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17 percent of G.D.P.

there is now one administrator or manager for every 4.7 employees, doing things like designing anti-harassment trainings, writing corporate mission statements, collecting data and managing “systems.”

This situation is especially grave in higher education. The Massachusetts Institute of Technology now has almost eight times as many nonfaculty employees as faculty employees

The general job of administrators, who are invariably good and well-meaning people, is to supervise and control, and they gain power and job security by hiring more people to work for them to create more supervision and control

Their power is similar to what Annie Lowrey of The Atlantic has called the “time tax.” If you’ve ever fought a health care, corporate or university bureaucracy, you quickly realize you don’t have the time for it, so you give up

As Philip K. Howard has been arguing for years, good organizations give people discretion to do what is right. But the trend in public and private sector organizations has been to write rules that rob people of the power of discretion

kids’ activities, from travel sports to recess, are supervised, and rules dominate. Parents are afraid their kids might be harmed, but as Jonathan Haidt and Greg Lukianoff have argued, by being overprotective, parents make their kids more fragile and more vulnerable to harm.

High school students design their lives to fit the metrics that college admissions officers require. And what traits are selective schools looking for? They’re looking for students who are willing to conform to the formulas the gatekeepers devise.

t Stanford is apparently now tamed. I invite you to read Ginevra Davis’s essay “Stanford’s War on Social Life” in Palladium, which won a vaunted Sidney Award in 2022 and details how university administrators cracked down on student initiatives to make everything boring, supervised and safe.

Mark Edmundson teaches literature at the University of Virginia. The annual self-evaluations he had to submit used to be one page. Now he has to fill out about 15 electronic pages of bureaucratese that include demonstrating how his work advances D.E.I., to make sure his every waking moment conforms to the reigning ideology.

the whole administrative apparatus comes with an implied view of human nature. People are weak, fragile, vulnerable and kind of stupid. They need administrators to run their lives

The result is the soft despotism that Tocqueville warned us about centuries ago, a power that “is absolute, minute, regular, provident and mild.”

this kind of power is now centerless. Presidents and executives don’t run companies, universities or nations. Power is now held by everyone who issues work surveys and annual reports, the people who create H.R. trainings and collect data

Trumpian populism is about many things, but one of them is this: working-class people rebelling against administrators. It is about people who want to lead lives of freedom, creativity and vitality, who find themselves working at jobs, sending their kids to schools and visiting hospitals, where they confront “an immense and tutelary power” (Tocqueville’s words) that is out to diminish them.

But only a handful of cancers—of the breast, lung, colon and cervix—have screening tests recommended by the U.S. Preventive Services Task Force

Many companies are developing blood tests that can detect cancer signals before symptoms occur, and Grail’s is the most advanced. A study found it can identify more than 50 types of cancer 52% of the time and the 12 deadliest cancers in Stages I through III 68% of the time.

There’s a hitch. The test costs $949 and isn’t covered by Medicare or most private insurance.

The trouble is that this cancer is almost never caught early. There’s no routine screening for it, and symptoms don’t develop until it is advanced. Mr. Royse, 64, had no idea he was sick until he took a blood test called Galleri, produced by the Menlo Park, Calif., startup Grail. He had surgery and chemotherapy and is now cancer-free.

Mr. Royse visited Grail’s website, which referred him to a telemedicine provider who ordered a test. Another telemedicine doctor walked him through his results, which showed a cancer signal likely emanating from the pancreas, gallbladder, stomach or esophagus.

An MRI revealed a suspicious mass on his pancreas, which a biopsy confirmed was cancerous. Mr. Royse had three months of chemotherapy, surgery and another three months of chemotherapy, which ended last February. Because pancreatic cancer often recurs, he gets CT and MRI scans every three months. In addition, he has signed up for startup Natera’s Signatera customized blood test, which checks DNA specific to the patient’s cancer and can signal its return before signs are visible on the scans

Grail’s test likewise looks for DNA shed by cancer cells, which is tagged by molecules called methyl groups that are specific to a cancer’s origin. Grail uses genetic sequencing and machine learning to recognize links between DNA methyl groups and particular cancers

The test “is based on how much DNA is being shed by tumor,” Grail’s president, Josh Ofman, says. “Some tumors shed a lot of DNA. Some shed almost none.

ut slow-growing tumors typically aren’t shedding a lot of DNA.” That reduces the probability that Grail’s test will identify indolent cancers that pose no immediate danger.

Grail’s test has a roughly 0.5% false-positive rate, meaning 1 in 200 patients who don’t have cancer will get a positive signal

Its positive predictive value is 43%, so that of every 100 patients with a positive signal, 43 actually have cancer

the legislation’s price tag could reduce political support. According to one private company’s estimate, the test could cost the government $39 billion to $145 billion over a decade. Mr. Goldman counters that analysts usually overestimate the costs and underestimate the benefits of medical interventions.

Because Grail uses machine learning to detect DNA-methylation cancer linkages, the Grail test’s accuracy should improve as more tests and patient data are collected

regulators may balk at approving the test, and insurers at covering it, until it becomes cheaper and more reliable.

How would the FDA weigh the risk that a false positive on a test like Grail’s could require invasive follow-up testing against the dire but hard-to-quantify risk that a deadly cancer wouldn’t be caught until it’s much harder to treat? It’s unclear.

some experts urge the FDA to require large randomized controlled trials before approving blood cancer tests. “Multicancer screening would entail tremendous costs and potentially substantial harms,” H. Gilbert Welch and Tanujit Dey of Brigham and Women’s Hospital wrote

Dr. Welch and Mr. Dey also suggested that companies should be required to prove their tests reduce overall mortality, even though the FDA doesn’t require drugmakers to prove their products reduce deaths or extend life. Clinical trials for the mRNA Covid vaccines didn’t show they reduced deaths.

One alternative is to rely on real-world studies, which Grail is already doing. One study of patients 50 and older without signs of cancer showed that the test doubled the number of cancers detected.

One recurring problem he has seen: “Epidemiologists are always getting cancer wrong,” he says. “Epidemiologists a decade ago said U.S. overtreats cancers. Well, no, the EU undertreats cancer.”

A 2012 study that he co-authored found that the higher U.S. spending on cancer care relative to Europe between 1983 and 1999 resulted in significantly higher survival rates for American patients than for those in Europe

By his study’s calculation, U.S. spending on cancer treatments during that period resulted in $556 billion in net benefits owing to reduced mortality.

He expects Galleri and other multicancer early-detection tests to reduce deaths and produce public-health and economic benefits that exceed their monetary costs

Expanding access to multicancer early-detection tests could also help solve the chicken-and-egg problem of drug development. Because few patients are diagnosed at early stages of some cancers, it’s hard to develop treatments for them

the positive predictive value for some recommended cancer screenings is far lower. Fewer than 1 in 10 women with an abnormal finding on a mammogram are diagnosed with breast cancer.

Mr. Royse makes the same point with personal force. “I would be dead right now if not for multicancer early-detection testing,” Mr. Royse told an FDA advisory committee last fall. “The longer the FDA waits, the more people are going to die. It’s that simple.”

Newsroom leaders, concerned that some Times journalists are compromising their neutrality and applying ideological purity tests to coverage decisions, are seeking to draw a line. 

Kahn noted that the organization has added a lot of digital-savvy workers who are skilled in areas like data analytics, design and product engineering but who weren’t trained in independent journalism. He also suggested that colleges aren’t preparing new hires to be tolerant of dissenting views

International editor Philip Pan later intervened, saying the WhatsApp thread—at its worst a “tense forum where the questions and comments can feel accusatory”—should be for sharing information, not for hosting debates, according to messages reviewed by the Journal. 

Coverage of the Israel-Hamas war has become particularly fraught at the Times, with some reporters saying the Times’s work is tilting in favor of Israel and others pushing back forcefully, say people familiar with the situation. That has led to dueling charges of bias and journalistic malpractice among reporters and editors, forcing management to referee disputes.

“Just like our readers at the moment, there are really really strong passions about that issue and not that much willingness to really explore the perspectives of people who are on the other side of that divide,” Kahn said, adding that it’s hard work for staffers “to put their commitment to the journalism often ahead of their own personal views.”

Last fall, Times staffers covering the war got into a heated dispute in a WhatsApp group chat over the publication’s reporting on Al-Shifa hospital in Gaza, which Israel alleged was a command-and-control center for Hamas.

While the Guild represents staffers across many major U.S. news outlets, its members also include employees from non-news advocacy organizations such as pro-Palestinian group Jewish Voice For Peace, Democratic Socialists of America and divisions of the ACLU. 

“Young adults who are coming up through the education system are less accustomed to this sort of open debate, this sort of robust exchange of views around issues they feel strongly about than may have been the case in the past,” he said, adding that the onus is on the Times to instill values like independence in its employees.

The publisher of the Times, 43-year-old A.G. Sulzberger, says readers’ trust is at risk, however. Some journalists, including at the Times, are criticizing journalistic traditions like impartiality, while embracing “a different model of journalism, one guided by personal perspective and animated by personal conviction,” Sulzberger wrote in a 12,000-word essay last year in Columbia Journalism Review. 

Despite such moves, NewsGuard, an organization that rates credibility of news sites, in February reduced the Times’s score from the maximum of 100 to 87.5, saying it doesn’t have a clear enough delineation between news and opinion.

Emboldened by their show of strength on Bennet, employees would flex their muscles again on multiple occasions, pushing to oust colleagues they felt had engaged in journalistic or workplace misconduct. 

One thing Powell noticed, he said, was that coverage that challenged popular political and cultural beliefs was being neglected. Powell’s work includes a story on MIT’s canceling of a lecture by an academic who had criticized affirmative action, and another examining whether the ACLU is more willing to defend the First Amendment rights of progressives than far-right groups.

Kahn, who succeeded Baquet as executive editor in June 2022, and Opinion Editor Kathleen Kingsbury said in a letter to staff that they wouldn’t tolerate participation by Times journalists in protests or attacks on colleagues.

Divisions have formed in the newsroom over the role of the union that represents Times staffers, the NewsGuild-CWA. Some staffers say it has inappropriately inserted itself into debates with management, including over coverage of the trans community and the war. 

The Times isn’t the only news organization where employees have become more vocal in complaints about coverage and workplace practices. War coverage has also fueled tensions at The Wall Street Journal, with some reporters in meetings and internal chat groups complaining that coverage is skewed—either favoring Israel or Palestinians.  

When Times staffers logged on to a union virtual meeting last fall to discuss whether to call for a cease-fire in Gaza, some attendees from other organizations had virtual backgrounds displaying Palestinian flags. The meeting, where a variety of members were given around two minutes to share their views on the matter, felt like the kind of rally the Times’ policy prohibits, according to attendees. 

In January, Sulzberger shared his thoughts on covering Trump during a visit to the Washington bureau. It was imperative to keep Trump coverage emotion-free, he told staffers, according to people who attended. He referenced the Times story, “Why a Second Trump Presidency May Be More Radical Than His First,” by Charlie Savage, Jonathan Swan and Maggie Haberman, as a good example of fact-based and fair coverage. 

“What Putin wants is to transform the world order” that evolved since World War II and the post-Cold War — where “the competition between nations was about who can be richer and who can help their people prosper the most . … Putin hates that world because he loses in that world — his system is a loser in a peaceful, global, wealth-enhancing paradigm. And so what he wants is to move us back to dog-eat-dog, to a 19th-century, great power competition, because he thinks he can, if not win, be more effective there. … Let’s not think that this is a Ukrainian problem; this is a problem for us all.”

These wars very much are our business — and now clearly inescapable, since we’re deeply entwined in both conflicts. What’s crucial to keep in mind about America — as the leader of the Inclusion Network — is that right now we’re fighting the war in Ukraine on our terms, but we’re fighting the war in the Middle East on Iran’s terms.

CNN recently described, per a source familiar with it, a declassified U.S. intelligence assessment provided to Congress saying that Russia had lost 87 percent of its preinvasion active-duty ground troops and two-thirds of its tanks that it had prior to its invasion of Ukraine. Putin can still inflict a lot of damage on Ukraine with missiles, but his dream of occupying the whole country and using it as a launching pad to threaten the Inclusion Network — particularly the NATO-protected European Union — is now out of reach. Thank you, Kyiv.

At a breakfast with NATO leaders devoted to the Ukraine issue at Davos this year, Canada’s deputy prime minister, Chrystia Freeland, noted that it is we, the West, who should be thanking the Ukrainians, not forcing them to beg us for more weapons.

China under President Xi Jinping straddles the two networks, along with much of what’s come to be called the global south. Their hearts, and often pocketbooks, are with the Resistors but their heads are with the Includers

the Resistance Network “is orchestrated by Iran, Islamists and jihadists” in a process they refer to as the “unity of battlefields.” This network, he noted, “seeks to bridge militias, rejectionists, religious sects and sectarian leaders,” creating an anti-Israel, anti-American, anti-Western axis that can simultaneously pressure Israel in Gaza, in the West Bank and on the Lebanon border — as well as America in the Red Sea, in Syria and in Iraq and Saudi Arabia from all directions.

In stark contrast, Koteich said, stands the Inclusion Network, one that’s focused on “weaving together” global and regional markets instead of battlefronts, business conferences, news organizations, elites, hedge funds, tech incubators and major trade routes. This inclusion network, he added, “transcends traditional boundaries, creating a web of economic and technological interdependence that has the potential to redefine power structures and create new paradigms of regional stability.”

things are different in the Middle East. There, it is Iran that is sitting back comfortably — indirectly at war with Israel and America, and sometimes Saudi Arabia, by fighting through Tehran’s proxies: Hamas in Gaza, the Houthis in Yemen, Hezbollah in Lebanon and Syria, and Shiite militias in Iraq.

Iran is reaping all the benefits and paying virtually no cost for the work of its proxies, and the U.S., Israel and their tacit Arab allies have not yet manifested the will or the way to pressure Iran back — without getting into a hot war, which they all want to avoid.

The members of the Resistance Network are great at tearing down and breaking stuff, but, unlike the Inclusion Network, they have shown no capacity to build any government or society to which anyone would want to emigrate, let alone emulate

For all of these reasons, this is a moment of great peril as well as great opportunity — especially for Israel. The competition between the Resistance Network and the Inclusion Network means that the region has never been more hostile or more hospitable to accepting a Jewish state.

From the point of view of Trump-skeptical Republicans, this election is no more about Joe Biden than a fire in a children’s hospital is about the fire extinguisher. They don’t think, Gee, I wish this extinguisher were newer, so I’ll let the children burn to death. They think, I hope there’s still an ounce or two of flame-retardant foam left in this old thing—and if there is, I’ll be damn grateful for it.

And why was the surge in illegal border crossings so troubling, even for voters who live far from the southern border? Not because they believe Mr. Trump’s florid demagogy about criminals, rapists and residents of mental hospitals pouring in but because they see a country unable to control its borders as a country unable to control its destiny

and as a country that treats strangers better than some of its citizens.

they are part of the same political project. Economic arrangements not only decide the distribution of income and wealth; they also determine the allocation of social recognition and esteem.

Democrats need to acknowledge that the neoliberal globalization project they and mainstream Republicans pursued in recent decades brought huge gains for those at the top but job loss and stagnant wages for most working people

The winners used their windfall to buy influence in high places. Government stopped trying to check concentrated economic power. The two parties joined forces to deregulate Wall Street. And when the financial crisis of 2008 pushed the system to the brink, they spent billions of dollars to bail out the banks but left ordinary homeowners mostly to fend for themselves.

Rather than contend directly with the damage they had done, both political parties told workers to improve themselves by getting college degrees.

The elites who offered this advice missed the implicit insult it contained: If you’re struggling in the new economy, it’s your fault.

as president, despite his centrist career, Mr. Biden turned away from the policies that had prompted populist backlash and empowered Mr. Trump.

Still, he remained unpopular. Mr. Biden and his team thought the problem was one of timing: Public investments take time to produce jobs and tangible benefits.

Mr. Biden’s ambitious public investments in infrastructure, manufacturing, jobs and clean energy recalled the muscular role of government during the New Deal. So did his support for collective bargaining and the revival of antitrust law. It made him one of the most consequential presidents of modern times.

But the real problem was more fundamental. Mr. Biden never really offered a broad governing vision, never explained how the policies he enacted added up to a new democratic project.

Mr. Biden offered no comparable story.When he broke with the era of neoliberal globalization, reasserting government’s role in regulating markets for the common good, he did so with little fanfare or explanation. He did not acknowledge that his own party had been complicit in the policies that had deepened the divide between winners and losers

Mr. Trump has proposed exempting tips from taxes. Well, here’s a bolder suggestion: Why not reduce or eliminate the payroll taxes employees pay and make up the revenue with a tax on financial transactions?

This made him a weak match for Mr. Trump, a candidate with little policy success but whose MAGA movement spoke to the anger of the age.

what does all of this mean for the Harris campaign?

Defeating Mr. Trump means taking seriously the divide between winners and losers that polarizes the country. It means acknowledging the resentment of working people who feel that the work they do is not respected, that elites look down on them, that they have little say in shaping the forces that govern their lives.

To do so, Ms. Harris should highlight a theme that has long been implicit but underdeveloped in Mr. Biden’s presidency: the dignity of work.

The Harris campaign should not only defend these achievements but also embark on something more ambitious: a project of democratic renewal that goes beyond merely saving democracy from Mr. Trump

democracy in its fullest sense is about citizens deliberating together about justice and the common good. The dignity of work is important to a healthy democracy because it enables everyone to contribute to the common good and to win honor and recognition for doing so.

For Ms. Harris, offering concrete proposals to honor work — and to reward it fairly — could force Mr. Trump and Mr. Vance to choose between the working-class party they hope to become and the corporate Republican Party they continue to be.

She should be asking questions that would invigorate progressive politics for the 21st century: If we really believe in the dignity of work, why do we tax income from labor at a higher rate than income from dividends and capital gains? Shouldn’t the federal minimum hourly wage be higher than $7.25?

in the end, it all made for impressive policy but themeless politics. His presidency was a legislative triumph but an evocative failure.

Beyond tax measures: What about public investment in universal child care not only to support those who work outside the home but also to improve the pay and working conditions of caregivers?

Democrats could promote sectoral bargaining so that fast food workers can negotiate wages and working conditions across their industry rather than company by company. Democrats could require companies to give employees seats on corporate boards and classify gig workers as employees

On climate change, rather than imposing top-down, technocratic solutions, what if we tried listening to those who fear their livelihoods will be upended — creating local forums that give workers in the fossil fuel industry and agriculture a chance to collaborate with community leaders, scientists and public officials in shaping the transition to a green economy?

The election season is too short, they might argue, and the stakes are too high; elevating the terms of public discourse is a project for another day.

But this would be a political mistake and a historic missed opportunity. Taunting Mr. Trump as a felon would rally the base but reinforce the divide. Offering Americans a more inspiring democratic project could change some minds, win over some voters and offer some hope for a less rancorous public life.