날씨는 풀렸는데 지쳐하시는 4월

각자의 이유들로 한국에 들어간 친구들. 가고싶다 나도, 하지만 할 일이 많은 여기. 그래도 행복하다. 기운이되기 위해서라도 하루하루 나의 할 일 책임감있게 잘 챙겨해야지. 

슬플 이유가 없다. 부럽지만 나도 가고싶고 쉬고싶지만 내가 바랬던 학교에서 바랬던 공부를하는 럭셔리함 .. 초심을 기억하면 참 간절했는데 - 그리 멀지도 않았은 과거. 어렵지만 즐겁다고 혹은 즐겁지만 어렵다고, 투정하되 불만이라하지 말자. 비교적 쉽다면 쉬운 학기 초반. 유비무환, 여유로운 것이 여유롭지가 않다. 


겁이난다 

이번 학기는 좀 무섭다 - 처절하기. 

week 4 지친다. 근래 약을 자주 먹는다, 잠은 많이 잘 수 있지만 아침의 느낌이 오늘따라 기이했다. 어딘지 머리도 아프지는 않되 지근거리고, 날은 밝은데 우울한 감성. 슬슬 지친다, 아직 제대로 시작도 않았는데. 내가 어디서 무얼하는건지 모르겠다. 정신이 맑지만은 않은가보다. 

첫 시험도 두번째 시험도 나쁘지만은 않게 지나갔다. 생존, 가야 할 길이 정확히 다섯배 멀다. 발전, 생존이상의 무언가가 욕심이난다. 


do not go home 어제는 너무나 긴 공강날이었다. 

지난 주 같은 실수를 막기위해 달력에 적은 일정이 나의 하루를 살렸다. 현명했다, 감사하다. 월요일 시험을 마치고 화요일을 종일 밖에서 보내고 수요일 얼추 틀이잡히니 목요일 또 풀어진다 .. 이미 금요일, 하루하루 바쁜 듯 괜찮은 듯 다가오는 시험은 무섭다가도 아니기도하고, 정신상태가 이게 아닌거다, 차려야한다. 


칭찬과 비난에 동일히 예민 할 수 있을까, 그것이 옳을까. 왜인지 칭찬에는 무뎌지고 비난조차도 실허 숨으려는 경향이 생겨버렸다. 무든 것에 겸손히 감사히 .. 수용하기에는 그릇이 못되나보다. 가야할 길이 멀다. 


jay z 는 왜 바람을 피웠을까 너무 슬프다 .. girls 에서 제일 예쁨 




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CreditJoyce Hesselberth

Maybe you have seen television ads starring the beefy, affable comedian and actor known as Larry the Cable Guy.

In his sleeveless shirt and gimme cap, he’s driving a monster truck or streaking along on a jet ski, pausing to chomp on a turkey drumstick or a barbecued rib, all the while proclaiming his love for America and for Prilosec OTC to fight “frequent heartburn.”The caution that the drug should be taken for no more than 14 days, and not more often than every four months, appears briefly on-screen. If you blink or go fetch your glasses, you’ll miss it.

Todd Semla has noticed the ads, too, and he’s not a fan. “I don’t see Larry the Cable Guy saying, ‘If you take this drug often, your kidneys may be affected or you could break a hip,’” said Dr. Semla, a pharmacist at the Feinberg School of Medicine at Northwestern University, and past president of the American Geriatrics Society.

Since their introduction in 1990, the drugs collectively known as proton pump inhibitors (common brand names: Nexium, Prevacid, Prilosec) have become among the most frequently prescribed in the country; as the Cable Guy points out, they are also available over the counter. They suppress stomach acid more effectively than a previous class of drugs called H2 blockers (Zantac, Tagamet, Pepcid).

They have also given users reason to be wary. In recent years, scores of studies have reported associations between prescription P.P.I. use and an array of health problems, including bone fractures, low magnesium levels, kidney injuries and possibly cardiovascular drug interactions.

They are also linked to infections, like the stubborn Clostridium difficile and pneumonia. Reducing the acidity of the stomach, researchers believe, allows bacteria to thrive and then spread to other organs like the lungs and intestines.

The latest findings, published in JAMA Internal Medicine, point to increased risk of chronic kidney disease among users, which is particularly worrisome.

“You can treat and hopefully cure infections,” said Dr. Adam Schoenfeld, an internal medicine resident at the University of California, San Francisco, and an author of an accompanying editorial on the drugs’ adverse effects. “Fractures can heal, though they can be catastrophic events for older people. But chronic kidney disease doesn’t go away.”

The new study, by a Johns Hopkins team, compiled years of data from two sources: a community sample of 10,482 adults in four communities in North Carolina, Mississippi, Minnesota and Maryland (average age: 63) and a cohort of nearly 250,000 patients in a rural Pennsylvania health care system. Those who took prescription proton pump inhibitors were 20 percent to 50 percent more likely to develop chronic kidney disease than nonusers, said the senior author, Dr. Morgan Grams, a nephrologist and epidemiologist at Johns Hopkins.

Like the rest of these drug studies, this one demonstrated an association, not a direct cause. But in the Pennsylvania sample, the researchers documented a dose effect: The risk of chronic kidney disease rose 15 percent among those taking the drug once a day, but 46 percent in those taking it twice daily, compared with nonusers. “That leads us to believe there’s a causal effect,” Dr. Grams said.

Relative risk statistics sometimes seem to exaggerate the dangers of a drug or an illness, if they were low to begin with. But “kidney disease is quite common, particularly among older adults,” Dr. Grams pointed out. And the P.P.I.-using population is vast, she added. “When you have 15 million people using these drugs, even relatively rare adverse effects can affect a lot of people.”

Older people should probably pay special heed. They are more likely to have reflux, Dr. Semla said, in part because the muscle that prevents stomach acid from rising into the esophagus weakens with age. Older adults are therefore more likely to take these drugs, and also more vulnerable to the diseases and disorders associated with them, especially with long-term use.

All of this led an American Geriatrics Society panel last year to add proton pump inhibitors to the list called the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults, citing the risk of bone loss and fractures and C. diff infection.

The Food and Drug Administration has also issued several safety announcements about these drugs’ association with C. diff, fracture riskand low magnesium, linked to kidney disease and other ailments.

So you’d think use of proton pump inhibitors would be declining. It’s not.

“Despite this information, those drugs are extremely overprescribed,” Dr. Schoenfeld said.

From 1999 to 2002, 9 percent of people ages 55 to 64 reported using a prescription gastric reflux drug (including non-P.P.I.s) in the previous 30 days, the Centers for Disease Control and Prevention has reported.

Ten years later, the proportion had risen to 16 percent. Among prescription medications, only cardiac and cholesterol drugs were more commonly used by adults ages 55 to 64.

Proton pump inhibitors can be crucial medications, doctors hasten to point out, for those with peptic ulcers or for intensive care patients, among others. They’re also the most effective option for severe reflux. But whether over the counter or prescribed (prescriptions can involve higher doses), they are usually recommended for short-term use.

Yet “there are definitely older people who’ve been on these for 10 or 20 years,” Dr. Schoenfeld said. Perhaps the medication was prescribed during a hospital stay, then never discontinued. Or a patient took a nonprescription version for a bout of indigestion, felt better and therefore kept taking it, though the initial problem may have long ago disappeared. Doctors, too, often fail to question extended use, Dr. Schoenfeld said.

Regularly reviewing all medications, prescription and over the counter, at office visits might help reduce this overuse. Dr. Schoenfeld recommends tapering off a proton pump inhibitor to see if it’s still needed, or switching to one of the less potent H2 blockers, which don’t appear to entail the same risks.

Better yet, nonpharmacological approaches can often reduce heartburn and other reflux-related problems. Losing weight helps; so does limiting certain medications, like aspirin. Dr. Semla suggests raising the head of your bed so stomach acid has a harder time climbing.

Moreover, “if people eat a lot of fatty, greasy foods or drink a lot of alcohol or caffeine, those are all triggers for heartburn,” Dr. Schoenfeld said. It probably also helps — “people are going to hate me” — to cut back on chocolate.

“With time or with dietary changes,” he said, “a lot of these symptoms would go away on their own.”

Listen up, Cable Guy.



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여행 그렇게 기다리던 방학 그리고 하와이! 시애틀 지내면서 한 번은 다녀와야지 가깝고도 멀던 hawaii. 지도에 너무나 당연하지만 멀게만 상상만 같았던 hawaii

무사히 시험을 클리어하고 한 학기를 마쳤다는 후련한 마음으로 향한 섬 동네. 지난 학기들보다 훨씬 편안한 마음으로 마무리지은 다섯번째 학기. 시험의 마지막 당일날 떠나는 무리같은 일정은 부담스러우면서도 돌아보면 대수롭지 않음. 집에서 마냥 쉬고싶지만 추억 행복이 되어 남는 것은 새로운 경험, 여행, 사진들 그리고 기억. 이전과는 다르게 어딘가 미안하고 고맙고 보고싶고, 유부녀의 부담인가봉가. 첫 날 누운 낯선 잠자리는 피곤함에도 불구하고 불편한 마음이 크게 느껴졌다. 이따금 느껴지던 공허함과 같은 괴로움, 숨 쉬기 어려움과 흡사한 답답함이 마음을 누르면서 울고싶었던 밤. 드디어 상상에 그리던 하와이에 도착하였는데, 드디어 기다리던 학교에서의 휴식, 방학을 맞았는데, 와중 이러한 불편한 마음을 느낄 수 있다니. 집이 그립고 익숙함에 마냥 고프던 밤, 수면제에 의존해 잠에 듦. 


실수 반성  여행을 다녀와서 마음이 많이 편안해졌다. 큰 사고도 없었고, 괴로운 실수도 없었다. 한 가지 마음에 걸리는 점이라면 웨이터에게 실례를 한 그 날 저녁의 나의 모습. 긴 하루 끝의 피곤을 그에게 던진 것 같아, 그러면 안됨을 순간 잊었던 듯. 혹은 그래도 된다고 순간 생각했던 것 같다. 타인에게 무례하면 안됨이라는 기본적인 자세를 .. 순간 흐트러졌음을 어쩌면 인지조차 하지 못 했을 실수를 다행히도 친구들이 장난처럼 point out 해주어 깨달았다. 돌아온 정신에, 크게 부끄러울 따름. 


집 집으로 돌아오는 여행의 마지막 날, 집에 간다는 사실에 마냥 행복. 집을 떠난 일주일은 금방이면서도 매우 길었던 것. 집에 돌아오자 마냥 편안 행복, 드디어 휴식 할 수 있는 듯한 마음으로 꿀같은 낮잠. 장보고 할머니에게 전화를 드리고 설거지하고 세탁 돌리고 청소기 돌리고 걸레질하고 몇 주 몇 달 전 부터 닦고싶었던 계단층들도 닦고, 짐도 푸르고 딩굴딩굴, 여유롭지만서도 분주한 방학의 마무리. 

집에 오니 너무너무 너무 좋으다. 침대의 전기장판도 좋고 티비보면서 먹는 라면도 좋고, 샤워도 집에서하는 샤워하 진정한 샤워다. 매일 했지만 일주일만에 처음 샤워하는 듯 한 집 샤워의 상쾌함, 아 좋으다. 잠옷입고 뒹굴 수 있고 하고싶던 집 구석 청소도 할 수 있고, 아무것도 안 할 수도 있고, 남편님이랑 저녁도 먹을 수 있고, 좋으다. 


건강 여행 후 무게가 줄었다. 시험 후 늘어난 무게가 안정을 찾은 듯. 바깥음식만 먹고도 무게가 줄수 있다는 놀라움, 무엇을 보다 얼만큼을 먹느냐가 보다 큰 영향인가보다. 더불어 패턴도 보다 규칙적이어졌다. 올 학기 시험기간들 동안은 보다 안정적인 날들을 보낼 수 있기를. 더불어 여행동안 음식에 굉장한 어쩌면 평범했을지도 모르지만 나에게는 과하다 싶게 느껴졌던 한 친구의 집착. 점심을 먹자마자 공항에 도착해서 비행기에서 먹을 메뉴를 고르고 식당에서 테이블을 기다리는 동안에도 굉장히 힘겨워한다. 뿐만아니라 타인에게 끊임없이 음식을 권하는 조금은 기이한 모습, 나만 저녁 식사에 가지 않았는데 원하는 것 없냐고 열번은 물어보고 메뉴와 음식들 사진을 끊임없이 보내주는, 감사키는 하지만 이십번 거절해야했던 기이한 모습. 더불어 본인의 칼로리는 과장하여 계산하면서도 타인의 칼로리는 오늘 이러한 이러한 소비 활동들을했으니 더 먹어도된다며 끊임없이 식사를 권유 .. 이해키 어려울 뿐더러 불안해보이는 모습, 나 자신의 모습에도 저러한 면이 있을까 반성. 


캠핑 겨울의 캠핑은 너무 춥다. 동네 마켓도 돌고 파도치는 물결 위 다리도 건너고 노을도 보고, 꿀같은 족발을 쌈싸먹고 부드러운 독일 필스너도 마시구, 즐겁게 놀고 비가 너무 많이 내려 취침키로. 다행히도 쏟아지는 비를 모두 막아 준 방수 텐트. 봄이라하지만 여전히 겨울인가봉가, 쿠션도 깔고 성능좋은 침낭이라해도 추위에 구겨져 한참을 시린발을 데우느라 잠들디 못 한 밤 .. 집에 가자고했는데 관심도 없으시고 주무시는 남편님 덕에 한 시간가량 울다 잠듦. 새벽같이 일어나 짐 후다닥 챙겨 돌아온 집. 오는 길에 설렁탕 한 그릇 만두 한 접시 먹고 귀가  역시 집이 최고다. 잠을 잔건지 훈련을 받은건지, 피곤에 골골대며 캠핌의 후유증으로 종일 낮잠으로 보낸 방학의 마지막 날. 힘들었지만 추억되는 방학의 주말, 몸은 고생했지만 함께 보내니 행복. 


가깝고도 먼 3 학년 어느새 2학년의 마지막 학기. 수업 첫 날부터 빠짐 반성. 이번 학기의 마무리는 보다 편안한 마음으로 맞이 할 수 있기를 바라며. 멀고도 가까운 10 주, 하루하루를 어떻게 보내느냐에 좌지우지 될 10 주 후의 나의 마음. 안정적인 마음으로 기말을 맞이 할 수 있도록.



봄학기 다짐 

수업 빠지지 않을 것 

건강 식습관 

건강 운동습관 


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▲ 야권통합 제안에 다른 생각하는 안철수-김한길 국민의당 안철수 공동대표와 김한길 상임선대위원장이 4일 오전 서울 여의도 당사에서 열린 선대위 회의에 참석하고 있다.
ⓒ 유성호

관련사진보기


한국의 정당은 세계사에서 그 유례를 찾아보기 어려울 만큼 기형적인 구조로 되어있다. 정당 구조와 운영이 도무지 일관성이 없기 때문이다. 

미국의 경우 정당은 정강채택, 예비선거, 후보선출 등 중요한 정치 프로세스를 처리할 수 있도록 되어있다. 이른바 오픈플랫폼 정당이다. 그러다 보니 예비선거와 후보선출 절차가 진행되지 않는 기간에는 사실상 존재하지 않는다고 볼 수 있다. 그리고 국고보조금이라는 개념 자체가 없다. 당비와 정치기부금에 대한 최소한의 규제만 두고 있기 때문에 정당 운영을 위한 모금에 큰 문제가 없다. 역사적으로 오랜 기간 소수정당 없이 양대 정당 체제로 운영되어 왔기에 사람과 돈을 끌어 모으기가 쉽다. 그러니 당연히 국가가 나설 이유가 없다.

독일의 정당 제도는 미국과 상당히 다르다. 우리와 비슷하게 국고보조금이 있다. 하원 선거 및 유럽의회 선거에서 총 유효표의 0.5%이상, 주 의회 선거에서 총 유효표의 1% 이상을 득표한 각 정당은 득표수 4백만 표까지는 매 득표 당 매년 85센트(Cent)를, 4백만 표 이상의 득표에 대해서는 매 득표 당 매년 70센트를 연방정부나 지방정부의 국고에서 지원한다. 제도의 취지 자체가 소수정당을 보호하기 위해서임을 알 수 있다. 그런데 우리는 유효 표를 기준으로 국고 지원을 하지 않고 의석수 기준으로 한다. 절대적으로 소수정당에게 불리한 구조다. 제도의 취지와 정반대로 운영하고 있는 셈이다.

그 뿐만이 아니다. 선거제도 자체도 소수정당의 출현을 불가능하게 만들고 있다. 소수정당이 제도권에 진입하기 위해서는 중대선거구제, 그리고 현재와 같은 비례대표제 운영이 아닌 권역별 비례대표제와 석패율 제도를 도입하고 총 의석수에서 비례대표의 비중을 높이는 것이 필요하다. 

그런데 우리는 소선거구제를 채택하고 있고 그나마 정당명부식 비례대표제도 지역구 의원의 1/4을 조금 넘는 수준에서 제한적으로만 운영하고 있다. 모든 선거제도를 거대정당에 절대적으로 유리한 구조로 만들어 소수정당의 출현 자체를 불가능하게 만들어놓고 소수정당 보호를 위한 정당 국고보조금을 이들 거대 정당에게 지원하고 있다. 한마디로 앞뒤가 맞지 않는 제도로 운영하고 있다.

정당이 '국고보조금'에 안주하니 '당원들 지지' 아쉬울 게 없어


왜 이런 기형적인 정당 구조가 만들어졌을까? 현행 헌법 기조라고 할 수 있는 1987년 직선제 개헌이 철저하게 양대 정당(민주정의당, 통일민주당)의 기득권을 강화하는 방향으로 진행되었기 때문이다. 여당에 비해서 정당 운영이 절대적으로 어려웠던 당시 야당이 정당 국고보조금 제도의 개선 및 확대 속에서 그 해답을 찾으려고 했고, 김영삼·김대중의 야권 분열로 인한 어부지리를 노렸던 여당은 국고보조금 도입을 약속하는 대신 소선거구제와 결선투표제를 제외해 선거 승리의 가능성을 높이고자 했다. 그러다 보니 선거제도와 정당운영에 있어서 소수정당이 아닌 기존 거대 정당의 기득권이 강화될 수밖에 없게 된 것이다. 당연히 원칙과 일관성이 유지될 수가 없다.

또 한 가지 흥미로운 사실이 있다. 우리의 정당 제도와 그 출발이 비슷한 독일 정당의 경우 당원들이 내는 당비와 외부로부터 들어오는 정당 기부금이 전체 재정에서 대략 40%를 차지한다. 그런데 우리 정당의 경우 여야 할 것 없이 재정의 절대적 비중을 국고보조금에 의존하고 있다. 당비를 내는 당원이 미미하고 외부 기부금을 정당이 받을 수 없도록 제도화되어 있기 때문이다. 그러다보니 당원 및 국민으로부터 지지를 받기 위해 노력할 이유가 사실상 없다.

만일 독일 정당이 정체성 훼손과 부정부패에 연루되었다면 당비와 기부금이 급감하여 그야말로 존폐의 기로에 놓이게 되었을 것이다. 그러나 우리의 경우 어떤 황당한 일이 벌어지더라도 의석수만 그대로 유지하면 국고보조금이 차곡차곡 들어오기 때문에 전혀 문제가 없다. 국보위 출신 김종인이 당원들의 의견 수렴도 없이 제1야당의 당권을 접수하는 것과 비슷한 일이 독일에서 벌어졌다면 그 정당은 아마도 간판을 내렸을 것이다. 

지금 안철수는 기존 여야 기득권 정당의 카르텔을 깨기 위해 제3당이 필요하다는 주장을 줄기차게 펴고 있다. 그러나 이것은 제3의 기득권 정당을 또 하나 만들어달라는 것처럼 들린다. 진정으로 거대정당 카르텔을 깨고 싶다면 제3당 뿐만이 아닌 제4당, 제5당, 제6당까지도 출현할 수 있어야 한다. 그리고 이들이 출현하기 위해서는 선거제도를 바꿔야 하고, 정당 국고보조금 지급방식도 의석수가 아닌 득표율 기준으로 바꿔야 하고, 정당 운영에 있어서 당비와 정치기부금의 비중을 획기적으로 올려야만 한다. 

다시 말해 자신의 정당을 기득권 속에 편입시켜 줄 것을 요구할 것이 아니라 모든 소수정당과 소수자의 권익을 대표하는 위치에 서는 것이 맞다. 그러므로 진짜로 정치개혁을 원한다면 정의당, 녹색당 등과 연대하는 것이 도리어 명분이 있다.

그런데 지금까지 안철수가 주장해온 것을 보면 일관성도 없고, 콘텐츠도 방향성과 디테일이 결여되어 있다. 도대체 무엇을 하자는 것인지 모르겠다.

지금까지 개헌에 대해 우리는 4년 중임제냐, 이원집정부제냐, 내각제냐의 관점에서만 바라보았다. 그런데 진짜 중요한 것은 그게 아니다. 기존 5년 단임제를 그대로 유지하더라도 선거제도와 정당운영은 시급히 바뀌어야 한다. 정당 국고보조금 제도를 그대로 유지할 것이라면 '소수정당 지원' 이라는 그 제도적 취지에 맞게끔 선거제도 개편을 통해 소수정당의 출현이 용이하도록 해야 하고, 기존 선거제도를 그대로 유지할 것이라면 차라리 정당 국고보조금 제도를 폐지하여 미국처럼 오픈플랫폼 형태의 정당으로 바꿔야 한다. 

이런 부분에 대해 확고한 철학을 갖고 정치개혁을 주장하는 쪽으로 안철수는 이제라도 방향을 선회해야 한다. 그의 정치개혁의 핵심은 87년 체제의 해체 및 소수정당 출현을 위한 새로운 체제 구축이 되어야만 한다.

대연정 하는 한 있더라도 개헌으로 정치 바꾸자던 뜻

10여 년 전 고 노무현 대통령은 정치권과 국민을 향해 대담한 제안을 했다. 한나라당과 대연정을 하는 한이 있더라도 헌법을 개정하여 정치를 본질적으로 바꾸자는 것이다. 지금 와서 생각해보면 소름이 돋을 정도로 정확한 진단이었고, 그 누구보다도 본질을 제대로 꿰뚫어 본 혜안이다. 결국 그의 진의를 이해하지도 받아들이지도 못했던 우리는 정당구조를 개혁하는 데에 실패했고, 백년정당을 꿈꾸던 열린우리당은 스스로 개혁하지 못한 채 몰락의 길을 걸어갔다.

그리고 마지막으로 우리의 정치에 대한 생각도 획기적으로 바뀌어야 한다. 정당이 당원과 국민의 권익을 대변하기를 바란다면 나도 정치와 정당에 그만큼 기여를 해야 한다는 것을 당연하게 생각해야 한다. 우리의 정당도 당비와 정치기부금의 비중이 독일 수준으로 40%까지 높아진다면 당연히 당원과 국민의 눈치를 보게 될 것이다. 

"결국 정당 국고보조금이 국민이 낸 세금이니 그것으로 국민을 잘 모셔야 한다"는 것은 이론적으로만 맞는 이야기일 뿐 정당과 정치인들은 신경조차 쓰지 않을 것이다. 기왕이면 안철수가 정당 국고보조금 제도 폐지 및 당비와 기부금 중심의 국민정당을 스스로 실현하겠다고 앞서나갔으면 좋겠다. 현재와 같은 기형적 정당 제도를 그대로 놓아둔 채 아무리 정치개혁을 외쳐봐야 그것은 공염불에 불과하다.

다시 한 번 강조하고 싶다. 대한민국의 정치개혁은 첫째도 정당개혁이고 둘째도 정당개혁이다. 그리고 그것을 실현하는 방법은 기형적으로 만들어진 1987년 체제를 헌법 개정을 통해 완전하게 바꾸는 것이다.


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결국 끝나버렸지만 배움의 시간이었다. 너무나 아쉬웠고, 믿을 수 없는 - 소설과 같았던 시간들. 격렬히 싸웠지만 성과없이 끝나버린, 허무치 않다고 결론짓고 싶지만 무력감의 허무함은 어쩔 수 없나보다.


기어코 막 내리는 필리버스터

이제 더민주는 뭘 보여줄 것인가

더민주, 의원 총회서 필리버스터 중단 최종 결론

16.03.01 19:53l최종 업데이트 16.03.02 00:02l
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  국회의장에 의해 직권상정된 테러방지법을 막기 위한 야당의원들의 무제한토론(필리버스터) 8일째인 1일 오후 여의도 국회에서 필리버스터 중단 여부를 논의하기 위한 더불어민주당 의원총회에 김종인 대표, 이종걸 원내대표가 참석해 국기에 대한 경례를 하고 있다.
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기사 관련 사진
  국회의장에 의해 직권상정된 테러방지법을 막기 위한 야당의원들의 무제한토론(필리버스터) 8일째인 1일 오후 여의도 국회에서 필리버스터 중단 여부를 논의하기 위한 더불어민주당 의원총회에 참석하기 위해 김종인 대표가 도착하고 있다.
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[최종신 : 2일 오전 0시 3분] 
더민주, 필리버스터 끝나는 대로 2일 본회의 참여

더불어민주당이 테러방지법 직권상정에 반대하는 필리버스터를 중단키로 최종 확정했다. 

이언주 원내대변인은 1일 오후 11시경 의총이 끝난 직후 기자들과 만난 자리에서 "내일(2일) 이종걸 원내대표의 무제한 토론 발언을 마지막으로 (필리버스터를) 종결할 것"이라며 "이 원내대표는 마지막 토론에서 최선을 다해 끝까지 국민들께 (테러방지법의 문제를) 호소할 것"이라고 밝혔다. 

이 원내대변인은 이어 "필리버스터를 끝까지 이어나가는 것은 현실적으로 어려운 점이 있기 때문에 테러방지법 독소조항에 대해 최대한 알릴 것"이라며 "뜻을 이루지는 못했지만 국민들에게 충분히 문제점을 알렸다고 생각하고 마지막으로 원내대표가 한 번 더 알릴 예정"이라고 설명했다. 

이 원내대변인은 일부 의원들이 필리버스터 중단에 반발했는지 묻는 질문에 "특별한 발언은 없었다"고 답했다. 

김종인 비상대책위원회 대표는 의총 이후 별다른 언급 없이 오후 11시 15경 국회를 떠났다. 이종걸 원내대표는 별도의 기자회견 없이 2일 토론을 준비 중인 것으로 전해졌다. 

오후 11시 현재 필리버스터는 정진후 정의당 원내대변인이 1시간 가량 이어가고 있는 중이다. 정 원내대변인에 이어 심상정 상임대표가 토론에 나서고, 마지막 토론으로 이종걸 더민주 원내대표가 단상에 오르게 된다. 이 원내대표는 늦어도 2일 오전 중에 토론을 시작할 것으로 보인다. 

더민주는 필리버스터가 끝나는 대로 2일 본회의에 참여해 테러방지법과 선거구 획정을 위한 공직선거법 개정안, 북한인권법 등 법안 처리에 나선다. 테러방지법의 경우 더민주가 표결까지 참여할지 여부는 아직 정해지지 않은 것으로 알려졌다. 원유철 새누리당 원내대표는 2일 오전 9시 의원총회를 소집했고, 10시 본회의 개최를 공지한 상태다. 

테러방지법 결국 한 글자도 못 고치고 국회 통과 

결과적으로 47년 만에 국회 본회의장에서 이뤄진 필리버스터는 테러방지법 독소조항 개정이라는 목표를 이루지 못하고 막을 내리게 됐다. 심상정 상임대표와 이종걸 원내대표의 토론이 남아 있는 상황에서 8일 동안 36명의 의원이 토론을 했으며 총 토론 시간은 이미 170시간을 넘겼다. 

당초 더민주는 필리버스터를 임시국회 종료일인 오는 10일까지 진행할 수 있다는 방침이었지만, 선거법 처리가 늦어지면서 역풍을 불 수 있다는 우려와 총선에서 '이념 논쟁'이 발생할 수 있다는 불리한 전망을 이유로 중단 결정을 내렸다. 

이와 함께 필리버스터로 10일까지 버틴다 해도 현행 국회법상 바로 다음날 테러방지법이 통과 될 수 있다는 '현실론'도 결정에 영향을 미친 것으로 보인다. 결국 '테러방지법 심판'을 걸고 '다수당을 만들어 주면 법을 고칠 수 있다'는 호소를 하는 것이 낫다는 판단이다. 

그러나 필리버스터에 지지를 보냈던 핵심 지지층의 반발이 거세다. 이날 소셜미디어에는 더민주의 필리버스터 중단을 비판하는 글이 쏟아졌고, 특히 이번 결정을 주도한 김종인 대표와 박영선 의원에 대한 비판도 거셌다. 

당 지도부의 판단에 따라 필리버스터를 중단한 이상 이후 정국도 당 지도부가 주도하게 된다. 특히 지지층의 반대 여론에도 불구하고 중단 결정을 강행한 김종인 대표는 당 안팎의 불만을 잠재우고 이후 자신이 강조한 '박근혜 정부 경제 실정'을 부각시켜야 하는 과제를 안게 됐다. 

테러방지법을 한 글자도 고치지 않고 뜻대로 통과시킨 새누리당은 이후 노동 관계 4법 등 경제 관련 입법에 나설 가능성이 크다. 야권 지지층에 실망을 안긴 김 대표가 어떻게 대응할 지켜봐야 할 대목이다. 

[2신 : 1일 오후 11시 3분] 
더민주, 의원 총회서 필리버스터 중단 최종 결론
이종걸 "최종 판단은 나와 김종인 대표가 한다"

기사 관련 사진
  국회의장에 의해 직권상정된 테러방지법을 막기 위한 야당의원들의 무제한토론(필리버스터) 8일째인 1일 오후 여의도 국회에서 필리버스터 중단 여부를 논의하기 위해 열리는 더불어민주당 의원총회에 이종걸 원내대표가 참석해 회의 시작을 기다리고 있다.
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필리버스터 중단 관련한 더불어민주당의 의원총회가 2시간이 넘도록 결론을 내리지 못하고 정회됐다. 

당 관계자에 따르면 일부 의원들이 필리버스터 중단 결정 철회를 요구하고 있지만 당 비상대책위원회의 결정을 뒤짚기에는 역부족인 것으로 보인다. 이날 의총에서 김 대표는 "당이 총선에 이기는 것에 전력해야 하므로 필리버스터를 종료하자"라는 취지로 의원들을 설득한 것으로 전해졌다. 

이종걸 원내대표 역시 이 같은 의총 분위기를 전했다. 그는 의총 도중 JTBC와 인터뷰에서 "국민들의 마음을 어떤 식으로 위로하고 장기적으로 테러방지법을 잘 고쳐나갈 수 있는, 새로운 법을 만들 수 있는 힘을 어떻게 국민들로부터 받아내고 함께할 수 있는가를 고민하고 있다"라고 말했다. 

이어 "(필리버스터 중단 시점은) 오늘 자정이지만, 의원들이 결정할 수 있는 범위 내에 있는 내용들을 의논해서 지혜롭게 결정할 수 있을 것이라 생각한다"라고 말했다. 이 원내대표의 말은 자정을 넘어 필리버스터가 진행될 수는 있지만 이를 중단하는 것은 기정사실화 한 것으로 볼 수 있다. 

다만 이 원내대표는 "(중단결정을 놓고) 찬반투표는 하기 어렵다, 의원들의 심도 있는 토론이 계속되고 그것으로 전체적인 분위기가 좌우될 수 있다"라며 "원내대표인 내가 (최종적으로) 판단해서 이를 김종인 대표와 의논하겠다"라고 일말의 여지를 열어놓았다. 

그러면서 "이미 오늘 아침에 중단할 예정이라고 말씀드렸지만, 그것을 확정적으로 말씀드리는 기자회견은 연기했고 오늘 의원총회를 통해서 그에 대한 판단을 유보했다", "의원들의 생각들을 잘 고려해서 전반적인 결정을 하겠다"라고 덧붙였다. 

이 원내대표는 "종인 대표는 박근혜 정부의 경제실정을 지적하고 선거전략을 짜는 데 있어서 이제는 필리버스터 정국을 종료하는 것이 우리 당의 미래에 맞다고 판단했다"라고 전했다.

더민주는 곧 의총을 재개해 논의를 계속 진행할 예정이다. 

[1신 : 1일 오후 7시 53분]
더민주, 필리버스터 중단 의원총회 시작

1일 더불어민주당 지도부가 테러방지법 필리버스터(합법적 의사 진행 지연)를 중단하기로 결정한 가운데 오후 7시 15분 경 의원총회가 시작됐다. 당 지도부는 의원총회를 통해 의원들의 양해를 구할 것으로 알려졌다. 의원총회 전체는 비공개로 진행된다. 

당초 6시 30분으로 예정된 의원총회는 김종인 비상대책위원회 대표가 40분 가량 늦게 도착하면서 지연됐다. 회의 장소에는 더민주 의원 60여 명이 참석한 상태다. 이종걸 원내대표는 김 대표보다 10분 가량 먼저 도착해 의원들과 별다른 대화 없이 맨 앞자리에 앉았다. 

의총에 참석한 의원들은 이날 오후 시민사회가 이종걸 원내대표와 간담회 자리에 만들어 왔던 '테러방지법 관련 시민사회 자료 묶음'이라는 문건을 읽으며 침묵 속에 회의 시작을 기다렸다. 

앞서 이종걸 원내대표는 이날 오전 성명에서 "더불어민주당은 뜻 깊은 3월 1일 오늘 중으로 소위 '테러방지법'에 대한 무제한 토론을 마칠 예정"이라고 밝혔다. 이에 일부 의원들은 소셜미디어에 불만을 공개적으로 표시하며 필리버스터 중단에 반발하고 있다. 

기사 관련 사진
  국회의장에 의해 직권상정된 테러방지법을 막기 위한 야당의원들의 무제한토론(필리버스터) 8일째인 1일 오후 여의도 국회에서 필리버스터 중단 여부를 논의하기 위한 더불어민주당 의원총회가 김종인 대표, 이종걸 원내대표 등이 참석한 가운데 열리고 있다.
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하늘과 바람과 별과 시



죽는 날까지 하늘을 우러러
한점 부끄럼이 없기를, 
잎새에 이는 바람에도 
나는 괴로워했다. 
별을 노래하는 마음으로
모든 죽어가는 것을 사랑해야지.
그리고 나한테 주어진 길을 
걸어가야겠다. 

오늘밤에도 별이 바람에 스치운다. 


- 윤동주의 시집《하늘과 바람과 별과 시》에 
               실린〈서시〉(전문)에서 -




서시따위에 감흥 느끼기에는 현실적인 고민들에 치이는 근래. 죽어가는 것을 돌볼 틈이 없다. 나 자신의 하루조차 어떻게 다루어야 할지 - 아쉬움이 따르는 날들이다. 

나에게 주어진 길, 내가 선택하였지만 그렇지도 않게만 느껴지는 길. 하루하루 행복하지만 알게모르게 만들어지는 오류에 조심스러워진다. i should be more sensible and cautious, caring and giving. 하나가 둘이되고 쌓인 슬픔이 버틸 수 없음이되고, 쌓인 감사함이 용서가된다. 고마운 마음을 기억하며 매일을 긍정의 방향으로 웃으며 지낼 수 있도록, 오늘 내일 지금 뿐이 아닌 오년 십년 후의 아름다움을, 죽는 날까지의 부끄럼 없음을 위하야 - 의식적으로 배려하며 고마워하며 존중하야, 한다. 


카페의 앞자리 아주머니, 샐러드에 프라푸치노에 물과 베이글을 주문하고 베이글에 크림치즈를 바른다. 괜스럽게 저게 무슨 짓이지 싶으면서 사람들 참 다양쿠나 싶다. 옆자리 삭행 까만 탱탑에 까만 양털 자켓에 검정 자개 초커를하고 900 장은 되어보이는 dental 교과서를 읽고 앉아있다. 반댓자리 애 엄마, 세네살 되어보이는 딸 둘을 데리고 초코우유와 젤리, 그리고 감자침을 먹인다. 이 높은 bar table 의자에 애들을 앉혀놓은 것이 내가 괜히 불안하다. 왜인지 제각의 사람들을 보며 이상하게 느끼면서도 위안이되는건 무엇인지 .. 내 기분이 이상한가보다. 

애 둘 딸린 아주머니가 떠났다, 테이블에 과자부스러기 천조각과 냅킨따위 남기고 .. 아이는 부모의 거울이라던데, 나는 저러지 말아야지. 뒷정리는 깨끗이



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best video ever forever 

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INTJ PERSONALITY (“THE ARCHITECT”)

It’s lonely at the top, and being one of the rarest and most strategically capable personality types, INTJs know this all too well. INTJs form just two percent of the population, and women of this personality type are especially rare, forming just 0.8% of the population – it is often a challenge for them to find like-minded individuals who are able to keep up with their relentless intellectualism and chess-like maneuvering. People with the INTJ personality type are imaginative yet decisive, ambitious yet private, amazingly curious, but they do not squander their energy.

Nothing Can Stop the Right Attitude From Achieving Its Goal

With a natural thirst for knowledge that shows itself early in life, INTJs are often given the title of “bookworm” as children. While this may be intended as an insult by their peers, they more than likely identify with it and are even proud of it, greatly enjoying their broad and deep body of knowledge. INTJs enjoy sharing what they know as well, confident in their mastery of their chosen subjects, but owing to their Intuitive (N) and Judging (J) traits, they prefer to design and execute a brilliant plan within their field rather than share opinions on “uninteresting” distractions like gossip.

“You are not entitled to your opinion. You are entitled to your informed opinion. No one is entitled to be ignorant.”

Harlan Ellison

A paradox to most observers, INTJs are able to live by glaring contradictions that nonetheless make perfect sense – at least from a purely rational perspective. For example, INTJs are simultaneously the most starry-eyed idealists and the bitterest of cynics, a seemingly impossible conflict. But this is because INTJ types tend to believe that with effort, intelligence and consideration, nothing is impossible, while at the same time they believe that people are too lazy, short-sighted or self-serving to actually achieve those fantastic results. Yet that cynical view of reality is unlikely to stop an interested INTJ from achieving a result they believe to be relevant.

INTJ personality

In Matters Of Principle, Stand Like a Rock

INTJs radiate self-confidence and an aura of mystery, and their insightful observations, original ideas and formidable logic enable them to push change through with sheer willpower and force of personality. At times it will seem that INTJs are bent on deconstructing and rebuilding every idea and system they come into contact with, employing a sense of perfectionism and even morality to this work. Anyone who doesn’t have the talent to keep up with INTJs’ processes, or worse yet, doesn’t see the point of them, is likely to immediately and permanently lose their respect.

Rules, limitations and traditions are anathema to the INTJ personality type – everything should be open to questioning and reevaluation, and if they see a way, INTJs will often act unilaterally to enact their technically superior, sometimes insensitive, and almost always unorthodox methods and ideas.

This isn’t to be misunderstood as impulsiveness – INTJs will strive to remain rational no matter how attractive the end goal may be, and every idea, whether generated internally or soaked in from the outside world, must pass the ruthless and ever-present “Is this going to work?” filter. This mechanism is applied at all times, to all things and all people, and this is often where INTJ personality types run into trouble.

One Reflects More When Traveling Alone

INTJs are brilliant and confident in bodies of knowledge they have taken the time to understand, but unfortunately the social contract is unlikely to be one of those subjects. White lies and small talk are hard enough as it is for a type that craves truth and depth, but INTJs may go so far as to see many social conventions as downright stupid. Ironically, it is often best for them to remain where they are comfortable – out of the spotlight – where the natural confidence prevalent in INTJs as they work with the familiar can serve as its own beacon, attracting people, romantically or otherwise, of similar temperament and interests.

INTJs are defined by their tendency to move through life as though it were a giant chess board, pieces constantly shifting with consideration and intelligence, always assessing new tactics, strategies and contingency plans, constantly outmaneuvering their peers in order to maintain control of a situation while maximizing their freedom to move about. This isn’t meant to suggest that INTJs act without conscience, but to many Feeling (F) types, INTJs’ distaste for acting on emotion can make it seem that way, and it explains why many fictional villains (and misunderstood heroes) are modeled on this personality type.


INTJ STRENGTHS AND WEAKNESSES

INTJ Strengths

INTJ strengths
  • Quick, Imaginative and Strategic Mind – INTJs pride themselves on their minds, taking every opportunity to improve their knowledge, and this shows in the strength and flexibility of their strategic thinking. Insatiably curious and always up for an intellectual challenge, INTJs can see things from many perspectives. INTJs use their creativity and imagination not so much for artistry, but for planning contingencies and courses of action for all possible scenarios.
  • High Self-Confidence – INTJs trust their rationalism above all else, so when they come to a conclusion, they have no reason to doubt their findings. This creates an honest, direct style of communication that isn't held back by perceived social roles or expectations. When INTJs are right, they're right, and no amount of politicking or hand-holding is going to change that fact – whether it's correcting a person, a process, or themselves, they'd have it no other way.
  • Independent and Decisive – This creativity, logic and confidence come together to form individuals who stand on their own and take responsibility for their own actions. Authority figures do not impress INTJs, nor do social conventions or tradition, and no matter how popular something is, if they have a better idea, INTJs will stand against anyone they have to in a bid to have it changed. Either an idea is the most rational or it's wrong, and INTJs will apply this to their arguments as well as their own behavior, staying calm and detached from these sometimes emotionally charged conflicts. INTJs will only be swayed by those who follow suit.
  • Hard-working and determined – If something piques their interest, INTJs can be astonishingly dedicated to their work, putting in long hours and intense effort to see an idea through. INTJs are incredibly efficient, and if tasks meet the criteria of furthering a goal, they will find a way to consolidate and accomplish those tasks. However, this drive for efficiency can also lead to a sort of elaborate laziness, wherein INTJs find ways to bypass seeming redundancies which don't seem to require a great deal of thought – this can be risky, as sometimes double-checking one's work is the standard for a reason.
  • Open-minded – All this rationalism leads to a very intellectually receptive personality type, as INTJs stay open to new ideas, supported by logic, even if (and sometimes especially if) they prove INTJs' previous conceptions wrong. When presented with unfamiliar territory, such as alternate lifestyles, INTJs tend to apply their receptiveness and independence, and aversion to rules and traditions, to these new ideas as well, resulting in fairly liberal social senses.
  • Jacks-of-all-Trades – INTJs' open-mindedness, determination, independence, confidence and strategic abilities create individuals who are capable of doing anything they set their minds to. Excelling at analyzing anything life throws their way, INTJs are able to reverse-engineer the underlying methodology of most any system and apply the concepts that are exposed wherever needed. INTJs tend to have their pick of professions, from IT architects to political masterminds.

INTJ Weaknesses

  • Arrogant – INTJs are perfectly capable of carrying their confidence too far, falsely believing that they've resolved all the pertinent issues of a matter and closing themselves off to the opinions of those they believe to be intellectually inferior. Combined with their irreverence for social conventions, INTJs can be brutally insensitive in making their opinions of others all too clear.
  • Judgmental – INTJs tend to have complete confidence in their thought process, because rational arguments are almost by definition correct – at least in theory. In practice, emotional considerations and history are hugely influential, and a weak point for INTJs is that they brand these factors and those who embrace them as illogical, dismissing them and considering their proponents to be stuck in some baser mode of thought, making it all but impossible to be heard.
  • Overly analytical – A recurring theme with INTJs is their analytical prowess, but this strength can fall painfully short where logic doesn't rule – such as with human relationships. When their critical minds and sometimes neurotic level of perfectionism (often the case with Turbulent INTJs) are applied to other people, all but the steadiest of friends will likely need to make some distance, too often permanently.
  • Loathe highly structured environments – Blindly following precedents and rules without understanding them is distasteful to INTJs, and they disdain even more authority figures who blindly uphold those laws and rules without understanding their intent. Anyone who prefers the status quo for its own sake, or who values stability and safety over self-determination, is likely to clash with INTJ personality types. Whether it's the law of the land or simple social convention, this aversion applies equally, often making life more difficult than it needs to be.
  • Clueless in romance – This antipathy to rules and tendency to over-analyze and be judgmental, even arrogant, all adds up to a personality type that is often clueless in dating. Having a new relationship last long enough for INTJs to apply the full force of their analysis on their potential partner's thought processes and behaviors can be challenging. Trying harder in the ways that INTJs know best can only make things worse, and it's unfortunately common for them to simply give up the search. Ironically, this is when they're at their best, and most likely to attract a partner.

INTJ PERSONALITY AND EMOTIONS

INTJs are defined by their confidence, logic, and exceptional decision-making, but all of this hides a turbulent underbelly – their emotions. The very notion of emotional expression is synonymous with irrationality and weakness to many INTJs, a display of poor self-governance and fleeting opinion that can hardly stand up to the enduring light of factual truth.

This mistrust of emotions is understandable, as Feeling (F) is the most weakly developed trait for INTJs – like any complex tool, skilled hands can use it to remarkable effect, while untrained hands make clumsy and dangerous work.

People with the INTJ personality type take pride in remaining rational and logical at all times, considering honesty and straightforward information to be paramount to euphemisms and platitudes in almost all circumstances. In many ways though, these qualities of coolness and detachment aren't the weapons of truth that they appear to be, but are instead shields designed to protect the inner emotions that INTJs feel. In fact, because their emotions are such an underdeveloped tool, INTJs often feel them more strongly than many overtly emotional types because they simply haven't learned how to control them effectively.

INTJ personality and emotions

There Is Not a Truth Existing Which I Fear

This is a challenging paradigm for INTJs to manage, especially younger and more Turbulent types who are already less confident than they would like to appear. These feelings are contrary to INTJs' idea of themselves as paragons of logic and knowledge, and they may go so far as to claim they have no emotions at all. This does not mean that people with the INTJ personality type should be seen as, nor should they aspire to be, cold-blooded and insensitive geniuses living by the mantra that emotions are for the weak. INTJs must understand that this isn't the case, and isn't ever going to be.

More mature and Assertive INTJs find more useful ways to manage their feelings. While they will never be comfortable with a truly public display of emotions, INTJs can learn to use them, to channel them alongside their logic to help them achieve their goals. While seemingly contradictory, this can be done in several ways.

Firstly, INTJs are goal-oriented, with long-term ideas founded on sound logic. When something does cause an emotional reaction, good or bad, that energy can be used to further those goals, aiding rational and pre-determined plans. Secondly, emotions are figurative canaries in the coal mine, indicating that something is off even though logic can't see it yet. These feelings can help INTJs to use their logic to ask questions they may not have thought to ask. "This is upsetting. Why? What can be done to resolve it?"

Question With Boldness

In this way, emotions are not INTJs' way of addressing a decision, but rather an indication that a decision needs to be addressed. INTJ personalities' Thinking (T) trait acts as a protective big brother to their Feeling (F) trait – seeing that something has upset the less able sibling, it steps in to take action, letting logic do the talking and resolving the condition rather than complaining about its consequences.

There comes a time though, when logic is simply the wrong tool for the job, when there just isn't a rational solution to a problem, and it is in these situations that INTJs must use their Feeling (F) trait most clearly. INTJs would do well to practice this from time to time, or at least be aware of it, because however they may try, it is impossible to truly separate emotion from the decision-making process. The fact is that INTJs do feel, and deeply, and this makes them better, not worse.

INTJ RELATIONSHIPS

In romance, people with the INTJ personality type approach things the way they do with most situations: they compose a series of calculated actions with a predicted and desirable end goal – a healthy long-term relationship. Rather than falling head over heels in a whirlwind of passion and romance, INTJs identify potential partners who meet a certain range of pre-determined criteria, break the dating process down into a series of measurable milestones, then proceed to execute the plan with clinical precision.

In a purely rational world, this is a fool-proof methodology – but in reality, it ignores significant details that INTJs are likely to dismiss prematurely, such as human nature. INTJs are brilliantly intellectual, developing a world in their heads that is more perfect than reality. People entering this world need to fit this fantasy, and it can be incredibly difficult for INTJs to find someone up to the task. Needless to say, finding a compatible partner is the most significant challenge most INTJs will face in life.

Politeness Is Artificial Good Humor

Sentiment, tradition, and emotion are INTJs' Achilles Heel. Social standards like chivalry are viewed by INTJs as silly, even demeaning. The problem is, these standards have developed as a means of smoothing introductions and developing rapport, of managing expectations, the basis of personal relationships. INTJs' propensity for frank honesty in word and action tends to violate this social contract, making dating especially difficult for them.

As they mature, INTJs will come to recognize these factors as relevant, incorporating pace and emotional availability into their plans. But the meantime can be dangerous, especially for more Turbulent INTJs – if they are shot down too many times they may come to the conclusion that everyone else is simply too irrational, or simply beneath them intellectually. If cynicism takes hold, INTJs may end up falling into the trap of intentionally displaying intellectual arrogance, making solitude their choice rather than happenstance.

Always Remain Cool

The positive side of INTJs' “giving up” is that they are most attractive when they aren't trying to be attractive, working in a familiar environment where their confidence and intelligence can be seen in action. Allowing others to come to them is often INTJs' best strategy, and if they perceive a potential to the relationship, they will spare no effort in developing and maintaining stability and long-term satisfaction.

INTJ romantic relationships

As their relationships develop, INTJs' partners will find an imaginative and enthusiastic companion, who will share their world and at the same time grant a huge degree of independence and trust. While INTJs may never be fully comfortable expressing their feelings, and may spend more time theorizing about intimacy than engaging in it, they can always be relied upon to think out a mutually beneficial solution to any situation.

INTJs seek strong, deep relationships, and trust their knowledge and logic to ensure that their partner is satisfied, both intellectually and physically.

But when it comes to emotional satisfaction, INTJs are simply out of their element. Not every partner has the sort of fun INTJs do in addressing conflicts and emotional needs as puzzles to be analyzed and solved. Sometimes emotions need to be expressed for their own sake, and putting every outburst under the microscope isn't always helpful. If this becomes habit, or INTJs think it may, they are capable of simply ending the relationship, rather than dragging things out.

Truth and Morality

INTJs are bewilderingly deep and intelligent people, bringing stability and insight into their romantic relationships. They prize honest, open communication, and all factors of the relationship are open to discussion and change, but this must be reciprocated. INTJs do what they think is right, and sometimes that comes across as cold – it's important to know that INTJs don't make these decisions lightly. They spend a tremendous amount of time and energy trying to understand why and how things go wrong, especially if they've devoted themselves to the relationship, and they certainly hurt deeply when things fall apart.

The challenge is finding partners who share those same values – though Intuitive (N) types are uncommon, they may be a must for many INTJs, as sharing this trait creates an immediate sense of mutual belonging. Having one or two balancing traits, such as Extraversion (E), Feeling (F), or Prospecting (P) can help to keep a relationship dynamic and growth-oriented by keeping INTJs involved with other people, in touch with their emotions, and open to alternate potentials.

INTJ FRIENDS

People with the INTJ personality type tend to have more success in developing friendships than they do with romantic relationships, but they none-the-less suffer from many of the same setbacks, substituting rational processes for emotional availability. This intellectual distance tends to go both ways, making INTJs notoriously difficult to read and get to know, and making INTJs not want to bother reading anyone they think isn't on their level. Overcoming these hurdles is often all but impossible without the sort of instant connection made possible by sharing the Intuitive (N) trait.

INTJ friends

No Person Will Complain for Want of Time Who Never Loses Any

INTJs tend to have set opinions about what works, what doesn't, what they're looking for, and what they're not. These discriminating tastes can come across as arrogant, but INTJs would simply argue that it's a basic filtering mechanism that allows them to direct their attentions where they will do the most good. The fact is that in friendship, INTJs are looking for more of an intellectual soul mate than anything else, and those that aren't prepared for that kind of relationship are simply boring. INTJs need to share ideas – a self-feeding circle of gossip about mutual friends is no kind of social life for them.

INTJs will keep up with just a few good friends, eschewing larger circles of acquaintances in favor of depth and quality.

Further, having more than just a few friends would compromise INTJs' sense of independence and self-sufficiency – they gladly give up social validation to ensure this freedom. INTJs embrace this idea even with those who do fit into their social construct, requiring little attention or maintenance to remain on good terms, and encouraging that same independence in their friends.

When it comes to emotional support, INTJs are far from being a bastion of comfort. They actively suppress their own emotions with shields of rationality and logic, and expect their friends to do the same. When emotionally charged situations do come about, INTJs may literally have no clue how to handle them appropriately, a glaring contrast from their usual capacity for decisive self-direction and composure.

But Friendship Is Precious

When they are in their comfort zone though, among people they know and respect, INTJs have no trouble relaxing and enjoying themselves. Their sarcasm and dark humor are not for the faint of heart, nor for those who struggle to read between the lines, but they make for fantastic story-telling among those who can keep up. This more or less limits their pool of friends to fellow Analysts (NT) and Diplomat (NF) types, as Observant (S) types' preference for more straightforward communication often simply leaves both parties frustrated.

It's not easy to become good friends with INTJs. Rather than traditional rules of social conduct or shared routine, INTJs have exacting expectations for intellectual prowess, uncompromising honesty and a mutual desire to grow and learn as sovereign individuals. INTJs are gifted, bright and development-oriented, and expect and encourage their friends to share this attitude. Anyone falling short of this will be labeled a bore – anyone meeting these expectations will appreciate them of their own accord, forming a powerful and stimulating friendship that will stand the test of time.

INTJ PARENTS

Parenting, like so many other person-to-person relationships, is a significant challenge for INTJs. Being so heavily invested in rational thought, logic, and analyzing cause and effect, INTJs are often unprepared for dealing with someone who hasn't developed these same abilities who they can't simply walk away from. Luckily, INTJs are uniquely capable of committing to a long-term project, especially one as meaningful as parenthood, with all the intellectual vigor they can muster.

INTJ parents

I Hope Our Wisdom Will Grow With Our Power...

First and foremost, INTJ parents will likely never be able to deliver the sort of warmth and coddling that stereotypes say they should. INTJs are rational, perfectionistic, often insensitive, and certainly not prone to overt displays of physical affection – it will take a clear and conscious effort on their part to curb and adapt these qualities to their children's needs, especially in the younger years. If they have an especially sensitive child, INTJs risk inadvertently trampling those sensitivities or coming across as cold and uncaring.

Even less sensitive children will need emotional support from time to time, especially as they approach adolescence – INTJs, even more so than other Analyst (NT) types, struggle to manage their own emotions in a healthy way, let alone others'. As a result, INTJs tend to avoid “unproductive” emotional support, instead taking a solutions-based approach to resolving issues. This is where INTJs are strongest – assessing a dilemma to find the underlying cause and developing a plan to solve the problem at its source.

INTJ parents don't just tell their children what to do, though – they prompt them, make them use their own minds so they arrive at the same conclusions, or better ones still.

INTJs also recognize that life is often the best teacher, and they will tend to be fairly liberal, allowing their children to have their own adventures and make their own decisions, further developing these critical thinking skills. This isn't to say that INTJs parents are lenient – far from it – rather, they expect their children to use their freedom responsibly, and often enough the weight of this expectation alone is enough to lay out understood ground rules. When they need to though, INTJ parents will communicate openly and honestly with their children, believing that knowing the truth is better than not knowing, or worse yet, simply being wrong.

...And Teach Us That the Less We Use Our Power, the Greater It Will Be

If their children are receptive to this approach, INTJ parents will find themselves respected and trusted. INTJs are excellent communicators when they want to be, and will frame problems as opportunities for personal growth, helping their children to establish their own brand of rational thinking and independent problem-solving skills to be applied to more and more complex situations as they grow, building their confidence as they make their own way. INTJs' ultimate goal as a parent is to ensure that their children are prepared to deal with whatever life throws their way.

All this is the exertion of INTJs' core philosophy of intelligent self-direction, and in this way they try to mold their children in their own image, working to create capable adults who can go on to use their own minds, solve their own problems, and help their own children in the same way when the time comes. INTJs understand that this can't happen if they shield their children from every source of ill and harm, but believe that if they give their children the right tools, they won't have to..

INTJ CAREERS

Professional competence is often the area in which INTJs shine most brilliantly. Their capacity for digesting difficult and complex theories and principles and converting them into clear and actionable ideas and strategies is unmatched by any other type. INTJs are able to filter out the noise of a situation, identifying the core thread that needs to be pulled in order to unravel others' messes so that they can be rewoven into something at once beautifully intricate and stunningly simple in its function.

The real challenge for INTJs is that in order for their innovative (and to less insightful individuals, seemingly counter-intuitive) ideas to be heard, they need to have a friendly ear to bend, and developing an amiable rapport with authority figures is not exactly in INTJs' list of core strengths. In their early careers, INTJs will often have to suffer through menial tasks and repeated rejections as they develop their abilities into a skillset that speaks for itself.

INTJs will often find ways to automate routine and mind-numbing tasks, and as they progress, their natural confidence, dedication, and creative intelligence will open the doors to the increased complexity and freedom they crave.

Where's My Drawing Board?

INTJs tend to prefer to work alone, or at most in small groups, where they can maximize their creativity and focus without repeated interruptions from questioning colleagues and meetings-happy supervisors. For this reason INTJs are unlikely to be found in strictly administrative roles or anything that requires constant dialogue and heavy teamwork. Rather, INTJs prefer more "lone wolf" positions as mechanical or software engineers, lawyers or freelance consultants, only accepting competent leadership that helps in these goals, and rejecting the authority of those who hold them back.

INTJ careers

Their independent attitude and tireless demand for competence mean that INTJs absolutely loathe those who get ahead by seemingly less meritocratic means like social prowess and political connections. INTJs have exceptionally high standards, and if they view a colleague or supervisor as incompetent or ineffective, respect will be lost instantly and permanently. INTJs value personal initiative, determination, insight and dedication, and believe that everyone should complete their work to the highest possible standards – if a schmoozing shill breezes through without carrying their own weight, they may find INTJs' inventiveness and determination used in a whole new capacity as the winds turn against them.

Timid Men Prefer the Calm

As their careers progress further and their reputation grows, so will the complexity of INTJs' tasks and projects. INTJs demand progress and evolution, new challenges and theories, and they often accomplish this by pushing into more active strategic positions. While they don't care for the spotlight, INTJs do enjoy controlling their ideas, and will often expand into low-profile but influential roles as project managers, system engineers, marketing strategists, systems analysts, and military strategists.

But really, INTJs' vision, creativity, and competence in executing their plans make them viable in just about any career that requires them to think about what they're doing. While some careers, such as low-level sales and human resources, clearly do not play to their strengths, INTJs are able to build a niche into just about any institution, including their own, that they put their minds to.

INTJ IN THE WORKPLACE

Above all else, INTJs want to be able to tackle intellectually interesting work with minimal outside interference, no more, no less. Time-consuming management techniques like trust-building getaways, progress meetings, and drawn-out, sandwiched criticisms are only going to annoy INTJs – all they need, be they subordinate, colleague, or manager, is to meet their goals with the highest standard of technical excellence and to be surrounded by, if anyone at all, people who share those values.

On paper this makes them appear to be exemplary employees, and in many ways they are, but there are many types, especially those with a combination of the Observant (S) and Feeling (F) traits, who will find a work (or any other) relationship with INTJs extremely challenging. INTJs have a fairly strict code of conduct when it comes to their work, and if they see coworkers valuing social activities and "good enough" workmanship over absolute excellence, it will be a turbulent environment. For this reason, INTJs tend to prefer to work in tight, like-minded groups – a group of one, if necessary.

INTJ Subordinates

INTJs are independent people, and they quickly become frustrated if they find themselves pushed into tightly defined roles that limit their freedom. With the direction of a properly liberal manager, INTJs will establish themselves in a position of expertise, completing their work not with the ambition of managerial promotion, but for its own intrinsic merit. INTJs require and appreciate firm, logical managers who are able to direct efforts with competence, deliver criticism when necessary, and back up those decisions with sound reason.

Note that it is INTJs' expectations of their managers that are being defined here, and not the other way around, as with some other personality types. Titles mean little to INTJs – trust and respect are earned, and INTJs expect this to be a two way street, receiving and delivering advice, criticisms and results. INTJs expect their managers to be intelligent enough and strong enough to be able to handle this paradigm. A silent INTJ conveys a lack of respect better than all their challenges ever will.

INTJ Colleagues

Active teamwork is not ideal for people with the INTJ personality type. Fiercely independent and private, INTJs use their nimble minds and insight to deflect personal talk, avoid workplace tension, and create situations where they aren't slowed down by those less intelligent, less capable, or less adaptable to more efficient methods. Instead, they will likely poke fun by forcing them to read between the lines and making them deal alone with work that could have been easier if they'd only taken INTJs' suggestions.

INTJs are brilliant analysts, and will likely gather a small handful of trusted colleagues to involve in their brainstorming sessions, excluding those who get too hung up on details, or who otherwise have yet to earn their respect. But more likely, INTJs will simply take the initiative alone – INTJs love embracing challenges and their consequent responsibilities, and their perfectionism and determination usually mean that the work comes out clean and effective, affording INTJs the twin joys of solitude and victory.

INTJ Managers

Though they may be surprised to hear it, INTJs make natural leaders, and this shows in their management style. INTJs value innovation and effectiveness more than just about any other quality, and they will gladly cast aside hierarchy, protocol and even their own beliefs if they are presented with rational arguments about why things should change. INTJs promote freedom and flexibility in the workplace, preferring to engage their subordinates as equals, respecting and rewarding initiative and adopting an attitude of "to the best mind go the responsibilities", directing strategy while more capable hands manage the day-to-day tactics.

But this sort of freedom isn't just granted, it's required – those who are accustomed to just being told what to do, who are unable to direct themselves and challenge existing notions, will have a hard time meeting INTJs' extremely high standards. Efficiency and results are king to INTJs, and behaviors that undermine these conditions are quashed mercilessly. If subordinates try to compensate for their weakness in these areas by trying to build a social relationship with their INTJ managers, on their heads be it – office gossip and schmoozing are not the way into INTJs' hearts – only bold competence will do.

INTJ PERSONALITY – CONCLUSION

Few personality types are as mysterious and controversial as INTJs. Possessing intellect and strategic thinking that allow them to overcome many challenging obstacles, INTJs have the ability to both develop and implement a plan for everything, including their own personal growth.

Yet INTJs can be easily tripped up in areas where careful and rational thinking is more of a liability than an asset. Whether it is finding (or keeping) a partner, making friends, reaching dazzling heights on the career ladder or adapting to the unpredictable, INTJs need to put in a conscious effort to develop their weaker traits and additional skills.

What you have read so far is just an introduction into the complex concept that is the INTJ personality type. You may have muttered to yourself, "wow, this is so accurate it's a little creepy" or "finally, someone understands me!" You may have even asked "how do they know more about me than the people I'm closest to?"

This is not a trick. You felt understood because you were. We've studied how INTJs think and what they need to reach their full potential. And no, we did not spy on you – many of the challenges you've faced and will face in the future have been overcome by other INTJs. You simply need to learn how they succeeded.

But in order to do that, you need to have a plan, a personal roadmap. The best car in the world will not take you to the right place if you do not know where you want to go. We have told you how INTJs tend to behave in certain circumstances and what their key strengths and weaknesses are. Now we need to go much deeper into your personality type and answer "why?", "how?" and "what if?"

This knowledge is only the beginning of a lifelong journey. Are you ready to learn why INTJs act in the way they do? What motivates and inspires you? What you are afraid of and what you secretly dream about? How you can unlock your true, exceptional potential?

Our premium profiles provide a roadmap towards a happier, more successful, and more versatile YOU! They are not for everyone though – you need to be willing and able to challenge yourself, to go beyond the obvious, to imagine and follow your own path instead of just going with the flow. If you want to take the reins into your own hands, we are here to help you.

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“Working in the White House on a Saturday afternoon had become routine for Zeke Emanuel and Bob Kocher,” Steven Brill tells us at the beginning of Chapter 9 of his ambitious new history of the Affordable Care Act, “America’s Bitter Pill” (Random House):

But they were usually able to leave at a decent hour. However, at 5 p.m. on Saturday, April 25, 2009, they were thrown into a state of near-panic. Emanuel, Kocher, and the rest of the staff from the Office of Management and Budget and the National Economic Council had been blindsided by the domestic policy crew.

At issue was a briefing paper written by the head of the White House health-care-reform effort, Nancy-Ann DeParle. It was early in the planning stages for Obamacare, and DeParle’s memo was a three-thousand-word document, in which she made the political case for a broad expansion of coverage. Kocher and Emanuel were taken aback. They were worried about the cost of the bill. The memo was supposed to go to the President at eight o’clock that night, which gave them just three hours to respond. “Any hopes for an early departure that Saturday evening were gone,” Brill writes.

By this point in the narrative, the reader is well acquainted with the cast of characters. DeParle was “a Rhodes scholar and graduate of Harvard Law School . . . a seasoned manager and savvy infighter when she had to be,” with a background in private equity. Kocher, a “Harvard-trained internist,” late of McKinsey, was “a walking encyclopedia of healthcare markets data who had an uncanny ability to turn it all into eye-opening PowerPoint presentations illustrating the dysfunction of the American system.” Emanuel was the “brashest” and most “academically credentialed of the trio of brilliant Emanuel brothers,” took “edgy” positions, and had an “MD and a PhD (in political philosophy) from Harvard, a master’s from Oxford, and a position teaching oncology at the Dana-Farber Cancer Institute in Boston.” He had “brains, cunning and [a] biting persona,” and was “ready, willing and able to layer it with the self-righteousness of a guy who treated cancer patients.” The two worked with Lawrence Summers—the “celebrated Harvard economics professor” and former Harvard president—and Peter Orszag, the whiz kid out of the Congressional Budget Office by way of Princeton and the London School of Economics. Brill, a graduate of Yale and Yale Law School, tends to specify the Ivy League credentials of his protagonists up front, with the result that his book sometimes reads like the class-notes section of an alumni bulletin. Barack Obama, we are reminded, is “the former Harvard Law Review president.” Jonathan Gruber, who was a Ph.D. student of Larry Summers at Harvard, was “an outgoing guy who had the intellectual chops of an Ivy League academic without the withdrawn personality.” And so on.

So there they were, Kocher of Harvard and Emanuel of Harvard blindsided by DeParle of Harvard. The evening became a blur. The two men tried desperately to alter the language of the briefing paper. But they were blocked by DeParle and her colleague Jeanne Lambrew—the “highly respected policy wonk,” who, at one of the first major congressional health-care summits, had “pushed back on the notion that the private sector could always be the answer.” The best they could do was alter a few words and phrases. Round One to DeParle.

For six pages, Brill painstakingly carries the story forward. Key phrases of the memo are parsed, their implications interrogated. “These options have been presented to your senior staff, and we have developed a package that could plausibly offset the cost of reform,” DeParle wrote. But the pronoun “we,” Brill argues, was ambiguous: it included her team but not the economic team. And could one side of the White House policy staff formulate a “package” without the other side? The directive from the Oval Office was clear. “Don’t bring us your problems,” Valerie Jarrett, the President’s gatekeeper, was known to say. “Bring us your solutions.” From that Saturday evening through the following Thursday, the two sides battled. Then came the showdown:

On April 30, 2009, a large group gathered with the president in the Roosevelt Room to review a PowerPoint about health-care reform. This was the meeting that DeParle’s April 25 memo had been meant to prepare the president for. But this time, the PowerPoint had been prepared jointly by the economic team and DeParle’s healthcare policy people. Peter Orszag and Larry Summers had insisted on that. In fact, Kocher, who prided himself on his McKinsey-bred PowerPoint skills, controlled the document.

Kocher controlled the document.

Near-history, the journalistic reconstruction of contemporary events, has come to be dominated by two schools. The first is represented by Michael Lewis. Lewis wrote about the 1996 Presidential election through the story of a Republican candidate no one had ever heard of, the eccentric millionaire Morry Taylor. “The Big Short” was an account of the financial crisis told through the eyes of four obscure short-sellers. Lewis’s interest is psychological and moral. His books have won him many admirers (including me) because they offer deceptively simple narratives in the service of a grand canonical theme. “Liar’s Poker,” which recounts the young Lewis’s stint in the Wall Street of the nineteen-eighties, is Daniel in the lion’s den. “Money Ball,” about the strategies of small-market baseball teams, is David and Goliath. “The Blind Side” is the Good Samaritan. “The Big Short” is Noah’s Ark, and “Flash Boys” is Jesus casting the money changers out of the temple.

The second school is associated with the Washington Post reporter Bob Woodward. Woodwardian history is kaleidoscopic. The reporter makes many telephone calls and office visits, and reads many documents. All key players are represented and events detailed. The approach is sociological: the great theme of the Woodward school is the interaction of institutions and vested interests. In a Lewis, if you remove the titles of the characters and simply identify them by their first names, nothing is lost: an individual’s character, not his position, is what matters. In a Woodward, the opposite is often true. Names may be irrelevant; titles tell you what you need to know. That is what makes Woodward and Carl Bernstein’s “All the President’s Men” a masterpiece: its great achievement was to show how the institutional power of the White House led to the President’s personal corruption. The Lewis brings drama to what we thought was prosaic. But when the underlying subject is inherently dramatic, and when the heart of the story lies behind doors that only dogged reporting can unlock, the Woodward is what we need. You don’t want Michael Lewis on Watergate. He’d get distracted by Rose Mary Woods and would never make it into the Oval Office.

“America’s Bitter Pill” is Brill’s attempt at a Woodward. The book is wrapped in the presumption of controversy: reviewers who received early copies had to sign a nondisclosure agreement. The reporting is exhaustive. Brill tells us that he interviewed “243 people—many of them multiple times—over twenty-seven months.” When Brill informs us that Valerie Jarrett likes to use the common managerial adage “Don’t bring us your problems; bring us your solutions,” he states that his source for this fact is the testimony of “three senior members of Obama’s staff.” Next comes a footnote:

Although Jarrett declined comment, assistant press secretary Eric Schultz denied this account offered by these senior Obama advisers, saying, “Valerie doesn’t use this phrase and regularly reminds our staff that the president and our senior team don’t like surprises, to further encourage staff to bring to their attention both problems and solutions.”

Then, in an appendix, Brill presents the text of questions that he submitted to Obama, including:

I am told by five people who have served in senior capacities in the Administration that Ms. Jarrett often told them that “the President wants you to bring us your solutions, not your problems.” . . . I feel compelled to ask you to comment on that.

Note how the three sources he interviewed in the text have now grown to five. Between the writing of the main text and the completion of the appendix, apparently in the belief that he had not fully explored the issue of Jarrett’s directive, Brill kept on going, enlisting one senior Administration official after another—up to and including the President—in his quest to resolve the Solutions vs. Solutions and Problems conundrum. Brill wants to take us behind the locked door.

“America’s Bitter Pill” consists of a series of parallel stories. Brill gives us case studies of Americans whose lives have been devastated by outrageous medical bills. He describes the launch of Obamacare in Kentucky; the early days of Oscar, a health-insurance startup in New York City; and his own terrifying experience with a life-threatening aortic aneurysm. Each of these stories orbits his central narrative, “the roller-coaster story of how Obamacare happened, what it means, what it will fix, what it won’t fix, and what it means to people.”

Brill’s intention is to point out how and why Obamacare fell short of true reform. It did heroic work in broadening coverage and redistributing wealth from the haves to the have-nots. But, Brill says, it didn’t really restrain costs. It left incentives fundamentally misaligned. We needed major surgery. What we got was a Band-Aid.

One of Brill’s examples is drug prices. While he was working on his book, he writes, “a drug called Sovaldi burst onto the scene.” Sovaldi is used for hepatitis C, and its manufacturer, Gilead Sciences, has priced it at a thousand dollars per pill—which comes out to eighty-four thousand dollars for a course of treatment. Brill quotes Sarah Kliff, who writes on health-care policy, pointing out that California might well end up spending more on Sovaldi for its Medicaid patients than it does on all K-12 and higher education. “The exact price Gilead chose for Sovaldi said something in and of itself about the nonexistent regulatory environment drug companies knew they faced in the United States,” he writes. “Rather than set the price at, say, $989 or $1,021—at least to create the impression that it was based on some calculation other than ‘Let’s charge whatever we want’—the company had chosen a simple round number, $1,000.”

How can we have a solution to the health-care crisis without making any attempt to curb runaway drug prices? Medicare isn’t even allowed to negotiate directly with drug companies. “Should we be embarrassed and maybe even enraged that the only way our country’s leaders in Washington could reform healthcare was by making backroom deals with all the interests who wanted to make sure that reform didn’t interfere with their profiteering?” Brill writes, in a section structured around a series of italicized questions. “Of course. We’ll be paying the bill for that forever.”

Brill devotes fifty pages to another Obamacare shortcoming, the early malfunctioning of the Web site. He originally thought that the site would be a showcase for what government could do. But, on the train back from his initial round of interviews in Washington, he glanced at his notes and realized that he had been given seven different answers to the question of who was in charge of the launch of the federal exchange, including an “incomprehensible” organizational chart with four diagonal lines crossing one another and forming a “lopsided” triangle:

Should we be amazed, and disappointed, at how Obama treated the nitty-gritty details of implementing the law as if actually governing was below the pay grade of Ivy League visionaries?

Absolutely. This failure to govern will stand as one of the great unforced disappointments of the Obama years.

At the end of “America’s Bitter Pill,” Brill offers his own solution to the health-care crisis. He wants the big regional health-care systems that dominate many metropolitan areas to expand their reach and to assume the function of insuring patients as well. He talks to Jeffrey Romoff, the C.E.O. of the University of Pittsburgh Medical Center, who is about to try this idea in the Pittsburgh area, and becomes convinced that the same model would work throughout the country. “The [hospital’s] insurance company would not only have every incentive to control the doctors’ and hospitals’ costs, but also the means to do so,” he writes. “It would be under the same roof, controlled by Romoff. Conversely, the hospitals and doctors would have no incentive to inflate costs or over-treat, because their ultimate boss, Romoff, would be getting the bill when those extra costs hit his insurance company.”

Cartoon
“It’s mostly sweater weight.”

Brill talks through his idea with several other prominent health-care-system C.E.O.s (“doctor-leaders,” he calls them), whose résumés are helpfully elaborated: “Glenn Steele, Jr., a former cancer surgeon and professor at Harvard Medical School,” and Gary Gottlieb, the head of a Boston group “formed by the merger of the area’s two most highly reputed hospital brands, both of which were affiliated with Harvard Medical School.” A system like this, Brill estimates, based on a few back-of-the-envelope calculations, could slice twenty per cent off the private-sector health-care bill.

It’s at moments like this that Brill’s book becomes problematic. The idea he is describing is called integrated managed care. It has been around for more than half a century—most notably in the form of the Kaiser Permanente Group. Almost ten million Americans are insured through Kaiser, treated by Kaiser doctors, and admitted to Kaiser hospitals. Yet Brill has almost nothing to say about Kaiser, aside from a brief, dismissive mention. It’s as if someone were to write a book about how America really needs a high-end electric-car company that sells its products online without being the least curious about Tesla Motors.

In a Lewis, this wouldn’t matter so much. “Flash Boys” was criticized by some on Wall Street for mischaracterizing the world of high-frequency trading. But “Flash Boys” explicitly set out to tell its story through the eyes of a renegade trader named Bradley Katsuyama, and the test of the book’s success was whether it captured Katsuyama’s view of high-frequency trading. In a Woodward, the goal is different. A book like Mark Bowden’s “Black Hawk Down”—a Woodward that outdoes even Woodward—sets out to describe things as they actually happened, not things as filtered through one person’s idiosyncratic perspective. The currency of the Lewis is empathy. The currency of the Woodward is mastery—and nothing is more corrosive to the form than the suspicion that the author doesn’t grasp the full picture.

Does the botched launch of the Web site deserve fifty pages? Maybe so. This certainly was something that felt significant at the time. But what we want to know is how much it ultimately mattered, and there is little in Brill’s reporting that sheds light on that question. The Administration built a Web site in order to give Americans access to one of the most complex pieces of legislation in history. The site had lots of bugs, in the beginning, as complicated pieces of software often do. Then the Administration fixed the bugs quickly, and the response was such that the Affordable Care Act reached its enrollment targets. “I was, like, never worried,” Brill quotes Mickey Dickerson, an expert from Google whom the Administration brought in to get the Web site on track, as saying. “It’s just a website. We’re not going to the moon.” Brill wants the Web-site saga to stand for something larger, but in the end what it seems to stand for is the fact that Web sites, in the beginning, sometimes crash a lot.

The Sovaldi example is equally puzzling. A thousand dollars for a pill sounds like a lot of money. But hepatitis C is a costly disease. It’s the leading reason for liver transplants, which are among the most expensive of all medical procedures. A 2013 study published in the journal Hepatology estimated the lifetime health-care costs of the average hepatitis-C patient (when medical inflation was factored in) at more than two hundred thousand dollars. The drug regimens that came before Sovaldi didn’t work very well and had terrible side effects. Brill quotes Sarah Kliff on how much the drug will cost the state of California, but what he doesn’t mention is that Kliff followed up on her initial analysis with another that was headlined, above a picture of Sovaldi capsules, “EACH OF THESE HEPATITIS C PILLS COSTS $1,000. THAT’S ACTUALLY A GREAT DEAL.

The problem with the pharmaceutical industry is not that it makes too many drugs like Sovaldi. It’s that it makes too many drugs that aren’t like Sovaldi, drugs whose costs vastly outstrip their benefits: cancer treatments that cost tens of thousands of dollars and extend life only minimally, or expensive me-too drugs that perform no better than cheap generics. We certainly need to be smarter about the drugs we use, and Medicare should be relieved of the congressionally mandated restrictions that make it impossible to bargain directly with drug companies. But Sovaldi targets a painful and costly disease with a substantially cheaper, safer, and more effective one-time cure. This is what we want drug companies to do. Of all the examples that Brill could have used to bolster his argument, why did he pick that one?

On May 2, 2009, Brill writes, the domestic-policy group at the White House blindsided the economic team with a second memo. It concerned something called the medical loss ratio, or M.L.R. The medical loss ratio compares what an insurer earns in premiums with what it pays out in benefits. An insurer who takes in a dollar and gives back eighty-five cents has a loss ratio of eighty-five per cent. Jeanne Lambrew wanted to place a floor on every insurer’s loss ratio: if a company kept too much of that dollar—if its M.L.R. fell below eighty-five or eighty per cent, say—it should have to refund the difference to its customers.

“Lambrew was certainly on firm political ground,” Brill writes. One senior White House aide called the proposal a “winner.” The rule would make it impossible for one of the economy’s least liked sectors to make excess profits. The feeling was, Brill says, that “it might end up being the single most politically appealing piece of healthcare reform.”

The economic team, however, wasn’t so sure:

Summers called it a “stupid idea,” and told his people to try to kill it. It was “dumb for us to cap anyone’s profits,” he said, dismissing the idea much the way the legendarily blunt Summers might have taken down a freshman economics student at Harvard who said something in class that he thought was “dumb.”

Summers’s point was that an M.L.R. floor distorted the insurer’s incentives. The argument goes like this: Suppose your doctor sends you to an imaging center to get a thousand-dollar MRI. But then your insurance company calls you and says that it’s found an equivalent provider just down the street that charges two hundred dollars. This, presumably, is what we want insurers to do. The market for medical procedures lacks price transparency and competition, and it’s scandalous that insurers routinely pay thousands of dollars for an MRI scan when the true cost of the procedure, by any metric, is a fraction of that. By taking steps like this, Summers thought, insurers could finally rein in, or even reduce, health-care premiums, which had been rising faster than inflation for years. But it is also highly likely that the insurer will keep a chunk of that eight-hundred-dollar savings for itself, in the form of higher profits. The prospect of higher profits is an insurer’s incentive for going to the trouble of looking for a cheaper MRI. In other words, if insurers do what we want them to do—cut costs and rein in premiums—it is likely that their loss ratios will fall. Why, Summers wondered, would you want to penalize them for doing that?

The economic team felt that health care could use a good dose of market incentives. The Lambrew-DeParle view, on the other hand, was that health care is different: the complex nature of the relationship between patients and their health-care provider is so unlike ordinary economic transactions that it can be governed only through cost controls and complicated regulatory mechanisms. When the two sides argued, they weren’t just reflecting a difference in tactics or emphasis. Their disagreement was philosophical: each held a distinct view about the nature of the transactions that take place around medical care.

Brill sides with the DeParle camp. His solution for the health-care problem is to treat the industry like a regulated oligopoly: he believes in price controls and profit limits and strict regulations for those who work within the health-care world, restrictions that he almost certainly thinks would be inappropriate for other sectors of the economy. A patient, he explains at the beginning of his book, is a not a rational consumer. That was the lesson he took from his own heart surgery. “In that moment of terror,” he writes, of blacking out after his surgery, “I was anything but the well-informed, tough customer with lots of options that a robust free market counts on. I was a puddle.”

But Brill spends very little time examining why he thinks this means that the market can’t have a big role in medicine, where most care is routine, not catastrophic. He just takes it for granted. And because he is not much engaged by the philosophical argument at the heart of the health-care debate, he can never really explain why someone involved in health-care reform might be unhappy with the direction that the Affordable Care Act ended up taking. He tells us who controlled the PowerPoint. But he can’t tell us why it mattered.

It is useful to read “America’s Bitter Pill” alongside David Goldhill’s “Catastrophic Care.” Goldhill covers much of the same ground. But for him the philosophical question—is health care different, or is it ultimately like any other resource?—is central. The Medicare program, for example, has a spectacularly high loss ratio: it pays out something like ninety-seven cents in benefits for every dollar it takes in. For Brill, that’s evidence of how well it works. He thinks Medicare is the most functional part of the health-care system. Goldhill is more skeptical. Perhaps the reason Medicare’s loss ratio is so high, he says, is that Medicare never says no to anything. The program’s annual spending has risen, in the past forty years, from eight billion to five hundred and eighty-five billion dollars. Maybe it ought to spend more money on administration so that it can promote competition among its suppliers and make disciplined decisions about what is and isn’t worth covering. Goldhill writes:

Medicare is cheaper to run than private insurance. So what? Cheaper doesn’t mean more efficient. It may be cheaper to run banks without security guards, hotels without housekeepers, and manufacturers without accountants, but that wouldn’t make those businesses more efficient.

Many state Medicaid programs have, similarly, a rule that says health-care providers cannot charge Medicaid more than the lowest price they give to anyone else. If you run an MRI machine and allow a privately insured patient to get a scan for two hundred dollars instead of a thousand dollars, you have to give all your Medicaid patients MRI scans for two hundred dollars. That’s a classic “health care is different” solution to the problem of excess health-care costs: pass a law guaranteeing the “sale price” to publicly funded patients. So what’s the result? Goldhill asks. Health-care providers behave the way any market participant would under the circumstances. They don’t have sales. What incentive would the Gap have for holding a Boxing Day blowout if, by law, it would have to offer those same low prices every other day of the year?

Goldhill takes a far more radical position than the economic team at the White House does. He believes that most of our interactions concerning health care are actually no different from our transactions concerning anything else: if we trust people to buy cars and houses and food and clothing on their own, he doesn’t see why they can’t be trusted to do the same with checkups, tonsillectomies, deliveries, flu shots, and the management of their diabetes. He thinks that the insurance function—inserting a third party between patients and providers—distorts incentives and raises prices, and has such an adverse impact on quality that health insurance should be limited to unexpected, high-cost occurrences the way auto insurance and home insurance are. These ideas are unlikely to make their way into policy anytime soon. But, in elaborating the market critique of the health-care status quo, Goldhill helps us understand what the argument we’re having right now is about. It is not just a political battle over Obama. It’s a battle over whether health care deserves its privileged status within American economic life.

The frustrating thing about “America’s Bitter Pill” is that Brill could have taken us one step further. He has introduced us to the policymakers, to Summers and DeParle, Kocher and Lambrew. He has taken us to the Roosevelt Room, where the two sides battle for the President’s attention. But, just at the point where “America’s Bitter Pill” could have become illuminating, exploring the conceptual gulf behind all the wrangling, Brill gets restless. He wants to get on to the next page in his notebook—to the next meeting that Obama had in the Roosevelt Room, to the briefing paper about such-and-such that was sent to So-and-So, and then, of course, to the debacle of the Web site, which had bugs until those bugs were fixed.

“Do you recall a memo that Peter Orszag wrote to you just after the law was passed urging you to put in charge someone with experience launching and running ventures as complicated as healthcare.gov?” Brill asks the President. He’s trying to be Woodward. It’s not as easy as it looks. “What were your reasons for not doing so? If you do not recall the memo, do you recall Peter and Larry Summers advising you to do this? . . .” 


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“Working in the White House on a Saturday afternoon had become routine for Zeke Emanuel and Bob Kocher,” Steven Brill tells us at the beginning of Chapter 9 of his ambitious new history of the Affordable Care Act, “America’s Bitter Pill” (Random House):

But they were usually able to leave at a decent hour. However, at 5 p.m. on Saturday, April 25, 2009, they were thrown into a state of near-panic. Emanuel, Kocher, and the rest of the staff from the Office of Management and Budget and the National Economic Council had been blindsided by the domestic policy crew.

At issue was a briefing paper written by the head of the White House health-care-reform effort, Nancy-Ann DeParle. It was early in the planning stages for Obamacare, and DeParle’s memo was a three-thousand-word document, in which she made the political case for a broad expansion of coverage. Kocher and Emanuel were taken aback. They were worried about the cost of the bill. The memo was supposed to go to the President at eight o’clock that night, which gave them just three hours to respond. “Any hopes for an early departure that Saturday evening were gone,” Brill writes.

By this point in the narrative, the reader is well acquainted with the cast of characters. DeParle was “a Rhodes scholar and graduate of Harvard Law School . . . a seasoned manager and savvy infighter when she had to be,” with a background in private equity. Kocher, a “Harvard-trained internist,” late of McKinsey, was “a walking encyclopedia of healthcare markets data who had an uncanny ability to turn it all into eye-opening PowerPoint presentations illustrating the dysfunction of the American system.” Emanuel was the “brashest” and most “academically credentialed of the trio of brilliant Emanuel brothers,” took “edgy” positions, and had an “MD and a PhD (in political philosophy) from Harvard, a master’s from Oxford, and a position teaching oncology at the Dana-Farber Cancer Institute in Boston.” He had “brains, cunning and [a] biting persona,” and was “ready, willing and able to layer it with the self-righteousness of a guy who treated cancer patients.” The two worked with Lawrence Summers—the “celebrated Harvard economics professor” and former Harvard president—and Peter Orszag, the whiz kid out of the Congressional Budget Office by way of Princeton and the London School of Economics. Brill, a graduate of Yale and Yale Law School, tends to specify the Ivy League credentials of his protagonists up front, with the result that his book sometimes reads like the class-notes section of an alumni bulletin. Barack Obama, we are reminded, is “the former Harvard Law Review president.” Jonathan Gruber, who was a Ph.D. student of Larry Summers at Harvard, was “an outgoing guy who had the intellectual chops of an Ivy League academic without the withdrawn personality.” And so on.

So there they were, Kocher of Harvard and Emanuel of Harvard blindsided by DeParle of Harvard. The evening became a blur. The two men tried desperately to alter the language of the briefing paper. But they were blocked by DeParle and her colleague Jeanne Lambrew—the “highly respected policy wonk,” who, at one of the first major congressional health-care summits, had “pushed back on the notion that the private sector could always be the answer.” The best they could do was alter a few words and phrases. Round One to DeParle.

For six pages, Brill painstakingly carries the story forward. Key phrases of the memo are parsed, their implications interrogated. “These options have been presented to your senior staff, and we have developed a package that could plausibly offset the cost of reform,” DeParle wrote. But the pronoun “we,” Brill argues, was ambiguous: it included her team but not the economic team. And could one side of the White House policy staff formulate a “package” without the other side? The directive from the Oval Office was clear. “Don’t bring us your problems,” Valerie Jarrett, the President’s gatekeeper, was known to say. “Bring us your solutions.” From that Saturday evening through the following Thursday, the two sides battled. Then came the showdown:

On April 30, 2009, a large group gathered with the president in the Roosevelt Room to review a PowerPoint about health-care reform. This was the meeting that DeParle’s April 25 memo had been meant to prepare the president for. But this time, the PowerPoint had been prepared jointly by the economic team and DeParle’s healthcare policy people. Peter Orszag and Larry Summers had insisted on that. In fact, Kocher, who prided himself on his McKinsey-bred PowerPoint skills, controlled the document.

Kocher controlled the document.

Near-history, the journalistic reconstruction of contemporary events, has come to be dominated by two schools. The first is represented by Michael Lewis. Lewis wrote about the 1996 Presidential election through the story of a Republican candidate no one had ever heard of, the eccentric millionaire Morry Taylor. “The Big Short” was an account of the financial crisis told through the eyes of four obscure short-sellers. Lewis’s interest is psychological and moral. His books have won him many admirers (including me) because they offer deceptively simple narratives in the service of a grand canonical theme. “Liar’s Poker,” which recounts the young Lewis’s stint in the Wall Street of the nineteen-eighties, is Daniel in the lion’s den. “Money Ball,” about the strategies of small-market baseball teams, is David and Goliath. “The Blind Side” is the Good Samaritan. “The Big Short” is Noah’s Ark, and “Flash Boys” is Jesus casting the money changers out of the temple.

The second school is associated with the Washington Post reporter Bob Woodward. Woodwardian history is kaleidoscopic. The reporter makes many telephone calls and office visits, and reads many documents. All key players are represented and events detailed. The approach is sociological: the great theme of the Woodward school is the interaction of institutions and vested interests. In a Lewis, if you remove the titles of the characters and simply identify them by their first names, nothing is lost: an individual’s character, not his position, is what matters. In a Woodward, the opposite is often true. Names may be irrelevant; titles tell you what you need to know. That is what makes Woodward and Carl Bernstein’s “All the President’s Men” a masterpiece: its great achievement was to show how the institutional power of the White House led to the President’s personal corruption. The Lewis brings drama to what we thought was prosaic. But when the underlying subject is inherently dramatic, and when the heart of the story lies behind doors that only dogged reporting can unlock, the Woodward is what we need. You don’t want Michael Lewis on Watergate. He’d get distracted by Rose Mary Woods and would never make it into the Oval Office.

“America’s Bitter Pill” is Brill’s attempt at a Woodward. The book is wrapped in the presumption of controversy: reviewers who received early copies had to sign a nondisclosure agreement. The reporting is exhaustive. Brill tells us that he interviewed “243 people—many of them multiple times—over twenty-seven months.” When Brill informs us that Valerie Jarrett likes to use the common managerial adage “Don’t bring us your problems; bring us your solutions,” he states that his source for this fact is the testimony of “three senior members of Obama’s staff.” Next comes a footnote:

Although Jarrett declined comment, assistant press secretary Eric Schultz denied this account offered by these senior Obama advisers, saying, “Valerie doesn’t use this phrase and regularly reminds our staff that the president and our senior team don’t like surprises, to further encourage staff to bring to their attention both problems and solutions.”

Then, in an appendix, Brill presents the text of questions that he submitted to Obama, including:

I am told by five people who have served in senior capacities in the Administration that Ms. Jarrett often told them that “the President wants you to bring us your solutions, not your problems.” . . . I feel compelled to ask you to comment on that.

Note how the three sources he interviewed in the text have now grown to five. Between the writing of the main text and the completion of the appendix, apparently in the belief that he had not fully explored the issue of Jarrett’s directive, Brill kept on going, enlisting one senior Administration official after another—up to and including the President—in his quest to resolve the Solutions vs. Solutions and Problems conundrum. Brill wants to take us behind the locked door.

“America’s Bitter Pill” consists of a series of parallel stories. Brill gives us case studies of Americans whose lives have been devastated by outrageous medical bills. He describes the launch of Obamacare in Kentucky; the early days of Oscar, a health-insurance startup in New York City; and his own terrifying experience with a life-threatening aortic aneurysm. Each of these stories orbits his central narrative, “the roller-coaster story of how Obamacare happened, what it means, what it will fix, what it won’t fix, and what it means to people.”

Brill’s intention is to point out how and why Obamacare fell short of true reform. It did heroic work in broadening coverage and redistributing wealth from the haves to the have-nots. But, Brill says, it didn’t really restrain costs. It left incentives fundamentally misaligned. We needed major surgery. What we got was a Band-Aid.

One of Brill’s examples is drug prices. While he was working on his book, he writes, “a drug called Sovaldi burst onto the scene.” Sovaldi is used for hepatitis C, and its manufacturer, Gilead Sciences, has priced it at a thousand dollars per pill—which comes out to eighty-four thousand dollars for a course of treatment. Brill quotes Sarah Kliff, who writes on health-care policy, pointing out that California might well end up spending more on Sovaldi for its Medicaid patients than it does on all K-12 and higher education. “The exact price Gilead chose for Sovaldi said something in and of itself about the nonexistent regulatory environment drug companies knew they faced in the United States,” he writes. “Rather than set the price at, say, $989 or $1,021—at least to create the impression that it was based on some calculation other than ‘Let’s charge whatever we want’—the company had chosen a simple round number, $1,000.”

How can we have a solution to the health-care crisis without making any attempt to curb runaway drug prices? Medicare isn’t even allowed to negotiate directly with drug companies. “Should we be embarrassed and maybe even enraged that the only way our country’s leaders in Washington could reform healthcare was by making backroom deals with all the interests who wanted to make sure that reform didn’t interfere with their profiteering?” Brill writes, in a section structured around a series of italicized questions. “Of course. We’ll be paying the bill for that forever.”

Brill devotes fifty pages to another Obamacare shortcoming, the early malfunctioning of the Web site. He originally thought that the site would be a showcase for what government could do. But, on the train back from his initial round of interviews in Washington, he glanced at his notes and realized that he had been given seven different answers to the question of who was in charge of the launch of the federal exchange, including an “incomprehensible” organizational chart with four diagonal lines crossing one another and forming a “lopsided” triangle:

Should we be amazed, and disappointed, at how Obama treated the nitty-gritty details of implementing the law as if actually governing was below the pay grade of Ivy League visionaries?

Absolutely. This failure to govern will stand as one of the great unforced disappointments of the Obama years.

At the end of “America’s Bitter Pill,” Brill offers his own solution to the health-care crisis. He wants the big regional health-care systems that dominate many metropolitan areas to expand their reach and to assume the function of insuring patients as well. He talks to Jeffrey Romoff, the C.E.O. of the University of Pittsburgh Medical Center, who is about to try this idea in the Pittsburgh area, and becomes convinced that the same model would work throughout the country. “The [hospital’s] insurance company would not only have every incentive to control the doctors’ and hospitals’ costs, but also the means to do so,” he writes. “It would be under the same roof, controlled by Romoff. Conversely, the hospitals and doctors would have no incentive to inflate costs or over-treat, because their ultimate boss, Romoff, would be getting the bill when those extra costs hit his insurance company.”

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“It’s mostly sweater weight.”

Brill talks through his idea with several other prominent health-care-system C.E.O.s (“doctor-leaders,” he calls them), whose résumés are helpfully elaborated: “Glenn Steele, Jr., a former cancer surgeon and professor at Harvard Medical School,” and Gary Gottlieb, the head of a Boston group “formed by the merger of the area’s two most highly reputed hospital brands, both of which were affiliated with Harvard Medical School.” A system like this, Brill estimates, based on a few back-of-the-envelope calculations, could slice twenty per cent off the private-sector health-care bill.

It’s at moments like this that Brill’s book becomes problematic. The idea he is describing is called integrated managed care. It has been around for more than half a century—most notably in the form of the Kaiser Permanente Group. Almost ten million Americans are insured through Kaiser, treated by Kaiser doctors, and admitted to Kaiser hospitals. Yet Brill has almost nothing to say about Kaiser, aside from a brief, dismissive mention. It’s as if someone were to write a book about how America really needs a high-end electric-car company that sells its products online without being the least curious about Tesla Motors.

In a Lewis, this wouldn’t matter so much. “Flash Boys” was criticized by some on Wall Street for mischaracterizing the world of high-frequency trading. But “Flash Boys” explicitly set out to tell its story through the eyes of a renegade trader named Bradley Katsuyama, and the test of the book’s success was whether it captured Katsuyama’s view of high-frequency trading. In a Woodward, the goal is different. A book like Mark Bowden’s “Black Hawk Down”—a Woodward that outdoes even Woodward—sets out to describe things as they actually happened, not things as filtered through one person’s idiosyncratic perspective. The currency of the Lewis is empathy. The currency of the Woodward is mastery—and nothing is more corrosive to the form than the suspicion that the author doesn’t grasp the full picture.

Does the botched launch of the Web site deserve fifty pages? Maybe so. This certainly was something that felt significant at the time. But what we want to know is how much it ultimately mattered, and there is little in Brill’s reporting that sheds light on that question. The Administration built a Web site in order to give Americans access to one of the most complex pieces of legislation in history. The site had lots of bugs, in the beginning, as complicated pieces of software often do. Then the Administration fixed the bugs quickly, and the response was such that the Affordable Care Act reached its enrollment targets. “I was, like, never worried,” Brill quotes Mickey Dickerson, an expert from Google whom the Administration brought in to get the Web site on track, as saying. “It’s just a website. We’re not going to the moon.” Brill wants the Web-site saga to stand for something larger, but in the end what it seems to stand for is the fact that Web sites, in the beginning, sometimes crash a lot.

The Sovaldi example is equally puzzling. A thousand dollars for a pill sounds like a lot of money. But hepatitis C is a costly disease. It’s the leading reason for liver transplants, which are among the most expensive of all medical procedures. A 2013 study published in the journal Hepatology estimated the lifetime health-care costs of the average hepatitis-C patient (when medical inflation was factored in) at more than two hundred thousand dollars. The drug regimens that came before Sovaldi didn’t work very well and had terrible side effects. Brill quotes Sarah Kliff on how much the drug will cost the state of California, but what he doesn’t mention is that Kliff followed up on her initial analysis with another that was headlined, above a picture of Sovaldi capsules, “EACH OF THESE HEPATITIS C PILLS COSTS $1,000. THAT’S ACTUALLY A GREAT DEAL.

The problem with the pharmaceutical industry is not that it makes too many drugs like Sovaldi. It’s that it makes too many drugs that aren’t like Sovaldi, drugs whose costs vastly outstrip their benefits: cancer treatments that cost tens of thousands of dollars and extend life only minimally, or expensive me-too drugs that perform no better than cheap generics. We certainly need to be smarter about the drugs we use, and Medicare should be relieved of the congressionally mandated restrictions that make it impossible to bargain directly with drug companies. But Sovaldi targets a painful and costly disease with a substantially cheaper, safer, and more effective one-time cure. This is what we want drug companies to do. Of all the examples that Brill could have used to bolster his argument, why did he pick that one?

On May 2, 2009, Brill writes, the domestic-policy group at the White House blindsided the economic team with a second memo. It concerned something called the medical loss ratio, or M.L.R. The medical loss ratio compares what an insurer earns in premiums with what it pays out in benefits. An insurer who takes in a dollar and gives back eighty-five cents has a loss ratio of eighty-five per cent. Jeanne Lambrew wanted to place a floor on every insurer’s loss ratio: if a company kept too much of that dollar—if its M.L.R. fell below eighty-five or eighty per cent, say—it should have to refund the difference to its customers.

“Lambrew was certainly on firm political ground,” Brill writes. One senior White House aide called the proposal a “winner.” The rule would make it impossible for one of the economy’s least liked sectors to make excess profits. The feeling was, Brill says, that “it might end up being the single most politically appealing piece of healthcare reform.”

The economic team, however, wasn’t so sure:

Summers called it a “stupid idea,” and told his people to try to kill it. It was “dumb for us to cap anyone’s profits,” he said, dismissing the idea much the way the legendarily blunt Summers might have taken down a freshman economics student at Harvard who said something in class that he thought was “dumb.”

Summers’s point was that an M.L.R. floor distorted the insurer’s incentives. The argument goes like this: Suppose your doctor sends you to an imaging center to get a thousand-dollar MRI. But then your insurance company calls you and says that it’s found an equivalent provider just down the street that charges two hundred dollars. This, presumably, is what we want insurers to do. The market for medical procedures lacks price transparency and competition, and it’s scandalous that insurers routinely pay thousands of dollars for an MRI scan when the true cost of the procedure, by any metric, is a fraction of that. By taking steps like this, Summers thought, insurers could finally rein in, or even reduce, health-care premiums, which had been rising faster than inflation for years. But it is also highly likely that the insurer will keep a chunk of that eight-hundred-dollar savings for itself, in the form of higher profits. The prospect of higher profits is an insurer’s incentive for going to the trouble of looking for a cheaper MRI. In other words, if insurers do what we want them to do—cut costs and rein in premiums—it is likely that their loss ratios will fall. Why, Summers wondered, would you want to penalize them for doing that?

The economic team felt that health care could use a good dose of market incentives. The Lambrew-DeParle view, on the other hand, was that health care is different: the complex nature of the relationship between patients and their health-care provider is so unlike ordinary economic transactions that it can be governed only through cost controls and complicated regulatory mechanisms. When the two sides argued, they weren’t just reflecting a difference in tactics or emphasis. Their disagreement was philosophical: each held a distinct view about the nature of the transactions that take place around medical care.

Brill sides with the DeParle camp. His solution for the health-care problem is to treat the industry like a regulated oligopoly: he believes in price controls and profit limits and strict regulations for those who work within the health-care world, restrictions that he almost certainly thinks would be inappropriate for other sectors of the economy. A patient, he explains at the beginning of his book, is a not a rational consumer. That was the lesson he took from his own heart surgery. “In that moment of terror,” he writes, of blacking out after his surgery, “I was anything but the well-informed, tough customer with lots of options that a robust free market counts on. I was a puddle.”

But Brill spends very little time examining why he thinks this means that the market can’t have a big role in medicine, where most care is routine, not catastrophic. He just takes it for granted. And because he is not much engaged by the philosophical argument at the heart of the health-care debate, he can never really explain why someone involved in health-care reform might be unhappy with the direction that the Affordable Care Act ended up taking. He tells us who controlled the PowerPoint. But he can’t tell us why it mattered.

It is useful to read “America’s Bitter Pill” alongside David Goldhill’s “Catastrophic Care.” Goldhill covers much of the same ground. But for him the philosophical question—is health care different, or is it ultimately like any other resource?—is central. The Medicare program, for example, has a spectacularly high loss ratio: it pays out something like ninety-seven cents in benefits for every dollar it takes in. For Brill, that’s evidence of how well it works. He thinks Medicare is the most functional part of the health-care system. Goldhill is more skeptical. Perhaps the reason Medicare’s loss ratio is so high, he says, is that Medicare never says no to anything. The program’s annual spending has risen, in the past forty years, from eight billion to five hundred and eighty-five billion dollars. Maybe it ought to spend more money on administration so that it can promote competition among its suppliers and make disciplined decisions about what is and isn’t worth covering. Goldhill writes:

Medicare is cheaper to run than private insurance. So what? Cheaper doesn’t mean more efficient. It may be cheaper to run banks without security guards, hotels without housekeepers, and manufacturers without accountants, but that wouldn’t make those businesses more efficient.

Many state Medicaid programs have, similarly, a rule that says health-care providers cannot charge Medicaid more than the lowest price they give to anyone else. If you run an MRI machine and allow a privately insured patient to get a scan for two hundred dollars instead of a thousand dollars, you have to give all your Medicaid patients MRI scans for two hundred dollars. That’s a classic “health care is different” solution to the problem of excess health-care costs: pass a law guaranteeing the “sale price” to publicly funded patients. So what’s the result? Goldhill asks. Health-care providers behave the way any market participant would under the circumstances. They don’t have sales. What incentive would the Gap have for holding a Boxing Day blowout if, by law, it would have to offer those same low prices every other day of the year?

Goldhill takes a far more radical position than the economic team at the White House does. He believes that most of our interactions concerning health care are actually no different from our transactions concerning anything else: if we trust people to buy cars and houses and food and clothing on their own, he doesn’t see why they can’t be trusted to do the same with checkups, tonsillectomies, deliveries, flu shots, and the management of their diabetes. He thinks that the insurance function—inserting a third party between patients and providers—distorts incentives and raises prices, and has such an adverse impact on quality that health insurance should be limited to unexpected, high-cost occurrences the way auto insurance and home insurance are. These ideas are unlikely to make their way into policy anytime soon. But, in elaborating the market critique of the health-care status quo, Goldhill helps us understand what the argument we’re having right now is about. It is not just a political battle over Obama. It’s a battle over whether health care deserves its privileged status within American economic life.

The frustrating thing about “America’s Bitter Pill” is that Brill could have taken us one step further. He has introduced us to the policymakers, to Summers and DeParle, Kocher and Lambrew. He has taken us to the Roosevelt Room, where the two sides battle for the President’s attention. But, just at the point where “America’s Bitter Pill” could have become illuminating, exploring the conceptual gulf behind all the wrangling, Brill gets restless. He wants to get on to the next page in his notebook—to the next meeting that Obama had in the Roosevelt Room, to the briefing paper about such-and-such that was sent to So-and-So, and then, of course, to the debacle of the Web site, which had bugs until those bugs were fixed.

“Do you recall a memo that Peter Orszag wrote to you just after the law was passed urging you to put in charge someone with experience launching and running ventures as complicated as healthcare.gov?” Brill asks the President. He’s trying to be Woodward. It’s not as easy as it looks. “What were your reasons for not doing so? If you do not recall the memo, do you recall Peter and Larry Summers advising you to do this? . . .” 


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Photo
CreditMichael Bierut

Steven Brill is not easily intimidated. The founder of Court TV and Brill’s Content, among many other ventures, Brill likes to dive deeply and quickly into complicated national policy issues — public education, health care — that he, by his own admission, knows relatively little about when he begins. This is his great appeal and can be a great frustration. It makes him vulnerable to the charisma of his sources, as was apparent in his 2011 book, “Class Warfare,” in which he seemed dazzled by individuals involved in privatizing public education, while he largely ignored the existing research.

But in Brill’s new book, “America’s Bitter Pill,” his fresh, outsider curiosity makes him a superb guide to the maze of issues in American health care and health care reform. He breaks down insider language, asks fundamental and surprising questions, and leaves the reader — at least this one — full of more questions yet with a much clearer map of the lines of debate. You may not be persuaded by his conclusions, but you’ll emerge with a broader understanding of the characters and questions shaping our health care system.

“America’s Bitter Pill” is an energetic, picaresque, narrative explanation of much of what has happened in the last seven years of health policy. It is full of insights, contradictions, apologias, flashes of anger, tidbits of history, extended stories of awe, compassion, some glibness and moments of brilliance. Above all, it includes fascinating reporting on how crucial decisions were made involving the drafting and implementation of the Affordable Care Act.

What is this book about? Well, every­thing. It reminded me of a Bruegel painting, so full of minor characters that I made a chart to keep track. It is about the conflicts between President Obama’s economic policy team and his health care policy team. It is about the initial white paper from Senator Max Baucus that didn’t even include the “public option” of a ­government-run insurance plan.It is about the “chargemaster” system of American health care, whereby hospital administrators easily drive up costs because of their relative bargaining power over insurers and patients. It is about a woman openly talking about how she and her husband — insured, but underinsured — had to create their own family “death panel” to weigh the cost of medical treatments that might keep him alive for another month. It is about Brill’s own open-heart surgery and how it affects his understanding of costs, and repeated visits to a group of well-­funded entrepreneurs trying to create a “cool” new insurance company. Following his 2013 Time magazine cover story that inspired the book, Brill introduces us to Americans with no coverage, as well as those with inadequate coverage, like the 61-year-old bus driver whose slip in her yard and busted nose led to six hours in the hospital, six stitches and six years of medical bills.

It is also about a Washington fight for power among five key forces: insurers, hospitals, patients, pharmaceutical companies and medical equipment suppliers, and the general public, including those who are supposed to represent them. In Brill’s account of the Affordable Care Act, the insurers got a fair shake, uninsured and underinsured patients truly benefited, hospitals and pharmaceutical companies and medical equipment companies were left free to charge exorbitant prices, while the general public was left with no real strategy for cost containment.

In other words, Brill is impressed with the expanded coverage provided by Obama­care, and depressed about the cost of care.

Despite the cynical title, this is a surprisingly triumphant book. A significant number of pages are dedicated to something extremely rare: three gripping stories of great government success.

First, there is the improbable story of passing any health care reform in the first place. Max Baucus, the Montana Democrat and chairman of the Senate Finance Committee, spends untold hours trying to court the Republican senators Charles Grassley and Olympia Snowe; Baucus’s initial bipartisan dream appears close enough to touch, and then it falls away. Edward Kennedy, an engine behind Obama’s focus on health care and a critical 60th vote, dies. Scott Brown, a Republican, wins Kennedy’s seat. Brown’s victory doesn’t end health care reform but severely circumscribes it, because House Democrats lose their negotiating power: They are forced to accept the Senate bill or face the prospect of no bill at all.

Photo
CreditMichael Bierut

Then there is the inspiring story of Steve Beshear, Democratic governor of Kentucky, and Carrie Banahan, the civil servant who manages a near-flawless rollout of Kynect, Kentucky’s implementation of the Affordable Care Act that included a properly functioning website. (This led Senator Mitch McConnell of Kentucky, the Republican leader, to campaign comically both for and against the same thing, saying he was opposed to Obamacare but in favor of Kynect — which was, of course, Obamacare.)

Finally, there is the long story of the botched website debut. As Brill tells it, the website was almost overdetermined to fail. There was no one in charge — or too many people in charge — and the people who built it had never been involved in a project of this magnitude. At the same time, the White House wanted to stall on the regulations necessary to set up the insurance exchanges because, as Brill notes, “they did not want to make any waves before the election.” But after the embarrassing beginning, the White House quickly addressed problems of structure and personnel, and 7.1 million people signed up within six months, 100,000 more than the initial goal.

Brill finds Obama’s early failure to be more involved in the “nitty-gritty details” a “great unforced disappointment,” but he looks with enormous admiration at what the president was able to accomplish, calling it “a milestone toward erasing a national disgrace.”

“America’s Bitter Pill” presents a personality-­driven view of historical change, including the temperaments and accidental moments that affect history, like the ill-timed December vacation of Martha Coakley, who was running against Scott Brown for Kennedy’s Senate seat. But two of the book’s more powerful insights have to do with matters of industrial or bureaucratic structure. The first involves the health delivery system. Many people tend to look with alarm at consolidation in the insurance industry, and they focus on insurance company lobbying power as the essential cause of rising ­prices. One of Brill’s critical insights is how consolidation in the hospital industry has actually decreased insurer power relative to provider power: Much of the rising cost of health care comes from overcharging by hospitals, not insurers.

Take the example of NewYork-­Presbyterian Hospital. Because of its size and array of serv­ices, no insurance company in the New York City area can sell policies if it doesn’t include NewYork-Presbyterian — therefore none of them are able to bargain aggressively for lower prices. This is not unique to NewYork-Presbyterian, nor is it even the most extreme example: Consolidation is the norm in many markets around the country. The hospital sets the price, and the insurer jumps to it.

The second insight has to do with the structure of management within the government. Brill argues that the initial website rollout failed in significant part because the “Office” in charge was demoted to a “Center,” in order to protect it from Republican funding cuts. In a wonderful passage, he recalls taking the train to Washington and reviewing his notes, noticing that when he asked different people who was in charge of establishing the federal exchange, he got seven different answers.

The subtitle — money, politics, back-room deals — refers primarily to the role the pharmaceutical industry plays in gutting any chance for cost effectiveness or price controls. According to the Center for Responsive Politics, the trade group Pharmaceutical Research and Manufacturers of America (PhRMA) has spent a quarter of a billion dollars since 1998 on lobbying. Brill shows what that means in day-to-day negotiations. Billy Tauzin, a former congressman and, until 2010, the trade group’s president, is the voice of Big Pharma in the book.

Tauzin is everywhere in the negotiations. He does not so much haggle as dictate policy, identifying the precise amount the industry would be willing to give up and still support the bill. Tauzin successfully guts comparative effectiveness research under Obamacare — Big Pharma’s profits are threatened by studies comparing which drugs work effectively at lower costs. With projections showing that the pharmaceutical industry will make at least $200 billion more with expanded coverage, Tauzin and his group “kick in” what amounts to $80 billion in givebacks, in exchange for killing any chance of containing the costs of drugs. He agrees to spend $70 million in political action funds supporting reform, and when pressured to raise his industry’s contribution to $120 billion, he sits tight, confident that he can kill the bill. Describing Tauzin’s position, Brill is matter-of-fact: “He knew they could never get 60 votes in the Senate if the drug makers switched sides and began financing a different set of ads, and he said so.”

Depending on one’s view,” Brill writes, “this secret deal between Obama political operatives, PhRMA, staffers from the Senate Finance Committee who had just brokered a multibillion-dollar deal with ­PhRMA, major unions and other liberal groups was proof that Washington was finally buckling down, coming together and getting the people’s business done; or it was Washington at its worst: liberal groups selling out to big business to accommodate all the groups’ special interests.”

Brill tells us what he thinks (the deals with Big Pharma were tragic but politically necessary); he becomes partisan when he wants to defend a subject he believes has been unfairly attacked; he fills a chapter with direct statements of conclusion. He brushes over some contentious issues, making a casual assumption that tort reform would keep medical costs down. (Texas has tort reform, but there is no evidence to show it has kept costs from escalating.) His glibness in these areas, along with a charming tendency to find some persuasive argument in almost everyone he interviews, led me to trust his reporting but to be more skeptical of his policy prescriptions.

Ultimately, Brill comes across as a fallible human trying to understand the politics and implications of health care on our behalf, and he has pulled off something extraordinary — a thriller about market structure, government organization and billing practices, by turns optimistic and pessimistic, by turns superficial and insightful, but always interesting, and deadly important.

 


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2월에 참 어울리는 말이다, 벌써. 너무 바빴던 지난 몇 주 - 시험 발표 손님들 일 .. 즐기는 일을 할 시간이 부족하니 학교도 일도 즐겨야 생활에 기가 그나마 돌겠구나 싶다. 봄방학 여름방학 휴식만 꼽아 기다리게된다. 그나마 이번 주는 지난 주 보다 업무량이 적어 숨을 좀 돌리나 싶지만 집에서 누워 있는 것도 그리 쉽지만은 않더라. 수영이 너무 가고싶은데 수영용품 따위가 어디 숨었는지 이사 후로 찾을 수가 없다. 

힘이든다 징징대었더니 웬일이냐며 엄마가 한 학기 휴학을 제안하신다, 엄마 옆에서 쉬라고. 아니에요 하니까 바로 그래라고 해주시니, 감사하다. 좋은 것만 생각하라고 하신다. 그래도 장단점이 있는 것이라고. 학생시절은 직장생활 그리고 육아생활과 또 다른 여유가 있으니 즐기라고. 하기야 그러하다, 근래 괜히 유모차 끄는 언니도 아닌 언니들이 부러운 것이 지금 아닌 미래만 보게된다, 그야말로 괜스레. 그렇게 멀리만 보다보면 지금이 훅하니 1월처럼 벌써 지나가겠지. 

사랑한다는 말을 빈번히 들으니 사랑받는구나 싶다. 가까운 사람들의 마음이 기운이되어 하루하루를 지낸다. 자신감이 흐려지는 와중 그나마 버틴다. 자신없을 때가 있느냐고 물으니 당연하지란다, 혼자 할 수 없을 것 같고 실제로도 그러하다고. 기도해야한단다. 간단하지만 어렵단다. 그러네.

생활에 신이 없어서 스벅에 앉아 책을 읽는다, 야생초 편지 따위. 별 감흥이 없다, 메말랐나보다. 


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For the past painful year, the Republican presidential contenders have been bombarding Americans with empty propaganda slogans and competing, bizarrely, to present themselves as the least experienced person for the most important elected job in the world. Democratic primary voters, on the other hand, after a substantive debate over real issues, have the chance to nominate one of the most broadly and deeply qualified presidential candidates in modern history.

Hillary Clinton would be the first woman nominated by a major party. She served as a senator from a major state (New York) and as secretary of state — not to mention her experience on the national stage as first lady with her brilliant and flawed husband, President Bill Clinton. The Times editorial board has endorsed her three times for federal office — twice for Senate and once in the 2008 Democratic presidential primary — and is doing so again with confidence and enthusiasm.

Mrs. Clinton’s main opponent, Senator Bernie Sanders, a self-described Democratic Socialist, has proved to be more formidable than most people, including Mrs. Clinton, anticipated. He has brought income inequality and the lingering pain of the middle class to center stage and pushed Mrs. Clinton a bit more to the left than she might have gone on economic issues. Mr. Sanders has also surfaced important foreign policy questions, including the need for greater restraint in the use of military force.

In the end, though, Mr. Sanders does not have the breadth of experience or policy ideas that Mrs. Clinton offers. His boldest proposals — to break up the banks and to start all over on health care reform with a Medicare-for-all system — have earned him support among alienated middle-class voters and young people. But his plans for achieving them aren’t realistic, while Mrs. Clinton has very good, and achievable, proposals in both areas.

The third Democratic contender, Martin O’Malley, is a personable and reasonable liberal who seems more suited for the jobs he has already had — governor of Maryland and mayor of Baltimore — than for president.

Mrs. Clinton is a strong advocate of sensible and effective measures to combat the plague of firearms; Mr. Sanders’s record on guns is relatively weak. Her economic proposals for financial reform reflect a deep understanding of the 2010 Dodd-Frank financial reform act, including the ways in which it has fallen short. She supports changes that the country badly needs, like controls on high-frequency trading and stronger curbs on bank speculation in derivatives.

Continue reading the main story

Mr. Sanders has scored some rhetorical points against Mrs. Clinton for her longstanding ties to Wall Street, but she has responded well, and it would be comical to watch any of the Republican candidates try to make that case, given that they are all virtually tied to, or actually part of, the business establishment.

One of the most attractive parts of Mrs. Clinton’s economic platform is her pledge to support the well-being and rights of working Americans. Her lifelong fight for women bolsters her credibility in this area, since so many of the problems with labor law hit women the hardest, including those involving child care, paid sick leave, unstable schedules and low wages for tipped workers.

Mrs. Clinton is keenly aware of the wage gap for women, especially for women of color. It’s not just that she’s done her homework — Mrs. Clinton has done her homework on pretty much any subject you’d care to name. Her knowledge comes from a commitment to issues like reproductive rights that is decades old. She was well ahead of Mr. Sanders in calling for repeal of the Hyde Amendment, which severely limits federal money to pay for abortions for poor women.

As secretary of state, Mrs. Clinton worked tirelessly, and with important successes, for the nation’s benefit. She was the secretary President Obama needed and wanted: someone who knew leaders around the world, who brought star power as well as expertise to the table. The combination of a new president who talked about inclusiveness and a chief diplomat who had been his rival but shared his vision allowed the United States to repair relations around the world that had been completely trashed by the previous administration.

Mrs. Clinton helped make it possible to impose tougher sanctions on Iran, which in turn led to the important nuclear deal now going into effect. She also fostered closer cooperation with Asian countries. She worked to expand and deepen the dialogue with China and to increase Washington’s institutional ties to the region. Mrs. Clinton had rebuked China when she was first lady for its treatment of women, and she criticized the Beijing government’s record on human rights even as she worked to improve relations.

In January 2011, before the Arab Spring, Mrs. Clinton delivered a speech that criticized Arab leaders, saying their countries risked “sinking into the sand” unless they liberalized their political systems and cleaned up their economies. Certainly, the Israeli-Palestinian crisis deepened during her tenure, but she did not cause that.

Mrs. Clinton can be more hawkish on the use of military power than Mr. Obama, as shown by her current call for a no-fly zone in Syria and her earlier support for arming and training Syrian rebels. We are not convinced that a no-fly zone is the right approach in Syria, but we have no doubt that Mrs. Clinton would use American military power effectively and with infinitely more care and wisdom than any of the leading Republican contenders.

Mrs. Clinton, who has been accused of flip-flopping on trade, has shown a refreshing willingness to learn and to explain, as she has in detail, why she changed her mind on trade agreements like the Trans-Pacific Partnership. She is likely to do more to help workers displaced by the forces of trade than previous presidents have done, and certainly more than any of the Republicans.

Mrs. Clinton has honed a steeliness that will serve her well in negotiating with a difficult Congress on critically important issues like climate change. It will also help her weather what are certain to be more attacks from Republicans and, should she win the White House, the possibility of the same ideological opposition and personal animus that President Obama has endured. Some of the campaign attacks are outrageous, like Donald Trump’s efforts to bring up Bill Clinton’s marital infidelity. Some, like those about Mrs. Clinton's use of a private email server, are legitimate and deserve forthright answers.

Hillary Clinton is the right choice for the Democrats to present a vision for America that is radically different from the one that leading Republican candidates offer — a vision in which middle-class Americans have a real shot at prosperity, women’s rights are enhanced, undocumented immigrants are given a chance at legitimacy, international alliances are nurtured and the country is kept safe.


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새해다. 

이사 함, 차 삼, 가구 만듬, 전화 삼, 테니스 침, 실컷 쉼, 일 함, 요리 함, 요거트 먹음, 산책 걸음, 좋음. 

나는 무엇을 하고 26년을 살았는가. 학업도 아직 남아있고, 나는 아직 사람이 되지 않은 것 같다. 성인은 어른이 아니라던데, 나는 어른이 되어야 함에 책임감을 느끼지 못했더라. 무언가를 해야한다는 생각이 드는 시점. 

반면에 올 해는 새해 다짐 따위가 없었다. 필요를 실감치 못 한 것인지 여유가 없는 것인지, 나태함인지. 혼자 곱씹을 생각이 줄어 그러하다. 어느 사이 나에 대한 관심이 줄어들었다. 그 결과는 좋고 아니함이 공존, 나눔의 행복에 잊혀지던 나. 나는 참 나에 관심을 많이 두었는데, 나를 위해 책도 읽고 음식도 가리고 돈도 쓰고 사람도 만나고, 나를 참 챙기던 시간들이 멀어지더라, 막아야한다. 나를 챙겨야 남을 챙길 수 있는 것임을, 타인을 위한다고 생각되는 것을 줄이으면 즐겁다가 한 순간 억울함이되고 서럽더라. 

2016 습관개선

50% raw

30 min yoga + 10 min meditation 

tennis / week 

신중히 말하기


2016 목표 

무사히 2 학년 마무리 

무사히 2 학년 여름 인턴 마무리 

여행 = 하와이, 뉴욕, 한국 ?



아줌마 

이제는 심지어 아줌마 - 새로운 목표는 아름다운 아줌마가 되는 것. 인정하기 싫지만 나는 이제 심지어 무려 아줌마. 나뿐아닌 관리해야 할 가족이 생기고 이것은 나에게 같은 관리를 주기 위해서는 보다 많은 관심과 의식적 투자가 필요하다는 것. 소홀해지지말자, 결국은 나를 위함이 모두를 위함이고, 나 또한 모두들 자신들을 관리 할 것을 기본적으로 예상키에 - 각자 몫을 책임지어야한다. 


식습관

이 참으로 많이 변하였다. 저녁은 소식 야식은 금물이었는데, 저녁은 하루의 메인 그리고 약식은 필수가 되어버린 지금. 이대로 살 수 없다. 아침식사를 중요시 여기는 나로써는 저녁까지 알차게 챙기면 나의 하루는 과식이 되고만다. 그렇다고 저녁을 차리지 않을 수는 없는 공동생활. 자제력따위는 어렵지만 필수. 

저녁소식 

야식금지 저녁 후 금식 

50% raw 

3일 운동 


소비습관 

다달이 보내던 필리핀 아이의 지원금을 취소하였다. 미국에 도착하여 첫 월급을 받으며 시작했던 지출이었는데, 지금은 되려 수입도 없을 뿐더러 나의 돈이 아니라는 생각에 - 다시 나의 수입이 생기면이라는 다짐과 함께 송금을 멈추었다. 비록 금액은 내가 사용하는 지출의 작은 부분일 뿐이지만 왠지 그 상징성이 복잡하게 느껴지는 것이 - 더 이상 단조롭지만은 않은 나의 생활을 반영타. 

의류 화장품 따위의 소비를 줄여도 소비가 늘어나는 기이하지만 당연한 현상. 식비도 늘어나고 가정이라는 공간을 정리하고 꾸미려는 비용이 늘어난다. 의미있는 변화, 좋은 현상이다


시간 

하루 적어도 두세네 시간은 의미있게 공유해야지 않겠는가. 저녁식사가 그러하고 방송시청이 그러하다. 잠과 공부를 줄인다고 볼 수도 있겠지만 홀로 의미 없이 보내던 시간도 그 얼마나 많았던가. 나만을 위한 시간이 줄기도하였지만 보다 알뜰히 계산하고 정리하면 그 언제보다도 충분하리. 


말 

틱대길래 틱을 올려드림 - 신중히 말하기 따위라기보다 신중히 틱을 굳이 전달. 아 모르겠다 - 세상이어 두 조각 나다오




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다큐 봄 - 블렌더 삼. 





SUPERFOODS

Superfoods are a special category of foods found in nature. By definition they are calorie sparse and nutrient dense meaning they pack a lot of punch for their weight as far as goodness goes. They are superior sources of anti-oxidants and essential nutrients - nutrients we need but cannot make ourselves. 

We all may be adding more salads and vegetables to our diets, but concern over the quality of foods grown on mineral depleted soils makes Superfoods an intelligent choice. For more information on how to use Superfoods in your day to day life please have a look at our our superfood greens and browse the pages on 5 most important categories of superfoods below.


Green Superfoods

Greens are good, Green Superfoods are even better! Green superfoods have the highest concentrations of easily digestible nutrients, fat burning compounds, vitamins and minerals to protect and heal the body. They contain a wide array of beneficial substances including proteins, protective photo-chemicals and healthy bacteria helping you to build cleaner muscles and tissues, aid your digestive system function and more effectively protect you against disease and illness.
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Fruit and Nut Superfoods

Fruit and nut superfoods are high in anti-oxidants that fight free radicals in the body. Free radicals may sound a little like an extremist terrorist sect evading capture and wreaking havoc across the globe and in fact within the context of your body this would be right. They are, in part, a natural occurrence through metabolism however extra and unnecessary free radical load can be put on our bodies by external factors including pollution, cigarette smoke, radiation, burnt foods, deep fried fats and cooked foods.
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Bee Superfoods

The Egyptians wrote about it back in 5500 B.C., the Indians used it for their religious ceremonies in 1000 B.C. and even the Babylonians have been noted to use it in their medicinal practices. The western world actually discovered the benefits of bee superfoods by accident during an investigation of native Russian Beekeepers who regularly lived past 100 years of age who ate raw honey, rich in bee pollen, every day.
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Seaweed Superfoods

Seaweeds are the most nutritionally dense plants on the planet as they have access to all the nutrients in the ocean. They can contain up to 10 times more calcium than milk and eight times as much as beef. The chemical composition of seaweeds is so close to human blood plasma, that perhaps their greatest benefit is regulating and purifying our blood system.
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Herb Superfoods

Herbs as nourishment offer the body a whole host of nutrients it may not have received either because of poor diet or environmental deficiencies in the soil or air. Herbs as medicine are essentially body balancers that work with the body functions so that it can heal and regulate itself. Herbs have been used for centuries as part of the wisdoms of natural healing methods.
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리뷰 극히 갈리는 이 영화, 난 80점. 

세 시간이라는 시공을 한 배경에서 채워 먹는다는 것이 참으로 대단하다, 인정. 한 공간에 구겨 갇혀 사람 대열 명 모아놓고 한 극에서 다른 극으로 오가는 그림, 심지어 집중도도 높았다. 격히 웃긴 대사하며 훌륭한 연기따위는 볼거리. 딱히 뭐 없는 비주얼은 현실묘사의 구실정도만 한다. 

같은 목적지를 향해 가는 사람들인데 제각 원하는 것이 다르고 공유라는 것은 서로에 대한 혐과 의심. 죽음이 무섭지 않은 시대이지만 분명 변해가는 시대이다. 같은 죽음이어도 정당성이 가려진다는 따위의 철학을 논하고, 더럽혀질 손이지만 이유를 부여하겠다는 목적으로 모욕과 수치를 쏟는다. 

흑백 사이에 흐르는 적대감이 어쩌면 최고에 닿았을 이 시대의 모습은 정말 이러했을까, 평시 생각지도 못 했을 시대를 기억하게한다. 링컨의 편지따위로, 그것 만으로, 삶의 질을 조작 할 수 있었다는, 너는 나의 삶을 모른다 말하는 잭슨. 내가 시키는 것을 모두 다하였는데도 네 아들은 천조가리를 바라다 죽었다며 숨넘겨 웃는 그 모습에 손가락질을 할 수 있는지는 미지수. 나는 모르지만 누군가는 겪었을, 그리고 겪고 있을, 희멀거진 어느 날의 역사. 

하지만 역사의 그림과는 다른 화면의 모습, 결국 마지막 웃는자는 역사를 역하면서도 반영한다. 다수의 백인 속에서 멸시당하던 유일한 흑인은 결국 목숨을 끝까지 끌어간다. 그것이 승리인지는 모르겠다, 이 더러운 구덩이에서 먼저 죽은 미니가 승자일지도. 

번잡하고 흐지부지한 메세지의 완벽치만은 않은 연출. 그래도 웃겼으니 난 좋음. 

그나저나 혼자 연기 다 해드시는 잭슨님, 그 까만 피부에 흰 눈동자 굴려가며 얼굴 근육 하나하나 치열하다, 감탄. 





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아무도 보지 않았어도 모두가 본 영화, 우리는 이영화를 보지 않았어도 보았다, 그럼에도 관객을 만족시키는 이 독단적인 영향력은 유일무이. 내가 본 유일한 스타워즈는 이십여년 전에 첫 편이지만 그러한 나에게도 보이는 연결고리. 새 시대와 구시대를 동시 공략의도

아무튼 나는 이 영화를 모르는데 나름의 재미. 골수팬덤은 어찌 반응했을지 모르지만 나 따위의 관객을 잡으려던 의도는 성공적인가, 미지수. 이 시대의 모든 트렌드를 나름 다룬 세련됨은 보인다. 리더는 여자이며 영웅은 흑인이며 독제를 규탄하려는 내부고발자로인해 승산을 거두는 사회구조. 대체적으로 훌륭한 연기었다는 전체적 평을 나는 이해치 못한다. 어설픔은 없었지만 훌륭함의 포인트또한 보이지 않았다. 츄이의 귀여움 따위를 제외콘 별 것 없는 유머. 

무엇보다 굉장함은 이 여자, 저 그렁그렁 눈빛이며 눈빛이며. 그냥 이 여자가 화면에 잡히면 그냥 좋으다. 독립적이지만 가족에 대한 깊은 그리움을 안고, 정많고 씩씩한 완전한 완벽 캐릭터. daisy ridley 



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카페에서 고르서치를 보았다, 4 년 전에도 이 동네 다른 카페구석에서 고르서치를 본 적이 있다. 그 때도 지금도 나는 공부를하고 있었고 고르서치는 업무를 보고있었다. 시간이 지났지만 고르서치는 변하지 않았다. 시간이 지났다고 변하지는 않나보다. 하기야 당연한 일인지도 생각이 드니 아쉽다. 나는 참 변하고 싶었는데, 지금도 그러하다. 언젠가는 유지를 지향 할 수 있을 지, 도.  


방학이 지나 개강이다. 2.5주라는 시간이 나 모르게 사라졌다, 무탈의 증거. 결혼 생활의 첫 연휴 - 새로운 삶, 그야말로 new life. 영화를 보아도 선택이 다르고 끼니를 챙겨도 메뉴가 다르다. 도서관 미술관 산을 가고싶었고, 그림을 그리고 글을 적고 싶었지만 그러지 못 하였다. 대신 나무를 골라 벤치를 만들었고 요리를 실컷했다. 사람들을 초대해 시간도 공유했고 가구도 옮겼다. 동네 숲도 거닐고, 집 앞에 장관에 감탄했다. 한국에 계신 친지분들에게 우리 모습이 담긴 사진들과 안부 카드도 보내드렸다. 벽난로 앞에서 딩굴딩굴 잠도 엄청 잤다. 질질 끌려가 테니스도 치고 우리끼리는 절대 안 갈 다운타운에서 초밥도 먹었다. 나의 시간은 줄어들고 챙길 인원은 늘었으니 - 좋고 싫음을 떠나 새로운 나의 하루, 매일, 평생, 행복하다. 







내 모든걸 바쳤지만 이젠 모두 푸른 연기처럼
산산히 흩어지고
내게 남아 있는 작은 힘을 다해
마지막 꿈 속에서
모두 잊게 모두 잊게 해 줄 바다를 건널거야




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Who is Priscilla Chan?

Mark Zuckerberg and Priscilla Chan welcome daughter Max

Dr. Priscilla Chan has kept a low profile over the past few years, but that will prove harder to do now.

The 30-year-old pediatrician just gave birth to her first child Max, a daughter, with husband Mark Zuckerberg, Facebook's founder and CEO.

She is cofounder and CEO of a new nonprofit private school in East Palo Alto called The Primary School, due to open next year.

And her name is attached to a new limited liability company -- the Chan Zuckerberg Initiative -- to fund nonprofits and "[participate] in policy debates" that help "advance human potential and promote equality." In announcing their daughter's birth, the couple also pledged to donate 99% of their Facebook stock -- worth about $45 billion -- "during our lives" to promote equality and the human potential.

Chan gave her first national TV interview to The Today Show's Savannah Guthrie last year, but up until then had avoided media appearances and posting publicly to her Facebook page.

Chan's childhood

In the interview, Chan talked about her past and how it influences her.

Priscilla Chan grew up in Quincy, Massachusetts, a town outside of Boston. Her parents immigrated to the United States in refugee boats, she told Guthrie.

Chan is the oldest of three girls, and the first in her family to go to college.

Her mother worked two jobs her entire childhood. On The Today Show, she recounted how she grew up speaking Cantonese and served as a translator for her grandparents, who didn't speak English.

Chan graduated from Quincy High School in 2003 as class valedictorian, and her classmates voted her "class genius."

As a kid, Chan recalled being "really uptight," telling Guthrie: "I bossed my middle sister around all the time."

Chan's college and professional life

Chan attended Harvard University from 2003 to 2007, where she met and started dating Zuckerberg. She earned a BA in biology and studied Spanish.

According to her Facebook profile, she moved to San Jose, California, after graduation and worked for a year as a science teacher for fourth and fifth graders at the Harker School, a private school.

Chan then started medical school at the University of California, San Francisco in 2008.

She graduated around the time she married Zuckerberg, which was on May 19, 2012, the day after Facebook went public.

She finished her residency in pediatrics this summer, and works at San Francisco General Hospitalas a pediatrician.

"Congratulations to Dr. Priscilla Chan for finishing your medical residency today! I'm so proud of you for all of the lives you've saved and families you've touched," Zuckerberg said about his wife on Facebook.

Chan's philanthropic projects

Chan's charitable goals are tied closely to her personal and professional backgrounds: mainly education, healthcare and science.

Together with her husband, Chan has donated more than $320 million to school systems, educational nonprofits and hospitals over the past few years.

Next year, she'll launch The Primary School, a nonprofit private institution that will provide K-12 education, prenatal support and on-site healthcare.

"For the past year, our small team has been working with East Palo Alto and Belle Haven families, educators and leaders to develop a model to address these complex needs," Chan wrote in October.

Most recently, the couple donated $75 million to San Francisco General Hospital's new trauma center and acute care wing named after them.

The two also gave out awards for the Breakthrough Prize, a nonprofit organization they helped launch that grants winners $3 million for various scientific achievements.

"Priscilla and I helped create the Breakthrough Prize because we believe that scientists should be recognized as heroes," Zuckerberg said in a post.


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