrees Celsius) in the shade outside the new Al Janoub soccer stadium, and the air felt to air-conditioning expert Saud Ghani as if God had pointed "a giant hair dryer" at Qatar.

Yet inside the open-air stadium, a cool breeze was blowing. Beneath each of the 40,000 seats, small grates adorned with Arabic-style patterns were pushing out cool air at ankle level. And since cool air sinks, waves of it rolled gently down to the grassy playing field. Vents the size of soccer balls fed more cold air onto the field.

Ghani, an engineering professor at Qatar University, designed the system at Al Janoub, one of eight stadiums that the tiny but fabulously rich Qatar must get in shape for the 2022 World Cup. His breakthrough realization was that he had to cool only people, not the upper reaches of the stadium - a graceful structure designed by the famed Zaha Hadid Architects and inspired by traditional boats known as dhows.

"I don't need to cool the birds," Ghani said.

Qatar, the world's leading exporter of liquefied natural gas, may be able to cool its stadiums, but it cannot cool the entire country. Fears that the hundreds of thousands of soccer fans might wilt or even die while shuttling between stadiums and metros and hotels in the unforgiving summer heat prompted the decision to delay the World Cup by five months. It is now scheduled for November, during Qatar's milder winter.

The change in the World Cup date is a symptom of a larger problem - climate change.

Already one of the hottest places on Earth, Qatar has seen average temperatures rise more than 2 degrees Celsius (3.6 degrees Fahrenheit) above preindustrial times, the current international goal for limiting the damage of global warming. The 2015 Paris climate summit said it would be better to keep temperatures "well below" that, ideally to no more than 1.5 degrees Celsius (2.7 degrees Fahrenheit).

Over the past three decades, temperature increases in Qatar have been accelerating. That's because of the uneven nature of climate change as well as the surge in construction that drives local climate conditions around Doha, the capital. The temperatures are also rising because Qatar, slightly smaller than Connecticut, juts out from Saudi Arabia into the rapidly warming waters of the Persian Gulf.

In a July 2010 heat wave, the temperature hit an all-time high of 50.4 degrees Celsius (122.7 degrees Fahrenheit).

"Qatar is one of the fastest warming areas of the world, at least outside of the Arctic," said Zeke Hausfather, a climate data scientist at Berkeley Earth, a nonprofit temperature analysis group. "Changes there can help give us a sense of what the rest of the world can expect if we do not take action to reduce our greenhouse gas emissions."

While climate change inflicts suffering in the world's poorest places from Somalia to Syria, from Guatemala to Bangladesh,in rich places such as the United States, Europe and Qatar global warming poses an engineering problem, not an existential one. And it can be addressed, at least temporarily, with gobs of money and a little technology.

To survive the summer heat, Qatar not only air-conditions its soccer stadiums, but also the outdoors - in markets, along sidewalks, even at outdoor malls so people can window shop with a cool breeze. "If you turn off air conditioners, it will be unbearable. You cannot function effectively," says Yousef al-Horr, founder of the Gulf Organization for Research and Development.

Yet outdoor air conditioning is part of a vicious cycle. Carbon emissions create global warming, which creates the desire for air conditioning, which creates the need for burning fuels that emit more carbon dioxide. In Qatar, total cooling capacity is expected to nearly double from 2016 to 2030, according to the International District Cooling & Heating Conference.

And it's going to get hotter.

By the time average global warming hits 2 degrees Celsius (3.6 degrees Fahrenheit), Qatar's temperatures would soar, said Mohammed Ayoub, senior research director at the Qatar Environment and Energy Research Institute. In rapidly growing urban areas throughout the Middle East, some predict cities could become uninhabitable.

"We're talking about 4 to 6 degrees Celsius (7.2 to 10.8 degrees Fahrenheit) increase in an area that already experiences high temperatures," Ayoub said. "So, what we're looking at more is a question of how does this impact the health and productivity of the population."

The danger is acute in Qatar because of the Persian Gulf humidity. The human body cools off when its sweat evaporates. But when humidity is very high, evaporation slows or stops. "If it's hot and humid and the relative humidity is close to 100 percent, you can die from the heat you produce yourself," said Jos Lelieveld, an atmospheric chemist at the Max Planck Institute for Chemistry in Germany who is an expert on Middle East climate.

That became abundantly clear in late September, as Doha hosted the 2019 World Athletics Championships. It moved the start time for the women's marathon to midnight Sept. 28. Water stations handed out sponges dipped in ice-cold water. First-aid responders outnumbered the contestants. But temperatures hovered around 90 degrees Fahrenheit (32.2 degrees Celsius) and 28 of the 68 starters failed to finish, some taken off in wheelchairs.

Workers are particularly at risk. A German television report alleged hundreds of deaths among foreign workers in Qatar in recent years, prompting new limits on outdoor work. A July article in the journal Cardiology said that 200 of 571 fatal cardiac problems among Nepalese migrants working there were caused by "severe heat stress" and could have been avoided.

The U.S. Air Force calls very hot days "black flag days" and limits exposure of troops stationed at al-Udeid Air Base. Personnel conducting patrols or aircraft maintenance work for 20 minutes, then rest for 40 minutes and drink two bottles of water an hour. People doing heavy work in the fire department or aircraft repair may work for only 10 minutes at a time, followed by 50 minutes of rest, according to a spokesman for the 379th Air Expeditionary Wing.

In early July, Qatar's Civil Defense Command warned against doing outdoor work between 10 a.m. and 3 p.m., putting gas cylinders in the sun, turning on water heaters, completely filling fuel tanks or car tires, or needlessly running the air conditioner. It urged people to drink plenty of fluids - and to beware of snakes and scorpions.

- - -

For now, managing climate change in a place like Qatar, whose slogan for the World Cup is "Expect Amazing," is primarily a matter of money.

And Qatar has plenty. Its sovereign wealth fund is worth about $320 billion. A few of its stakes include Harrods department store, London's gigantic Canary Wharf, the Paris Saint-Germain soccer club, the CityCenterDC office and residential development and a 10 percent stake in the Empire State Building.

Qatar has used its riches to great effect at home, where 11 winners of the prestigious Pritzker Architecture Prize have built striking high-rises and stadiums. The result is a strange combination of avant-garde architecture, oil wealth, Islamic conservatism, shopping malls and climate change that Qatari American artist Sophia al-Maria has dubbed "Gulf Futurism."

"With the coming global environmental collapse, to live completely indoors is like, the only way we'll be able to survive. The Gulf's a prophecy of what's to come," she said in an interview in Dazed Digital, an online magazine covering fashion and culture.

So far, Qatar has maintained outdoor life through a vast expansion of outdoor air conditioning. In the restored Souq Waqif market, a maze of shops, restaurants and small hotels, three- to four-foot-high air-conditioning units blow cool air onto cafe customers. At a cost of $80 to $250 each depending on the quality, they are the only things that make outdoor dining possible in a place where overnight low temperatures in summer rarely dip below 90 degrees.

Recently, the luxury French department store Galeries Lafayette opened in a shopping mall that features stylish air-conditioning grates in the broad cobblestone walkways outside. Each of the vents, about 1 by 6 feet, has a decorative design. Many of them hug the outside of buildings, cooling off window shoppers looking at expensive fashions. Though nearly deserted in the heat, by 5 p.m. some people begin to emerge to sit outside places like Cafe Pouchkine.

One recent afternoon as the temperature eased to 110 degrees Fahrenheit (43.3 degrees Celsius), Aida Adi Baziac, an interior designer, was sharing iced lattes with a friend. They had just finished work and were perched over a cooling grate at an outdoor table at Joe's Cafe.

"I would say it's wasteful," Adi Baziac said. "I know how it impacts the environment negatively."

But it allows them to enjoy the outdoors in the summer, she added. "We can sit outside in an air-conditioned, controlled area, and we sit and mix and mingle."

Even Qatar's small band of climate activists sympathize. Asked about the outdoor air conditioners, Neeshad Shafi, executive director of Arab Youth Climate Movement Qatar, said, "That's about survival. It's too hot. That's the reality."

Qatar already has the distinction of being the largest per-capita emitter of greenhouse gases, according to the World Bank - nearly three times as much as the United States and almost six times as much as China.

Many Qataris believe that the World Bank's accounting is misleading. Qatar's huge exports of liquefied natural gas (LNG) are burned by distant customers across the globe. The bank's methodology charges Qatar for those emissions, rather than its fossil-fuel-gobbling customers.

Even so, Qatar emits a lot of greenhouse gases. About 60 percent of the country's electricity is used for cooling. By contrast, air conditioning accounts for barely 15 percent of U.S. electricity demand and less than 10 percent of China's or India's.

And higher temperatures combined with a growing population will mean greater energy demand, primarily for fossil fuels. While native Qataris number roughly 300,000, the number of foreign workers in Qatar has grown by a million just in the last decade, pushing the population to 2.7 million.

Qatar is adding natural gas capacity faster than it's adding solar - and at low prices. The country's new dairy farm, a natural candidate for solar power, uses 35 megawatts from the natural-gas-fired grid to keep the cows cool enough to survive the heat.

Moreover, solar power plans will be dwarfed by the government's plans to expand LNG production by 43 percent by 2024, adding 60 new tankers to its armada.

- - -

Scientists are wrestling with the question of why this small desert country and its rapidly industrializing capital have experienced such extraordinary rates of warming. Over the past five years, a large swath of the country measured more than 2 degrees Celsius (3.6 degrees Fahrenheit) warmer than during the preindustrial era, according to data from Berkeley Earth.

Abdulla al-Mannai, director of the Qatar Meteorology Department, argued in emails to The Washington Post that the fast warming of Doha is being driven largely by urbanization, or what is known as the urban heat island effect, in which the dark surfaces of city streets and rooftops absorb solar radiation.

Mannai provided data showing that temperatures in the city of Doha have climbed by an astonishing 2.8 degrees Celsius (5.1 degrees Fahrenheit) since 1962. The National Oceanic and Atmospheric Administration and NASA give lower figures, but ones that still reflect a major warming of 1.9 degrees Celsius (3.4 degrees Fahrenheit) in just over 50 years. And that is after an adjustment that is designed to take urbanization into account.

Mannai said that international experts rely too heavily on temperature readings at the Doha airport, which he said is susceptible to urban warming. The Doha airport temperature records are the nation's most complete, but other monitoring stations around the country show less warming, he wrote.

"Even though there is an increase in temperature, it is far less than in industrial countries," Mannai wrote.

Urban heat islands can indeed drive temperature increases. Doha is warming faster at night, research shows - one telltale sign of urban-driven factors.

But there is also evidence that Doha is warming because of climate change. Its temperatures are in sync with other places in the Middle East and Persian Gulf, including nonurban areas, studies show.

Many of these countries experienced a temperature spike from 1997 to 1999, a period punctuated by a major El Niño, a periodic warming that starts in the Pacific Ocean and affects the entire planet. At the time, 1998 was the warmest year on record. But temperatures didn't come back down again, suggesting a climatic change, not a limited urban one.

The Qatar Peninsula is also exposed to warming seas. One recent study, for instance, found that between 1982 and 2015, sea surface temperatures across the shallow Persian Gulf and Gulf of Oman jumped by about 1 degree Celsius (1.8 degrees Fahrenheit), far above global readings. During July, the average sea surface temperature reaches 32.4 degrees Celsius (90.3 degrees Fahrenheit).

Lelieveld, the atmospheric chemist in Germany, says the country is caught in a feedback loop. Though there are virtually no clouds or rain in Qatar, rising water temperatures in the Persian Gulf lead to more atmospheric humidity in certain months. That means there is more water vapor, which is a greenhouse gas and contributes to yet more warming.

"The story is that these areas are warming faster than the rest of the globe, and in certain cities on top of that you have an urban heat island effect and urban pollution," said Lelieveld.

Ayoub, the climate research director, worries that some extreme weather events such as dust storms or rainstorms might be tied to climate change, too. And on Oct. 20 last year, as much as 98 millimeters (3.9 inches) of rain - 120 percent of the annual average and 25 times as much as the average October - fell in just four hours. The freak storm flooded homes and roads.

"It is an outlier," Ayoub said. "The question is: Is it part of a trend?"

In the Middle East, concerns are rising that the combination of heat and humidity will one day exceed the capacity of humans to tolerate the outdoors. In such conditions, air conditioning would no longer be a convenience; it would be essential to survival.

"I often get asked: 'Can we reverse whatever is happening in the climate?' " Mannai said in an email. "I ask: Can you turn off air conditioning and refrigeration and stop using cars? Nobody will say yes."

- - -

Mannai advises "adapting to the new norm," which carries a dual meaning. It is in one sense a surrender, a realization that there is little to be done about the vast store of carbon in the atmosphere. Yet it also means that in finite urban localities, it might be possible to moderate temperatures.

In August, Qatar's Public Works Authority paved over a 200-meter stretch of road near the souq with layers of bright blue material designed by a Japanese company. Unlike asphalt, the material reflects much of the sun's radiation. Temperature readings dropped by as much as 12 degrees to a mere 136.4 degrees Fahrenheit (58 degrees Celsius).

A short walk away, the Qatar Foundation - a progressive organization set up by Sheikha Moza bint Nasser, the current emir's mother - is overseeing a high-end bit of urban planning known as the Msheireb. The development's walkways and streets point north to take advantage of breezes that come from that direction. Cylindrical pillars will blow cool air in an open courtyard featuring water fountains and a sun-blocking canopy can be closed on windy days.

The development has 6,400 solar panels that will generate 4 percent of the development's energy.

At the Gulf Organization for Research and Development, Horr, the environmentalist who heads the group, is developing regional building quality standards that he hopes will bring about far-reaching change.

Some of the early high-rises - such as the 802-foot Palm Towers - used glass to clothe their exteriors, allowing more heat inside. New regulations limit glass to no more than 40 percent of a building's exterior, says Hassan Sultan, a member of the Qatar branch of the American Society of Heating, Refrigeration and Air-Conditioning Engineers.

"When two-thirds of your electricity goes to air conditioning, unless you manage this part all your other measures are minor," Horr said.

- - -

Late last year, the government announced that the World Cup would be carbon neutral. That means that for every mile flown from overseas, for every mile driven between venues, for every factory that produced construction materials, and for every air conditioner running overtime, there should be an offsetting reduction in greenhouse gas emissions.

Qatar's government says the carbon emissions will be smaller than those at other World Cup venues where stadiums were far apart or even spread across different countries. The distance between Qatar's stadiums is never more than 35 miles and as close as three. Five of the eight stadiums will be connected to new metro lines still under construction. Both could trim spectators' global travel, which accounted for about 57 percent of the carbon emissions at the games in Russia.

Shafi, the climate activist and environmental engineer who comes from India, says that the government is undercounting the cost of the World Cup, making it easier to become carbon neutral. Many big ticket infrastructure items are not being counted as World Cup projects because they are considered to be part of the country's preexisting 2030 building plan, he said.

That building program includes roughly $200 billion for metros, a new airport and roads.

The Supreme Committee for Delivery & Legacy, responsible for the World Cup preparations, said its budget for stadiums and training sites would come to about $7 billion. A committee official, who was not authorized to speak for the committee, said other developments were "not a direct result of the tournament coming here."

The government recently unveiled a plan to plant 1 million trees in Qatar. Shafi calls it "unrealistic," and said, "10 saplings are planted by VIPs and then they go home."

Nevertheless, the committee is pushing ahead. It says it will rebuild one stadium using construction waste for 88 percent of its materials. Another will be made of shipping containers and modular steel components so it can be broken down and sent to a country that needs stadiums more than Qatar will after the games. Thousands of seats at other stadiums can be relocated, too.

"We don't want to be left with white elephants," said the committee official. "They will be very easy to undo and take apart." Ghani said "like Lego."

Bodour Mohammed al-Meer, the manager for sustainability and environment at the Supreme Committee, said that the World Cup would also feature 8.6 million square feet of landscaping.

But one important method for getting to carbon neutral is for the Supreme Committee to buy credits using the Global Carbon Trust set up by Horr. The trust, like similar cap-and-trade mechanisms in Europe or California, would certify climate projects that reduce greenhouse gas emissions, he said. The reductions would then be packaged as credits that can be sold to companies, organizations or governments in the region that have failed to meet targets and need to offset carbon emissions. The higher the price, the more likely companies will address their own emissions rather than buy others'.

That climate-consciousness has been largely limited, however, to the World Cup.

In its submission to the Paris climate conference in 2015, where many countries volunteered specific targets for cutting emissions, Qatar demurred and said that it has been "blessed with oil and gas resources that are being used to overcome the living difficulty on this land."

The government acknowledged that "ecological and human systems are vulnerable to the adverse impact of climate change," but it said only that it would seek "to strike a balance between development needs and environmental protection."

Then on Oct. 9, Qatar Petroleum announced that it would construct a facility to capture and store 5 million tons of carbon from the company's liquefied natural gas operations by 2025. The facility, which will eventually have a 2.1 million-ton-per-year capacity, would be bigger than all but two worldwide, said Pavel Molchanov, a senior analyst at the investment firm Raymond James.

Along Doha's Corniche, climate seems like a pressing issue. Every week, thousands upon thousands of foreign workers gather to stroll, eat, lie on a strip of grass and dance on docked traditional boats.

Zahir Ahmmed Ali Ahmmed, 48, comes from Bangladesh and has spent 19 years abroad working mostly for a refrigeration company in Saudi Arabia. He's hoping to find work here, where most low-skilled foreign workers make $300 to $425 a month. While he looks, he is staying with friends, four of whom share a room with him.

Ahmmed is aware of climate change. Back in Bangladesh, where his wife and three sons live, farmers waited for rains this year before planting. And they waited. And waited. But the rain didn't come. He blames climate change.

"The change of seasons back home, it isn't how it used to be," he said.

Now, in Qatar, he says he glances every day at the temperatures back in Saudi Arabia. Qatar, he said, is much hotter.

As the sun began to set one afternoon outside the Khalifa International Stadium, Ghani, the cooling expert, was trying to make sure that in the meantime Qataris can take refuge in air-conditioned places, even if they are outside.

"Yes, we are very concerned about climate change," he said, noting that the projects use locally sourced materials and locally manufactured seats. "We looked at every aspect of how to minimize our carbon footprint."

The Al Janoub stadium is a point of pride. He built a 92-by-92-foot building next door to store cool water at night. That is piped during the day into the stadium, which extracts the cold through heat exchangers. There are intake returns in the floor, so the equipment is re-cooling air from inside the already cooled stadium and isn't sucking in sweltering air from outside. When the first game was played at 10:45 p.m. in May, the system worked well.

Now, Ghani is designing a covered open-air walkway so that spectators don't expire from heat on the way to and from the parking lot or metro.

Outside Khalifa International Stadium, whose cooling system he also designed, Ghani looked at two prototypes. Each features cooling vents, hanging plants and curved solar panels.

So far, Ghani said, the design still needs work. The solar panels don't provide enough power to run the cooling system. The plants are scraggly. And, worst of all, a stiff hot breeze is blowing through, rendering the cooling system ineffective. "Wind is your biggest enemy," he said.

Ghani said he is concerned about cooling the planet, but for now he'd settle for cooling the pedestrian walkway. He hasn't given up.

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The Washington Post's Chris Mooney and John Muyskens contributed to this report.

Bruce Springsteen conquered music and Broadway - now he's making movies

By Ann Hornaday
Bruce Springsteen conquered music and Broadway - now he's making movies
Bruce Springsteen at his home in Monmouth County, N.J., in September. Springsteen co-directed

COLTS NECK, N.J. - "Ahh, it's early!" Shortly after 9:30 on a warm autumn morning, Bruce Springsteen walks into the cozy kitchen-sitting area of Thrill Hill, the recording studio nestled into a corner of his Monmouth County farm. "For the first interview of my 70s, it's early!"

A few days after turning 70, Springsteen looks tan and fit as he settles into a leather slingback chair, stretches his arms and runs his hands through brush-cut hair the color of steel shavings. This is the same room where "Western Stars," a movie based on his recent album of the same name, was in postproduction over the summer, with co-director Thom Zimny editing at a nearby dining table as he listened to Springsteen working on the score in the next room. The movie had its world premiere at the Toronto International Film Festival in September; it opens in theaters on Oct. 25.

Springsteen makes his feature directing debut with "Western Stars," sharing a credit with Zimny and making official a fact that has been obvious to anyone who's ever listened closely to his music: Bruce Springsteen - singer, songwriter, rock star, consummate showman, American icon - has always been a filmmaker. Whether in the form of widescreen, highly pitched epics or low-budget slices of daily life, Springsteen's records have been less aural than immersive, unspooling with cinematic scope, drive and pictorial detail. Phil Spector might have built a wall of sound, but Springsteen used sound to build worlds.

He greets the suggestion that he's an auteur with one of his frequent self-effacing chuckles. But Springsteen admits that a cinematic point of view came naturally to him. "Movies have always meant a lot to me," he says in his familiar rasp. "It's probably just a part of being a child of the '50s and '60s and '70s, when there was so much great filmmaking."

He grew up in a blue-collar, Irish-Italian family at a time when the local bijou was still a vital community hub. "The Strand Theatre in Freehold, New Jersey, was dead in the center of town," he recalls. "It was your classic old, small-town movie theater. Its main attraction was, 'Come on in, it's cool inside.'"

He laughs again.

"It didn't matter what they were playing, it was air-conditioned. So, on all those dead, small-town summer days, when it would get up into the 90s in Freehold, you'd drift in no matter what was playing, and see what was on the screen."

Springsteen's first album, "Greetings from Asbury Park, N.J.," introduced him in 1973 as an instinctively visual, character-driven storyteller. The title of his second album that year, "The Wild, the Innocent & the E Street Shuffle" was inspired by a 1959 movie starring the icon of postwar American Westerns, Audie Murphy. The songs evoked everything from "West Side Story" to the edgy, urban style of young Martin Scorsese.

But it was 1975's "Born to Run" that brought Springsteen's sensibility into its fullest expression. Structured as a day in the life of young people trying to escape their own dead, small-town summer days, the record plays like a movie of the mind's eye, with propulsive movement, linear narrative and third-act catharsis.

Zimny, who has directed several Springsteen music videos and documentaries and recently won an Emmy for "Springsteen on Broadway," recalls listening to "Born to Run" long before the two worked together, and being particularly affected by the album's most ambitious track: the street opera "Jungleland," with its fugitive leading man, barefoot love interest and kids flashing guitars "just like switchblades." The song "opened up a world of possibility for me," he says, "because it just dealt in imagery. 'Jungleland' was the first time I heard a sax solo feel like a Technicolor film."

If "Born to Run" evoked the chrome, concrete and escapist fantasies of the movies Springsteen watched at the Strand, the lexicon of "Darkness on the Edge of Town" was grainier and less mannered, but still harked back to the imaginary worlds of his youth.

"When I wrote 'Born to Run' and 'Darkness,' I saw them as B-pictures," Springsteen says. "If they worked really well, they were good ones, and the songs I was unhappy with were bad ones."

He wanted both records "to have the breadth of cinema," he says, "while at the same time remaining very, very personal for me. Those were the parameters of what I was imagining at that particular moment. I was sort of using the contours and the shape of films and movies, while at the same time trying to find myself in my work. But the film-ness of my songs was never far from my mind."

And it was a self-mythologizing vernacular that his audience immediately understood.

"It was just how you processed everything," he continues. "As a teenager, you were looking for a dramatic life. Where is my dramatic life? As if things weren't dramatic enough. And you were writing your own script in your head as you walked down the street. It was all just part of living at that time."

- - -

Jon Landau co-produced "Born to Run" and "Darkness on the Edge of Town" (as well as several subsequent records) and would talk with Springsteen for hours about music, novels and movies, a conversation that still hasn't ended (Landau has been Springsteen's manager for 41 years). While they were making "Darkness," he remembers, Springsteen told him about a movie he'd seen on TV, without catching the title. "He started to describe the film to me, and I said, 'Oh, Bruce, that was "The Grapes of Wrath."' He said, 'That's about the greatest thing I've (ever) seen.' I said, 'What did you like about it?' And he said, 'Everything. The look, the intensity, the focus, the artistry, everything.' And I said, 'Well, you know, John Ford directed that.' And he said, 'Oh, I've heard of him.'"

That was the point, Landau says, when Springsteen "started looking at film in a whole different way. He started to make contact with great American cinema and it just grew and grew and grew." Eventually, Springsteen formed his own canon of go-to movies, each of which has had an imprint on his records - Ford's ambivalent Western epic "The Searchers," noir classics "The Night of the Hunter" and "Out of the Past," Scorsese's "Mean Streets" and "Taxi Driver," "The Godfather." All share Springsteen's love for poetic imagery, volatile emotion and deep misgivings about the American myth.

"The Grapes of Wrath" would become the chief influence on Springsteen's 1995 record "The Ghost of Tom Joad," just as the desolate acoustic mood of "Nebraska" had been inspired by "The Night of the Hunter," Terrence Malick's "Badlands" and the 1980s crime drama "True Confessions," with Robert De Niro and Robert Duvall. "There was something about the stillness of it that affected the way that I wrote at the time," Springsteen says. "The violence underneath."

Nearly every Springsteen record has its own musical signature but also its own production and lighting design, character arcs and shot structure: the high-kicking production numbers of "Rosalita" and "Out in the Street." The gleaming close-ups and jump-cut rhythms of "Born to Run." The "East of Eden" Oedipal rage of "Adam Raised a Cain." The erotic-thriller charge of "Candy's Room" and "I'm On Fire." The lurid neon nightscape of "Tunnel of Love." The aging actors and magic-hour tonal values of "Western Stars." Over the course of a nearly 50-year career, both as a solo performer and with the E Street Band, Springsteen's music has become its own extended cinematic universe, populated by recurring characters, environments and themes: Broken heroes. Rattrap towns. Dashed ideals and dogged faith in redemption. And, always, the beckoning highway.

Along with the characters he invented, Springsteen has shaped his persona to emulate musical heroes like Elvis Presley and Woody Guthrie, as well as his favorite actors. On the cover of "Darkness on the Edge of Town" he could be Al Pacino playing Travis Bickle, while wearing Marlon Brando's T-shirt under James Dean's leather jacket. Springsteen says he was "tremendously" influenced by actors as he sought to forge his identity as a performer, from Dean and Brando to Pacino and Robert De Niro.

"Italian American actors from the 1970s had a huge impact on me," he says. "If you came and saw us onstage in the '70s, you saw a very theatrical performance. I was kind of channeling all of those actors from that time, and bringing them onstage with me." Even the piratical high jinks with Miami Steve Van Zandt and the playful showdowns with saxophonist Clarence Clemons felt like they sprang directly from the screen: Sharks-vs.-Jets by way of the Bowery Boys.

It was also at that time - the first crest of his eventual superstardom - that Springsteen landed on the covers of both Time and Newsweek, prompting the inevitable calls from Hollywood. He met with Milos Forman, who considered him for "Hair." And he laughs at a classic "Kid, I like your moxie!" moment with "King of the Gypsies" producer Dino De Laurentiis. "I was like, 25, and he was behind a big desk smoking a big cigar. It was just that entire scene, played out hilariously."

Eric Roberts eventually got that part. But Springsteen has no regrets. "I didn't have the confidence at the time," he says. "I thought, I don't really deserve to be working in this arena right now, because I hadn't done the homework. I hadn't prepared myself. Whereas in music, I'd prepared myself thoroughly."

In a rock 'n' roll world that prizes authenticity above all else, Springsteen has succeeded at both embodying unaffected sincerity and shrewdly deploying it as a brand: In addition to the unassuming men and women he valorized in his songs, perhaps his most brilliant character is The Boss, a Bruce-adjacent alter ego who, in hundreds of music videos, movie soundtracks and "Sopranos" needle-drops, has gone from scruffy boardwalk hustler to bandana-and-biceps teen idol to a multimillionaire in working-class drag.

In the 1992 single "Better Days," Springsteen sang about being "a rich man in a poor man's shirt." Today, in addition to the sprawling horse farm in New Jersey, he owns homes in Florida and Los Angeles, but still convincingly radiates man-of-the-people modesty, a contradiction he deflects by being the first person to call it an act. ("I made everything up!" he says at one point. "It's a fascinating magic trick.") Springsteen admits that he continues to find the notion of authenticity elusive, "knowing what a self-creation I was, and to some degree still am. But the strange thing of it all is that if you do it long enough, you start to become the thing that you pretended to be."

In fact, the man and the image now feel so organically fused that Springsteen has become an emotional instrument in his own right. The latter-day meta-version of Bruce Springsteen, as seen in both "Springsteen on Broadway" and "Western Stars," is simultaneously subject and protagonist, humble singer-songwriter and larger-than-life leading man.

In both films, the camera often pushes in for a tight shot and stays there, a strategy that Landau notes is by design. "Some of that comes instinctively from our shared love of Sergio Leone, who is the man who proved that you could never be too close," he explains. But it's also the result of learning over the years that Springsteen is physically far more expressive than stylized visuals or manipulative edits. Even on huge stadium screens, Landau observes, the close-up has always been king. "The story of the song is on his face,"he says. "If you weren't hearing the lyrics, you'd still have some idea of what he's saying just from looking at him."

- - -

As a movie, "Western Stars" began with a modest proposition. Instead of touring for the album, Springsteen intended to release a documentary of a performance he and his wife, Patti Scialfa, recorded over two days with a band and a 30-piece orchestra in their farm's 100-year-old barn. "I said, 'OK, I'll shoot the record start to finish,' " Springsteen recalls, "and that would be my tour."

But as he watched the concert footage, he realized that the songs and their lush '70s-era arrangements needed more context. One night, while Scialfa watched TV, Springsteen spent a couple of hours writing introductions that became the voice-over script for "Western Stars." He and Zimny went to the desert near Joshua Tree, where Springsteen can be seen roaming amid the brush, reflecting on the American Dream, its disappointments, personal demons ("If I loved you deeply," he says at one point, "I would try to hurt you.") and his cardinal theme: "the struggle between individual freedom and communal life."

Eventually, "Western Stars" morphed from a straightforward concert doc to a sweeping montage and introspective portrait, composed of present-day footage, home movies, archival photographs and an achingly beautiful live performance. In the process, Zimny realized that Springsteen's instincts as an image-maker were just as canny 40-plus years after "Jungleland." The two were in "constant communication" throughout filming, Zimny says, with Springsteen throwing out ideas far beyond just the music. "It's getting texts, it's getting imagery, it's getting lines from a song and visual references."

At one point, Zimny received a text from Springsteen suggesting a shot of his hand on the steering wheel of a vintage El Camino, then a similar image, this time including Scialfa's hand. The bookends made the final cut, symbols of freedom and community writ large, but also a man reconciling a lifetime of restlessness and all-consuming ambition to the consolations of domesticity and commitment.

For Landau, the themes and imagery of "Western Stars" circle back to the conversations he and Springsteen had about their mutual love for John Ford decades ago. But mostly, he says, it reflects "the maturation of Bruce's whole life of learning about film." More than any previous movie or video, "this one is him from the get-go, 100 percent," Landau says. "Every idea, word, sound, edit and cut."

Springsteen describes "Western Stars" as of a piece with both his 2016 memoir and the Broadway show - a trilogy that, perhaps unconsciously, was part of his coming to terms with the birthday he just celebrated.

"I was thinking, 'How do I sum up my experience to this point?'" he says. "The book, the play and this film, they all serve that purpose. It kind of cleanses the palate and it will allow me to move on to whatever we do next."

The "we" in that sentence is the E Street Band and "next" is recording a new batch of songs he wrote for them earlier this year. Springsteen doesn't see another movie in his immediate future, unless it's the four-minute kind he's been making all along.

"Music was always enough for me," he says philosophically. "Anything else that came along was just an adjunct, and an organic and happy accident that came from being a musician, which is what I wanted to be my whole life."

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Video: Movies like "Mean Streets" and "The Searchers" are just some of the influences that informed Bruce Springsteen while penning some of his most classic songs.(REF:oconnore,REF:woehrd/The Washington Post)

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Rosario Dawson is so much more than just Cory Booker's 'actress girlfriend'

By Jada Yuan
Rosario Dawson is so much more than just Cory Booker's 'actress girlfriend'
Actress and activist Rosario Dawson was among the crowd of several thousand people who gathered on the National Mall for the

NEW YORK - There, on the sidelines of a run-through for a show at New York Fashion Week, is a lone figure, dancing and whooping and singing. Stony-faced models file by, but Rosario Dawson, the actor who co-designed the clothes they're wearing from the Ghana-based fashion line Studio 189, is throwing off enough light and energy for all of them.

"You know those charity dances where you have to dance for, like, 30 hours straight? I could totally do that," she says, not at all out of breath, before running backstage to give out hugs and motivational speeches.

"I am fa-reaked out! Y'all look so beautiful!" Dawson tells her runway walkers: kids, grandmas, actual models, friends and bare-chested female dancers in gold body paint. All around Dawson and Studio 189 co-founder Abrima Eriwah is a rainbow of skin tones and gender identities and jubilant patterned fabrics reflecting the collection's inspiration: They called it "Heritage" to mark the 400th anniversary of the first slave ships departing Africa for Virginia.

Were Dawson a politician instead of a longtime activist who's dating a guy who's running for president, these would be her constituents. She's doing the Elizabeth Warren selfie line, except she's the one who wants pictures with everyone.

Fantasia was there, along with Jay-Z protegee Young Paris, Black Lives Matter co-founder Opal Tometi, and a packed house of some 800 people. But not Sen. Cory Booker, or "noted boyfriend of Rosario Dawson," as New York magazine's feminist website the Cut likes to call him.

Their first anniversary was Oct. 14, and the year has been a mishmash of convoluted schedules. In September, the senator from New Jersey was prepping for the third Democratic debate in Houston during her fashion show. And by the time he took the debate stage, Dawson was already back in Albuquerque on the set of "Briarpatch," the neo-noir anthology series for USA network that she stars in (as an investigator having an affair with a senator!) and which just wrapped a 3 1/2-month shoot.

"I laugh because it's like, 'OK, you're flying and connecting through here. Maybe we can meet at the airport hotel,' " Booker said in an interview last week, calling in from the campaign trail. "It has made for great adventures of, you know, making seven hours together be magical."

Dawson is also working on several social justice documentaries; voicing Wonder Woman in an animated feature; promoting the big-budget movie "Zombieland: Double Tap"; and working as a board member for Voto Latino, the voting rights organization she co-founded with María Teresa Kumar 15 years ago. Not to mention her personal obligations as a single mother of an adopted teenage daughter and the Hollywood success story in a big Puerto Rican family from New York's Lower East Side.

As recognizable as Dawson is - she's starred as Claire Temple in the Netflix Marvel universe and gets mobbed by fans - it is interest in her relationship with Booker that is currently dominating her story. He's the only unmarried Democratic presidential candidate and potentially the first modern bachelor president. She's the young Jane Fonda of the Afro-Latinx world (or, perhaps, labor leader Dolores Huerta if she'd also starred in "Sin City" and the movie version of "Rent"). They are the rare power couple capable of fascinating political analysts, Hollywood gossips and your mother.

Until now, they've rarely been seen together in public. Instead, Booker has gushed about her on talk shows, and they drop little windows into their relationship on Dawson's Instagram, through cute videos or screenshots of text messages she posted of Booker's buddies congratulating him for having a girlfriend who was a clue in last Sunday's New York Times crossword puzzle.

Tuesday's debate in Ohio is the first Dawson has managed to attend. Booker arrived holding her hand. She stayed until the end, documenting it on Instagram. It seems to be part of a new phase of openness in their relationship.

"I'm in love! I am absolutely in love, and it is so exciting," Dawson said last month, while sitting barefoot in a gown on her hotel bed during a 24-hour trip to the Toronto Film Festival.

Because "Briarpatch" wrapped in late September, she's been home in Los Angeles and Booker has come to her. He kissed her on the red carpet of her "Zombieland: Double Tap" premiere on Thursday.

When the Daily Mail wrote in a headline that Dawson had joined her presidential candidate boyfriend at the premiere of the sustainable agriculture documentary "The Need to Grow," Booker corrected it on Twitter, "Actually, I joined her."

"It's just lazy," Dawson says in a later phone call. "Like, I narrate that movie and I'm a producer on it."

All this togetherness, Dawson says, is just a function of her having some free time. But it certainly can't hurt Booker's flagging poll numbers; he's averaging 1.4 percent in national surveys.

Dawson says she's planning to ride around Iowa in an RV next month with him. "RV tours are my jam," she says. "I think there's no way of making that happen without quote-unquote 'joining him on the campaign trail.' It's going to show up like that no matter what, but I'm just trying to spend time with my boyfriend."

- - -

Flash back to the 2016 election: Booker was a freshman senator who'd endorsed Hillary Clinton and was a possible VP pick. Dawson was a vocal Bernie Sanders surrogate, stumping for him around the country. She also got arrested in the "Democracy Spring" protests at the Capitol, calling for reform of voting laws and removing money from politics.

"I don't know what it would be for, but I could see myself getting arrested again in the near future, if that's what draws people's attention to something. For me, it's always on the table," says Dawson, who has said that running for office is on her bucket list.

Indeed, Dawson was so far left in 2016 that many people believe that after Sanders lost the primary, she voted for Jill Stein. "No, I didn't!" she says. "It's on my Wikipedia and it keeps getting proliferated, but it's not true."

She was at the Democratic convention, she saw the infighting, she got sad, and mad. And she says she's still upset anyone would think she'd do something to have put Donald Trump in office.

Dawson's mom, Isabel Celeste, also stumped for Sanders and says that when she first met Booker, she told him, "You know, you don't get my vote."

But after getting to know him, she's convinced: "He's young, he's hard-working, he's stoic, he's amazing, he's probably going to marry my daughter and shut the front door."

It seems as if Dawson and Booker, then, are a case of opposite Democrats attract. Some clickbait-y blind items have circulated on the internet insinuating that their relationship is fake. If this were for show, honestly, she'd be a little edgy for his presidential brand. Toward the left side of progressive. Has been arrested for social justice and expects to do it again.

And then there's that celebratory video for her 40th birthday that she posted on Instagram this May of herself topless and outdoors, looking at palm trees as birds chirped in the background. She showed nothing but her back and confidence and excellent complexion, and yet she inspired a slew of incredulous responses on conservative media and Twitter wondering whether Cory Booker's "actress girlfriend" had gone nuts.

These two seem to take it in stride. She's 40. He's 50. They've both lived public lives for a long time. "I think that's actually pretty cool," says Dawson. "I don't need to make that legitimate for anybody else."

Like most couples who've been together for a while, their origin story is evolving. Though Booker has said that Dawson didn't give him the time of day when they first met at a summer 2018 fundraiser for Ben Jealous, a mutual friend who was running for governor of Maryland, he tells it a little differently this time.

"There was no love connection there," he says. "I think it was the places of life we were in. I was probably dating somebody when we first met."

Dawson's last known boyfriend before dating Booker - the most earnest man in politics - was comedian Eric André, perhaps best known for finding inventive ways to appear fully nude on his Adult Swim talk show.

Then in October 2018, Dawson and Booker ran into each other again. "I mean, gosh, that night we talked for hours and hours," says Booker. At the end of the night, he says, "I had trouble asking for her phone number. ... I think I said something really stupid like, 'Uh, how would I get in touch with you?' And she mercifully said something like, 'Oh, you want my phone number?' And my insides were like, 'Hell, yeah!' "

Was he really the dork he says he was?

"A million and one percent," says Dawson. "He's so charming and so confident and so capable, but it's not like that translates to being some super-smooth kind of guy. That's not his style. What wins me over with him is definitely the dad jokes."

They live on opposite coasts, but Booker says that almost immediately they started seeing each other once a week. The couple knew that Booker's schedule would become insane once he declared on Feb. 1 and that Dawson's would become immovable once she started "Briarpatch."

But then Dawson's dad, Greg Dawson, got diagnosed with pancreatic cancer at the beginning of the year, and she oriented all the time she could toward caring for him and flying back for his chemo appointments.

Rosario Dawson says that his tumor has shrunk dramatically and that she's both glad she was able to be his advocate and furious at how byzantine the health-care system is.

Her 16-year-old daughter, Isa, meanwhile, spent most of the summer with her in New Mexico, which didn't leave a ton of time for Booker. Dawson says they went two months without seeing each other. But they've made up for it with FaceTime, which they try to do twice a day. He's gotten in the habit of sending her music every morning, and he just finished reading David Benioff's World War II novel "City of Thieves" to her over the phone. Dawson says he's the only partner she's ever spoken to every day, multiple times a day. They both enjoy pointing out that they are vegan.

She calls him CAB and forgets that he doesn't like it when she uses that around other people.

"Not everybody has good initials," she says. "He's my anchor. He's my guy, you know. He's very presumptuous. My initials are R-I-D. But he calls me RIB."

"Look, both of us, you know, we've had relationships," says Booker, "but I'm not sure if I've ever fully given myself over to a relationship as much as I have with her and allowed myself to be as vulnerable."

Dawson says that she was trying to explain to a younger cousin how you know you're in love, and she could only describe how she feels about Booker. "For my whole life, I've always felt like, even when I got into a relationship, I was trying to be the center of the storm and everything was just this maelstrom out there," she says. "But for the first time, I feel like I have someone in the center of the storm with me."

- - -

Dawson was about 7 years old when she started marching with her family for housing rights, homelessness rights, women's rights, LGBTQI rights. Her mother would push Rosario and her younger brother Clay, who is now a writer and DJ, around in a shopping cart lined with pillows.

"I would have a staple gun and sticks and poster board," Isabel Celeste says, "and they would have magic markers, and they would make banners for people, so they'd have something to march with." Dawson's great-grandmother and grandmother marched in support of unionizing female garment workers.

They were a young family; Isabel Celeste was 17 when she had Rosario, who has no relationship with her biological father. When Rosario was little, her mother married Greg Dawson, a carpenter who raised her.

Living conditions grew unbearable in the only Lower East Side apartment they could afford, so they moved into an abandoned building around the corner that didn't have electricity or running water but at least was clean.

Growing up, Dawson was the performer of the family, according to her uncle Gustavo Vasquez, who is a comic-book artist: "She would dress up like Madonna did with the bows and patterns." And, he says, she seemed to absorb the creative energy of the artists who were also squatting in their building. Still, no one in the family had ever been in show business, and had she not been sitting on her stoop at age 15 at the exact time director Larry Clark and writer Harmony Korine walked by, Dawson wouldn't be, either.

They asked her to do a screen test, put her in their 1995 film, "Kids," about New York City youths grappling with HIV/AIDS, and her life changed. She still lived at home, though, even after Spike Lee cast her in "He Got Game."

As an actress, Dawson has always veered toward genre, whether it's because she grew up devouring comic books with her uncle Gus or because those are the roles she's offered. "I've had indie films where I've either been the lead or a co-lead," she says. "But usually I'm a co-star."

"Briarpatch," her USA show, which premieres in January, may be the meatiest role she's had. It's based on a hard-boiled crime novel from prolific author (and World War II veteran) Ross Thomas. Creepy hotel. Small-town Texas villains who turn out to be terrifying. Exploding cars. Zoo animals run amok. Alan Cumming.

And at the center is Dawson's character, Allegra Dill, a woman from a Texas border town who comes home from Washington, D.C., to investigate her sister's murder. Allegra also happens to be having sex with her boss - a U.S. senator.

Andy Greenwald, the well-known TV critic who adapted Thomas' book into the series and is the "Briarpatch" showrunner, says he couldn't believe it when he heard Dawson was interested in the role.

"I feel like people have been asking her to be the lead in a TV show for a decade," Greenwald says. "And she said no every time."

Dawson has done an 18-episode guest arc on "Jane the Virgin." But she's never had her own series. "It's the commitment," she says. Unlike most TV shows, "Briarpatch" is a 10-episode anthology that wraps up Dawson's character arc.

Being No. 1 on the call sheet is a huge responsibility, and Dawson did not take it lightly. The No. 1's mood can make or break everyone's experience on a production. Greenwald says Dawson made a point to be "relentlessly optimistic and positive" no matter what was going on with her daughter or her dad's cancer or Booker being so far away - though he did come to the set once, driving three hours out of his way while in New Mexico for a fundraiser.

- - -

Back what seems like a lifetime ago, in Dawson's hotel room at the "Briarpatch" premiere at the Toronto Film Festival in September, Dawson grabbed a bottle of water and began adding an inky, green substance to it from a dropper.

"Have you had chlorophyll water?" she asks. She'd been using it to treat her altitude sickness in New Mexico. "It's the difference between me having migraines and then throwing up or me being able to sleep and function and actually have extra energy," she says.

She'd been having a great time in Toronto. The news was getting her a little annoyed, though. She'd told a reporter she wanted to work on voter registration vs. stumping for candidates this election, and suddenly there were articles saying she didn't endorse Booker. A month earlier Page Six had published its third article about how Booker's "actress girlfriend" wasn't attending his campaign events. (Dawson posted it to her Instagram with the caption, "I made it!")

"It's important for me to maintain my own space and my own character and personality and career and professionalism," she says. No one's accusing Booker of being neglectful if he doesn't come to some of her events. "I'm like, 'I call B.S. on this.' I don't need to be on his arm to be supportive of him and vice versa."

"Both of us are feminists," Booker said in a later interview, "and both of us find it a double standard that they don't ask me the same questions that they ask her. You know, I have an incredibly successful, self-made woman as my girlfriend who is managing a business, nonprofit work, a career. And when she has her big moments, nobody says, 'Hey, where's your boyfriend?' "

Plus, there'd been reasons, even beyond work and time, that she'd been laying low. She and Booker get harassed sometimes when they go out in public. Sometimes her daughter is with them. She's been in relationships with other actors before, but this is a level of intense scrutiny, coupled with fear, that she'd never experienced before. A pipe bomb, she pointed out, had been intercepted on the way to Booker's New Jersey office last year.

She wants to find more meaningful acting projects, produce more documentaries, maybe go back to college and learn about "regenerative farming and soil practices to capture carbon." She'll also continue to grow Voto Latino, which registered 200,000 voters last year and started holding leadership summits.

She and Booker have talked about kids, and are seriously think about it. She adopted Isa at age 12, and together they've grown. "I feel very much like I checked the mom box in this lifetime." And as much as she loves babies, "I don't know that I have to be the one to actually push them out."

Still, she finds all the speculating she gets from strangers, and her mother, amusing. "People go, 'Oh, my God, if you guys became the first family, then you can be pregnant in the White House!' I'm like, 'Slow down.' There's a lot of time between here and then."

Booker's poll numbers are improving, and he qualified for the fifth Democratic debate in November, but this field is fraught and full.

For the first time in a while, though, she has a little breathing room just to be.

"We're here and we're thriving, somehow," she says. "And I want more of that. And I want that for the rest of my life."

Pulitzer-winning opinion from the most respected voices in the world.

Hey, Democrats, why not talk about health-care delivery, not just about costs?

By megan mcardle
Hey, Democrats, why not talk about health-care delivery, not just about costs?

MEGAN MCARDLE COLUMN

(FOR IMMEDIATE PRINT AND WEB RELEASE)

(For McArdle clients only)

By MEGAN MCARDLE

EDITORS -- Effective Nov. 1, columns by Megan McArdle will be available for print publication only.

A few things have changed in the health-care debate since the Great Health Care Wars of 2007-2013. For one thing, advocating a government-run, single-payer system was a distinctly minority view a decade ago. This time around, two of the three top Democratic presidential contenders have committed to Medicare-for-all, by which they mean a universal system that would functionally outlaw private insurance.

But the more interesting difference between then and now is less ideological than technocratic: The entire Democratic debate seems mostly focused on how to finance health care, not on how to deliver it. Possibly because their proposals on the finance side are so radical, Sens. Elizabeth Warren, D-Mass., and Bernie Sanders, I-Vt. -- and by extension, everyone else in the race -- have spent a great deal of time reassuring everyone that nothing about their health care will change except for the cost. That's a pretty significant shift from the Obama era, when we heard how government would make care not just cheaper but better, too.

After attending the Democratic presidential debate in Westerville, Ohio, on Tuesday, I drove from Columbus to Cleveland, where I spent a day at the Cleveland Clinic, which served as one of the models for Obamacare's reforms. Founded in 1921 by doctors who thought medical experts should work as a team, the Cleveland Clinic has kept true to that mission for nearly a century. Its doctors are salaried and get no reward for doing more procedures; its administration pursues both innovation and integration of care.

Almost all the things that are broken about the U.S. health-care system actually work at the Cleveland Clinic. The doctors focus narrowly on one thing; in the kidney and urology institute, for example, one specialist will handle just prostate cancer, another incontinence, a third kidney disease. Research has shown that this type of specialization produces better outcomes than a broader practice. The specialists work closely in teams with other equally specialized experts, in institutes organized around diseases -- and thus the affected patients -- rather than in departments organized around the kind of specialists who work in them.

But that's just one example of the ways in which Cleveland's integrated-care model differs from what's available to most Americans. Health-care IT is usually startlingly inept and hard to use; the Cleveland Clinic's is user-friendly and offers patients easy access to high-tech features such as virtual office visits. The clinic's very buildings are designed to make the system easy for patients to navigate, to minimize the number of visits and the number of buildings visited, and to speed up the time between diagnosis and treatment.

These things are possible only because of Cleveland's highly integrated model. Two years ago, I switched from the traditional fee-for-service system into Kaiser Permanente, which takes Cleveland's salaried-doctor-and-integrated-facility model one step further by also functioning as your health insurer. Choosing Kaiser over a traditional insurer was a deliberate experiment by someone who often writes about health care and knew quite a bit about their model -- and even so, I was stunned when I experienced firsthand how much easier such systems make life for patients.

If you offered sick people a choice between reforming the payment side of the system so that everything functions more like Medicare, or reforming the delivery side so that all hospitals function more like the Cleveland Clinic or Kaiser, they might well choose to reform the delivery side. Medical bills are scary, of course, but so is navigating through the fractured mazes of different systems that most very sick people end up caught between. So it's worth asking why Democratic politicians -- like too many health systems -- seem so relentlessly focused on the money rather than the patients.

One answer is that reforming delivery systems is hard. The government can't command other health systems to replicate the cultural values, or the institutional expertise, of a Kaiser Permanente or a Cleveland Clinic or a Mayo Clinic. All the government can do is alter payment schedules. And when the Obama administration tried to use that financial lever, it turned out that in the absence of a better institutional culture, patients saw, at best, marginal improvements. At worst, the results were perverse: New Medicare rules that penalized hospital readmissions seem to have resulted in the deaths of some patients.

Unfortunately, if Democrats aren't going to reform the delivery system, then they probably can't reform the payment system, either. Because unless America gets a handle on how patients are cared for, we can't care for millions more of them at a price the American taxpayer will accept.

Follow Megan McArdle on Twitter, @asymmetricinfo.

(c) 2019, Washington Post Writers Group

Yet again, the truth outed

By kathleen parker
Yet again, the truth outed

KATHLEEN PARKER COLUMN

(Advance for Sunday, Oct. 20, 2019, and thereafter. Web release Saturday, Oct. 19, 2019, at 8 p.m. Eastern time.)

(For Parker clients only)

WRITETHRU: 4th graf, 1st sentence: "in order to obtain help investigating the 2016 hacking of a Democratic National Committee server!" sted "in exchange for help investigating the 2016 hacking of a Democratic National Committee server!"

By KATHLEEN PARKER

EDITORS -- Effective Nov. 1, columns by Kathleen Parker will be available for print publication only.

WASHINGTON -- Shakespeare long ago wrote that "truth will out," meaning that what's true -- by virtue of its basis in fact and logic -- eventually will conquer the lie.

Sometimes truth is so eager to be heard that it slips past the speaker's tongue without his conscious cooperation.

Enter acting White House chief of staff Mick Mulvaney. On Thursday, Mulvaney's cat escaped the bag he had been carrying for Trump during his 10-month-long "acting" tenure.

(BEG ITAL)Yes, yes, yes, we withheld funds to Ukraine in order to obtain help investigating the 2016 hacking of a Democratic National Committee server!(END ITAL) You could almost hear the relief of having gotten it out -- the truth, that is -- so that he could get some REM sleep for a change.

Keeping the lie that there was no quid pro quo, as the official White House narrative went on and on, would have been a burden to the good, which Mulvaney is. If he were otherwise, surely he'd be the non-acting chief of staff by now. It's the liars and the not-so-good who seem to survive in the Trump administration.

Mulvaney's days, on the other hand, are likely numbered. Truth may be the heart's best friend, but it is not helpful in the sort of presidential politics being played out on Pennsylvania Avenue. This may explain Mulvaney's near-immediate walk-back of his comments to the press. He issued a statement asserting "there was absolutely no quid pro quo" (because Ukraine didn't produce anything?) and that the pause on funding was related only to "corruption" in Ukraine and had nothing to do with the fantastical server heist.

Remember that the Mueller report concluded that Russian operatives did, in fact, hack a DNC server to gain information that might be helpful to Trump's election. Trump is still so undone by this now-obvious truth that he seems determined to disprove it and has become obsessed with the conspiracy that the server somehow ended up in Ukraine and contains evidence that there was no hacking by the Russians. Even though the special counsel also concluded that there was no coordination between the Trump campaign and Russian operatives, the president seemingly has a desperate need to prove that he won by his own genius.

"I want to see the server," he told reporters in the White House last Wednesday. "I think it's very important for this country to see the server." Really? I have bad news for the president: The idea even that a single server exists -- and can be hidden somewhere -- is ludicrous. Nowadays, a "server" is actually dozens of different interconnected systems.

In other words, Trump has risked everything, inviting impeachment, to prove that he won fair and square. His Ukraine parry was a matter not of national security but of ego. His need for reassurance and public validation is so consuming that he's apparently blind to consequences, never more obvious than his recent dealings with Turkish President Recep Tayyip Erdogan, which led to Turkey's invasion of northern Syria. In that case, however, people -- not reputations -- died. What part Trump's ego played in that transaction hasn't been discovered yet, but Utah Sen. Mitt Romney's theory that Erdogan issued an ultimatum and Trump caved may be getting warm.

Before we leave the subject of the 2016 election, let's be very clear: Trump didn't win so much as the Democrats lost. And, if they're not very careful starting immediately -- that is, if they don't stop sounding like aliens whose implanted data receivers haven't yet mastered the code for "Mainstream America" -- they could lose again.

Mulvaney's stab at survival, meanwhile, may have been a smart move. A wise friend once told me: "Always tell the truth as soon as possible." You may not win friends; you may sacrifice something wanted. But over time, lies will consume the liar, make you crazy, and paranoia usually follows. Mulvaney may lose his job over the truth -- the bus under which so many have been cast sits idling outside the West Wing -- and it calls for thee.

Granted, he might have skipped his other lines about "Get over it" and "We do that all the time," but he must feel that a weight has been lifted. Mulvaney, at least, will enjoy an afterlife beyond the White House. As for Trump, his paranoia expands with his prevarications. By The Washington Post's Fact Checker's count as of Oct. 9, the president had made 13,435 false or misleading claims since taking office.

If truth ever does slip off his tongue, Congress will have to declare a national holiday.

Kathleen Parker's email address is kathleenparker@washpost.com.

(c) 2019, Washington Post Writers Group

Mick Mulvaney's quid pro quo defense (Updated)

By alexandra petri
Mick Mulvaney's quid pro quo defense (Updated)

ALEXANDRA PETRI COLUMN

(FOR IMMEDIATE PRINT AND WEB RELEASE)

(For Petri clients only)

By ALEXANDRA PETRI

EDITORS -- Effective Nov. 1, columns by Alexandra Petri will be available for print publication only.

You're so naive.

To be clear: If I did anything bad (I did) with respect to Ukraine, holding up aid to oblige Ukraine to look into a wild server conspiracy theory I had concocted, if there was a quid pro quo, it was just because -- well, why not? Everyone does it. It's the reality of life. Wake up, sheeple. Imagine needing to ask if there were a quid pro quo. Imagine living in a world where there (BEG ITAL)wasn't a(END ITAL) quid pro quo all the time! You're SO naive.

Whereas our opponents are probably secretly in the pocket of sinister autocratic forces, I am openly and visibly climbing into a large pocket full of money and disappearing entirely from view. Isn't honesty great!

Isn't my candor refreshing? Our opponents probably push old men down the stairs in private and kept it a secret so that no one would ever find out. That is why I am pushing an old man down the stairs right now, in front of you! Everyone does it! What?

The other side probably has a basement bunker full of infants they sacrifice to retain their youthful vigor. That is why -- pass me your baby, please. I am just doing what they would do if they weren't hypocrites, to show how much I respect you.

My predecessors probably refused aid to any country that wouldn't look into their theory that, at Disney World, there are creatures walking around who appear to be costume characters but actually, those heads are their real heads! Or to investigate a more bizarre theory than that, which now that I have seen it articulated, haunts me! Probably they did that, and that is why I am, before God and Man, demanding investigation of a wild, bizarre conspiracy theory of my own.

Quid pro SURE, WHY NOT? This is real life, not "The West Wing"! Not some fantasia concocted by liberals and children and walking brooms who know nothing of the world, where people do the right thing in public and in private. Such a world doesn't exist, and you should be ashamed for wanting it! We're just doing what everyone does, probably! And the reason you haven't heard about (BEG ITAL)them(END ITAL) doing it is another deep conspiracy we are going to look into soon!

They are probably secretly deeply corrupt. That is why I am publicly, openly, deeply corrupt.

My opponents worship a goat-god in secret, in a big hidden bunker with John Podesta, where no real Americans can see. I worship the goat-god here, in front of you! I pour incense at his hooves! All hail the goat-god! Isn't it nice to be free of lies?

Everything bad you have ever suspected was happening, however groundlessly -- oh, it is true, it goes all the way to the top, and that is why I am doing it openly, right now.

It is unrealistic of you to think that people have not been doing this for centuries. Just look at the Founders! They did this, probably, in secret, this very thing. And you haven't heard about it because -- the Masons. You get it. We all get it. My opponent probably spit in your food in the kitchen. I will spit in your food now, here, in the open, because I have integrity.

You are to blame. You are naive, for thinking that maybe there was a version of the world where no one did any of this. Did you ever, however briefly, imagine you deserved to be treated better? Did you imagine people would be punished for acting this way? No one is better. No one is punished.

This is the most you deserve.

UPDATE: Wait, actually, what I meant to say was that, uh, we did not do any of these things! That is what I meant to say, sorry. Uh.

Follow Alexandra Petri on Twitter, @petridishes.

(c) 2019, Washington Post Writers Group

Trump has turned White House into quid pro freak show

By dana milbank
Trump has turned White House into quid pro freak show

DANA MILBANK COLUMN

(Advance for Sunday, Oct. 20, 2019, and thereafter. Web release Saturday, Oct. 19, 2019, at 8 p.m. Eastern time.)

(For Milbank clients only)

By DANA MILBANK

EDITORS -- Effective Nov. 1, columns by Dana Milbank will be available for print publication only.

WASHINGTON -- Et tu, Mulvaney?

Three weeks ago, House Speaker Nancy Pelosi unveiled the impeachment inquiry with a Latin phrase spoken by Julius Caesar when he crossed the Rubicon. "Alea iacta est," she said. The die is cast.

Since then, President Trump has absolved himself by repeating -- ad infinitum -- some Latin of his own: "There was no quid pro quo." No this for that.

Enter Mick Mulvaney, deus ex machina, to destroy Trump's defense. The president's (still) acting chief of staff briefed reporters Thursday and, in flagrante delicto, admitted Trump committed the sine qua non of a quid pro quo.

Mulvaney said there was "no question" that one of the reasons Trump withheld military aid to Ukraine was to force Ukraine to investigate "corruption" related to the Democratic Party. "And that is absolutely appropriate," Mulvaney argued. "We do that all the time with foreign policy."

Thus did the White House admit -- ipso facto -- to the exact crime Trump is accused of in the impeachment inquiry. "No quid pro quo" became "quid pro quo -- so?" (a.k.a., quid apropos).

Mulvaney's modus operandi is clear enough: The White House must be in extremis realizing that depositions to Congress by administration officials are proving a de facto quid pro quo. Trump needs a new defense.

To be fair, Mulvaney didn't admit a quid pro Joe (trading military aid for dirt on the Democratic front-runner) but a quid pro down-low (trading military aid for dirt supporting a conspiracy theory about Democrats). Still, the transcript of Trump's call with the Ukrainian president makes clear it was a quid pro combo.

In a sense, Mulvaney is correct when he says "we do that all the time." Trump's tenure has been one big quid pro. He decreed Thursday that next year's Group of Seven gathering of world leaders must be at the Doral resort he owns in a clear quid pro cash flow for the Trump Organization. His funneling of government business to Mar-a-Lago has been a quid pro chateau. Having the U.S. military patronize his Scotland property is a quid pro Glasgow, and Vice President Pence's hawking of Trump's Ireland property is a blatant quid pro brogue. Trump's Washington hotel rakes in lobbyists' and foreign governments' cash in a quid pro dough, and government funds paid to his New York and New Jersey properties complete the quid pro portfolio.

This benefits not only Trump but his sons, in what might be called a quid pro slow (or a quid pro I dunno). Donald Trump Jr.'s protests about Biden family nepotism this week, while ignoring his own, can only be termed a quid pro bozo. Trump's national security adviser, Robert O'Brien, last week floated a quid pro whistleblow: He's clearing out career professionals (prospective whistleblowers) by slashing the NSC staff. The administration also tried to block cooperation with the inquiry, in a quid pro Pompeo. And then there's Trump's decision to let Rudolph Giuliani take over U.S. foreign policy: a quid pro schmoe.

Mulvaney, in his appearance Thursday, attempted a quid pro John Doe, pretending that he didn't know the names of the officials testifying to Congress. The attorney general, William Barr, has trashed his principles to give Trump a quid pro ego.

Trump has been doing this sort of thing since a quid pro big toe kept him out of Vietnam. He abandoned gun-safety plans after meeting with the NRA, a quid pro ammo. His voter-suppression efforts are a quid pro Jim Crow. Evangelical Christians tolerate his immorality in exchange for his judicial nominees, a quid pro Roe. Much of his presidency has been a quid pro Moscow.

He trades in false claims (quid pro Pinocchio) and plugs for friendly Fox News hosts (quid pro puppet show). And his requiring of constant flattery from underlings (quid pro braggadocio) has turned the West Wing into a quid pro freak show.

Because impeachment has made us all Latin speakers, I asked my longtime classics consultant, Vanessa, to translate into genuine Latin some of Trump's trade-offs:

Quid pro impendio (this for payment).

Quid pro deverticulo (this for a resort).

Quid pro luto (this for dirt).

Quid pro vitio (this for a crime).

Quid pro reo (this for a sinner).

Quid pro imperio (this for power).

Giving Giuliani responsibility for anything? A blatant quid pro asino (this for a fool). But that's pro forma for a president who sold his soul (quid pro animo) and made his office a quid pro mimo: this for a farce.

Follow Dana Milbank on Twitter, @Milbank.

(c) 2019, Washington Post Writers Group

On health care, Warren sounded like a student who hadn't done her reading

By megan mcardle
On health care, Warren sounded like a student who hadn't done her reading

MEGAN MCARDLE COLUMN

(FOR IMMEDIATE PRINT AND WEB RELEASE)

(For McArdle clients only)

By MEGAN MCARDLE

EDITORS -- Effective Nov. 1, columns by Megan McArdle will be available for print publication only.

WASHINGTON -- Though her fans will probably bridle at the observation, Tuesday's Democratic presidential debate made it clear that Sen. Elizabeth Warren, D-Mass., is not really a health-care wonk.

Warren's appeal to voters is as the thinking man's Sen. Bernie Sanders, I-Vt. Among a certain sector of the electorate -- highly educated, urbane, prone to reading "explainers" -- the pedantic glamour of the Harvard professoriate blurs her radical edges and limns her most pedestrian pronouncements. These are the sort of people who praise Warren over Sanders because (BEG ITAL)she really knows her stuff(END ITAL).

Yet consider her answer on Tuesday night when Marc Lacey, a New York Times editor, asked her about health-care insurance: "You have not specified how you're going to pay for the most expensive plan, Medicare-for-all. Will you raise taxes on the middle class to pay for it, yes or no?"

The former professor sounded like a freshman who hadn't done the reading. Warren ambled between heart-tugging anecdote and amiably unobjectionable generalities -- "Look, the way I see this, it is hard enough to get a diagnosis ... what you shouldn't have to worry about is how you're going to pay for your health care after that." She didn't attempt to answer the question, except to insist that the only people who will pay for her new plan are the rich and big corporations. As real wonks know, that math doesn't work.

The top 1% garner about 20% of national income, which, coincidentally, is close to the share of national income America spends on health care. But according to the nonpartisan Tax Policy Center, that top 1% of taxpayers collectively took home about $1.9 trillion in after-tax income, which wouldn't begin to cover the estimated $32 trillion per decade cost of Medicare-for-all even if every penny were confiscated. You could make the math work by applying equally confiscatory rates to the top 5%, except people don't work just to hand all their money over to the government; a 100% tax rate, or even something close, would hardly raise any money at all.

No, paying for Medicare-for-all would entail taxing the dickens out of the middle class. You could argue, as Sanders has, that the middle class would still be getting a good deal, because they'd (eventually) save so much on whatever they or their employers are now spending on insurance premiums. What you can't argue is that Medicare-for-all is possible without those tax hikes. At least, not while retaining your wonk cred.

At the presidential debate, when Pete Buttigieg, the mayor of South Bend, Ind., called Warren out for her evasions, she scrambled to invoke her professorial credentials, saying, "I've been studying this, you know, for the biggest part of my life ... why people go bankrupt." And here Warren is making the same mistake that many of her supporters do: thinking that "wonkiness" is a generalizable characteristic rather than a specific proficiency.

It's true that Warren's best-known research suggested that illness causes more than half of all bankruptcies. Her critics, including me, have pointed out that her study has fundamental methodological problems and that the results she found are far higher than in other, more careful work. Nonetheless, Warren unquestionably knows a lot about bankruptcy.

That knowledge may have fooled her, and has definitely fooled many of Warren's followers, into thinking that she therefore knows a lot about fixing the health-care system. But in a given year, only 0.2% of the American population declares bankruptcy for any reason; the percentage who face medical bankruptcy is even lower. So even if you knew everything about bankruptcies due to illness, you still wouldn't know that much about the problems patients face in the U.S. health-care system. Nor would you know much about the other difficulties that reformers must tackle, such as "How do we pay for it?" and "How do we get our reform past hospitals, doctors, nurses and other mediagenic lobbying groups?" and "How do we cut costs without critically disrupting care?"

The fact that these problems haven't been solved, despite the Obama administration's best efforts, tells you they're very hard. I have my doubts that a viable solution exists, at least in the near term. But I'm quite certain that if the problems are going to be fixed, it will be by someone who starts by carefully digging into the evidence and then works their way forward to the conclusion, rather than the other way around -- by a real health-care wonk, in other words, and not just someone who plays one on TV.

Follow Megan McArdle on Twitter, @asymmetricinfo.

(c) 2019, Washington Post Writers Group

Perhaps Sanders and Warren are the ones being politically expedient

By catherine rampell
Perhaps Sanders and Warren are the ones being politically expedient

THE MILLENNIAL VIEW

(FOR IMMEDIATE PRINT AND WEB RELEASE)

(For Rampell clients only)

By CATHERINE RAMPELL

EDITORS -- Effective Nov. 1, columns by Catherine Rampell will be available for print publication only.

Another Democratic debate, another argument about how anyone who questions the merits of various lefty ideas just doesn't have "the guts" (to use Vermont Sen. Bernie Sanders' preferred term) to "dream big and fight hard" (quoth Massachusetts Sen. Elizabeth Warren).

The moderates, allegedly, are prioritizing political expediency over principle. They're in thrall to polls and focus groups. They're terrified of alienating independent voters perpetually camped out in Iowa diners.

If only those sell-out center-left politicians would show some leadership!

Allegations of political cowardice can seem rich coming from candidates unwilling to acknowledge the obvious truths that, say, solving the climate crisis will require some public sacrifice, including putting a price on carbon. Or that yes, Medicare for All would require higher taxes on the middle class.

Clearly all candidates, to varying degrees, consider the political landscape when deciding what policies to propose and how to make the case for them. Look at South Bend, Indiana, Mayor Pete Buttigieg, who sanctimoniously criticized Warren for failing to detail how her Medicare for All would be financed but has provided scant details on how to pay for his (BEG ITAL)own(END ITAL) health plan.

That said, it has been frustrating to watch more moderate positions be characterized as solely driven by political calculations.

Many of these center-left proposals are good policies that should be defended on the merits, and not because they may (or may not) be more politically expedient. Moderates should make the affirmative case for what the far left has been writing off as wishy-washy realpolitik.

For instance: It isn't a compromise of values or principles to believe that people who can afford to pay something to go to college should pay something to go to college. A college education is a valuable thing, most of whose benefits still accrue to the person receiving the degree.

Yes, public colleges should be cheaper -- and even free for those who would otherwise be unable to attend. While the degree recipient retains most of the value of higher education, there are indeed significant spillover benefits to having a more educated populace; and as a nation, we also want all individuals to have a shot at achieving their full potential, regardless of their financial circumstances at birth.

In other words, there is both an economic and a moral case for improving overall access to higher education, specifically among students on the margin of enrolling.

But there is neither an economic nor a moral argument for making college free for (BEG ITAL)everyone(END ITAL) -- including rich kids who can afford tuition and who are likely to go to college no matter what because they know it's worth the money.

So if there isn't an economic or a moral argument for free college for the wealthy, you know what there is? An oft-cited political one: that maybe if rich people think they're personally benefiting more from the welfare state, they'll be less resistant to its expansion.

Now who's opting for political expediency, rather than the best policy?

Likewise, it isn't an abandonment of principles, or of the poor, to say you can guarantee affordable health coverage for all Americans without completely rearranging 18% of the economy into a single-payer plan.

Yes, everyone needs health care. But not everyone needs to get it through Uncle Sam or completely for free, as Sanders' Medicare for All bill prescribes. Even the current Medicare program, while universal for Americans over age 65, charges premiums based on income.

Once again, it's OK to ask people with means to pay for stuff of value, even stuff they need. People need food, and we still don't make everything available in supermarkets free to all comers regardless of income.

Or let's say you want to raise taxes on the rich, as both far-left and center-left Democratic contenders generally do.

It isn't an act of political cowardice to point out that it might be constitutionally cleaner and administratively simpler to use tools other than an annual wealth tax. Such tools include taxing capital gains at regular income rates; eliminating the "stepped-up" basis; adding an inheritance tax; and imposing a "retrospective" capital tax.

If you're not familiar with these ideas, you're not alone: Whatever their policy merits, these are all wonky, technical changes to the tax code. They're difficult to explain succinctly and clearly on the campaign trail. In fact, one reason Warren and Sanders might be stressing an annual wealth tax, rather than these other ideas, might be precisely because a "wealth tax" -- like "free college" or "Medicare for All" -- is a simpler, more intuitive slogan.

More politically expedient, you might even say.

Catherine Rampell's email address is crampell@washpost.com. Follow her on Twitter, @crampell.

(c) 2019, Washington Post Writers Group

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