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Vegas was in the midst of building a real urban center, trying to turn what was just a break from sanity - fake Eiffel Tower! giant dancing fountain! a dance in every lap! - into a permanent installation of insanity. If we decide that we don't need a resort town that's roughly the same size as Washington, D.C. (which Las Vegas is) - that we can't continue to devote as many resources to gambling, tasting menus, spas, strip joints and nightclubs as we do to our national government - then we finally revert from being a nation of optimistic materialism...
...turn out of my hotel's full parking lot, veering onto the Strip, I come across something rarely seen in Vegas: frozen construction projects. I pass cranes abandoned at the site of the Echelon, a huge, multibillion-dollar project of four hotels that is now just three buildings of nine floors of concrete and steel beams sitting idly on some of the most expensive real estate in the country. I pass three more abandoned sites - 63 empty steel floors of the Fontainebleau, a sad unfinished shell that was supposed to be Caesars Palace's Octavius Tower and two cranes halted...
...bill. Reform advocates say charging even $7,100 for something as ordinary as a kidney stone just doesn't make sense and points up what they call the rampant U.S. practice of "defensive medicine": ordering excessive treatment out of fear of being sued for malpractice, which in turn points up how important malpractice reform is, as President Obama acknowledged this summer. "It underscores the problem of healthcare over-utiization," says Linda Quick, president of the South Florida Hospital & Healthcare Association. "We have to change the way we pay for care and set more appropriate ceilings...
...possible remedy, which could get funding in a federal reform bill, is a healthcare delivery model called Patient-Centered Medical Homes. PCMH links patients up with personalized healthcare teams in their communities, which in turn provide more focused, efficient and less costly medical services. An important PCMH feature is making non-emergency care - like less expensive urgent care - more 24/7 accessible to patients who really don't require emergency-level attention. (My kidney stone hit me at night, when my local urgent-care clinic was closed, leaving me with little choice but an E.R.) PCMH "is something we need...
...seen spats between the Supreme Leader, Ayatullah Ali Khamenei, and Ahmadinejad. The Revolutionary Guards leadership has a vested financial interest in isolating the Islamic republic from the West - and focusing its sights eastward toward places like China. Indeed, some observers believe the IRGC's economic functions may eventually turn it into an entity like South Korea's government-supported chaebol or multinational conglomerates that were key to that country's modernization, albeit in controversial ways...