★☆★Economist系列精读★☆★

GenevUID：2543794

GRE考试的两大关键：阅读+词汇，词汇可以在阅读中积累熟悉，阅读中可以复习掌握词汇的精确用法，注意长句难句，又可以在做填空题的时候不费吹灰之力。

本次开展的Economist阅读活动，每篇文章不限时间，请各位同学以读懂为止，学习词汇和句子，目的是在平时打好基本功，以后可以自如应对各种英文考试。题材将主要以科技文艺生活类为主，以接近考试的选材。

建议摘抄背诵词汇、句子和例子，学习最in最标准的英文表达方法，对写作也会很有帮助。

如果阅读中遇到疑问，可以跟贴提出。

America's climate-change bill
In need of a clean
Jun 27th 2009
From Economist.com
America’s climate-change bill is a bundle of compromises

THE headline is a big one: for the first time, America’s House of Representatives agreed, by 219 votes to 212, on Friday June 25th to cap emissions of carbon dioxide, the main greenhouse gas. The bill envisions modest reductions of 17% from 2005 levels by 2020, but the cuts get more swingeing over time (under the assumption that technology to mitigate emissions will improve). By 2050 the cuts should hit 83%.

But environmental campaigners have gritted their teeth as the bill has passed through the legislative process. Drafted by Henry Waxman and Ed Markey, with support from the Obama administration, the bill originally envisioned a cap-and-trade system whereby credits conferring the right to emit greenhouse gases would be sold to the highest bidders. The revenue from such an auction would be used to offset increasing energy bills.

But to the ire of the green faithful, the bill will now give away 85% of the permits to emit carbon, while auctioning off the rest. Even in that form, though, the bill looked like it might generate opposition from fiscally conservative Democrats or those that represented states with lots of farmers. The support of those Democrats would be needed to get the legislation past near-unanimous Republican opposition.

To mollify the farmers, Mr Waxman had to agree that “indirect land-use changes” would not affect how American farmers producing crops to make ethanol would be considered under the bill. Farmers had howled that, by the original proposals, planting more crops to produce ethanol would mean less land devoted to food crops. This would clearly cause food prices to rise. Farmers in (say) Brazil might then cut down Amazon rainforest to make up the shortfall in America. That chopped-down Amazon would have counted against the Iowan corn farmer when carbon credits were doled out. Mr Waxman agreed to suspend the provision for five years, so the National Academy of Sciences could further study the subject.
The next big trade-off also came late in the day at the insistence of the farmers. The Department of Agriculture, rather than the Environmental Protection Agency, will determine what counts as a carbon “offset”. This means that farmers who prevent carbon emissions by, for example, planting trees or reducing tillage, would get carbon credits. The EPA is reckoned to be a tough regulator that would make sure farmers did not get credits for doing things that they would do anyway. The Department of Agriculture is expected to be more friendly to farmers.

Many of the mainstream environmental groups-the Natural Resources Defence Council, the Environmental Defence Fund, the Sierra Club and others-have said that the bill is flawed but far better than nothing. More than that, they claim that once in place it can be tightened over time.

But the bill must pass the Senate where farm states have even more clout than in the House (since each state, no matter how sparsely populated, gets two senators). It must go through another clutch of committees, each of which is susceptible to lobbying by special interests with long experience of getting their way. The energy committee, for example, has already passed a bill on renewables that has disappointed greens. The Senate’s majority leader, Harry Reid, wants a vote on the package by mid-September.

With just a few months to go before global talks in Copenhagen
on a successor to the Kyoto protocol other big countries are showing their hands on climate change. Russia and Japan have announced targets that are well shy of the goals set by European countries, currently leading the world with their green ambitions. China and India are refusing to countenance any hard ceilings on their own emissions. An American carbon bill is regarded as a necessary step before anything of substance can be agreed in Copenhagen. But a weak bill might mean that the impetus for serious discussions is lacking.

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地震预测仍然是世界难题，文中绿色标出的是现有的预测依据和方法。

All shook up
Jun 26th 2009
From Economist.com

Getting earlier warnings before earthquakes strike

YOU never really get used to earthquakes. In 1994, your correspondent’s home in southern California was badly shaken by the Northridge earthquake, which delivered wallop of magnitude 6.7 and some of the highest ground accelerations (up to 1.8g) ever recorded. A year to the day later, his home-from-home near Kobe was hit by the magnitude 6.9 Hanshin earthquake. Being rudely awoken in the middle of the night by one major earthquake may be regarded as a misfortune; being disturbed by two looks like carelessness.

Splitting his time between two of the more seismically active regions of the world, your correspondent has at least learned not to panic when the ground lurches violently. As the faster, and relatively harmless, primary wave steals across the threshold and rattles the windows, he grabs his shoes and family, and (time permitting) jams open an outside door and has everyone wedge themselves there ready for the full blast of the secondary and Rayleigh shocks.

He wishes the warning would come minutes, rather than mere seconds, earlier. And nowadays there is no technical reason why it should not. Thanks to low-orbit surveillance and communications satellites, such alarm systems are being used along the eastern edge of the Indian Ocean to warn coastal communities of imminent tsunamis. In Japan, they tell speeding bullet-trains to slow down in time to prevent derailments. One day, such earthquake early-warning systems could be as ubiquitous in the home as smoke detectors—at least, in seismically active areas.

Providing five-minute warnings of earthquakes is one thing; predicting them days or weeks ahead is quite another. Detecting the primary waves from an earthquake is like seeing the flash of lightning before hearing the thunder and getting drenched by the rain. It is an integral part of a deterministic process that is already under way.

The magnitude and timing of an earthquake depend on the size of the fault being ruptured, the stiffness of the rocks in question and the amount of stress that has accumulated in them. Scientists can make rough guesses of what they may be, but the deterministic devil is in the details. Understanding what is happening—at the level of detail that determines the actual outcome—is nigh impossible.

That has not stopped people trying. Pseudo-scientific theories and predictions about earthquakes abound. Over the centuries, people have tried everything from the behaviour of animals and unusual cloud formations to the water level in wells and the phases of the moon to predict earthquakes. More recently, researchers have sought to associate electromagnetic fields, the radon or hydrogen content of the soil and seismicity patterns with impending earthquakes. All to no avail.

So far it has proved impossible to predict earthquakes in any meaningful way—that is, of a given magnitude, at a given place, on a given day. That is because of the complexity of the problem and the lack of information about how the stresses around the cat’s cradle of neighbouring faults accumulate in some places and are relieved in others. Anyone who says they can predict such things precisely and repeatedly is a charlatan or a crank.
A cat's cradle is a string game: put a bunch of X's between somebody's hands, cat's cradle 翻绳儿（又叫挑绷子）游戏，用线绳圈绕于两手手指上，翻出各种花样形状。这是一种儿童游戏

The one time an earthquake prediction came true (though it could just as easily have been a fluke) was in the Chinese city of Haicheng in 1975. An evacuation warning was issued the day before an earthquake of magnitude 7.3 shook the city. In the months before, there had been a swarm of small earthquakes, along with changes in ground-water levels and the elevation of local terrain. A sudden increase in the size and frequency of the shocks prompted the authorities to issue the alert.

Unfortunately, few earthquakes tip their hand like that. And despite their success at Haicheng, Chinese seismologists failed to predict the far more deadly magnitude 7.6 shock that devastated Tangshan in 1976, killing an estimated 250,000 people.

What seismologists can do is identify places where there is a high probability of a strong earthquake happening in the future. On average, there are 18 killer quakes of magnitude 7.0 or greater around the world each year. Most occur along the “Ring of Fire”, a belt of seismic and volcanic activity around the Pacific rim that includes California and Japan.

Seismologists know, for instance, that similar magnitude 6.0 earthquakes have occurred at regular intervals along the San Andreas fault in California—probably the most intensely studied fault in the world. What they cannot say is precisely when and where the next one will strike. The last time seismologists were bold enough to attempt a forecast, the earthquake came at the designated place but 12 years after the four-year prediction window had closed.

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留印——及时雨呀。
等过了基础储备期，就步步紧跟。

GenevUID：2543794

China's internet censors

Dammed if you do

Jun 25th 2009 | BEIJING
From The Economist print edition

Protecting China’s innocents from smut, violence and the Dalai Lama

THE internet is full of stuff of which China’s government disapproves. Yet there are 300m Chinese internet-users. Keeping the two apart has embroiled the Chinese authorities in a long cat-and-mouse struggle. Service-providers and internet cafés are closely supervised, and a wide array of filtering mechanisms already overlays the national internet architecture. A fresh initiative goes one step further. From July 1st every personal computer sold in China will have to come with new filtering software called Green Dam Youth Escort.

It has yet to be decided whether Green Dam must be pre-loaded, or left on a disk for users to install. But it has sparked an uproar. Chinese internet users have vented online their spleen at being nannied. Hackers are reported to have mounted repeated attacks on the website of Green Dam’s developer. It has also received more than 1,000 harassing phone-calls, including death threats.

An American firm, Solid Oak Software, claims Green Dam includes stolen copyrighted code from one of its products, and has launched legal action. Computer makers are understandably reluctant to abet a massive censorship scheme, or to anger their customers with unwelcome software. Moreover, independent experts at the University of Michigan found Green Dam to be riddled with outdated code and security flaws that would leave computers at risk.

America’s Commerce Department this week lodged a formal complaint with the Chinese government, asking it to rescind the new rule. The government stresses Green Dam’s role in protecting young people from “unhealthy” and “poisonous” pornographic and violent content. But the Michigan experts found that it is also scans text for “politically sensitive” phrases.
Whether to do with Tibet, Taiwan, or Falun Gong, a spiritual sect, there are plenty of these, leading to sites deemed “harmful” by China. In a year of harder economic times and sensitive political anniversaries, the authorities are especially edgy. The thin and cautious reporting in the press of events in Iran suggests they are also nervous about access to news of political protest elsewhere.

Despite the opposition, however, which includes a grassroots attempt to organise an internet boycott in China on July 1st, the government remains undaunted, promising that technical flaws will be fixed and that Green Dam will go forward. It has also opened a second front, lashing out at Google for including a feature in its Chinese service that automatically completes search-query terms—it complains that this can lead users to sites containing pornography.

Google has long struggled to reconcile its corporate credo (“Don’t be evil”) with the onerous demands of China’s internet regulators. It has promised to renew its efforts to keep in line with Chinese standards. But the company also has fair cause to wonder why it has been singled out. Its main Chinese competitor, Baidu, is just as good at finding smut.

single out挑选

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写作文已经到了江郎才尽的田地了……

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顶，第一篇，学习笔记～
cap: to prevent from growing or spreading: set an upper limition on
     eg.cap oil prices
swinge: 鞭笞 beat,scourge; 烧焦 singe,scorch
swingeing: very large,high,or severe
unamimous: 一致意见 having the agreement and consent of all
dole out: 少量发放 to give or deliver in small portions
tillage: 耕地 cultivated land

GenevUID：2543794

New materials for renewable energy

The power of being made very small

Jul 2nd 2009 From The Economist print edition

Nano-engineering can produce substances with unique properties that will give renewable energy a boost

BIG improvements in the production of energy, especially from renewable sources, are expected over the coming years. Safer nuclear-power stations, highly efficient solar cells and the ability to extract more energy from the wind and the sea are among the things promised. But important breakthroughs will be needed for these advances to happen, mostly because they require extraordinary new materials.

The way researchers will construct these materials is now becoming clear. They will engineer them at the nanoscale, where things are measured in billionths of a metre. At such a small size materials can have unique properties. And sometimes these properties can be used to provide desirable features, especially when substances are formed into a composite structure that combines a number of abilities. A series of recent developments shows how great that potential might be.

Grand designs
Researchers have already become much better at understanding how the structure of new nano-engineered materials will behave, although the process remains largely one of trial and error because different samples have to be repeatedly manufactured and tested. Michael Demkowicz of the Massachusetts Institute of Technology is developing a model that he hopes will address the problem from a different direction: specifying a set of desired properties and then trying to predict the nanostructures needed to deliver them.

Dr Demkowicz is working with a team based at the Los Alamos National Laboratory, one of a number of groups being funded under a new $777m five-year programme by the American government to accelerate research into energy technologies. The material Dr Demkowicz is looking for will be good at resisting damage from radiation. It could be used instead of stainless steel to line a nuclear reactor, which would extend the reactor’s working life and allow it to be operated more efficiently by burning a higher percentage of nuclear fuel. At present, says Dr Demkowicz, reactors burn only around 1% of their fuel, so even a modest increase in fuel burn would leave less radioactive waste.

The reason why the linings of nuclear reactors degrade is that metals can become brittle and weak when they are exposed to radiation. This weakness is caused by defects forming in their crystal-lattice structure, which in turn are caused by high-energy particles such as neutrons bumping into individual atoms and knocking them out of place. When these displaced atoms collide with other atoms, the damage spreads. The result is holes, or “vacancies”, and “interstitials”, where additional atoms have squeezed into the structure.

Dr Demkowicz says it is possible to design nanocomposites with a structure that resists radiation damage. This is because they can be made to exhibit a sort of healing effect in the areas between their different layers. The thinner these layers are, the more important these interfaces become because they make up more of the total volume of the material. Depending on how the nanocomposites are constructed, both the vacancies and the interstitials get trapped at the interfaces. This means there is a greater chance of their meeting one another, allowing an extra atom to fill a hole and restore the crystal structure. In some conditions the effect can appear to show no radiation damage at all, he adds.

The ideal nanocomposite would not only resist radiation damage. It would also not itself become radioactive by absorbing neutrons. Dr Demkowicz has used his modelling techniques to come up with some candidates; iron-based ones for fission reactors and tungsten-based ones for those that may one day use nuclear fusion. It could still take years before such materials are approved for use, but the modelling methods will greatly speed up the process.

Across the spectrum
Nano-engineered materials will also play an important role in a more efficient generation of solar cells, according to an exhibition by researchers at Imperial College, London, called “A Quantum of Sol”, which opened this week at the Royal Society Summer Science Exhibition, also in London. Again, the desired effects are obtained by using combinations of material produced at extremely small sizes. In this case, they are used to make “multi-junction” solar cells, in which each layer captures energy from a particular colour in the spectrum of sunlight. Overall, this is more efficient than a conventional solar cell which converts energy from only part of the spectrum.

Whereas conventional solar cells might turn 20% or so of the energy in sunlight into electricity, multi-junction solar cells already have an efficiency of just over 40% and within a decade that could reach 50%, predicts Ned Ekins-Daukes, a researcher at Imperial. Until nano-engineering costs come down with economies of scale, multi-junction solar cells will remain expensive. The researchers expect that electricity-generation costs can still be cut in the meantime by using mirrors to concentrate sunlight on the cells.

Through the glass
Solar cells could also be incorporated into the structure of buildings, including windows. Researchers at the Fraunhofer Institute for Mechanics of Materials are looking for suitable transparent materials to make them. They too are using computer models to explore atomic structures and then to simulate how electrons will behave in them. With the right combination of conductive and transparent material, says Wolfgang Körner, from the German institute, it should be possible to produce completely see-through electronics.

The nanostructure of composites can also provide great mechanical strength in relatively light materials. Composites such as fibreglass and carbon fibre bonded in a plastic resin are already widely used to replace metal in making, for instance, cars and aircraft. But by controlling the direction and the tension of the fibres during their construction it is possible to produce a morphing composite, which adjusts its shape under certain conditions. The change can be instigated by an external control or it can be automatic, for instance in response to variations in heat, pressure or velocity.

These morphing composites could be used to produce more efficient turbine blades in wind and tidal generators, a seminar at Bristol University’s Advanced Composites Centre for Innovation and Science was told this week. A bistable composite capable of altering its aerodynamic profile rapidly when wind and current conditions changed would help to remove unwanted stresses in the blades. That would increase the efficiency of the blades and extend the working life of the generator systems they power, says Stephen Hallett, a member of the Bristol team. Morphing composites would mean, for instance, that tidal generators could be made smaller and would last longer, which would make them more viable commercially. In this way many tiny changes in the science of materials could generate a big future for renewable energy.

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Autism and extraordinary ability
Genius locusApr 16th 2009
From The Economist print edition

There is strong evidence for a link between genius and autism. In the first of three articles about the brain this week, we ask how that link works, and whether “neurotypicals” can benefit from the knowledge
Ronald Grant Archive

THAT genius is unusual goes without saying. But is it so unusual that it requires the brains of those that possess it to be unusual in others ways, too? A link between artistic genius on the one hand and schizophrenia and manic-depression on the other, is widely debated. However another link, between savant syndrome and autism, is well established. It is, for example, the subject of films such as “Rain Man”, illustrated above.

A study published this week by Patricia Howlin of King’s College, London, reinforces this point. It suggests that as many as 30% of autistic people have some sort of savant-like capability in areas such as calculation or music. Moreover, it is widely acknowledged that some of the symptoms associated with autism, including poor communication skills and an obsession with detail, are also exhibited by many creative types, particularly in the fields of science, engineering, music, drawing and painting. Indeed, there is now a cottage industry in re-interpreting the lives of geniuses in the context of suggestions that they might belong, or have belonged, on the “autistic spectrum”, as the range of syndromes that include autistic symptoms is now dubbed.

So what is the link? And can an understanding of it be used to release flashes of genius in those whose brains are, in the delightfully condescending term used by researchers in the area, “neurotypical”? Those were the questions addressed by papers (one of them Dr Howlin’s) published this week in the Philosophical Transactions of the Royal Society. The society, Britain’s premier scientific club and the oldest scientific body in the world, produces such transactions from time to time, to allow investigators in particular fields to chew over the state of the art. The latest edition is the outcome of a conference held jointly with the British Academy (a similar, though younger, organisation for the humanities and social sciences) last September.

A spectrum of belief
A standard diagnosis of autism requires three things to be present in an individual. Two of these three, impairments in social interaction and in communication with other people, are the results of autists lacking empathy or, in technical jargon, a “theory of mind”. In other words they cannot, as even fairly young neurotypicals can, put themselves in the position of another being and ask themselves what that other is thinking. The third criterion, however, is that a person has what are known as restrictive and repetitive behaviours and interests, or RRBI, in the jargon.
Until recently, the feeling among many researchers was that the first two features were crucial to someone becoming a savant. The idea was that mental resources which would have been used for interaction and communication could be redeployed to develop expertise in some arbitrary task. Now, though, that consensus is shifting. Several of the volume’s authors argue that it is the third feature, RRBI, that permits people to become savants.

Francesca Happé of King’s College, London, is one of them. As she observes, obsessional interests and repetitive behaviours would allow someone to practice, albeit inadvertently, whichever skill they were obsessed by. Malcolm Gladwell, in a book called “Outliers” which collated research done on outstanding people, suggested that anyone could become an expert in anything by practising for 10,000 hours. It would not be hard for an autistic individual to clock up that level of practice for the sort of skills, such as mathematical puzzles, that many neurotypicals would rapidly give up on.

Many, but not all. Dr Happé has drawn on a study of almost 13,000 individual twins to show that childhood talent in fields such as music and art is often associated with RRBIs, even in those who are not diagnosed as classically autistic. She speculates that the abilities of savants in areas that neurotypicals tend to find pointless or boring may result from an ability to see differences where a neurotypical would see only similarities. As she puts it, “the child with autism who would happily spend hours spinning coins, or watching drops of water fall from his fingers, might be considered a connoisseur, seeing minute differences between events that others regard as pure repetition.”

Simon Baron-Cohen, a doyen of the field who works at Cambridge University, draws similar conclusions. He suggests the secret of becoming a savant is “hyper-systematising and hyper-attention to detail”. But he adds sensory hypersensitivity to the list. His team have shown one example of this using what is known as the Freiburg visual acuity and contrast test, which asks people to identify the gap in a letter “c” presented in four different orientations. Those on the autistic spectrum do significantly better at this than do neurotypicals. That might help explain Dr Happé’s observations about coins and raindrops.

Insight, too, is given by autists themselves. Temple Grandin is a professor of animal science at Colorado State University. She also writes about her experience of being autistic. As she describes in the volume, one of the differences she perceives between her experience and that of most neurotypicals is that she thinks in images. She says her mind is like an internet search engine that searches for photographs. To form concepts, she sorts these pictures into categories. She does not, however, claim that all autistic people think like this. To the contrary, she describes two other sorts: pattern thinkers who excel at maths and music, and verbal specialists who are good at talking and writing, but lack visual skills. The latter might not qualify as autistic under a traditional diagnosis, but slip into the broader autistic spectrum.

The question of how the autistic brain differs physically from that of neurotypicals was addressed by Manuel Casanova of the University of Louisville, in Kentucky. Dr Casanova has spent many years dissecting both. His conclusion is that the main difference is in the structure of the small columns of nerve cells that are packed together to form the cerebral cortex. The cortical columns of those on the autistic spectrum are narrower than those of neurotypicals, and their cells are organised differently.

The upshot of these differences is that the columns in an autistic brain seem to be more connected than normal with their close neighbours, and less connected with their distant ones. Though it is an interpretative stretch, that pattern of connection might reduce a person’s ability to generalise (since disparate data are less easily integrated) and increase his ability to concentrate (by drawing together similar inputs).

Rain and sunshine
Given such anatomical differences, then, what hope is there for the neurotypical who would like to be a savant? Some, possibly. There are examples of people suddenly developing extraordinary skills in painting and music in adult life as a result of brain damage caused by accidents or strokes. That, perhaps, is too high a price to pay. But Allan Snyder of the University of Sydney has been able to induce what looks like a temporary version of this phenomenon using magnetism.

Dr Snyder argues that savant skills are latent in everyone, but that access to them is inhibited in non-savants by other neurological processes. He is able to remove this inhibition using a technique called repetitive transcranial magnetic stimulation.

Applying a magnetic field to part of the brain disrupts the electrical activity of the nerve cells for a few seconds. Applying such a field repeatedly can have effects that last for an hour or so. The technique has been approved for the treatment of depression, and is being tested against several other conditions, including Parkinson’s disease and migraines. Dr Snyder, however, has found that stimulating an area called the left anterior temporal lobe improves people’s ability to draw things like animals and faces from memory. It helps them, too, with other tasks savants do famously well—proofreading, for example, and estimating the number of objects in a large group, such as a pile of match sticks. It also reduces “false” memories (savants tend to remember things literally, rather than constructing a mnemonic narrative and remembering that).

There are, however, examples of people who seem very neurotypical indeed achieving savant-like skills through sheer diligence. Probably the most famous is that of London taxi drivers, who must master the Knowledge—ie, the location of 25,000 streets, and the quickest ways between them—to qualify for a licence.

The expert here is Eleanor Maguire of University College, London, who famously showed a few years ago that the shape of the hippocampus, a part of the brain involved in long-term learning, changes in London cabbies. Dr Maguire and her team have now turned their attention to how cabbies learn the Knowledge.

The prodigious geographical knowledge of the average cabbie is, indeed, savant-like. But Dr Maguire recently found that it comes at a cost. Cabbies, on average, are worse than random control subjects and—horror—also worse than bus drivers, at memory tests such as word-pairing. Surprisingly, that is also true of their general spatial memory. Nothing comes for nothing, it seems, and genius has its price.
Savant syndrome, then, is a case where the politically correct euphemism “differently abled” has real meaning. The conclusion that should be drawn, perhaps, is not that neurotypicals should attempt to ape savants, but that savants—even those who are not geniuses—should be welcomed for what they are, and found a more honoured place in society.

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Health-care reform in America
This is going to hurt
Jun 25th 2009
From The Economist print edition
Barack Obama was elected in part to fix America’s health-care system. Now is the time for him to keep his word
DIAGNOSING what is wrong with America’s health-care system is the easy part. Even though one dollar in every six generated by the world’s richest economy is spent on health—almost twice the average for rich countries—infant mortality, life expectancy and survival-rates for heart attacks are all worse than the OECD average. Meanwhile, because health insurance is so expensive, nearly 50m Americans, an obscene number in such a rich place, have none; those that are insured pay through the nose for their cover, and often find it bankruptingly inadequate if they get seriously ill or injured.

The costs of health care hurt America in three other ways. First, since half the population (most children, the very poor, the old, public-sector workers) get their health care via the government, the burden on the taxpayer is heavier than it needs to be, and is slowly but surely eating up federal and state budgets. Second, private insurance schemes are a huge problem for employers: the cost of health insurance helped bring down GM, and many smaller firms are giving up covering employees. Third, expensive premiums depress workers’ wages.

Every rich country faces some of these problems, but nobody suffers worse from them than America. This summer’s debate about health care may determine the success of Barack Obama’s presidency. What should he do?
Uncomfortably numb
If he were starting from scratch, there would be a strong case (even to a newspaper as economically liberal as this one) for a system based mostly around publicly funded health care. But America is not starting from scratch, and none of the plans in Congress shows an appetite for such a European solution. America wants to keep a mostly private system—but one that brings in the uninsured and cuts costs. That will be painful, and require more audacity than Mr Obama has shown so far.

The uninsured are the relatively straightforward bit. All you need do is “mandate” everyone to take out health insurance, much as drivers are legally required to have car insurance. Poorer Americans would get subsidies, and (as with car insurance) insurance-providers would be forced to offer affordable plans and not exclude the sick or the old. This has already happened in Massachusetts as well as in a raft of countries, including the Netherlands, Israel and Singapore. All the main proposals now working their way through Congress include some version of a mandate. Mr Obama opposed a mandate on the campaign trail, but since he has not come up with any plausible alternative, he should quietly swallow one.

The snag is that all these subsidies are expensive. Those congressional plans might cost $1.2 trillion to $1.6 trillion over ten years: the White House is feverishly trying to massage the estimates downward, as well as working out how to plug the hole through various savings and tax increases. But the sticker-shock for the mandate is really just a reflection of the second big problem: the overall cost structure of American health care. Indeed, one of the worst things about Mr Obama’s oddly hands-off approach to health reform is that he is concentrating on a symptom, not the underlying disease.

A bolder president would start by attacking two huge distortions that make American health care more expensive than it needs to be. The first is that employer-provided health-care packages are tax-deductible. This is unfair to those without such insurance, who still have to subsidise it via their taxes. It also encourages gold-plated insurance schemes, since their full cost is not transparent. This tax break costs the government at least $250 billion a year. Mr Obama still shies away from axing it, as do the main congressional plans on offer; but it ought to go (albeit perhaps in stages).

Perversity on stilts, or crutches
The second big distortion is that most doctors in America work on a fee-for-service basis; the more pills they prescribe, or tests they order, or procedures they perform, the more money they get—even though there is abundant clinical evidence that more spending does not reliably lead to better outcomes. Private providers everywhere are vulnerable to this perverse incentive, but in America, where most health care is delivered by the private sector rather than by salaried public-sector staff, the problem is worse than anywhere else.

The trouble is that many Americans are understandably happy with all-you-can-eat health care, which allows them to see any doctor they like and get any test that they are talked into thinking they need. Forcing people into “managed” health schemes, where some species of bureaucrat decides which treatments are cost-effective, is politically toxic; it was the central tenet of Hillary Clinton’s disastrous failed reform in 1994.

But to some extent it will have to be done. There is solid evidence to suggest that by cutting back on unnecessarily expensive procedures and prescriptions, anything from 10% to 30% of health costs could be saved: a gigantic sum. The Mayo Clinic in Minnesota and the California-based Kaiser Permanente system have shown that it is possible to save money and produce better outcomes at the same time. So reform must aim to encourage more use of managed health care, provided by doctors who are salaried, or paid by results rather than for every catheter they insert. Medicare, the government-run insurance scheme for those over 65, could show the way, by making much more use of results-based schemes and encouraging more competition among its various providers and insurers.

But in the end it will be up to the private health-care system. One thing that should be unleashed immediately is antitrust: on a local level many hospitals and doctors work as price-fixing cabals. Another option, favoured by many Democrats and the president, is for the government to step in with a results-based plan of its own, to compete against the private industry. That could harm innovation and distort the market further. Mr Obama should use it as a threat, rather than implement it now. If the private sector does not meet certain cost-cutting targets in, say, five years, a public-sector plan should automatically kick in. Such a prospect would encourage hospitals and doctors to accept a painful but necessary reform now.