29.03-05.04.

2019

*
RADICALLY
PERSONALIZED
MEDICINE
IS HERE,
ABU DHABI DH35
ALBANIA €6.25
CROATIA HKR70
CYPRUS €6.50
FRANCE €6.50
GERMANY €6.50
IRELAND €6.25
ISRAEL NIS35
LUXEMBOURG €6.25
MALTA €6.50
OMAN OR 3.250
POLAND PLN28
SERBIA RSD1035
S LEONE SLL30,000
SWEDEN SKR60
SWITZERLAND CHF8.90
BUT AT WHAT
AUSTRALIA $11.00 CZECH REP CZK180 GIBRALTAR £6.05 ITALY €6.50 MONTENEGRO €8.30 PORTUGAL €6.50 SINGAPORE $11.95 UK £4.95
AUSTRIA €6.25 DENMARK DKR49.95 GREECE €6.50 KUWAIT KD3.00 MOROCCO MDH70 QATAR QR65 SLOVAKIA €6.50 US $9.99 COST?
BAHRAIN BD3.5 DUBAI DH35 HOLLAND €6.50 LATVIA €6.50 NEW ZEALAND $14.00 MALAYSIA RM27.90 SLOVENIA €8.50 ZIMBABWE ZWD4.00
BELGIUM €6.50 EGYPT E£ 65.00 HONG KONG HK80 LEBANON LL10,000 NIGERIA $3.40C ROMANIA LEI 42.00 SOUTH AFRICA R55.00
CHINA RM80 FINLAND €7.60 HUNGARY FT1,800 LITHUANIA €8.99 NORWAY NKR45 SAUDI ARABIA SR35.00 SPAIN €6.50
NEVER PEDESTRIAN
harrysoflondon.com
 INTERNATIONAL EDITION

MARCH 29 - APRIL 05, 2019 _ VOL.172 _ NO.10

FEATURES

18 30
CLEAN BILLS OF HEALTH
Newsweek partnered with Statista, a
global market-research and consumer data
company, to develop a groundbreaking
ranking of the world’s best hospitals.
The Doctor Best
Is Watching Hospitals
6 & , ( 1 & (  3 + 272  / , % 5 $ 5<ʔ* ( 7 7 <

COVER CREDIT Data-driven medicine Our panel of doctors,

Artwork by Ben Fearnley for Newsweek
is here. Can we trust
the medical system to
handle it?
For more headlines, go to
NEWSWEEK.COM BY DAVID H. FREEDMAN
medical professionals and
administrators picks winners
across four continents.
BY NOAH MILLER

1
 */2%$/(',725,1&+,() _ Nancy Cooper

CREATIVE DIRECTOR _ Michael Goesele

INTERNATIONAL EDITION
EXECUTIVE EDITOR _ Mary Kaye Schilling
MARCH 29 - APRIL 05, 2019
VOL.172 _ NO.10 '(387<(',725ʤ86ʥ _ Michael Mishak

'(387<(',725ʤ(8523(˥23,1,21ʥ_ Laura Davis

SPECIAL PROJECTS EDITOR Fred Guterl

EDITORIAL

Breaking News Editor _ Juliana Pignataro

DEPARTMENTS
S ondon Bureau Chief _ Robert Galster
Lo
Poolitics Editor _ Jason Le Miere
*DPLQJ (GLWRU _ Mo Mozuch
ntertainment Editor _ Maria Vultaggio
En
In Focus News Editor _ Jon Haworth
06 Nikola-Lenive
08 Skyros, Greece
THE TARIFF GUY?
Donald Trump (with
President Xi Jinping) is
being advised to hold
out for a better deal
with China. But the
politics of 2020 might
push him to the table.

Deputy Editors _ Jen Glennon*DPLQJ
Asssociate Editors _ James Etherington-Smith,
ets, Hannah Osborne (Science), Dom Passantino,
Harriet Sinclair (Politics)
Russia ondon Sub-Editor _ Hannah Partos
Lo
So Long, Wintter Copy Chief _ Elizabeth Rhodes Ernst
Senior Copy Editors _ %UXFH-DQLFNH-RH:HVWHUɿHOG
e Copy Editors _ Marlaine Glicksman, Karin Halperin,
Catherine Lowe
Party Animalss Contributing Editor, Opinion _ Lee Habeeb
ditorial Assistant _ Jason Pollack
Ed
Montasik, Ind
donesia
In the Weed C REATIVE
Director of Photography _ Diane Rice
Caracas, Venezzuela Contributing Art Director _ Michael Bessire
Troubled Waters Senior Designer _ Paul Naughton
P. 48 Asssistant Photo Editor _ Alessandra Amodio
Contributing Production Director _ Melissa Jewsbury
Digital Imaging Specialist _ Katy Lyness
Art Assistant _ Annie Kozak
A
WRITERS
'DYLG%UHQQDQ1LQDb%XUOHLJK'DQ&DQFLDQ
Periscope Brendan Cole, Shane Croucher, Chantal Da Silva,
6DP(DUOH%HQMDPLQ)HDUQRZ.DVKPLUD*DQGHU
$UL*HRUJLRX1LQD*RGOHZVNL1LFROHb*RRGNLQG
10 Trade Katherine Hignett, Dory Jackson, Jessica Kwong,
-DPHV/D3RUWD7LPb0DUFLQ&ULVWLQDb0D]D$QQD0HQWD
The Conflicting 7RPb2Š&RQQRU(ZDQ3DOPHU&DOOXP3DWRQ0DULDb3HUH]
Pressures of a 7RPb3RUWHU%LOOb3RZHOO1LFROH5RMDV5REHUWRb6DYLDQR
'DYLG6LP-HIIb6WHLQ0DUF9DUJDV-DQLFHb:LOOLDPV
Deal With China Christina Zhao (*Contributing)
14 Opinion VIDEO
Howard Schultz’s Video Production Manager _ Jessica Durham
Phony Populism London Video News Editor _ Daniel Orton
Bangalore Video News Editor _ Nandini Krishnamoorthy
Senior Video Producers _
Alexandra Rosenmann, Sho Murakoshi
Culture Video Producers - Sean Billings, Chiara Brambilla,
)520723,//8675$7,21%<%5,7 763(1&(51,&2/$6$6)285,ʔ$)3ʔ*(7 7 <
Rufaro Ndoro, Frances Rankin, N. Ravichandran,
Holly Snelling, Alexis Wierenga
42 Theater 0RWLRQ*UDSKLFV3URGXFHUVBGogoull Kirouchenaradjou,
Justin Maiure, Simon Vella
A Gender-Bending
King Lear PUBLISHED BY
Newsweek LLC
46 Music
&KLHI([HFXWLYH2IɿFHU _ Dev Pragad
Chinese Hip-Hop &KLHI&RQWHQW2IɿFHU _ Dayan Candappa
&KLHI2SHUDWLQJ2IɿFHU _ Alvaro Palacios
Collective the &KLHI)LQDQFLDO2IɿFHU _ Amit Shah
Higher Brothers &KLHI7HFKQRORJ\2IɿFHU _ Michael Lukac
*HQHUDO&RXQVHO _ Rosie Mckimmie
48 Parting Shot VP, HR Business Partner _ Leiann Kaytmaz
693*OREDO&UHDWLYH'LUHFWRU _ Robert Lee
Julianne Moore Director, Content Strategy _ Nalin Kaul
Senior Digital Marketing Strategist _ Adam Silvers
Managing Editor, Branded + Native Content _ Paula Froelich
Editor, Branded + Native Content _ Dan Avery
*OREDO([HFXWLYH3URGXFHU _ Alfred Joyner
NEWSWEEK,661ʻʸʾʻʺʸˁʺLVSXEOLVKHGZHHNO\H[FHSWRQHZHHNLQ-DQXDU\)HEUXDU\0DUFK$SULO0D\ *OREDO+HDGRI3URJUDPPDWLF3DUWQHUVKLSV _ Jeremy Makin
June, July, August, September, October, November and December due to combined issues. SVP, Product + Business Intelligence _ Luciano Costa
1HZVZHHN,QWHUQDWLRQDOLVSXEOLVKHGE\1HZVZHHN0DJD]LQH//&ʻʾ&DQDGD6TXDUH&DQDU\:KDUI
VP, Programmatic Sales _ David McClain
/RQGRQ(ʺʽʾ/48.3ULQWHGE\4XDG*UDSKLFV(XURSH6S]RR:\V]NRZ3RODQG
Senior Sales Director _ Chantal Mamboury
For Article Reprints, Permissions and Licensing www.NewsweekReprints.com
Head of Subscription Operations _ Samantha Rhodes
Newsstand Manager _ Kim Sermon

2 NEWSWEEK.COM
 Tinalbarka wants to be a lawyer.
She and her family fled violence in Mali.

We stand together
#WithRefugees
PHOTO: © UNHCR / A . DRAGA J

www.refugeeday.org
Rewind

TheArchives
After 39 days of “crackling…maudlin...and bewildering testimony, the
1976 most sensational trial of the television era” was over. In February 1974,
Patty Hearst, 19, granddaughter of media mogul William Randolph Hearst, had
been kidnapped by the Symbionese Liberation Army. That April, she was caught
on tape participating in a bank robbery. Her defense argued coercion and duress;
the jury disagreed, finding her guilty on all counts. Her sentence of 35 years put to
rest any notion that “her famous name and odd crime” could help her in court. In
the end, President Jimmy Carter commuted her sentence after 22 months served.

1964
As sexual attitudes softened, a “disquieting
revolution” began to take shape on college
campuses, Newsweek reported. Where
mothers once wondered what to tell their
daughters about sex, “Today they ask, ‘Is
there anything left to tell her?’” These “girls”
were “supposed to be as [sexually] free
as boys,” but “boys now expect far more.”

&/2 &.:,6()520/()7$39<7$69$/$,7,63,(7523(58*,12ʔ5$%$7 7 , ' 20 , 1* ,( ʔ$.*

2005
In revisiting how the “failed prophet
came to be viewed by billions as the only
begotten son of God,” Jon Meacham,
Newsweek’s editor-in-chief, reminded
readers of reformed Christianity’s
emphasis on “equality and freedom.” It was
a good message in a culturally divided
America: “Faith, like history, is nearly
always more complicated than it seems.”

4 NEWSWEEK.COM A PR I L 05, 2019

 HELPING
N YOU NAVIGATE A R APIDLY CHANGING
N W ORLD

↓ ↓ ↓ ↓
Award-winning Download issues National and global Expert analysis beyond
journalists and and read offline coverage on the the headlines on a
photographers on any device issues that matter wide range of topics

++ ++ +
g Newsweek since 1965.
“I’ve been reading
It is the source of much of my world knowledge.
I find myself quoting it about once a week.”

EASY WAYS
TO SUBSCRIBE
Go to Newsweek.com/try or complete and return this form.

→ Select One: Deliver to:

□ 1 Year for €139

NAME

(€2.67 PER WEEK) 46% SAVINGS ADDRESS

□ 2 Years for €219

(€2.11 PER WEEK) 57% SAVINGS CITY REGION/STATE

BEST
POSTAL CODE COUNTRY
OFFER!
RETURN TO:
R □ Visa □ Mastercard □ Amex
NEWSWEEK CARD NO.
SUBSCRIPTIONS
DEPARTMENT EXP. CCV CODE
24th Floor
25 Canada Square NAME ON CARD
London, E14 5LQ
SIGNATURE

To receive an email confirmation and other information, please provide your email address:
* Percentage savings calculated as a saving
on our cover price, as found on the cover of
EMAIL
Newsweek. The weekly price is an indication
of what you will pay per issue, we will charge
you the full price for the term you select. □ Payment enclosed (cheques made payable to NW Publishing UK Ltd)
In Focus THE NEWS IN PICTURES

6 NE K.COM A pr i l 05, 2019

 NIKOLA-LENIVETS, RUSSIA

Paris Is
Burning
A fortress built of wooden pallets is set
ablaze during a celebration for Maslenitsa
on March 9. The Eastern Slavic folk
holiday—a farewell to winter—takes place
the week before the start of Russian
Orthodox Lent and involves the burning
of a large effigy (this one representing
the Bastille, a symbol of the French
Revolution). The abandoned village
of Nikola-Lenivets, about 140 miles
southwest of Moscow, is now an art park.
→ M L A D E N A N T O N OV
M L A D EN AN TO NOV/A FP/GE T T Y
8
In Focus

NEWSWEEK.COM
A pr i l 05, 2019
C LO CK WI SE F ROM B OT TOM L E FT: C H A I D E E R M A H Y UD D I N /A F P/G E T T Y;
A N GE LOS TZO RT Z I NI S /AFP/GE T T Y; FE D E R I C O PA R R A /A F P/G E T T Y
 SKYROS, GREECE
Party Animals
Men wearing goatskin masks,
hairy jackets and dozens of
copper bells take part in a
pre-Lenten festival, the Skyrian
Carnival, on March 9. The
costume signifies the “Old
Man”—a character who dances,
clangs and sometimes brawls
through town—accompanied by
a male partner dressed as a bride.
→ ANGELOS TZORTZINIS
MONTASIK, INDONESIA CARACAS, VENEZUELA
In the Weed Troubled Waters
A drone captures an In a city where blackouts have left
image of a man carrying millions without running water, a
marijuana plants during man bathes in a stream at Waraira
a police raid in Montasik, Repano mountain on March
Indonesia, on March 14. 13. The power crisis shut down
The province of Aceh, pumping stations, forcing desperate
a conservative Islamic citizens to seek relief elsewhere—
region in northern from water trucks (distribution is
Sumatra, has long been controlled by the military), public
a center for cannabis. fountains and filthy rivers.
→ CHAIDEER MAHYUDDIN → FEDERICO PARRA
NEWSWEEK.COM 9
Periscope NEWS, OPINION + ANALYSIS

SETTING THE TABLE

A meeting between Xi
and Trump is lined up
for the end of March.
The plan: Reach an
overarching trade deal
between China and the
U.S. The hope: Trump
stays competitive in
states he won in 2016.
 “Fizzling as fast as the
e ill-
fated Maple Macchiato.” » P.14

TRADE

Shut Up
and Deal
The White House trade representative says Trump
can get a better agreement with China. But the politics
of 2020 are pulling the president to the table

for donald trump, the politics of trade
always seemed straightforward.
Ripping pretty much any other country with
which the U.S. runs a trade deficit—and China,
trade villain No. 1, in particular—was a way to win
72 3  5 , * + 7  0 , . (  3 2 1 7ʔ : , 5 ( , 0 $* ( ʔ* ( 7 7 <
imposition of tariffs on major U.S. trading partners
would give him precious “leverage” in the negotia-
tions that would follow. And to Trump, leverage is
the coin of the realm. “I’m a tariff guy,” he would
say to journalists and anyone else who would ask, in

hearts and minds of voters throughout the indus- part because he believes they give him bargaining
trial Midwest in 2016. When it turned out that power. “I’m using [them] to negotiate,” he told The
those voters, in states such as Wisconsin, Michigan Wall Street Journal last year.
and Pennsylvania, would unexpectedly give him the But the president didn’t impose tariffs on just
presidency, Trump’s instincts—his gut—were rat- China; he slapped levies on traditional U.S. allies
ified. “I won,” he once told his friend Tom Barrack, such as Canada, Japan, South Korea and the Euro-
a prominent investor and Trump campaign fund- pean Union. Unsurprisingly, this freaked out pretty
raiser, “because of trade.” much anyone with a 401(k). While the investor class
What Trump didn’t understand that night, (a traditional GOP constituency) loved Trump’s
according to friends, associates and economic policies of tax cuts and
people who work for him today in his deregulation—so much so that they
administration, was how complicat- BY
drove up stock prices pretty much
ed the issue of trade is. As a business- from election night onward—they
man and self-described deal-maker BILL POWELL hated trade conflict. As an analysis by
of unparalleled excellence, he felt the @billasia2010 economic advisory firm IHS Markit

Illustration by A L E X F I N E NEWSWEEK.COM 11
Periscope
showed, the markets reacted badly
whenever trade war headlines were
prominent, bouncing back whenever
it seemed like resolution was at hand.
Thus was born the central eco-
nomic policy debate of the Trump
era, one that rages to this moment
in the White House: Trump may be
a self-professed “tariff guy,” but he
also loves Wall Street, reveling in the
fact that the Dow Jones Industrial
Average hit record highs during his
presidency. Advisers say he has been
“relieved and delighted,” in the words
of Larry Kudlow, head of Trump’s
National Economic Council, that
the stock market has recovered in
the first quarter of this year after last
December’s sudden, sharp swoon,
as global recession fears intensified.
“What he has discovered,” says one
senior economic adviser who spoke
on condition of anonymity to discuss
the president’s thinking, “is that it’s
very hard to have both a trade war
and rising stock prices.”
Trump’s moment of choosing is
at hand. For much of this year, Wall
Street came to believe—based most-
ly on signals from Trump’s econom-
ic advisers—that a deal with China
on trade was imminent. Indeed,
after a recent round of talks with
their counterparts from Beijing,
White House officials said a meeting
between Trump and Chinese Pres-
ident Xi Jinping would occur at the
end of March, at which an overarch-
ing deal would be signed.
The substance of that deal, howev-
er, is very much in debate, as Trump’s
administration remains divided on
trade. Though the White House pub-
licly goes to great lengths to deny
any internal strife—most recently,
Kudlow went on Fox News Sunday
to insist that economic advisers
were all of one mind—it’s not that
simple. Kudlow, like his predecessor,
12 NEWSWEEK.COM
TRADE
former Goldman Sachs Chief Oper-
ating Officer Gary Cohn, is a relative
dove on trade, pushing for an agree-
ment with China sooner rather than
later, arguing to Trump that the stock
market—and the economy more
broadly—would react positively once
the trade issue was in the rearview
mirror. He’s joined in that assessment
by Treasury Secretary Steve Mnuchin
and Council of Economic Advisers
chief Kevin Hassett.
But Trump’s main adviser on this
issue, U.S. Trade Representative Rob-
ert Lighthizer, is urging the president
to be patient, believing the U.S. can
get a better, more comprehensive deal
with Beijing than the one currently
Lighthizer has
detailed what one
White House source
calls a “holistic”
trade case against
China’s mercantilism.
TRICKS OF THE TRADE Trump’s main
“hang tough and we’ll get a better deal.”
on the table. In the most recent
round of talks, sources on both sides
say China offered the U.S. a reduction
of tariffs on a broad range of imports,
including automobiles, and pledged
to buy significantly more American
agricultural products and energy, as
well as a commitment to import a
massive amount of liquefied natu-
ral gas. That would ostensibly bring
down the huge bilateral trade deficit
with China and enable Trump to say
during his 2020 re-election cam-
paign that he delivered on his prom-
ise to get tough with Beijing.
In an Oval Office meeting with
Trump in the first week of March,
Lighthizer, according to multiple
sources, said that deal didn’t go far
enough. Unlike any of his predeces-
sors in the trade rep job, he has de-
tailed what one White House source
calls a “holistic” trade case against
China’s mercantilism: theft of intel-
C LO CK W I SE F RO M L E FT: M A ND E L N G AN /AFP/G ET T Y; ST R /A F P/GE T T Y; W I N M CN AM E E /G ET T Y; A L EX WONG /GET T Y
lectual property, subsidies to state-
owned companies in key industries
and requirements that foreign mul-
tinationals form joint ventures with
domestic firms and share technology
with them, as well as a variety of oth-
er traditional barriers, including tar-
iffs. His influence with the president,
says a friend of both men, is rooted
in two things: Trump’s own get-tough
instincts on trade, and the president’s
belief that his trade rep is right “on
most, if not all, of this stuff ”—some-
thing much of Washington’s econom-
ic establishment has come to believe.
Lighthizer has further argued that
time is on Trump’s side. While the U.S.
economy remains relatively robust,
China’s is flagging, according to a
slew of recent data—an intensifying
adviser on a deal with China is Lighthizer,
whose attitude, one official says, is
A pr I L 05, 2019

hangover after years of debt-fueled
growth. His message to Trump is
clear: Xi, under political pressure at
home (economic growth being the
main source of the Chinese Commu-
nist Party’s legitimacy), needs a deal
more than you do. “Hang tough, and
we’ll get a better deal” is how one offi-
cial describes it. Trump, for now, has
bought Lighthizer’s reasoning. He has
not yet committed to a deal, which is
a prerequisite for the Chinese to sign
off on a Xi visit to Mar-a-Lago.
But, as the 2020 campaign gets
underway, politics is very much on
Trump’s mind as well. He wants a
SPIN MACHINES
Top: Trucks being
loaded for export
in China, where the
economy has slowed.
Bottom, from left:
Kudlow and Miller,
who are both pushing
for a deal sooner
rather than later.
campaign based on two overarch-
ing themes: widespread prosperity
and living up to the core campaign
promises he made in 2016. His key
markers on the economy are the low
unemployment rate and rising stock
prices. “He checks what’s happening
in the stock market several times a day,
almost every day,” says a friend. “He
sees it as a daily ratification of his [eco-
nomic policies] when it’s going up.”
The comfort Trump takes from
rising stock prices could be fleeting
between now and the next election,
though. Not only do markets always
fluctuate, but they depend on rising
earnings growth from corporate
America, which requires a strong mac-
roeconomic environment. Most econ-
omists expect a downshift in gross do-
mestic product growth this year, as the
stimulative effects of Trump’s tax cut
wear off, which could make it difficult
for a sustained stock market rally.
His other obsession—the overall
trade deficit—is also misplaced, as
the most recent trade data demon-
strated. Last year, the U.S. racked up
its largest trade deficit ever, showing
that macroeconomic conditions usu-
ally swamp specific trade policies. That
the domestic economy was growing
strongly in 2018, while major trading
partners—China and Europe in par-
ticular—were slowing sharply, meant
the U.S. bought more from them while
their demand for our exports softened.
Still, Trump’s political aides know
he would like a rising stock market
straight through 2020. They also
know that the biggest risk to that
would be ongoing trade conflict with
Beijing. Key advisers in the White
House, including Stephen Miller,
senior adviser for policy, are pushing
Trump to accept the deal that’s more
or less on the table now: increased
agricultural and energy exports,
which would help Trump secure his
red state base (farmers, in particular,
have been restive about his trade poli-
cies), and lower Chinese tariffs on au-
tos and other industrial goods, which
would help him to be competitive in
the states he shocked the world by
winning in 2016: Wisconsin, Michi-
gan and Pennsylvania. Approval rat-
ings in those states have since sagged.
Trade hawk Lighthizer may have
brought a compelling, lawyerly case
against China’s multiple trade abuses,
but the only jury Trump cares about is
the electorate. And that means, sooner
or later, he’ll do a deal with Beijing and
declare victory—warranted or not.
NEWSWEEK.COM 13
Perisco
GrandeEgo
Forget pinstripe populist Howard Schultz.
Industrialist Henry Kaiser was the real deal
Howard ScHultz and HiS
potential presidential cam-
paign are fizzling as fast as the ill-
fated Maple Macchiato.
With widespread ridicule of his
rollout and favorability ratings in
the low single digits, the former
Starbucks chairman, like the failed
coffeehouse concoction, is chock-
full of conflicting ingredients.
First, Schultz is offering one of
the oldest propositions in politics:
A superstar CEO will “run America
like a business.” That pitch propelled
Donald Trump and offered rationales
for other business leaders who have
14 NEWSWEEK.COM
OPINION
sought the presidency, including Ross
Perot, Carly Fiorina and Herman Cain.
Second, Schultz presents himself
as a kinder, gentler capitalist who
treats his baristas as partners, not
proletarians, provides health care
and promotes social concerns such
as conversations about race.
However, he’s running not as a
longtime liberal Democrat but as
a “centrist indepen-
dent.” Schultz opposes
Medicare for all, higher BY
taxes on the super-rich,
a $15-an-hour mini- DAVID KUSNET
mum wage and union @DavidKusnet
organizing at Starbucks as vehemently
as he speaks out against Trump’s bor-
der wall. (“I don’t think the American
people want to embrace an economic
environment in which socialism is
going to rule the day,” he told a Texas
crowd in early March.)
Typifying his self-contradictory
campaign, he claims Franklin D.
Roosevelt as his favorite president
while criticizing two cornerstones
of the New Deal—activist govern-
ment funded by progressive taxa-
tion and strong unions that even the
odds between billionaire bosses and
frontline workers.
A gifted marketer, Schultz must
be getting the message that, as
his fellow billionaire Michael
Bloomberg recently acknowledged,
there’s no mass constituency for
his “socially liberal but fiscally con-
servative” brew. And it’s too late to
rebrand his candidacy.
But, as a corporate statesman,
Schultz should consider and learn
from another iconic business leader
from the Pacific Northwest, who was
on FDR’s shortlist for his successor
and addressed Schultz’s concerns,
including infrastructure, health care
and middle-class jobs: Henry J. Kaiser.
Known as FDR’s favorite business-
man, Kaiser built his companies by
meeting national needs. He founded
a construction company in Spokane
that worked on state road and bridge
projects throughout the region. Com-
pleting the work quickly and inex-
pensively, Kaiser won contracts for
major federal projects, including the
Bonneville and Grand Coulee dams
in Washington state and Oregon.
To meet deadlines within budgets,
Kaiser drove workers to the breaking
point. While building the Hoover
Dam in 1931, 14 men died from heat
exhaustion in one day, prompting
1,400 workers to strike.
A pr i l 05, 2019
 Serving social needs
and treating workers
Deal’s socio-economic goals, Kaiser
was FDR’s favorite. But after sound-
when they or their parents had met
“Henry J.” (Kaiser Aluminum is now
ings showed voters thought Kaiser under new management that works

fairly is the right way was either German or Jewish, FDR

to build business.
That caused a transformation of
his attitudes: Kaiser raised workers’
pay, improved safety and recognized
unions. This was good business as
his companies expanded beyond
construction to industries requir-
ing stable workforces. And, often
with support from politically influ-
ential unions, he won more con-
tracts from the pro-labor Roosevelt
administration.
During World War II, FDR turned
to Kaiser to equip the nation for
the fight against fascism. Beginning
in 1940, Kaiser started up seven
shipyards in California, Washing-
ton and Oregon, employing about
F RO M L EF T: M I C H A E L S. WI L L I AM S ON / T H E WASH I NGTO N P O ST/G E T T Y; BE T T M A NN ARC H I VE /G ET T Y
opted for a safer choice: Missouri
Senator Harry Truman, who would
succeed FDR.
Until his death in 1967, Kaiser
continued to pursue innovative
ways to humanize workplaces. For
instance, Kaiser Aluminum plants
in Washington state offered some-
thing unheard-of—then or now:
sabbaticals for blue-collar workers.
Every five years, workers could take
10 weeks off at 13 weeks’ pay. When I
spoke with Kaiser workers from these
plants who had clashed with a newer,
crueler management in the late 1990s,
they spoke reverently about the times
collaboratively with the union, fulfill-
ing its founder’s legacy.)
Now, it’s time for corporate and
political leaders to “meet” Kaiser.
Today’s America should relearn the
lesson of his legacy: Serving social
needs and treating workers fairly is
the right way to build business.
→ David Kusnet was chief speech-
writer for then-President Bill Clin-
ton from 1992 through 1994. He is
the author of Love the Work, Hate
the Job: Why America’s Best Work-
ers Are More Unhappy than Ever
(Wiley, 2008), a study of workplace
conflicts in the Seattle area.

200,000 workers, including African-

Americans and women, and build-
ing a third of the nation’s new ships
for the Navy and Merchant Marine.
Wanting a healthy, committed work-
force, Kaiser developed prepaid
medical care (the forerunner of the
Kaiser-Permanente health main-
tenance organization) and onsite
child care with nurses and teachers
(a model for preschool programs).
By 1944, an ailing FDR wanted to
replace his left-leaning vice president,
Henry Wallace. Having attained a
celebrity that Schultz would envy,
as well as having furthered the New

THIS IS HOW YOU DO IT

Schultz, opposite, could learn a lot
from Kaiser, right, FDR’s favorite
businessman, who pursued innovative
ways to humanize workplaces.

NEWSWEEK.COM 15
Shedding the Light on “Japan’s Monozukuri”
It is not the strongest of the
companies that survives,
nor the most intelligent, but
the one most responsive
to change.
Do you know what word the ancient
Greeks employed before “literature”
was ever written in a dictionary?
The answer is “Techne,” meaning
“to produce by letting appear.” As
such, fables like Homer’s Iliad and
Odyssey ‘produced’ strong cultural
and social realities which allow to-
day’s Liberal Arts practitioners a
peek in the Hellenics’ culture. To
classify emerging genres of techne,
“poiesis” (or to make) was added
to the vocabulary but its definition
remained closely intertwined with
that of its predecessor. In Plato’s
dialogue ‘Phaedrus,’ poiesis is de-
fined as that which “shines bright…
and resplends.”
And that is how, more than 2300
years ago, the cultural junction be-
tween literature and light, truth and
visibility, understanding and perceiv-
ing, was born.
During the centuries that fol-
lowed, light became a cultural sym-
bol for goodness, beauty and life.
In religious writings, God used it
to abolish darkness and create our
world: “God said ‘let there be light,’
and there was light.” (Genesis 1:3).
Millenniums later, Shakespeare’s
Romeo uses light to depict the emo-
tion he feels as he discovers the
grave of his only love, Juliet. “A
grave? O, no, a lantern, slaughtered
youth, For here lies Juliet, and her
beauty makes This vaults a feasting
presence full of light.”
From churches to theaters, light
has carried cultural, social and bio-
logical assumptions that mold our
understanding of the world. More
than a mere source of visibility, il-
lumination has been proven to have
a direct effect on our emotions.
Unsurprisingly so, light has grown
into a central theme in the fields of
architecture, design, photography
and more importantly, liberal arts.
In his academic keynote speech
presentation at the University of
California, Berkeley, in November
2018, Mr. Goro Terumichi discussed
the historical relationship between
natural lighting and the architec-
ture of Kyoto’s temples and shrines.
“Just as each person has his or her
own background, each city has its
own unique culture and history.
Light in the city environments is
associated with various important
aspects of such background to
which there is no generally cor-
rect or absolute answer.”
Mr. Goro Terumichi, group C.E.O.
of Modulex Inc., a global corporate
group specialized in providing profes-
sional technical lighting solutions,
has taken on the ambitious mission
to transform mere light into ‘light-
ing,’ therefore bringing a cultural
and social impact that enriches so-
ciety. “While visibility has an obvi-
ous function, light can be a media
through which people find their own
enjoyment. Like the sound becoming
music, light has the capability to
intensively inspire human emotion in Photo Takashi Shigemoto
order to enhance our life,” he states.
Similar to the relationship be- “While visibility has an
tween culture and light, the group obvious function, light can
C.E.O. of the Tokyo-based profes- be a media through which
sional lighting company believes that
Japanese “Monozukuri,” or the art people find their own
of “making things,” is solely derived enjoyment. Like the sound
from the country’s historical, social becoming music, light has
and cultural background. “Developed the capability to intensively
in the post-war Japan through trial inspire human emotion in
and error, Japan’s ‘Monozukuri’ was
born from a fundamental awareness order to enhance our life.”
which saw people voluntarily come
up with their own development and Mr. Goro Terumichi,
production methods. ‘Monozukuri’ Group CEO of ModuleX Inc.
was strongly influenced by the “his-
torical background” and “economic
background” (the “Backdrop”) of
the country.”
During Japan’s economic reces-
sion, or the so-called “lost decades,”
which denominate the years of stag-
nation between 1991 and 2010, large
Japanese corporations (for instance,
in the electronic field) began losing
market share to competitors from
neighboring countries. Today, many
experts argue that the success of
emerging countries’ manufacturers
was due to their ability to “copy”
traditional Japanese ‘Monozukuri.’
However, Mr. Terumichi advocates
that ’Monozukuri’ exists only in the
context of the ‘Backdrop’ that have
constantly inspired the appropriate
production concepts. Since differ-
ent countries have developed with
their own ‘Backdrop’ and in pursuit
of their own respective objectives,
the interpretation of Mr. Terumichi
claims that Japan’s “Monozukuri”
and those of its neighboring coun-
tries cannot be compared as they are
the result of different stages and eras
of development. “Herein lies a major
misunderstanding,” he adds.
As certain large corporations
from Japan have yet to recover
from their economic downfall,
many manufacturers have aggres-
sively relocated their factories to
countries with lower labor cost.
“To recover from the burst of the
bubble economy, many Japanese
corporations over-prioritized
profit margins through cost re-
ductions without reviewing the
importance of manufacturing do-
mestically,” he advances.
In the field of Development Eco-
nomics, the “first-mover’s advan-
tage” states that the firsts to enter
a market have opportunities to grab
a technological and pricing lead. By
exporting their production facilities
overseas, manufacturers without
their country’s unique character-
istics could consequently lose this
competitive edge. In “The Origin of
Species,” Charles Robert Darwin ad-
vocates that “it is not the strongest
of the species that survives, nor the
most intelligent, but the one most
responsive to change.” Instead of
over-prioritizing on easy profit mar-
gin, Mr. Terumichi insists that Japa-
nese manufacturers must primarily
reconsider their country’s Backdrop
to deliver next-generational value. “I
believe that a ‘Monozukuri’ which
expresses the characteristics of Ja-
pan’s next-generation affluences,
with the matured culture of a de-
veloped country, has an essentially
significant opportunity to demon-
strate the Japanese approach to
the global market, and will create
a new horizon that gives Japan
the first-mover’s advantage,” he
says. With this in mind, Mr. Teru-
michi mentions that the “Made by
Japan” must leverage on its three
core advantages: superior Japanese
aesthetics backed by the country’s
unique Backdrop; integration of
technologies supported by the ma-
tured culture; and fields employing
big data utilization.
The philosophy of Mr. Terumichi
is present in ModuleX’s unique
approach to its market of predi-
lection. With the recent rise of
LEDs, certain lighting devices have
transformed into simple “semicon-
ductor items”. In a market which
has steadily grown emotionless,
ModuleX has made it its mission
to stimulate human emotions.
“Our lighting solutions are care-
fully planned by understanding the
significance and background of the
various buildings, places and cities
we serve,” he explains.
To deliver natural human emo-
tions, the Tokyo-based company has
developed a proprietary environ-
ment-adapting technology known
as “ModuleX Controls.” ModuleX
Controls is a combination of hard-
ware devices, environmental design
and advanced controlling technol-
ogy that comprehensively adapts
lighting to blend in with a given
environment. Through its unique
hardware technology and design
technique, the company is able to
reproduce natural lighting effects.
“ModuleX is not only a manufac-
turer that produces and sells light-
ing devices; it is also a company that From Tokyo’s highest branded cent, ModuleX has shortened the
provides a variety of added values hotel bars to corporate offices, communication gap between its
that enhance the impact of lighting residences and luxurious fashion divisions and can incorporate its
on human emotion.” stores, the prestige of ModuleX’s client’s demands from the early
By virtues of its advanced en- client base is only matched by its stages of development.
gineering expertise, the lighting diversity. To cater for such a dis- To preserve its integrated man-
fixtures of ModuleX enjoy a high parate audience, the company has agement method, the company has
degree of modularity, which have combined its engineering modular- maintained its production facilities
been multi-awarded from the world. ity with a unique organizational in Japan, largely disregarding the
As the head of lighting design, hard- structure where design, production strategy to secure higher profit mar-
ware engineering and group man- and after-sales are closely related. gins through factory relocation. “We
agement, Mr. Terumichi’s creations “We are strategically adopting a have been focusing on the challenge
are composed of interchangeable management method that is dif- of creating added-values through
components that allow its products ficult to achieve for larger compa- which we can receive distinctive
to adjust to various demands simul- nies; realizing completely different appreciation from the market. We
taneously. By producing a process types of design-ins in both devel- call our brand ‘ModuleX made in
of selection in which customers opment and production within a Tokyo’ to symbolize this concept.”
choose non-interchangeable solu- single proposal, as well as added And perhaps, also to symbolize the
tions, ModuleX offers its clients value.” By keeping both design and journey ‘Monozukuri’ must take to
tailor-made solutions. production geographically adja- rediscover its light.
ADVERTISING SECTION
 Some physicians believe they can
dramatically improve health care
for heart disease,diabetes and other
chronic diseases — if patients agree
to be PRODDED, POKED and SPIED ON

► by DAVID H. FREEDMAN ► Photograph by C.J. BURTON

18 NEWSWEEK.COM A PR I L 05, 2019

 ndres rubiano first got the news that his blood pressure was
too high in the 1990s, when he was in his late 30s. It didn’t come as
a complete surprise—his father had had chronic hypertension at an
early age too. His doctor prescribed medication and encouraged him
to get more exercise and cut down on the amount of salt in his diet.
Rubiano, though, wasn’t very diligent about following this regimen. Each time he re-
turned for a checkup, doctors gave him the same advice and Rubiano disregarded it.
Four years ago, something caused Rubiano to turn himself around. His doctor
convinced him to enroll in a pilot project in digital health care. Once a day, Rubia-
no slipped on an automatic cuff that wirelessly sent blood pressure readings to
his smartphone, which in turn relayed the data to a team of clinicians at Ochsner
Health System, an academic medical center based in New Orleans. His Apple Watch
relayed heart-rate and physical-activity readings. Soon, Rubiano was getting text
messages reminding him to take his pills and emails suggesting ways to cut down on
salt and boost physical activity. Each month, his doctor’s office called to discuss his
readings, tweak his medication dosage and examine new diet and exercise strategies.
The digital prodding paid off. Rubiano now takes his pills, goes to the gym
three times a week and eats less salt. “I don’t even like the taste of it anymore,” he
says. His blood pressure dropped from 150 over 100 to a reasonable 130 over 78.
Rubiano is an early beneficiary of a new data-driven approach to health care that
is starting to take hold in the medical industry. As the fate of the Affordable Care Act
plays out in the courts and politicians and patients wring their hands over the ris-
20 NEWSWEEK.COM
ing cost of drugs and treatments, a growing army of
researchers, practitioners, entrepreneurs and execu-
tives think tech could be a simpler way to fix much of
what ails the U.S. health care system. Essentially, they
F RO M TOP : FS P ROD UCT I O N S/G ET T Y; PE O PL E I M AGE S/G E T T Y; L I S A WE R NE R /G ET T Y
want to do for medicine what Facebook and Google
did for social media and internet search. By gathering
real-time data on patients and using it to prod, poke
and persuade them to do the right thing, they believe
that doctors could improve outcomes dramatically
for patients with a broad range of chronic diseases
and conditions, including heart disease, cancer, diabe-
tes and Alzheimer’s. “We can’t just fix chronic disease;
you’ll have it until you die,” says Richard Milani, a car-
diologist who serves as chief clinical transformation
officer at Ochsner. “We need to surveille you closely
and catch you when you’re heading out of bounds.”
WIRED A digital health industry has spent billions on
developing new tools and projects in recent years. To
improve patient care, they are trying to create an
ecosystem of apps and devices that link hospitals, above,
and doctors’ offices to data from portable devices like the
Fitbit, right, and insulin injectors, top right, for diabetics.
A PR I L 05, 2019
 HEALTH

There are, however, clear risks. If you think Face- doctor sets it and you go home. That mode works poorly in early detection and
book and Google invaded your privacy, imagine treatment, which is what’s needed to keep a patient with heart disease or diabetes
what hackers could do with a minute-to-minute log from slipping into a medical crisis. The Centers for Disease Control and Prevention
of your disease symptoms, behaviors, locations and reports that 60 percent of the U.S. population has a chronic disease and that 40
even your appearance and conversations. The key to percent has at least two. Heart disease, diabetes, cancer, Alzheimer’s and stroke
digital medicine is, after all, the gathering and shar- together account for almost three-quarters of all deaths in the U.S. and 86 percent
ing of copious data about nearly every aspect of a of health care costs. Chronic disease is “the leading health burden on Americans,”
patient’s life. Are hospitals, researchers, Big Pharma, says Milani. “And it’s where the digital piece can make its greatest contribution.”
insurers and tech companies worthy stewards of Digital medicine is a key tool in a broader trend toward “value-based” care,
such sensitive data? “If a system can detect signs of in which health providers are compensated not for each procedure they per-
cognitive decline in patients’ voices, they don’t want form, which drives up costs, but for keeping a population healthy. That puts
it being used against them in job situations or health the emphasis on prevention, which is exactly what digital medicine is suited
insurance,” says Christine Lemke, co-founder of Evi- to. A whole new field of data-driven medical research has arisen to explore the
dation, a health data company.
If experts can figure out a way to lock
down privacy, digital medicine could pay CHRONIC DISEASE is “the leading
off big time. Its biggest impact is likely to
be in chronic care. At present, U.S. health health burden on Americans.
care is designed for crisis-oriented trans-
actional care—you break your arm, the And it’s where the digital piece
can make its greatest contribution.”

links between health and genes, the environment and behavior. Researchers use
artificial intelligence (AI) to digest this data and uncover important patterns.
There are indications that people would be willing to take the risk and trust the
medical establishment with their vital signs and other intimate details. Millennials,
despite Big Data hacks and abuse by tech companies, seem blasé about privacy but
don’t much like their health care. According to a recent Accenture survey, people
aged 22 to 38 are up to three times more likely than older patients to express dis-
satisfaction with the health care system, and half of them are already using digital
tools to self-manage some aspect of their health. Even Rubiano, now 58, says he
doesn’t mind having his vital signs digitized and shared in real time. “It’s really
made a difference knowing that someone is always watching over me through
these readings, instead of waiting one or two years for anyone to notice,” he says.

Beyond the Fitbit

a digital health industry has sprung up quickly in recent years. inves-
tors inked almost 700 deals last year for nearly $7 billion, according to a study by
Health Data Management, an industry journal. Billions more flowed from health
care institutions to develop digital tools and start pilot projects and from tech gi-
ants like Apple, Amazon and Google, which are determined to capture market share.
Much of the investment is aimed at finding ways to collect health data that go
well beyond conventional patient electronic medical records. Google’s parent com-
pany, Alphabet, for example, runs a company called Verily that’s partnering with
Duke and Stanford universities to collect a broad range of data on 10,000 mostly
healthy people. And Mindstrong, a Silicon Valley startup co-run by former National
Institute of Mental Health leader Thomas Insel, is aiming to track people’s behavior

NEWSWEEK.COM 21
in order to catch early signs of mental-health and other brain-related problems.
Much of that data comes from the wireless gadgets that we have become
accustomed to interacting with all day long. The worldwide market for smart
watches and other activity trackers is now $6 billion and growing at 20 per-
cent a year. Health care–specific trackers are also on the rise; entrepreneurs
and investors aim to build an ecosystem of apps and gadgets that patients can
pick and choose from to manage their medical data. Everything about your
body, your behavior and your environment can be mined for insights. Scientists
at Cedars-Sinai Medical Center in Los Angeles, for example, are developing a
device that sits against the abdomen to listen to what goes on in the colon to
understand digestion. A new watch from Withings monitors blood pressure
and takes electrocardiograms. Data from Fitbit trackers alone has inspired 675
studies in health-related journals. Even the 50 million security cameras in the
U.S. could be harvested for data on how fast, frequently and robustly you walk
or run, and whether you look happy, sad, pained or confused.
Health care professionals call it “quantified biology.” For years, medical re-
searchers have been studying the genome, which is the sum total of an individu-
al’s DNA, and the proteome, which encompasses all the proteins a person’s cells
produce. Now, they are looking at the exposome, which contains data about the
environment—the sounds, chemicals, people, sunlight and anything else that an
individual encounters in life—and the behaviorome, which encompasses behav-
ioral tendencies while eating, sleeping, exercising and beyond.

A FIX FOR
BAD BEHAVIOR
By monitoring blood pressure patients continuously,
cardiologist Richard Milani has gotten them
to change their ways ƹ BY DAVID H. FREEDMAN
THOUSANDS OF PEOPLE WITH UNCONʝ
trolled blood pressure are having their
vital signs monitored remotely by doctors
at Ochsner Health System, an academic
medical center in New Orleans. Patients
are sent home with a smartphone app
and a wireless, automatic blood-pressure
cuff. If the readings start to climb, some-
one from Ochsner’s team gets in touch.
Compared with conventional
treatments, the program has more than
doubled the rate at which patients keep
their blood pressure under control. “The
digital program was cheaper, more
convenient and had better outcomes,”
says cardiologist Richard Milani, the
medical center’s chief clinical transforma-
WLRQ RIɿFHU ţ:HŠUH GRLQJ ZKDW \RX FDQŠW
GR LQ D PLQXWH RIɿFH YLVLWŤ News-
weekk FRQWULEXWRU 'DYLG + )UHHGPDQ
WDONHG ZLWK 0LODQL DERXW WKH SURJUDP
DQG WKH DGYDQWDJHV RI GLJLWDO KHDOWK
Q. Where does the current
health care system fall short in
dealing with chronic disease?
A. ,WŠV DQ DQDORJ DFXWHFDUH V\VWHP
JRRG IRU ɿ[LQJ SQHXPRQLD RU WUDXPD
,W ZDVQŠW GHVLJQHG WR PDQDJH FKURQLF
GLVHDVH ,I \RX FRPH LQ ZLWK GLDEHWHV D
SK\VLFLDQ ZLOO H[DPLQH \RX WDON ZLWK
\RX PHDVXUH \RXU EORRG VXJDU DQG XVH
WKDW LQIRUPDWLRQ WR PDNH DQ DVVHVV
PHQWŜ\RXŠUHGRLQJJUHDWRUZHQHHGWR
add a medication, or some other change.
%XW ZKDW LI , FRXOG ʀLS WKDW VFULSW E\
collecting the information I need to make
DQ DVVHVVPHQW IURP WKH SDWLHQWŠV KRPH"
7KHQ , FDQ NHHS DQ H\H RQ WKH SDWLHQW LQ D
FRQWLQXRXV IDVKLRQ DQG FDOO \RX LI WKHUHŠV
D ODFN RI SURJUHVV 7KDWŠV ZKDW ZH GR LQ
RXU GLJLWDO SURJUDP ,I , FDQ NHHS \RXU
GLVHDVH XQGHU FRQWURO WKHUHŠOO EH OHVV
XWLOL]DWLRQ RI WKH V\VWHP DQG ORZHUFRVW
Q. How are patients in the
digital programs reacting?
A. :HŠYH IRXQG SDWLHQWV UHDOO\ OLNH KDYLQJ
WKH KLJKHU OHYHO RI DFFRXQWDELOLW\ ,I \RX
RU , JR WR WKH GRFWRU WRGD\ ZH JHW DGYLFH
DERXW GLHW DQG H[HUFLVH VHH \RX EDFN LQ
VL[ PRQWKV 7KDWŠV OLNH KRPHZRUN <RXŠOO
ZRUU\ DERXW LW ZKHQ LWŠV DOPRVW GXH
ɿYH PRQWKV IURP QRZ ,Q RXU SURJUDP
SDWLHQWV NQRZ ZHŠUH QRWLFLQJ KRZ WKH\ŠUH
GRLQJ 7KH\ ɿQG WKDW FRPIRUWLQJ DQG WKDW
KHOSV LPSURYH DGKHUHQFH 7KH\ JHW WKDW
IHHGEDFN IURP VHHLQJ WKHLU QXPEHUV LW
JHWV WKHP LQYROYHG LQ WKHLU RZQ FDUH
$ORW RIWKLVLVDERXWFKDQJLQJ

22 NEWSWEEK.COM

The data on exposomes and behavioromes is
currently sparse, but that’s changing. Yale biolo-
gist Caroline Johnson, who specializes in metab-
olomics—the study of chemicals that insinuate
themselves from the environment into our bod-
ies—notes that researchers have found 750,000
metabolites that are linked in some way to health
issues. Emory University researchers have devel-
oped tests that can identify these metabolites in
a urine sample at a rate of 1,000 per minute. The
National Institutes of Health (NIH) has set up a $1.5
billion program, called All of Us, that’s planning to
gather all sorts of tracking, environmental and oth-
DATA COLLECTION The race is on to collect patient
data. Top left: A health tracking watch by Withings. Left:
Verily, owned by Google parent company Alphabet, has
partnered with Duke and Stanford to collect information
about mostly healthy people. Below: Ochsner’s blood
pressure program has enlisted thousands of people.
)520723&2857(6<2):,7+,1*6&2857(6<2)9(5,/<&2857(6<2)2&+61(5+($/7+6<67(0
HEALTH
er health-related data from at least 1 million people. One goal is to look for clues
about how variables like exercise, diet, sleep and heart rate are linked to disease.
To get a sense of how this new “omic” data might improve health outcomes,
consider Walter De Brouwer, a computational-linguist-turned-entrepreneur
from Mountain View, California, who not long ago was having trouble sleep-
ing through the night. Lack of sleep is linked to high blood pressure, heart
disease, diabetes, Alzheimer’s and even to cells’ ability to repair errant genes.
The sleep-tracking app on De Brouwer’s Apple Watch confirmed that he was
waking up twice each night. He found the first culprit by checking video from
the security cameras scattered around his house: His son was making noisy
late-night visits to the kitchen. A data dump from his smart thermostat revealed
the second: a middle-of-the-night temperature spike in his bedroom.
De Brouwer channeled his data obsession into a startup called Doc.ai, which
makes a medical app that automates the process of assembling its users’ expo-
some and behaviorome. You start by taking a selfie, which the app’s AI uses to
estimate your age, height, weight and gender (the idea is to reduce the amount
of information a user has to enter manually). Next, you enter your current and
previous ZIP codes, which the software uses to query databases of air pollution.
In the future, the company plans to add location-based data on water pollution,
disease prevalence, mosquito counts
and other data. Then, if you trust Doc.ai
app, you grant it access to all your online
patients’ behavior. But physicians today
aren’t well trained in behavior change;
they’re trained to tell you what’s harming
you and what you need to do about it.
We know from behavioral science that
just giving someone information rarely
changes their behavior. In our digital
programs, we allow the doctors to unload
that job to a dedicated team of coaches.
They work with patients to set goals, and
then they get to accumulate data on the
patients in real time so they can act on it
and focus the intervention based on what
ZLOO PRVW EHQHɿW HDFK LQGLYLGXDO SDWLHQW
Q. Do you have evidence that
the outcomes are better?
A. With 5,000 patients now in our pro-
gram, we’re achieving double or triple the
rates of controlling the disease, compared
to ordinary care. Patients are reporting
better adherence to treatment. They’re
not missing work or school to come in
for a visit, looking for parking, waiting
in the waiting room. The only complaint
I’ve gotten is: What took you so long?
NEWSWEEK.COM 23

health information—your health care provider’s patient portal, labs where you
had blood or other tests, the results of a 23andMe gene scan and so on. The final
step is to connect the app to your phone’s GPS, fitness-tracking watches and other
smart devices. Doc.ia keeps all the personal information on your phone, says De
Brouwer, not in the cloud, to keep it away from potential hackers.
Doc.ai is just one of many startups that aim to be the go-to app that patients
can use to manage their health data. The company signed up 35,000 people in
six months, enough to run some statistically meaningful trials. It is partner-
ing with health care providers, insurers and research institutions to offer its
users opportunities to put that data to work in managing their own health, or
contributing to research, or—as is typical in medical studies—both. Each user
decides on a case-by-case basis who gets what data for which study or service.
So far, Doc.ai has offered its early users access to an allergy research study in
partnership with Harvard Medical School and health insurer Anthem—the
2,000-person study filled up in three weeks, with another 8,000 on a wait list.
Studies on Crohn’s disease and colitis are live, and epilepsy is coming.
Converting Data to Health
although the field is new, health care organizations are already
exploring ways of applying data to care. Ochsner’s blood pressure program has en-
listed more than a thousand patients, and the numbers are encouraging: 79 percent
manage to keep their blood pressure in safe territory, compared with 31 percent for
the hospital overall. In addition, Ochsner has set up a digital program for patients
24 NEWSWEEK.COM
$ 61$36+27 2) :(//ʝ%(,1* Digital health can
capture, in a quantitative way, a broad picture of human
health. Left: Air pollution can lead to respiratory illnesses.
Below right: A scientist studies data about a person’s
genetic makeup. Bottom right: Smartphones provide
a wealth of information that’s relevant to health.
with chronic obstructive pulmonary disease, nearly
a third of whom wind up in the emergency room at
some point gasping for air, which is traumatic and
imposes enormous costs on the system.
To head off these crises, doctors at Ochsner wired
their patients’ inhalers to alert them to patterns
of usage that signal growing respiratory distress.
Those patients get a text or call at home suggesting
a change in medication or prompt a checkup. Pa-
tients also get text alerts when air particle readings
are dangerously high in their communities, urg-
ing them to ease up on outdoor activity. “We can
wirelessly manage the symptoms of thousands of
patients closely,” says Milani. “That’s beyond the
capabilities of a non-digital physician’s office.” (See
story on Page 22.)
Obesity is another target. Wake Forest Baptist
Health in Winston-Salem, North Carolina, for ex-
ample, has injected a strong digital component into
its highly regarded clinical weight-loss program. Pa-
tients get a digital scale for home that transmits daily
weigh-ins to an app, which makes the data accessible
to doctors. It also tracks physical activity, food choic-
es, water intake, sleep and other factors. “We use all
that data to provide constant feedback to the patient,”
says program director Dr. Jamy Ard. “We can modify
) 5 2 0  72 3   7$2  = + $ 1 * ʔ* ( 7 7 <  72 0  : ( 5 1 ( 5 ʔ* ( 7 7 <  : ( 67 ( 1 '   ʔ* ( 7 7 <
the plan, suggest different foods and activities, and
set up a video visit if the patient opts for it. Because
of that data, we can have a meaningful conversation.”
(See story on Page 28.)
Drug companies are developing smart drug-dos-
ing devices that collect patient data while they’re be-
ing used. Eli Lilly is piloting insulin injection pens
and pumps that can gather information on how
much insulin a diabetic patient injects, and when
and what impact it has on blood sugar levels. Doc-
tors download that data to monitor the patient and
adjust treatments accordingly. Future versions of the
devices have AI that can learn to recognize when a
patient is about to sit down to a fancy meal or raid
the refrigerator, and adjust dosages on the fly. Lilly is
looking at applying similar data-gathering capabili-
ties to track migraine-headache symptoms.
A PR I L 05, 2019
 HEALTH

Calculated Risks of an eating disorder within the past five years.

a rule of thumb in mental health is that a To see how well these factors can predict an elevated risk of suicide, Mordecai
psychiatric patient has a slightly less than 1 percent
gave the AI historical data on another batch of 7 million patient visits but with-
chance of attempting suicide. That average is of no held information on which patients actually attempted suicide, leaving it to the
help to those patients who fall in the 1 percent, of program to make its best guess. The software accurately identified those patients
course. If doctors could identify patients who are atwho were 5 percent or more likely to make an attempt on their lives in the next
a slightly greater risk of suicide, they could apportion
90 days. “That’s much better than anything we’ve ever had before,” says Mordecai.
resources to track them more closely and hopefully “It shows suicide attempts are more predictable than most medical conditions.”
intervene in time. Psychiatrist Don Mordecai of Kai- He plans to start a pilot project later this year and eventually to extend the model
ser Permanente, a large nonprofit health care provid-beyond psychiatric patients to the general population, using data on social isola-
er headquartered in Oakland, California, says that AItion, divorce and job loss.
may be able to help. Such AI-powered “predictive analytics” could be applied to many types of dis-
Mordecai took data from 14 million patient visits eases, allowing doctors to halt or slow the progress of diseases and in some cases
to clinics run by Kaiser Permanente and two other keep patients from getting sick. The Mayo Clinic in Rochester, Minnesota, plans
health care systems that collaborated on the proj- to roll out just such a pilot system later this year that is designed to flag patients
ect. The data included whether or not each patient at risk for multiple chronic diseases. “If we can merge enough sources of data, we
ultimately attempted suicide. Then he fed the data can leverage AI to better know which patients are at greatest risk for which serious
into “machine-learning” software, a form of AI that events, such as stroke, heart attack and cancer,” says Tufia Haddad, an oncologist
can identify complex patterns in reams of data that and researcher at the clinic.
humans cannot see. The AI found 150 factors that, in Apostolos Davillas, a health economist at the University of Essex in Colchester,
various combinations, tend to signal that
a patient is at an elevated risk. One factor
is whether or not a patient had taken a
benzodiazepine, a class of anti-anxiety “We can’t just fix chronic disease;
drugs, within the past three months; an-
other is whether a patient showed signs you’ll have it until you die. We need
to surveille you closely and catch you
when you’re heading OUT OF BOUNDS.”

England, is putting data on the condition of communities and households, includ-

ing income, education levels and culture, into predictive AI models. These “social
determinants of health” are often easily obtained in government databases and
can be linked to patient data. Davillas has crunched that data for thousands of
patients and says that it serves as a strong predictor of disease risk.
One factor in particular has proved to have strong predictive power: the health
of the spouse. “There’s a sort of contagion effect of health risks in couples,” he
explains. “People tend to be attracted to those with similar health-related habits
and genes, and then when they live together, any health risks snowball as they
influence each other’s habits.” For example, he says, smokers tend to end up with
other smokers, after which they’re more likely to retain or even expand the habit
over years of cohabitation. “Offering similar screening interventions to the spous-
es of high-risk patients would save lives,” he says.
Digital approaches to medicine are creating much-needed efficiencies in drug
testing. Today, clinical trials are often delayed because of the time and expense
of recruiting patients. Many fail to gather enough data to produce meaningful
results. About 17 percent of all trials collapse without having enrolled any patients

NEWSWEEK.COM 25
 HEALTH

at all, according to the NIH. wearable trackers, environmental data, online sur-
Digital medicine can pull patients in from all over the U.S., without requiring veys, and genetic tests and blood tests that can be
them to travel to a major medical center. The Mayo Clinic has enlisted IBM’s taken at local labs.
Watson AI system to pore over the notes in breast cancer patients’ electronic
medical records to determine which patients are most likely to qualify for which Big Health Is Watching
trials. A pilot effort boosted patient enrollment by 80 percent, and now the Mayo
physicians and medical researchers worry
Clinic has the system looking over the records of patients with lung or gyne-
about patient privacy—that routinely monitoring pa-
cologic cancers and will soon add gastrointestinal-cancer patients. “If a trial is
tients outside the hospital and mining their records
following Parkinson’s disease patients through monthly office visits, you’ll end
could cross ethical boundaries. “These tools are pow-
up with 12 data points at the end of a year,” says Andrea Coravos, a researcher at
erful but scary, and I’m a little ambivalent,” says Kaiser
the Harvard-MIT Center for Regulatory Science and co-founder of digital health
Permanente’s Mordecai, who developed the suicide risk
measurement platform Elektra Labs. “If you do it at home with remote sensors,
prediction system. “If we tell patients that our system
you’ll get 12 data points a day.” has gone through their data and predicted they’re at
Such studies can cost one-100th as much as conventional studies, notes Evi-
some risk of self-harm, some might say they’re relieved
dation’s Lemke, a data analyst who used to figure out ways to target video-game
and want the extra help, but some might say they
ads until she decided to apply her skills to improving health. “The scale at which
don’t want us looking over their shoulder like that.”
we can run a study at reduced cost is compelling,” she says. “And the subjects are
He adds that because most of these systems are new
in real-world situations, not going through complicated processes at a clinical
and largely experimental, no one really knows how
site with physicians.” The company has signed up 10,000 patients for a current
patients and the general public will react to them
yearlong study of chronic pain based on data gathered from a combination of
when they’re rolled out and scaled up.
The best way forward, says Haddad,
is to ensure patients call the shots on
No matter how great the enthusiasm or who has the data and how it’s tapped.
“Clinicians need to start recognizing
how sensible the concepts seem, these that not all patient health data should
be homed at the medical institution,”
technologies will eventually rise or fall
on results that can be RIGOROUSLY PROVED.

26 NEWSWEEK.COM A PR I L 05, 2019

 she says. “The patients should have ownership, and
they should be the gatekeepers. We’re going to need
F RO M L EF T: BS I P/G E T T Y; BS I P/U I G /GE T T Y; K I M KU L I SH /C OR B I S /GE T T Y
to go to them to ask permission.”
Or they can work with third parties, such as Doc.
ai or Google, that can manage permissions on a
patient’s behalf. Third-party companies that gath-
er, store and integrate patient data could serve as
brokers that collect payment on behalf of patients
from companies and institutions that want access
to that data. Pharmacy and drug companies and
some retailers have long compiled, bought and sold
AI ADVISER Making sense of digital data would be
difficult without help from artificial intelligence. Top: De
Brouwer, who founded Doc.ia, a startup that seeks to
bring together an individual’s health data in one place.
Left: The anti-anxiety drug Xanax, a benzodiazepine.
Far left: A woman uses an asthma inhaler.
health-related data on customers and prospective customers in order to better
target their marketing—health care advertising alone is more than a $100 billion
a year business. Data that consumers could compile themselves via electronic
monitoring would be worth much more than that, says Doc.ai’s De Brouwer. Why
shouldn’t consumers be allowed to get in on the action? “Medical data has latent
economic value that most people aren’t aware of,” he says. “It can be monetized.”
Ultimately, government regulation will have to set boundaries on how health
data can be shared, extending the protection it already gives patient health infor-
mation under the Health Insurance Portability and Accountability Act. The HIPAA
keeps health care providers in line, but it may not apply to consumer health tech-
nology companies, which largely emerged after the legislation was enacted in 1996.
Wake Forest Baptist Health’s Ard says he purposely avoided integrating con-
sumer weight-tracking apps into his obesity program because it might violate
the HIPAA or otherwise expose patients to privacy violation risks. The app, built
internally, “took lots of resources to get it to where it has the privacy agreements,
security and legal specifications it needed,” he says. Consumer apps rarely offer that
level of protection. Another issue is consumer monitoring devices’ uneven accu-
racy, which may render some inadequate as health tools. For instance, consumer
NEWSWEEK.COM 27
KEEPING THE
WEIGHT OFF
A digital tracking program helps obese
patients lose 10 percent of their body weight
in six months ƹ BY DAVID H. FREEDMAN
OBESITY TAKES A DECADE OFF A PERSON’S
OLIH VSDQ RQ DYHUDJH DQG LW DIʀLFWV D
WKLUG RI $PHULFDQV 7KDW PHDQV LWŠV RQ
WUDFN WR URE WKH FXUUHQW 86 SRSXOD-
WLRQ RI D ELOOLRQ \HDUV RI OLIH 'U -DP\
$UG ZDQWV WR XVH GLJLWDO WHFKQRORJ\
WR ZLQ VRPH RI WKRVH \HDUV EDFN
3DWLHQWV ZKR SDUWLFLSDWH LQ WKH ZHLJKW
ORVV SURJUDP KH UXQV DW :DNH )RUHVW
%DSWLVW +HDOWK LQ :LQVWRQ6DOHP 1RUWK
&DUROLQD JHW D GLJLWDO VFDOH IRU KRPH WKDW
WUDQVPLWV GDLO\ ZHLJKLQV WR $UG DQG KLV
WHDP ,W DOVR WUDFNV SK\VLFDO DFWLYLW\ IRRG
FKRLFHV ZDWHU LQWDNH VOHHS DQG RWKHU
IDFWRUV $YHUDJH ZHLJKW ORVV DIWHU VL[
PRQWKV LV  SHUFHQW RI ERG\ ZHLJKW DQG
 SHUFHQW RI SDWLHQWV ORVH  SHUFHQW RI
ERG\ ZHLJKW RU PRUH ţ,I ZHŠUH JRLQJ WR
PRYH WKH QHHGOH RQ SUHYHQWLRQ DQG FRVW
VDYLQJV ZHŠYH JRW WR ɿJXUH RXW KRZ WR
GHOLYHU WUHDWPHQW VWUDWHJLHV DW VFDOH ZKLOH
VWLOO PDLQWDLQLQJ DQ LQGLYLGXDO DSSURDFK
WR HDFK SDWLHQWŤ KH VD\V $UG VSRNH ZLWK
Newsweek FRQWULEXWRU 'DYLG )UHHGPDQ
DERXW WKH RSSRUWXQLWLHV LQ LQWHJUDWLQJ
REHVLW\ PDQDJHPHQW DQG GLJLWDO KHDOWK
Q. What sort of patient population
are you working with?
A. We see about 750 new patients a
year. They are typically middle-aged,
40 percent are African-American, and
they’re from a wide range of socio-
economic situations, with a fairly high
percentage on Medicaid or Medicare.
Most have another chronic disease,
like diabetes or high blood pressure.
About 80 percent of our patients are
female, which isn’t unusual for this sort of
program. Men don’t engage with the health
care system as often as women in general,
but it’s even more true with obesity.
Q. +RZ GRHV DUWLɿFLDO LQWHOOLJHQFH
KHOS WKLV SURFHVV"
A. Obesity is related to a combination
of things, including mental health, food
preferences, physical activity, socioeco-
nomic environment, culture, gender and
other factors. Some of these are soft
IDFWRUV WKDW FDQ EH KDUG WR JHW VSHFLɿF
information on, and they usually aren’t
in the medical records. There could be
D UROH IRU DUWLɿFLDO LQWHOOLJHQFH LI ZH FDQ
FRPH XS ZLWK VWDQGDUGL]HG TXHVWLRQV
WKDW WKH SDWLHQW FRXOG ɿOO RXW WKDW ZRXOG
VSHFLI\ PRVW RI WKHVH IDFWRUV 7KHQ ZH
could put it all into a machine-learning
system that could spit out the prob-
DELOLW\ RI D VSHFLɿF WUHDWPHQW EHLQJ
VXFFHVVIXO IRU D VSHFLɿF SDWLHQW
:H GRQŠW NQRZ \HW LI WKDW FDQ ZRUN
in obesity, but in theory it could. But
, WKLQN LQWHUDFWLRQ ZLWK D KXPDQ
FOLQLFLDQ ZLOO SUREDEO\ DOZD\V EH DQ
important part of the process.

Q. How are digital approaches

useful for treating obesity?
A. ,Q PRVW FRPPHUFLDO RU VHOIKHOS
DSSURDFKHV WR ORVLQJ ZHLJKW SHRSOH WHQG
WR ORVH VRPHZKHUH DURXQG  SHUFHQW
RI WKHLU ERG\ ZHLJKW )RU SHRSOH ZLWK
PRUH VHYHUH REHVLW\ DQG ZKR KDYH
RWKHU FKURQLF GLVHDVHV WKH\ GR PXFK
EHWWHU HQJDJLQJ LQ D FRPSUHKHQVLYH
WUHDWPHQW SURJUDP 7KH FKDOOHQJH IRU
PRVW SHRSOH LV WR NHHS WKH ZHLJKW WKH\ŠYH
ORVW RII IRU D ORQJ SHULRG RI WLPH 2EHVLW\
LV D FKURQLF GLVHDVH ,I \RX VWRS WKH
WUHDWPHQW WKH UHODSVH UDWH JRHV XS
6R ZH ZDQW WR UHJXODUO\ HQJDJH
patients in ongoing treatment for the
LQGHɿQLWH IXWXUH 7KDWŠV DOZD\V EHHQ FKDO-
OHQJLQJ EXW WHFKQRORJ\ QRZ RIIHUV VROX-
WLRQV :LWK UHPRWH PRQLWRULQJ DQG YLUWXDO
FOLQLFLDQ YLVLWV WKH SDWLHQW FDQ UHPDLQ LQ
FRQWDFW ZLWK D GLHWLWLDQ D EHKDYLRU FRDFK
D SK\VLFLDQ :H FDQ RIIHU WKH HTXLYDOHQW
RI D IXOO FOLQLFśYLVLW H[SHULHQFH ZLWKRXW
UHTXLULQJ WKHSDWLHQW WR EH WKHUHLQSHUVRQ

28 NEWSWEEK.COM A PR I L 05, 2019


C LO CK W I SE F RO M L E FT: C OU RT E SY O F WA K E FO R EST BAPT I ST H E A LT H ; P H OTOA LTO/SI GR ID OLSSON /G ET T Y; M AT T H IAS BA LK/ PICT UR E AL LIA NC E/G ET T Y
Medicine “is not like Silicon Valley,
devices that monitor heart rhythm may
be too quick to issue an alert when noth-
ing serious is wrong. Too many false pos- break things. If you do that
itives could flood ERs, causing doctors to
ignore alerts.
For all the excitement over data-driven
medicine and the genuine potential to
improve health care, so far there isn’t a large body of “Insurers aren’t good about paying for these types of treatments, but they have
evidence that the approach would improve health care
or lower costs in the long term. The few studies done so
far turn up surprisingly mixed early results. Research
published recently in the journal Health Affairs con-
cluded that “leading digital health companies have
not yet demonstrated substantial impact on disease
burden or cost in the U.S. health care system.” That’s a
major shot across the industry’s bow—a warning that
no matter how sensible the concepts seem, these tech-
nologies will rise or fall on rigorously proven results.
CHANGING BEHAVIOR Left: At his obesity clinic
at Wake Forest, Ard tracks patients’ weight, activity,
food choices, water intake, sleep and other factors.
Top: Cigarette smoking is one health factor that
doctors want to track; IBM’s Watson AI system was
enlisted to filter records for a breast cancer trial.
HEALTH
Footing the Bill
the most immediate obstacle to digital health care is the status quo.
In spite of all the hand-wringing over the staggering costs and poor outcomes
of the U.S. health care system, physicians, hospitals, pharmaceutical companies
and health insurers are, by and large, doing just fine without digital medicine.
A case in point: Even though preliminary data from the Ochsner digital
health monitoring programs run by Milani with 5,000 patients suggest that
the approach produces better health outcomes and pays for itself within a year,
health insurers won’t cover it. Medicaid requires health providers to collect a
copayment for all services they provide. That would create a burdensome bliz-
zard of $16 copays for patients in Milani’s project, which emphasizes frequent
doctor-patient interactions.
One reason insurers are reluctant to pay us is that they first want to see
multiple, published, large, long-term studies—not preliminary reports from
projects like Ochsner’s. Insurers also fear that they won’t reap the payoff
from up-front investments in digital health because patients in the U.S.
tend to switch health plans frequently. As a result, the health care system
as a whole remains needlessly costly—but in a way that keeps insurance
profits high.
“It’s ironic,” says Ard, whose digital obesity program Medicaid refuses to cover.
where they like to move fast and
in health care, PEOPLE DIE.”
no problem paying for the huge costs of someone going from prediabetes to
Type 2 diabetes, or from slightly high blood pressure to needing three daily
medications a day. Our program is getting people with diabetes down to normal
blood sugar in less than a year. We need to change our perspective on what we
value and pay for in medicine.”
Ultimately, it may come down to waiting for doctors to push for it. Some
already do, of course, but many are overworked by the enormous adminis-
trative demands of the industry’s long, painful switch to electronic medical
records. A jump to digital medicine might bring other burdens. “Their incen-
tives aren’t aligned with digital health,” says Lemke. “They aren’t being paid
to monitor someone’s data, and there’s no way you’re going to turn most of
them into data scientists.”
New technologies could lower that barrier and make it easier to run a digital
practice, but the transition will be slow. And that’s not necessarily a bad thing.
Medicine, says Evidation’s Lemke, “is not like Silicon Valley, where they like to move
fast and break things. If you do that in health care, people die.” Ultimately change
will come from the people, one app at a time.
NEWSWEEK.COM 29
 T h e W o r l d’s B e s t

30 NEWSWEEK.COM A PR I L 05, 2019

 2019
GETTY

Illustration by I R I N A S T R E L N I K O VA NEWS K.COM 31

 METHODOLOGY

THIS LIST IS COMPOSED OF THE

world’s best hospitals in 11
countries: Australia, Canada,
France, Germany, Israel, Japan,
Singapore, South Korea, Switzer-
land, the United Kingdom and the
United States. The countries were
selected mainly because of their
standard of living, life expectan-
cy, population size, number of
hospitals and data availability. To
be considered, hospitals had to
have a capacity of at least 100

&/2 &.:,6()5205,*+7&2857(6<2)0$<2&/,1,&ʤʥ1(:6:((.6, 1(/$%86$50<6,*1$/&2536ʔ,17(51$7,21$/$512/'1(:0$1

inpatient beds (Switzerland
and Canada: 80 beds; U.K.: 75).
Included are single branches of
hospitals (e.g., the Mayo Clinic in
Rochester, Minnesota). Hospital
groups are not included.
One thousand hospitals from
f all the industries on the threshold of transformation, the 11 countries were selected
none is more politically contentious, tightly regulated, sci- based on three data sources:
recommendations from medical
entifically significant or economically important than health care. Hospitals professionals (doctors, hospital
around the globe will drive—and be shaped by—much of this disruption. managers, health care profes-
newsweek has spent the better part of nine decades covering every aspect sionals), patient survey results
and, where available, medical
of health care, and we are committed to helping our readers make sense performance indicators.
of the changes sweeping this industry. As part of that commitment, we The list of the top 100 is
partnered with Statista Inc., a global market research and consumer data separated into two parts: the top
10, sorted by rank, and the best
company, to develop a groundbreaking ranking of the world’s best hospitals. of the rest—11 to 100—sorted
The hospitals on this list are at the forefront of adapting to these new alphabetically. The top 10 were
challenges while providing top-notch patient care. They range from the determined by the number of
international recommendations
Mayo Clinic in Rochester, Minnesota, with its peerless educational arm; to from medical professionals. The
Singapore General Hospital, which pursues clinical research and offers out- remaining 90 hospitals consist of
standing nursing; to the Charité hospital in Berlin, which employs more the top 10 percent of each coun-
try from the list of 1,000. (They
than half of Germany’s Nobel Prize winners in physiology or medicine. are alphabetized because the
How far would you go to get the best care for yourself or your family? This data used in the different coun-
guide helps newsweek readers discover the ways leading hospitals—close tries is not homogeneous enough
to allow for a detailed cross-coun-
to home and around the world—are shaping the future of medicine. try comparison.) The full list of
—Nancy Cooper, global editor-in-chief 1,000 is online at Newsweek.com.

32 NEWSWEEK.COM A PR I L 05, 2019

 T H E W O R L D'S B E S T HOSPITALS

The hospitals on our

INTENSIVE
list are all world
leaders in health
care, but these are the
very best—the TOP 10,
according to Newsweek’s
panel of doctors,
CARE

medical professionals
and administrators
across four continents

BY _ NOAH MILLER

The Mayo Clinic

THE ROCHESTER, MINNESOTA–BASED MAYO CLINIC HAS PROVIDED PATIENTS WITH
comprehensive medical care for over 150 years. Now with centers in Arizona, Florida
and Minnesota, as well as over 19 hospitals in five states, its health system serves
more than 1.3 million people annually. But it’s the nonprofit’s peerless educational
arm, including the Mayo Clinic Alix School of Medicine and 57 research centers, that
sets it apart, providing vital innovation for the entire medical community (more than
7,200 peer-reviewed publications to date). That, along with superb patient support,
earns the Mayo Clinic Newsweek’s top spot for 2018–19. ► MayoClinic.org

NEWSWEEK.COM 33
 SINGAPORE
GENERAL HOSPITAL

The oldest hospital in

S I NG A POR E GE NER AL H OS P ITA L ; J OH N S H OP KINS ; S CH ÖN ING /UL LSTE IN B ILD/GE T T Y; B R EN DA N SM I ALOWS K I/A F P/G ET T Y
Singapore, founded in
1821, has grown from a

C OU NT ERCLO C KW I S E FROM TO P L E FT: D O N G ER DA /CL EVE LA ND CL INIC ; ROB ERT B EN S ON/C LE VELA ND CLI N IC;
British imperial troop
cantonment near the banks
of the Singapore River
into the island nation’s
largest health system,
serving more than 1 mil-
lion patients annually. As
a tertiary referral hospi-
tal with ancillary on-
campus specialist centers,
the SGH provides afford-
able care for patients,
leads patient-driven
clinical research and
provides undergraduate to
postgraduate educational
training for both students
and medical professionals.
It was the first hospi-
tal in Asia to achieve the
Magnet designation in 2010
for nursing excellence,
awarded by the American
Nurses Credentialing
Cleveland Clinic Center. ► www.SGH.com.sg

The Cleveland Clinic—site of the world’s first total facial

transplant—is among the largest medical providers in
the world, with over 7.6 million patient visits in 2017
at hospitals in the U.S., Canada and the United Arab
Emirates (a London location is planned for 2021). Its
Heart and Heart Surgery program at the Miller Family
Heart & Vascular Institute has been ranked the best
in America every year since 1995, and it was the first
major medical center to organize with patient-center
institutes to combine clinical services around a single
disease or organ system. It has also, for 10 years
running, hosted the Patient Experience: Empathy &
Innovation Summit, the world’s largest conference for
the integration of the quality of patient experience with
the digital medical sphere. ► MyClevelandClinic.org

34 NEWSWEEK.COM A PR I L 05, 2019

 T H E W O R L D'S B E S T HOSPITALS

Charité
This research-based
university hospital in
Berlin, associated with
Humboldt University and
Freie Universität Berlin,
has 13,700 employees (in-
cluding more than half of
Germany’s Nobel laureates
in physiology or medicine)
working on over 1,000
projects devoted to pa-
tient-oriented research
JOHNS HOPKINS HOSPITAL through interdisciplin-
ary collaboration. As a
The Baltimore-based institution—founded in the late 1800s by the banker, hospital, Charité—which
philanthropist and abolitionist it is named for—houses Johns Hopkins celebrated its tricen-
University’s School of Medicine, the second-highest-rated medical school tennial in 2010—is on the
in America (after Harvard Medical School), offering among the most cutting-edge of biomed-
advanced clinical research in the world. The hospital’s health system— ical innovation, with
including six academic and commercial hospitals, four health care and biotech startup labs, ad-
surgery centers and over 40 patient care locations—receives up to 3 visory roles and business
million patients annually. A leader in neurosurgery and child psychiatry, the initiatives focused on the
Hopkins Gender Identity Clinic was also the first in the United States to convergence of technology
complete male-to-female reassignment surgery. ► HopkinsMedicine.org and medicine. ► Charite.de

NEWSWEEK.COM 35
 THE WORL D'S BES T HOSPITALS

Toronto
General Hospital
TGH, one of eight hospitals that make up Canada’s United Health

&2817(5&/2 &.:,6()520723/()7<2 216%<81ʔ7+(%26721*/2%(ʔ* (7 7<7252172*(1(5$/+263,7$/6$0ʝ&+89ʤʥ6+(%$0(',&$/&(17 ( 5   .2 , & + ,  . $ 0 2 6 + , '$ ʔ* ( 7 7 <

Network, is also the biggest and most well-funded research
organization in the country and the largest transplant center
in North America. As the teaching hospital for the University
of Toronto, it leads transplantation research and innovation,
accomplishing many “firsts,” including a triple organ
transplant (double-lung, liver and pancreas) in 2015. TGH is
home to the Peter Munk Cardiac Centre (named for the founder
of Barrick Gold, who donated $100 million), a global leader
in open-heart surgery and cardiovascular health. ƹ UHN.ca

MASSACHUSETTS
GENERAL HOSPITAL

/RFDWHGLQ%RVWRQ0*+ZKLFK
is the third-oldest hospital in the
United States, is also the teaching
hospital of Harvard Medical School,
the pre-eminent medical school in
the country, with virtually all of its
physicians serving as Harvard Med
faculty. With an annual research budget
RIPRUHWKDQPLOOLRQLWDOVRKDV
the largest hospital-based research
SURJUDPRYHUFOLQLFDOWULDOVDUH
conducted at Mass General at any given
WLPHDQGLQś0*+WRSSHG
the Nature Index list, publishing more
articles in “high-impact” journals
than any other hospital in America.
Current projects include combating
the opioid epidemic and studying the
impact of social and economic status
on health. ƹ MassGeneral.org

36 NEWSWEEK.COM A PR I L 05, 2019

 UNIVERSITY OF TOKYO HOSPITAL
Japan’s vital medical hub has advanced both medical research and practice,
while educating the top doctors and researchers in the country. The hospi-
tal’s emphasis, in Japan and worldwide, is on the well-being of patients. In
LWVVSHFLDOL]HGFOLQLFDOGHSDUWPHQWVFRPSOHWHGWULDOVLQDGGLWLRQWR
WUHDWLQJPRUHWKDQPLOOLRQSDWLHQWV,QWKHKRVSLWDORSHQHGWKHWUDLO-
blazing Department of Disaster Medical Management. ƹH.U-Tokyo.ac.jp

LAUSANNE
UNIVERSITY
HOSPITAL Sheba Medical
Located in Lausanne,
Center at
Switzerland, beneath Tel HaShomer
the snowcapped peaks
surrounding Lake Geneva,
the world-class CHUV serves Sheba Medical Center—or Tel HaSho-
as the teaching hospital mer Hospital—in Tel Aviv is a leader
for the country’s French- in medical science and biotechnical
speaking citizens. It was innovation, both in the Middle East
one of only two hospitals and worldwide. The center’s collabo-
in Switzerland’s “Health rations with international parties have
Valley” (home to nearly advanced innovative medical practices,
1,000 biotechnolgy and hospital systems and biotechnology.
medical technology 7KHWHUWLDU\UHIHUUDOKRVSLWDODIɿOLDW-
companies) chosen by the ed with Tel Aviv University, includes
World Health Organization centers for nearly all medical divisions
to conduct the all- and specialties, and serves over 1
important Ebola vaccine PLOOLRQSDWLHQWVSHU\HDU0RUHWKDQ
trials in October 2014. percent of all Israeli medical clinical
CHUV is also committed research takes place at its state-of-
to sharing cutting-edge the-art facilities, and as a hospital
medical practices through it works with nearly every Israeli
its free magazine, In medical institute to educate students
Vivo, published in French and advance the future of the med-
and English. ƹ CHUV.ch ical profession. ƹEng.Sheba.co.il

NEWSWEEK.COM 37
THE $ʝ= INDEX
OF EXCEPTIONAL
HOSPITALS Glasgow Royal
,QɿUPDU\
Glasgow,
Hospital Henri Mondor
Créteil, France
Chu-Mondor.APHP.fr
United Kingdom SPE CIALTIES
Addenbrooke’s Hospital Catholic University Duke University NHSGGC.org.uk Cardiology, General
Cambridge, United of Korea, Seoul St. Hospital SPEC IALTIE S and Visceral Surgery,
Kingdom Mary’s Hospital Durham, North Carolina Cardiology, General Neurology/Neurosurgery,
CUH.NHS.uk Seoul, South Korea DukeHealth.org and Visceral Surgery, Plastic Surgery, Urology
SPECIA LTIE S* CMCSeoul.or.kr S PEC IALTIES Plastic Surgery
Cardiology, General S PECI ALTI ES Cardiology, General Hospital Purpan
and Visceral Surgery, Cardiology, General and Visceral Surgery, Guy’s Hospital Toulouse, France
Neurology/Neurosurgery, and Visceral Neurology/Neurosurgery, London, United Kingdom Chu-Toulouse.fr
Plastic Surgery, Urology Surgery, Neurology/ Plastic Surgery, Urology GuysAndStThomas SPE CIALTIES
Neurosurgery, Plastic .nhs.uk General and
Ajou University Hospital Surgery, Urology Emory University SPEC IALTIE S Visceral Surgery
Suwon, South Korea Hospital Cardiology, General
Hosp.AjouMC.or.kr Cedars-Sinai Atlanta, Georgia and Visceral Hospital Timone
SPECIA LTIE S Medical Center EmoryHealthCare.org Surgery, Neurology/ Marseille, France
Cardiology, General Los Angeles, California S PEC IALTIE S Neurosurgery, Plastic Fr.AP-HM.fr
and Visceral Surgery, Cedars-Sinai.org Cardiology, General Surgery, Urology SPE CIALTIES
Neurology/Neurosurgery, SPECI ALTI ES and Visceral Cardiology, General
Plastic Surgery, Urology Cardiology, General Surgery, Neurology/ Hannover Medical and Visceral Surgery,
and Visceral Neurosurgery, Urology School Neurology/Neurosurgery
The Alfred Surgery, Neurology/ Hanover, Germany
Melbourne, Australia Neurosurgery, Plastic European Hospital MH-Hannover.de Hospital of the
AlfredHealth.org.au Surgery, Urology Marseille, France SPEC IALTIE S University of Munich
SPECIA LTIE S Hopital-Europeen.fr Cardiology, General Munich, Germany
Cardiology, General Chelsea and S PEC IALTIE S and Visceral Klinikum.Uni-Muenchen.de
and Visceral Surgery, Westminster Hospital Cardiology, Neurology/ Surgery, Neurology/ SPE CIALTIES
Neurology/Neurosurgery, London, United Kingdom Neurosurgery, Urology Neurosurgery, Plastic Cardiology, General
Plastic Surgery, Urology ChelWest.NHS.uk Surgery, Urology and Visceral Surgery,
S PECI ALTI ES Foothills Medical Neurology/Neurosurgery,
Asan Medical Center Cardiology, General Centre Hirslanden Plastic Surgery, Urology
Seoul, South Korea and Visceral Calgary, Alberta Clinic, Zurich
AMC.Seoul.kr Surgery, Neurology/ AlbertaHealthServices.ca Zurich, Switzerland
SPECIA LTIE S Neurosurgery, Plastic S PEC IALTIES Hirslanden.ch
Cardiology, General Surgery, Urology Cardiology, General SPEC IALTIE S
and Visceral Surgery, and Visceral Surgery, Cardiology, General
Neurology/Neurosurgery, Cleveland Clinic, Neurology/Neurosurgery, and Visceral
Plastic Surgery, Urology Fairview Hospital Plastic Surgery Surgery, Neurology/
Cleveland, Ohio Neurosurgery, Plastic
Barnes-Jewish Hospital MyClevelandClinic.org Freeman Hospital Surgery, Urology
St. Louis, Missouri S PECI ALTI ES Newcastle Upon Tyne,
BarnesJewish.org Cardiology, General United Kingdom Hospital Claude Huriez
SPECIA LTIE S and Visceral Newcastle-hospitals.org.uk Lille, France
Cardiology, General Surgery, Neurology/ S PEC IALTIE S CHU-Lille.fr
and Visceral Surgery, Neurosurgery, Plastic Cardiology, General and SPEC IALTIE S
Neurology/Neurosurgery, Surgery, Urology Visceral Surgery, Urology Cardiology, General
Plastic Surgery, Urology and Visceral Surgery,
Clinique Pasteur Geneva University Plastic Surgery, Urology
Brigham and Toulouse Hospitals, Cluse-
Women’s Hospital Haute-Garonne, France Roseraie Hospital Cochin
Boston, Massachusetts Clinique-Pasteur.com Geneva, Switzerland Paris, France
BrighamAndWomens.org SPECI ALTI ES HUG-ge.ch APHP.fr
SPECIA LTIE S Cardiology, General S PEC IALTIES SPEC IALTIE S
Cardiology, General and Visceral Cardiology, General Cardiology, General
and Visceral Surgery, Surgery, Neurology/ and Visceral Surgery, and Visceral Surgery,
Neurology/Neurosurgery, Neurosurgery, Plastic Neurology / Neurosurgery, Neurology/Neurosurgery,
Plastic Surgery, Urology Surgery, Urology Plastic Surgery, Urology Plastic Surgery, Urology

38 NEWSWEEK.COM *Selected Specialties

 T H E W O R L D’S B E S T HOSPITALS

Hospital of the John Radcliffe Hospital Kangbuk Kyoto University Montreal General
University of Oxford, United Kingdom Samsung Hospital Hospital Hospital, McGill
Pennsylvania, OUH.NHS.uk/ Seoul, South Korea Kyoto, Japan University Health
Penn Presbyterian hospitals/jr/ Kbsmceng.Kbsmc.co.kr KUHP.Kyoto-U.ac.jp Centre
Philadelphia, Pennsylvania S PECI ALTIES SPE C IALTIE S SP EC IALTIE S Montreal, Quebec
PennMedicine.org Cardiology, General Cardiology, General Cardiology, General MUHC.ca
SP E CIA LTIE S and Visceral and Visceral and Visceral SPE CIALTIE S
Cardiology, General Surgery, Neurology/ Surgery, Neurology/ Surgery, Neurology/ Cardiology, Neurology/
and Visceral Neurosurgery, Plastic Neurosurgery, Plastic Neurosurgery, Plastic Neurosurgery, Urology
Surgery, Neurology/ Surgery, Urology Surgery, Urology Surgery, Urology
Neurosurgery, Urology Mount Sinai Hospital
Juntendo University Korea University Kyung Hee University 1HZ <RUN 1HZ <RUN
Jefferson Health, Hospital Anam Hospital Medical Center MountSinai.org
Thomas Jefferson Tokyo, Japan Seoul, South Korea Seoul, South Korea SPE CIALTIE S
University Hospitals Juntendo.ac.jp/hospital/ Anam.kumc.or.kr KHUH.or.kr Cardiology, General
Philadelphia, Pennsylvania global/english/ SPE C IALTIE S SP EC IALTIE S and Visceral
Hospitals.Jefferson.edu S PECI ALTIES Cardiology, General Cardiology, General Surgery, Neurology/
SP E CIA LTIE S Cardiology, General and Visceral and Visceral Surgery, Neurosurgery, Plastic
Cardiology, General and Visceral Surgery, Neurology/ Neurology/Neurosurgery, Surgery, Urology
and Visceral Surgery, Neurology/ Neurosurgery, Plastic Plastic Surgery, Urology
Surgery, Neurology/ Neurosurgery, Plastic Surgery, Urology NCGM Center Hospital
Neurosurgery, Plastic Surgery, Urology Kyushu University Tokyo, Japan
Surgery, Urology Kurashiki Hospital Hosp.NCGM.go.jp
Kameda Medical Center Central Hospital Fukuoka, Japan SPE CIALTIE S
Jewish General Kamogawa, Japan Kurashiki, Japan Hosp.Kyushu-U.ac.jp/en Cardiology, General
Hospital Kameda.com/us/ KCHnet.or.jp SP EC IALTIE S and Visceral
index.html
* /2: : ( / / 1(6 6ʔ* (7 7<

Montreal, Quebec S PEC IALTIE S Cardiology, General Surgery, Neurology/

JGH.ca S PECI ALTIES Cardiology, General and Visceral Surgery, Neurosurgery, Plastic
SP E CIA LTIES Cardiology, General and Visceral Neurology/Neurosurgery, Surgery, Urology
Cardiology, General and Visceral Surgery, Neurology/ Plastic Surgery
and Visceral Surgery, Surgery, Neurology/ Neurosurgery, Plastic New York-Presbyterian
Neurology/Neurosurgery, Neurosurgery, Plastic Surgery, Urology Lindenhof Hospital, Columbia
Plastic Surgery Surgery, Urology Hospital Bern and Cornell
Bern, Switzerland 1HZ <RUN 1HZ <RUN
LindenhofGruppe.ch NYP.org
SP ECIALTIE S SPE CIALTIE S
Cardiology, General Cardiology, General
and Visceral Surgery, and Visceral
Neurology/Neurosurgery, Surgery, Neurology/
Plastic Surgery, Urology Neurosurgery, Plastic
Surgery, Urology
Lyon Sud Hospital
Center North York General
Pierre-Bénite, France Hospital
CHU-Lyon.fr Toronto, Ontario
SP EC IALTIE S NYGH.on.ca
General and Visceral SPE CIALTIE S
Surgery, Neurology/ Cardiology, Plastic
Neurosurgery, Plastic Surgery, Urology
Surgery, Urology
Northwestern
Mayo Clinic, Phoenix Memorial Hospital
Phoenix, Arizona Chicago, Illinois
MayoClinic.org NM.org
SP ECIALTIE S SPE CIALTIE S
Cardiology, General Cardiology, General
and Visceral Surgery, and Visceral Surgery,
Neurology/Neurosurgery, Neurology/Neurosurgery,
Plastic Surgery, Urology Plastic Surgery, Urology

NEWSWEEK.COM 39
 T H E W O R L D’S B E S T HOSPITALS

NYU Langone Hospitals Pellegrin Hospital Group Ronald Reagan UCLA Royal Melbourne Seirei Hamamatsu
1HZ<RUN1HZ<RUN Bordeaux, France Medical Center Hospital City Campus General Hospital
NYULangone.org Chu-Bordeaux.fr Los Angeles, California Melbourne, Australia Hamamatsu, Japan
SPECIA LTIE S SPECI ALTI ES UCLAHealth.org Thermh.org.au Seirei.or.jp/hq/
Cardiology, General Cardiology, General SPECIALTIES SPEC IALTIE S SPE CIALTIES
and Visceral Surgery, and Visceral Surgery, Cardiology, General Cardiology, General Cardiology, General
Neurology/Neurosurgery, Neurology/Neurosurgery, and Visceral and Visceral Surgery, and Visceral Surgery,
Plastic Surgery, Urology Plastic Surgery, Urology Surgery, Neurology/ Neurology/Neurosurgery, Neurology/Neurosurgery,
Neurosurgery, Plastic Plastic Surgery Plastic Surgery, Urology
Osaka University Rechts der Isar Surgery, Urology
Hospital Hospital, Technical Royal Prince Seoul National University
Suita, Japan University of Munich Royal Brisbane and Alfred Hospital Bundang Hospital
Hosp.Med.Osaka-u.ac.jp Munich, Germany Women’s Hospital Sydney, Australia Seongnam, South Korea
SPECIA LTIE S Mri.TUM.de Brisbane, Australia SLHD.NSW.gov.au SNUBH.org
Cardiology, General SPECI ALTI ES MetroNorth.Health SPEC IALTIE S SPE CIALTIES
and Visceral Cardiology, General .qld.gov.au Cardiology, General Cardiology, General
Surgery, Neurology/ and Visceral Surgery, SPECIALTIES and Visceral Surgery, and Visceral Surgery,
Neurosurgery, Plastic Neurology/Neurosurgery, Cardiology, General Neurology/Neurosurgery, Neurology/Neurosurgery,
Surgery, Urology Plastic Surgery, Urology and Visceral Plastic Surgery, Urology Plastic Surgery, Urology
Surgery, Neurology/
Paris Saint-Joseph Rockyview General Neurosurgery, Plastic Royal Victoria Hospital, Seoul National
Hospital Group Hospital Surgery, Urology McGill University University Hospital
Paris, France Calgary, Alberta Health Centre Seoul, South Korea
HPSJ.fr AlbertaHealthServices.ca Royal Jubilee Hospital Montreal, Quebec SNUH.org
SPECIA LTIE S SPECI ALTI ES Victoria, British Columbia MUHC.ca/royalvic/ SPE CIALTIES
Cardiology, General Cardiology, General IslandHealth.ca dashboard Cardiology, General
and Visceral Surgery, and Visceral Surgery, SPECIALTIES SPEC IALTIE S and Visceral Surgery,
Neurology/Neurosurgery, Neurology/Neurosurgery, Cardiology, General Cardiology, General Neurology/Neurosurgery,
Plastic Surgery, Urology Plastic Surgery, Urology and Visceral Surgery and Visceral Surgery, Plastic Surgery, Urology
Neurology/Neurosurgery,
Plastic Surgery, Urology Severance Hospital,
Yonsei University
5R\DO 9LFWRULD ,QɿUPDU\ Seoul, South Korea
Newcastle Upon Tyne, Sev.ISeverance.com
United Kingdom SPE CIALTIES
Newcastle- Cardiology, General
Hospitals.org.uk and Visceral Surgery,
SPEC IALTIE S Neurology/Neurosurgery,
Cardiology, General Plastic Surgery, Urology
and Visceral Surgery,
Neurology/Neurosurgery, Stanford Health Care,
Plastic Surgery Stanford Hospital
Stanford, California
Salford Royal Hospital StanfordHealthCare.org

) 5 2 0  / ( ) 7  6 + $ 1 1 2 1  )$* $ 1 ʔ* ( 7 7 <  5 2 1  / ( 9 , 1 ( ʔ* ( 7 7 <

Salford, United Kingdom SPE CIALTIES
SRFT.NHS.uk Cardiology, General
SPEC IALTIE S and Visceral
General and Visceral Surgery, Neurology/
Surgery, Neurology/ Neurosurgery, Urology
Neurosurgery, Urology
St. Thomas’ Hospital
Samsung Medical Center London, United Kingdom
Seoul, South Korea GuysAndStThomas
SamsungHospital.com .NHS.uk
SPEC IALTIE S SPE CIALTIES
Cardiology, General Cardiology, General
and Visceral Surgery, and Visceral Surgery,
Neurology/Neurosurgery, Neurology/Neurosurgery,
Plastic Surgery, Urology Plastic Surgery, Urology

A PR I L 05, 2019
 University Medical
Center Freiburg
Freiburg, Germany
Uniklinik-Freiburg.de
SPECIALTIE S
Cardiology, General
and Visceral
Surgery, Neurology/
Neurosurgery, Plastic
Surgery, Urology

University Medical
Center Hamburg-
Eppendorf
Hamburg, Germany
UKE.de
SPECIALTIE S
Cardiology, General
and Visceral Surgery,
Neurology/Neurosurgery,
Plastic Surgery, Urology
St. Luke’s UCLA Medical University University Hospital
International Hospital &HQWHU 6DQWD 0RQLFD Hospital Erlangen Schleswig-Holstein, University of
Tokyo, Japan Santa Monica, California Erlangen, Germany Campus Kiel Michigan Hospitals,
Hospital.Luke.ac.jp UCLAHealth.org UK-Erlangen.de/en/ Kiel, Germany Michigan Medicine
SP E CIA LTIES SPECI ALTIE S S PEC IALTIES UKSH.de Ann Arbor, Michigan
Cardiology, General Cardiology, General Cardiology, General S PEC IALTIES Med.UMich.edu
and Visceral and Visceral Surgery, and Visceral Surgery, Cardiology, General SPECIALTIE S
Surgery, Neurology/ Neurology/Neurosurgery, Neurology/Neurosurgery, and Visceral Cardiology, General
Neurosurgery, Plastic Plastic Surgery, Urology Plastic Surgery, Urology Surgery, Neurology/ and Visceral Surgery,
Surgery, Urology Neurosurgery, Plastic Neurology/Neurosurgery,
UCSF Medical Center University Surgery, Urology Plastic Surgery, Urology
St. Vincent’s Hospital San Francisco, California Hospital Heidelberg
Melbourne, Australia UCSFHealth.org Heidelberg, Germany University University of
SVHM.org.au SPECI ALTIE S Klinikum.Uni-Heidelberg.de Hospitals Cleveland Wisconsin Hospitals
SP E CIA LTIES Cardiology, General S PEC IALTIES Medical Center Madison, Wisconsin
Cardiology, General and Visceral Surgery, Cardiology, General and Cleveland, Ohio UWHealth.org
and Visceral Neurology/Neurosurgery, Visceral Surgery, Urology, UHHospitals.org SPECIALTIE S
Surgery, Neurology/ Plastic Surgery, Urology Neurology/Neurosurgery S PEC IALTIES Cardiology, General
Neurosurgery, Plastic Cardiology, General and Visceral Surgery,
Surgery, Urology University University Hospital and Visceral Neurology/Neurosurgery,
College Hospital Pitié Salpêtrière Surgery, Neurology/ Plastic Surgery, Urology
Sunnybrook Health London, United Kingdom Paris, France Neurosurgery, Plastic
Sciences Centre UCLH.NHS.uk PitiesalPetriere.APHP.fr Surgery, Urology UPMC Presbyterian
Toronto, Ontario SPECI ALTIE S S PEC IALTIES and Shadyside
Sunnybrook.ca Cardiology, General Cardiology, General University Pittsburgh, Pennsylvania
SP E CIA LTIES and Visceral and Visceral Surgery, Hospital Zurich UPMC.com
Plastic Surgery Surgery, Neurology/ Neurology/Neurosurgery, Zurich, Switzerland SPECIALTIE S
Neurosurgery, Urology Plastic Surgery, Urology USZ.ch Cardiology, General
Teikyo University S PEC IALTIES and Visceral Surgery,
Hospital University University Hospital Cardiology, General Neurology/Neurosurgery,
Tokyo, Japan Hospital Cologne Regensburg and Visceral Plastic Surgery, Urology
Teikyo-Hospital.jp Cologne, Germany Regensburg, Germany Surgery, Neurology/
SP E CIA LTIES UK-Koeln.de UKR.de Neurosurgery, Plastic Vancouver General
Cardiology, General SPECI ALTIE S S PEC IALTIES Surgery, Urology Hospital
and Visceral Cardiology, General Cardiology, General Vancouver, British Columbia
Surgery, Neurology/ and Visceral Surgery, and Visceral Surgery, VCH.ca
Neurosurgery, Plastic Neurology/Neurosurgery, Neurology/Neurosurgery, SPECIALTIE S
Surgery, Urology Plastic Surgery, Urology Plastic Surgery, Urology Neurology/Neurosurgery

Ơ T H E F U L L L I S T O F 1 , 0 0 0 B E S T H O S P I TA L S I S AVA I L A B L E AT N E WSWE E K .CO M

Culture HIGH, LOW + EVERYTHING IN BETWEEN

THEATER

Stars Align
Glenda Jackson, Jayne Houdyshell and Elizabeth Marvel on the cosmic,
timeless fury of Shakespeare’sKing Lear

TRIPLE THREAT
From left: Jackson,
Houdyshell and
Marvel. The Broadway
production also stars
Ruth Wilson as Cordelia.
 ALL-SINGING, ALL-DANCING
Julianne Moore breaks it down in Gloria Bell » P.48
glenda jackson is holding court at a
noisy New York City diner on a Sunday after-
noon. “I’m done with this,” she barks, handing an
unfinished fruit salad to the waiter. “And take their
orders.” The waiter, more bemused than affronted,
looks at the two women seated in the booth across
from Jackson. They dutifully order.
Jayne Houdyshell and Elizabeth Marvel are Jack-
son’s co-stars in a gender-bending production of
William Shakespeare’s King Lear, currently occupy-
ing the Cort Theatre on Broadway. Despite their own
busy, esteemed careers (Houdyshell won a Tony for “The first time I did an eighth performance in the
2016’s The Humans), they are clearly awed by their
entertainingly spiky star. Well, who wouldn’t be?
In late 2016, Jackson returned to the London stage
after 23 years as a member of Parliament. The role
was Shakespeare’s mad king, her performance a crit-
ically acclaimed barn burner. At age 81, Jackson then
hightailed it to Broadway, picking up a Tony in 2018
for Edward Albee’s Three Tall Women. After a short
breather—“mostly on grandma patrol,”
she says—she’s reprising Lear in New
York. The production, directed by Sam
Gold (Tony Award winner for 2015’s Fun
Home), is otherwise entirely new, with MARY KAYE
Houdyshell as the Earl of Gloucester, a SCHILLING
nobleman loyal to Lear, and Marvel as
the power-mad Goneril, the eldest of Lear’s three
daughters. Gold’s production is as no-frills as the
U.K.’s—performed without raiment, in modern
dress—with an original score by Philip Glass.
)520/()76/$9(19/$6,&ʔ*(77<9,&725+8*2ʔ*(77<12$0
Lear is not for the faint of heart, requiring
stamina from cast and audience. The play is long
*$/$,ʔ*(77<7235,*+7&,1'<25'ʔ725<%85&+ʔ*(77<
(three-plus hours), fast and full of primal fury. “It’s
a meat grinder,” says Marvel. In some cases, liter-
ally: Gloucester gets both eyes gouged out; most of
the characters die horribly; everyone suffers. It’s
also filled with the rich, metaphoric language of
Shakespeare—gorgeous to the ear, if incomprehen-
sible to many modern listeners. People sit forward
in their seats, says Houdyshell: “It’s not easy. You
have to work. I can hear the audience listening.”
The overall, timeless message of Lear is to look past
the surface—beyond rank, power, wealth and gen-
der; the truth of people is in their heart and actions,
not easy words. The prideful, self-righteous Lear and
Photo illust rat ion b y G L U E K I T
the credulous Gloucester catastrophically trust the
wrong children: wicked Goneril and Regan in Lear’s
case (as opposed to his devoted youngest daughter,
Cordelia); villainous, illegitimate Edmund, rather
than virtuous, legitimate Edgar, in Gloucester’s.
Newsweek spoke with Jackson, Houdyshell and
Marvel a few weeks before the play’s April 4 opening
(the limited run ends on July 7). Laughter is frequent,
exhaustion evident. During previews, the cast is con-
tinuing to rehearse before performances—seven a
week until an eighth is added the week of April 8.
U.K., the rest of the cast were waiting for me to die—
they were probably disappointed I didn’t,” Jackson
joked recently. Lear’s energy saves the day. “It’s imme-
diate,” she says now. “If you tap into that, it feeds you.”
Glenda, do you see a difference between
American and U.K. audiences?
Jackson: Oh my God, are you kidding?
Houdyshell: How are they different?
Jackson: They’re there! They roar!
BY They leap to their feet. Mind you, in
England, it’s very different. We tend
to look down our noses at America’s
obsession with standing ovations. A
standing O for him? What’d he do that
was so good?
But that’s also the marvelous thing about work-
ing with American actors. They’re so alive! I’m of an
age where when I started in England the fashion for
actors was to go, Oh God, is that my cue? Right, I’ll
put the crossword down. Here, it’s a matter of life
and death, isn’t it? That’s great to work with.
How would each of you persuade a young
person, unfamiliar with or daunted by
Shakespeare, to see King Lear?
Marvel: [Gestures to Jackson and Houdyshell] You’re
seeing two of the greatest actors, for one thing.
Jackson: Good God.
Marvel: It’s also Shakespeare’s greatest play.
Jackson: Some people say The Tempest is his greatest;
I agree that it’s Lear. The great excuse for Hamlet is
youth, youth, youth. Lear is richer for being written
from an older perspective.
NEWSWEEK.COM 43
Culture
Marvel: Hamlet is a solo journey.
Lear is about the world. It’s cosmic,
metaphysical—it’s everything. All
the characters are heard and seen.
That’s something we’re all proud
of with this production: Everyone’s
point of view is valid and justified—
to a point. [Laughs.]
Houdyshell: The reason great actors
essay the role of King Lear more than
once is because it has layers of mean-
ing, which change as you age. You
want to go away and come back to it.
When you’re working on any great
piece of dramatic literature, a defin-
itive thing is never possible; it’s con-
stantly evolving. I listen to Lear very
carefully still, and for an actor, the
evolution will never stop, through
the last performance.
Jackson: You learn more about your
own character from what the other
characters say about you. It’s so
fucking genius.
Marvel: It’s like a giant gold mine,
this play. You keep digging out more.
Jackson: I can’t get over the fact—
well, I can—that Shakespeare wrote
Lear, the Scottish play [Macbeth] and
Antony and Cleopatra all in the same
year—using bloody candlelight and
quill pens!
Houdyshell: Another argument for
seeing Lear is Edgar. He’s the young-
est voice in the play and the last one
you hear: He’s left to survive somehow,
some way. I think that would resonate
with young people questioning every-
thing that has come before after many,
many years of abuses. The world is in
dire straits, and this play, among other
things, maps out the journey towards
that kind of destruction and decay.
Edgar’s motives are ambiguous
for much of the play. After being
betrayed by Edmund, he disguises
himself as a mad beggar and does
seem to go a bit crazy. But he’s also
44 NEWSWEEK.COM
THEATER
the play’s final hero. His radical
shifts can be confusing.
Jackson: These are people with very
quick brains and huge, immediate
responses. They don’t plot. They find
themselves in these situations and
they react. They discover for them-
selves what they are.
Houdyshell: It’s radical moments
and awakening that keep unfolding.
That’s life, right?
Marvel: Edgar is an impossible part,
but I’d love to play him. I’m endlessly
fascinated by what’s happening with
his mind. Shakespeare understood
something about mental health—that
the trauma of abandonment in young
people can create extreme psychic
shifts. His experience is bifurcated;
part of it is this desperate need to dis-
guise, and part of it is a whole other
landscape that his brain is functioning
in. Shakespeare gives voice to mental
illness in a way that rarely happens.
Jackson: But also Shakespeare’s
acknowledgment, through Edgar,
that abject poverty is accepted—it
simply isn’t noticed. We do it now:
How many people today are sleeping
on our streets?
Comparisons have been made
between Lear and Donald Trump.
Jackson: [Grimacing and shrinking
into the corner of the booth] Hardly!!
“I can’t get over the
fact that Shakespeare
wrote Lear, Macbeth
and Antony and
Cleopatra in one
year—using bloody
candlelight
and quill pens!”
Yes, Glenda, he does see the error
of his ways—eventually, after
going mad—but the king we meet
at the beginning is an extreme
narcissist; he doesn’t rely on
counsel, fudges facts, rewards
those who compliment him. When
George III was king of England,
Lear was banned because of
George’s insanity. If the Trump
administration had such power,
they might employ it.
Marvel: I guarantee you, Donald
Trump has never read King Lear.
Houdyshell: That magnetic and cor-
rupting draw to power—whether it’s
people who desire it for themselves or
people who want to be close to it—is a
human thing. Shakespeare is examin-
ing the universal, which is in all of us.
Jackson: I always think of Henry VIII;
no one ever said no to him, which is
very much the center of King Lear. It
was the time when an absolute power
was acceptable because, of course, it
could carry you with it, or just as eas-
ily kick you out and kill you. And that
kind of obeisance to power, however
it’s defined, hasn’t changed in our
world. It’s still there.
Marvel: And it applies to Trump,
North Korea, Russia.
When Shakespeare wrote his
plays, female actors didn’t exist.
Women were played by teenage
boys. It’s about time, then, that
the tables were turned.
Jackson: Well, exactly. But also, as we
age, absolute gender boundaries go. I
noticed that when I would visit old
people’s homes when I was in Parlia-
ment. The tension between men and
women isn’t necessarily different, but
the boundaries fray.
Houdyshell: My initial approach to
the role of Gloucester was, OK, what
it is to be a father as opposed to a
mother? And I found that there aren’t
A pr I L 05, 2019

that many significant differences. Love
is love, and the parental bond is the
parental bond. So I don’t look at him
as a man going through his journey,
but as a human being going through it.
And it’s quite a journey. To see the
truth, Gloucester has to literally
lose his eyes.
Houdyshell: Gloucester has many
blind spots. [Laughs] And some of
that, actually, is societal, in terms of
the way in which he regards the legit-
imacy of his children. He has an awak-
ening about that. He becomes a larger,
richer person, and he discovers parts
of himself that society, and positions
in his society, had closed him off to.
Marvel: I’ve been thinking about the
Book of John, when God calls out to
Peter and says, Do you love me? And
that is the question this play begins
with: Lear dividing his kingdom based
on how his three daughters respond
B R I GI T T E L AC OM B E ( 2 )
to the question, Do you love me? And
love is complicated, because love and
admiration are two different things.
When we admire someone, we lift
them up; they’re separate. When we
love someone, we want to join with
them. And this play begins with the
misunderstanding of that question,
and it devolves from there. It puts two
people under a microscope—Lear
and Gloucester—and it makes them
examine that question of love versus
admiration. Our society is so compet-
itive—relationships with people, so
often, are shaped by competition. Lear
looks at all of that.
What have you learned from
each other?
Jackson: That I have to learn my lines
better. I’ve left both of them wonder-
ing, What the fuck is she not saying?
Marvel: It’s funny because the con-
versations I’ve had with Glenda and
Jayne—[to Glenda] we mostly talk
ROYAL PAINS Top: Houdyshell as the
blinded Gloucester, led by son Edgar,
disguised as a mad beggar (played by
Pedro Pascal). Bottom: Jackson as Lear.
politics and travel; [to Jayne] we talk
philosophy and spirituality. We don’t
talk about acting. I haven’t told you
this, Glenda, but when I was a very
young person, I saw you on PBS doing
Strange Interlude. It was transforma-
tive. And so I’ve carried you with me.
Jackson: Sorry about that, girl.
Marvel: And I saw you, Jayne, very
early, when I came to New York. So
you both had a massive impact on me
as an artist. It’s been so lovely work-
ing with these women because we all
grab our shovels and just get digging. I
revere them, but we’re the same.
Jackson: There is such support in that.
We get up and do the bloody work.
Houdyshell: My first experience of
seeing Glenda was also on PBS, doing
Marat/Sade. I was 15, and I wanted
to be an actor, but my experience of
theater was limited. That performance
was life-changing for me; it expanded
my vision of what was possible—I
didn’t think acting could be that.
Jackson: Well, that was [director]
Peter Brook, wasn’t it?
For me, it was seeing Glenda
in Women in Love when I was a
teenager. I thought, That’s the
woman I want to be!
Jackson: She was a bit off in my book.
But that scene where you’re
dancing among the bulls, taunting
them? Whoa.
Jackson: “Closer,” said [director]
Ken [Russell]. “Get closer!” They had
huge fucking horns! He said, “You
don’t need to be worried about them.
They’re more frightened of you than
you are of them.” I said, “How do you
know what I’m feeling!”
NEWSWEEK.COM 45
Culture

MUSI C

MadeinChina
The mainland’s acclaimed hip-hop collective is poised
to cross over to America. How have the Higher Brothers
avoided censorship at home?

the name is not what you
think. On a humid day in
2016, four rappers in search of a tag
were listening to beats in a studio in
Chengdu, China. One of them noticed
their Haier Group air conditioner’s
logo, the Haier Brothers. The electric
company introduced the robot broth-
ers (symbolizing wisdom and power)
in a 1996 cartoon, and in the ensuing
series, the massively popular Haier
mascots traveled the world, saving
humanity from natural disasters.
“We were inspired to write a song
imagining that as our future,” one of
the friends, MaSiWei, tells Newsweek.
“We wanted to become as famous as
the Haier Brothers.”
That choice proved
auspicious. The inter-
BY
nationally acclaimed
Higher Brothers are,
CHRISTINA ZHAO
indeed, traveling the @christinaxzhao
world. Saving human-
ity is on hold, at least for now.
If hip-hop isn’t your music, or you
don’t live in China, a quick update:
Last year, Higher Brothers—Psy.
P, DZknow, Melo and MaSiWei—
were named hip-hop artist of the
year by NetEase, one of China’s top
music-streaming platforms. Since
forming in 2016, the subversive “Made in China” was intended spe-
quartet has played to sold-out crowds
in China, Hong Kong and Taiwan,
and starred in ad campaigns for
top brands such as Adidas, Sprite,
Guess and Nike. In late February,
they released their second album,
Five Stars, featuring major Western
rappers ScHoolboy Q, J.I.D, Soulja
Boy, Denzel Curry and Ski Mask the
Slump God (looking forward to hear-
ing the story behind that name).
America got a taste of the Brothers
in the spring of 2018, with their Jour-
ney to the West mini tour, named after
a 16th-century classic Chinese novel.
An EP of the same name was released
simultaneously. They will be back this
year, during a world tour that begins
in May. If their popularity does cross
over in the West, it will be a first.
Despite billions of dollars invested
into manufacturing homegrown pop
stars, Beijing has failed to export a
single popular music act beyond Asia.
As one university fan
summed up the national
enthusiasm (and hope)
surrounding the Higher
Brothers: “China FTW!”
Listen to the group’s
debut album, Black Cab, released
in May 2017, and the musical globe
shrinks: Chinese pride, WeChat (Chi-
na’s biggest social media platform) proved that, yes, yes they can. “I was
and Mandarin conflate with English so mad. I watch TV shows, and peo-
words, trap beats and nods to Ken- ple in America have a lot of things
drick Lamar, A$AP Rocky and Migos. made in China,” says Psy. P. “I used
The Richie Souf–produced track that anger to make a song. The intro
[sets it up]. And then, for the rest of
cifically to answer the question: Can the song, I’ll show you how we rap.”
the Chinese even do rap? The bawdy The “Made in China” video, viewed
satire, specifically mocking West- 15 million times to date, was followed
ern reactions to the Brothers (and by a profile-boosting reaction video
featured during the end credits of that included Migos, Lil Yachty and
HBO comedy Silicon Valley last year) Playboi Carti. “I don’t think I ever

46 NEWSWEEK.COM A PR I L 05, 2019

 STRAIGHT OUTTA CHENGDU
From left: DZknow (the “Chinese
Biggie”), Psy. P, Melo and MaSiWei
of the Higher Brothers. Some have
called them the Migos of the East.

stripes (such as Ai Weiwei, actress Fan

“low-taste content.”
wanted to be Chinese more than
this moment,” American rapper Kyle
commented, speaking of DZknow,
“Yo, he’s like the Chinese Biggie.” Rap-
per Xavier Wulf extolled the quartet’s
emphasis on Chinese culture, saying,
“That’s what sticks. That’s what makes
“I don’t think I ever
Bingbing, designer Chen Peng, rapper
Awkwafina and everyone else in the
blockbuster Crazy Rich Asians), but
at home many of them face oppres-
sive censorship, and particularly
homegrown rappers; the pressure to
appease Beijing is intense. In January
2018, China’s State Administration of
Press, Publication, Radio, Film and
Television banned hip-hop culture and
anyone with visible tattoos from media.
According to Chinese news outlet Sina,
regulators now “specifically require
that programs should not [depict] hip-
hop culture, subculture and dispirited
culture” in a bid to crack down on
So how do artists in a genre that
promotes authenticity above all else
survive government scrutiny? Some
better than others. While Chinese
rappers PG One and GAI have been
sanctioned, the Higher Brothers—
despite subversive lyrics and a “scum-
bro” aesthetic—have avoided censure.
One popular theory: Their material
unintentionally supports Commu-
nist Party propaganda. But there isn’t
much evidence to support that.
Still, the Higher Brothers are deft
at keeping it inoffensively real. They
aren’t, for example, interested in
tweaking Beijing over its control of
the press. When talking to a Western
reporter, they stick to enthusiastic
generalities. American audiences,
says Melo, might not understand

wanted to be
this s**t amazing.” Chinese, “but they are all different
The Chinese government is less colors and backgrounds. They bring
PE T ER H OAN G

enthusiastic about the country’s grow-

Chinese more their energy and their feel to the live

than this moment.”

ing hip-hop culture. The West might performances.” Maybe they should
be embracing Chinese artists of all run for office?

NEWSWEEK.COM 47
Culture Illustration by B R I T T S P E N C E R

P A R T I NG SHOT

Julianne Moore
“when the world ends, i hope i go down dancing,” says gloria What attracted you to Gloria?
Bell, the titular character in director Sebastián Lelio’s new American Sebastián, for one thing. He looks
film—a cover version, as he has described it, of his “secret musical,” the 2013 at the world as a humanist—in all of
Chilean film Gloria. In both movies, the character is a mother of two grown KLVɿOPV+HFDSWXUHVWKHIHHOLQJRI
kids who lives alone and works a mundane job. She is a free spirit who smokes being alive. And Gloria is awesome.
weed, does yoga and dances her nights away in clubs, where, in Gloria Bell, she +HUDSSUHFLDWLRQIRUWKHSHRSOHVKH
hooks up with a new man (played by the terrific John Turturro). Simple enough. loves, her willingness to try new
But as often happens when the Oscar-winning Julianne Moore is the star, the WKLQJVVRPHWLPHVWRDIDXOWŜ,ɿQG
ordinary becomes sublime. Her performance has been heaped with praise, and WKDWDGPLUDEOHDQGLQVSLULQJ
the opening weekend box office was second only to Captain Marvel in New ,ŠPDOZD\VLQWHUHVWHGLQFKDUDFWHUV
York and Los Angeles. Not bad for a small film about a middle-aged divorcée. ZKRDUHQRWWKHWUDGLWLRQDOFHQWHURID
“Sometimes I would come home after filming, exhausted, and think, I didn’t +ROO\ZRRGQDUUDWLYH,QVRPHVFHQHV
do anything,” Moore tells Newsweek. “The scenes were so subtle, so minutely *ORULDLVMXVWZDWFKLQJDFRQYHUVDWLRQ
drawn; not much happens—and yet everything happens. I absolutely loved it.” WDNLQJSODFHDURXQGKHU$QGWKDWŠV
really who most of us are. We’re not
all Dwayne Johnson, you know? We
ţ'DQFHLVDERXW ZLVK%XWZHŠUHDOOWKHFHQWHURIRXU
own narratives. For most of us, you
MR\,ZDQWHG HPSW\WKHGLVKZDVKHU\RXIHHGWKH
WREULQJWKDW FDW\RXJRWRZRUN\RXFRPHKRPH
idea to Gloria— To me, that’s it: Tell that story in as

that she vital and engaged a way as you would

WKHVWRU\RIDVXSHUKHURSOD\HGE\
PRYHVWROLYHŤ Dwayne Johnson.

/HOLRUHIHUVWRWKHɿOPDVDţVHFUHW
PXVLFDOŤ*ORULDUHJXODUO\VLQJV
DORQJWRVRQJVZLWKWKHHPRWLRQV
H[SUHVVHGLQWKHO\ULFVUHYHDOLQJ
QHZDVSHFWVRIKHUFKDUDFWHU
RUKHUVLWXDWLRQ$QGVKHVWDUWV
DQGHQGVWKHɿOPE\GDQFLQJ
&DQ\RXUHODWH"
,ŠPQRWWKDWSHUVRQ7KHODVWWLPH
,ZHQWWRDFOXEZDVLQRU
something—it was a long time ago!
-RKQ7XUWXUURLVDGDQFHUDQGKH
DOZD\VVD\VWKDWKHORYHVGDQFH
EHFDXVHLWŠVDERXWMR\,ZDQWHGWR
bring that idea to Gloria—that she
moves to live. —Dory Jackson

48 A PR I L 05, 2019
Nicole Kidman

EVERYONE CAN SAVE A LIFE WITH

HANDS ONLY CPR
It takes less than a minute to learn at handsonly.nyc.

City of New York