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Death by the violence of paperwork in the U.S. healthcare system āļøš¤
Hi š
Weāre back again with another reading list of some of the best longform journalism across the internet āØ
āTis the season to be jolly, and apparently for me and the people around me, to be sick.
It feels like Iāve been barely fighting off a fever for a week now. My throat is scratchy and my nose is sniffly and my head feels like itās being weighed down by an anvil. Reading has been tough. Which sucks because Iāve been having quite the streak lately. Maybe this is my bodyās way of telling me to slow it down.
Still, weāre running a pretty hefty list this week. The Mediaās publishing machine has been on a roll, too, which is why there are a few more recent stories in this edition than usual. Weāll keep the archive picks for slow Media weeks.
A choice selection of what you can expect in the newsletter below:
Swedenās underage killers.
Recovering from a surgeryāand from social media.
The mining industry dives deep.
ALSO: Since the end of the year is quickly approaching, ātis also the season to look back on what has been more than 11 months of longform reading. And also the season to give myself the gift of a tiny break (who am I kidding. Iāll be using the time off to re-evaluate my newsletter strategy).
All that to say that our publishing schedule for December will change just the tiniest bit. Hereās how the rest of the month will look:
December 16 - TLR as usual
December 23 - TLRās 2024 wrap-up
December 30 - Year-end break, meaning no newsletter
Back to regular programming on January 6!
Happy reading and see you again next Monday!
Story in Spotlight
So thereās that massive thing that happened last week. As per usual, the Internet has descended into chaos. Everywhere online has been an explosion of public statements, unsolicited opinions and, perhaps unsurprisingly, memes.
It can be extremely easy to get swept up in the avalanche of articles and posts and tweets and what-have-yous. Believe me, I know. But since maybe 2013 or 2014, Iāve always tried to resist the undertow of doomscrolling by grounding myself in stories.
And the first story that popped into my head when I read the news was this 2023 investigation from STAT News. (Aside, and a bit of a disclosure, I guess: I work in biopharma media and I have many excellent colleagues from STAT. This quality of reportage is par-for-the-course for them. Definitely give them a read and a subscribe!)
Now before anything else, and because the Internet likes to misconstrue everything: I donāt endorse violence. I am sharing this article solely to provide a more holistic and well-rounded view of the incident. To provide what is in my opinion very crucial context that led to the killing. And to hopefully make it absolutely clear that I donāt condone violence. In all forms. Be it via bullet or paperwork.
Now that thatās out of the way: This investigation is massive. Maybe Iām being biased because I know how rabidly secretive healthcare companies can be, but I think the amount of insider and previously undisclosed info in this story is nothing short of groundbreaking. Internal communications and reports are, in my experience, near-impossible to secure. The industry is very insular and most employees typically share that tendency.
The revelations in this investigation were also supposed to move people to action. Or at least they were supposed to be eye-opening. And I guess they were for the regular person, but as far as I can tell, things have stayed largely the same for UHCāand for insurance providers more broadly. There was that senate hearing earlier this year where the CEOs of the Big Three pharmacy benefit managers were grilled, but thatās been pretty much it. Premiums continue to rise, claims continue to be denied, people continue to die.
PS - This one is behind a paywall. I have a subscription for STAT but unfortunately, I donāt think the site supports gift links (or Iām just too stupid to figure it out). So please feel free to reach out to me if you need help accessing the story.
Pretty long. And if you live in the U.S., then you most likely have first-hand experience of having claims denied, maybe even resulting in devastating outcomes. In that case, this story might be extremely frustrating for you, or it might open up old wounds, which could affect reading time. Iād set aside an hour for this.
The Longform List
š My Adventures With the Trip Doctors | The New York Times, Free
This was very nearly our spotlight story of the week. I understand that Michael Pollan is a writer not without controversy, but this piece of his was really well-written and well-researched.
If youāve been a close reader of TLR, youāll know that I have a soft spot for these types of experiential journalism, and Pollan really put himself through quite a bit for this story. He did one of those underground psilocybin therapies, which is something that Iām not sure I could put myself through for a story (though Iām fairly certain that he did it for himself, too, not just this piece).
And the result is a really compelling illustration of what an MDMA trip looks likeāand how it might help address mental health problems. On that note, Pollan also dips into the politics of therapeutic psychedelics, which as he reports was once an emerging (and promisingāthough it wasnāt really given the chance to prove itself) therapeutic modality, but was quickly made illegal.
This is really interesting to me as a biopharma/healthcare reporter becasuse there was an earnest effort recently to have an MDMA therapy approved for PTSD, but that turned out to be a clusterf*ck. Thereās still a lot to be done in this field.
Very long. But, in my opinion, this is a very compelling readāeven if youāre not into science writing too much. Might need to commit more than an hour though.
š The Nonstop Gay Sex Party on the Mexico City Subway | The Nation, Free
I absolutely adored this story.
As a gay man myself (though I have not yet hooked up in a train!), I deeply appreciated how sensitively and carefully and respectfully the writer illustrated the ultimo vagon. And I have even greater respect for Mexicoās queer community for having the courage and strength to carve out and maintain a safe space for them. I understand that public sex on a train isnāt exactly what most people would consider acceptable (I myself admit to having some shades of prudishness), but who are we to dictate how marginalized people should struggle?
Extra props to the writer for also giving some space to the political and legal challenges that Mexicoās LGBT+ community faces.
Long, but not excessively so. Maybe 40 minutes?
š¦š¼ Children Carry Out Surge of Contract Killings as Swedish Gangs Exploit Loophole in the Law | The Telegraph, Free
Also another top-tier story. And a pretty impressive investigation, too.
The reporter jumps into the dangerous world of Swedish gangs to speak with children who are being used (and dehumanized, if Iām being frank) to carry out the most violent crimes. This is only possible because of an egregious loophole in Swedish law that sets the minimum age of prosecution at 15. The story does a great job of spelling out the ramifications of this legal blindspot.
I think what holds the story back for me is that it also tries to be a feature, instead of just leaning fully into an investigative tone and style. Plus I wish that it went a little bit more into the societal forces that makes these young killers even possible in the first placeāthat is, the severe discrimination (both socially and economically) against migrants and refugees.
Not too long, honestly. But can be a painful read. Took me 20 focused minutes.
š The 10-Minute Mecca Stampede That Made History | Vanity Fair, $
Ah yes, yet another William Langewiesche entry. Pretty much a TLR staple now, no?
As per usual, this story is impeccably written. Prose and pacing are incredible and the structure is borderline genius. The research is also really great. Itās very obvious that William put in a lot of time and effort and energy into securing his facts and interviews.
But with all the Langewiesche reading Iāve been doing in recent weeks, Iāve started to see weaknesses in his craft. (No shade there. Thatās normal for every writer). Langewiesche is a product of his time. Which is to say that he has pretty glaring cultural blind spots. Many of his pieces deal with overseas affairs (largely in poor, Brown, non-Christian countries) and he is liable to perpetuating damaging stereotypes or otherwise approach sensitive topics brusquely. He also often implicitly puts greater importance on his white charactersāand only his white characters. Itās subtle, but once you see it, it keeps jumping out at you.
Then again, thatās true of the vast majority of U.S. journalists and writers. Race notwithstanding.
Very, very long. But also a very gripping story. Maybe 1 hour or more.
Quick disclosure: I live in a country where EVs arenāt yet big. But apparently, theyāre on their way. Or I think they are, given the increasing number of EVs Iāve been seeing on the road. Theyāve been top-of-mind for me recently. (Thereās another EV-related story lined up for next week)
And so this story could not have come at a better time for me. It dives really deep (pun not intended but enjoyed) into what it calls the next frontier of mining, which is apparently the deep sea. Now look: As it is, Iām not a fan of the mining industry. I think itās extractive and destructive and exploitative. So Iām already extremely wary of this new push. And it really makes me question the green-ness of EVs. Is it really sustainable if we need to semi-destroy the planet just to make it work? Doesnāt that kind of defeat the purpose?
On a more practical note: The research and the science communication here are top-notch. Itās able to take some very new and obscure knowledge and make it relatively accessible. I presume it also does that without severely dumbing things down. Plus the way it weaves in the industry and political threads is A+ science writing.
Pretty long and can feel dense in some spots. Maybe 45 minutes, distractions included.
š¦ Gutted | Medium (Janis Hopkins), Free
I likely still havenāt seen the whole landscape of Medium, but at least from my vantage point, it seems that the site is pretty much all essays and first-person thinkpieces. That can be very annoying, especially since most of them donāt seem to be backed by solid reporting, or they donāt try to say anything new.
But this one stands out. Itās raw and emotional and honest and messy. And not entirely what I expected. I thought this would be an essay about a pretty rare but severe medical condition. Itās that, but itās also so much more. It makes a genius connection between the loss of the writerās omentum (which is an actual anatomical thing) and also the loss of his agency over his attention, surrendered totally to social media.
It takes two very orthodoxāIād argue overdoneātropes in first-person writing and links them together in an absolutely unexpected way. This essay feels like a sucker punch to the face in the best way possible.
Not long. And once it starts to get going, it really pulls you along. Iād say 15 minutes at most.
š® The Legend of Nintendo | Bloomberg, $
Iāll admitāI (willingly) jumped into this thinking that itād be a puff piece for Nintendo, and I wasnāt completely wrong.
There isnāt anything particularly hard-hitting about this story. It just traces the history of Nintendo, though the writer tries hard to make it seem like the companyās ups and downs are bigger than they actually are. I wonāt contest that Nintendo really does tend to pendulum a bit more extremely than its peers, but I donāt think thatās a unique problem. Other establishment companies also swing a lot.
More to the pointāand really why I wanted to put this on the listāis that this story turned out to be prescient. At the time, it was cautiously ringing alarms that the Switch would run into a rough patch (sales-wise and growth-wise). That has essentially come true, especially in the past year, after rumors of the Switch 2 failed to materialize into the actual thing. And I think this is one of those nexus points for Nintendo. Their next few big steps will heavily influence whether it will slip into one of its notorious bust phases or not.
A tiny critique: The story feels like it loses its way in some spots. The writer has a weird fixation with the juxtaposition between the sterility of the Nintendo HQ with the color of its games; between the dynamism of the game industry and the perceived impassiveness of Japanese culture. Feels tinged by the tiniest bit of cultural stereotypes, if Iām being honest.
Not too long, but can feel dragging in some spots. Probably 30 minutes.
š Unraveling the 50-Year Mystery of the Body in the Basement | Rolling Stone, $
Hmm. I have mixed feelings about this one.
On one hand, itās a really gripping premise. Thatās what hooked me and what kept me reading. And on that storyline, it delivers greatly. It builds tension really well, and itās clear that the writer did good research. I will say that itās a bit unsatisfying to see that the mystery remains unsolved, but I think thatās typical for True Crime stories.
On the other hand: I donāt know if itās a comprehension problem on my part, but I donāt completely understand why this story even weaves in the NYC music scene? Is it just because the victimās body was found in Steve Paulās club? That seems like a pretty forced connection to me, no? That kept on throwing me off and taking me out of the story.
Not too long. But can get confusing because of the forced connection I referenced above, and if you're like me, that will slow you down considerably. I took maybe 45 minutes?
š° Journalismās What If Problem | The Atlantic, $
Iām torn about this one, too.
It makes a very strong point about the speculative tone that journalism has taken on. And I heavily agree with it on this one. Not to force some kind of fake and shallow ethos of objectiveness onto the news, but it really does have no business dabbling in the practice of predictionāno matter how informed or educated it may be. Thatās the purview of expert analysts (who run columns on newspapers and news sites, further blurring the line between news and opinionābut thatās for another newsletter).
That said, I do think that the writerās view of how the people perceived facts and news in the past is a bit too rosy. Weāve always been easily swayed as a species. Emotion has always overpowered logic. Weāve always been ruled by impulse. Itās not as if the Media industry came along and then suddenly everyone was so cerebral. Thatās why the Media has always played to the audienceās emotions.
In an ideal world, the Mediaās role is to inform. But information isnāt inert. And words and phrases and sentences and paragraphs and angles and context sure as heck arenāt inert. There has always been (and will always be) some measure of propagandizing with journalism. That is a fact of language that we will all do well to accept and be mindful of to become better consumers of media.
Not long at all. 10 minutes if you can stay focused. Maybe 15 at most.
How did you like this week's list? |
QUICK PS
When I started TLR earlier this year, I allowed myself to hope for 1,000 subs by the end of 2024.
(It wasnāt really a goal becuase I didnāt want to pressure myself to chase growth too much. Thatās a sure path to burnout).
But now weāre so so close. Just a few dozen new readers to go! So Iād be really, really, really thankful if you helped TLR hit a thousand by sharing this newsletter with colleagues, friends, family (or even strangers) who you know would enjoy a longread recommendation or two every week š
Thanks so much for the support and for reading with me! š
See you again next Monday!
Thanks for reading! Please, please reach out if you have feedback, suggestions, or questions. Alternatively, you can fill out this super quick survey form. I promise it wonāt even take five minutes of your time, and itāll be a HUGE help!
ALSO: I know some of the stories I recommend might be behind paywalls, and maybe I can help you with access to those. Send me a message and letās see what we can do š
Until next Monday! š
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