For years, the United States’ high health-care costs and poor outcomes have provoked hand-wringing, and rightly so: Every other high-income country in the world spends less than America does as a share of GDP, and surpasses us in most key health outcomes.Another couple of paragraphs:
Recriminations tend to focus on how Americans pay for health care, and on our hospitals and physicians. Surely if we could just import Singapore’s or Switzerland’s health-care system to our nation, the logic goes, we’d get those countries’ lower costs and better results. Surely, some might add, a program like Medicare for All would help by discouraging high-cost, ineffective treatments.
But lost in these discussions is, well, us. We ought to consider the possibility that if we exported Americans to those other countries, their systems might end up with our costs and outcomes. That although Americans (rightly, in my opinion) love the idea of Medicare for All, they would rebel at its reality. In other words, we need to ask: Could the problem with the American health-care system lie not only with the American system but with American patients?
For example, one cost-reduction measure used around the world is to exclude an expensive treatment from health coverage if it hasn’t been solidly proved effective, or is only slightly more effective than cheaper alternatives. But when American insurance companies try this approach, they invariably run into a buzz saw of public outrage. “Any patient here would object to not getting the best possible treatment, even if the benefit is measured not in extra years of life but in months,” says Gilberto Lopes, the associate director for global oncology at the University of Miami’s cancer center. Lopes has also practiced in Singapore, where his very first patient shocked him by refusing the moderately expensive but effective treatment he prescribed for her cancer—a choice that turns out to be common among patients in Singapore, who like to pass the money in their government-mandated health-care savings accounts on to their children.Go read the rest.
Most experts agree that American patients are frequently overtreated, especially with regard to expensive tests that aren’t strictly needed. The standard explanation for this is that doctors and hospitals promote these tests to keep their income high. This notion likely contains some truth. But another big factor is patient preference. A study out of Johns Hopkins’s medical school found doctors’ two most common explanations for overtreatment to be patient demand and fear of malpractice suits—another particularly American concern.
Nearly two-thirds of India sizzled on Tuesday under a spell of a heatwave that is on course to becoming the longest ever as scalding temperatures killed four train passengers, drained water supplies, and drove thousands of tourists to hill stations already bursting at the seams.I see other news sites say that the death toll from the heatwave is 36: but isn't it hard to believe that there are not more premature deaths than that in the poorest part of the community that has trouble accessing air conditioning?
Across large swathes of northern, central and peninsular India, the mercury breached the 45 degree mark, including in Jhansi in Uttar Pradesh, Churu and Bikaner in Rajasthan, Hisar and Bhiwani in Haryana, Patiala in Punjab, and Gwalior and Bhopal in Madhya Pradesh.
The Capital, which sweltered on its hottest June day in history on Monday (48 degrees Celsius) recorded as maximum temperature of 45.4 degrees Celcius at Palam in spite of a spell of light rain in the morning.
Why does Japan fear tattoos so much? According to “Modern Encyclopedia of the Yakuza” (2004), the government in 1720 decided to reduce the punishment on some criminal offenses. Criminals would no longer have their noses or ears removed. Instead, their crimes would be identified with tattoos on the skin, usually the arms.
Tattoos were popular with gangsters before and after the war for a number of reasons. Symbolically speaking, however, the act of being tattooed once showed a resolve to sever ties with ordinary society and live in the underworld.
According to a National Police Agency study in the early 1990s, 73 percent of all gang members had a tattoo. It’s likely this number has decreased since 1992, when the first anti-gang laws went into effect and gangsters began hiding their identities. Obviously, if you want to blend in and pass yourself off as an ordinary businessman, tattoos aren’t a plus.I've heard some of her music. Yes. Yes she is. :)
The new generation of gang members doesn’t get tattoos. Criminals are increasingly declining to get tattoos, while the rest of the world is embracing them as body art. Does anyone think U.S. pop star Ariana Grande is a menace to society?
The Notre-Dame cathedral will host its first mass this weekend since a fire ravaged the Paris landmark almost two months ago, the city’s diocese said Tuesday.
The mass led by Archbishop of Paris Michel Aupetit will be celebrated on a very small scale late Saturday, the diocese said.
It will take place in a “side chapel with a restricted number of people, for obvious security reasons,” it said.
Just 20 people are expected to take part, including priests and canons from the cathedral.
The event will be broadcast live by a French television channel so that Christians from all over France can participate, the diocese added.
The article does note that this whole system does carry the risk of extremely long delays if there is a hitch in the IT system.Your treasured and travel-weary passport may soon become, like your first mobile phone, a relic of the past, if border agencies from the UK to Singapore, the United Arab Emirates and our own have anything to do with it.The race is on to create a system whereby travellers will no longer need to present their documents to either a border official or passport kiosk.
For the Australian traveller, this could mean the days of standing in line at our international airports will end.
Licence plate images and photos of individuals who travelled in and out of the United States were taken in a malicious hack impacting U.S. Customs and Border Protection (CBP), according to a report in the Washington Post. The agency learned last month about the breach, which took place thanks to a hack of an unnamed subcontractor.I wonder about the point of such a hack...
CBP, which blamed the subcontractor for failing to follow security and privacy rules by transferring the agency’s photos to its own network, operates a database of visa and passport photos as part of a face recognition system and database used widely at American airports despite criticism for privacy and accuracy failures. The agency processes over 1 million travellers per day and is building up to use the face recognition system in at least 20 airports thanks to a Trump executive order.
A lack of funding is not the main reason for the research gaps. Although there have been few funding programmes targeted at marine-geoengineering experiments and modelling so far, many basic tests are cheap and can be done in the lab — for instance, assessing whether impurities in mineral powders are toxic to marine life. And a range of negative-emissions technologies, such as enhanced weathering of rocks to increase ocean alkalinity, are already being funded in targeted research programmes, including one in the United Kingdom. Other streams of research, such as modelling, are under way in Germany, and a call for research proposals has been made in Japan. Private money is being invested in some marine approaches, such as a proposed pilot study of the impacts of iron fertilization on fisheries off Chile. However, that project has stalled, largely because of a lack of support from scientists (see Nature 545, 393–394; 2017).It's clear that there is no simple idea that is an obvious panacea.
Another problem is that many geoengineering proposals and analyses are found on transient websites, not in peer-reviewed journals. For example, only half of the web links to ideas, plans and documents cited in a detailed 2009 synthesis study of marine-geoengineering approaches4 still worked when we examined them in 2018. By contrast, academic and intergovernmental documents from that era are easy to find.
Again, the reasons for this are unclear, but could include inadequate funding, privacy concerns about disclosing details of the methods, and maintenance of proprietary rights over technologies. Some scientists worry that even starting geoengineering research or reporting results could lead to deployment of inadequately studied approaches5.
Yet it is essential that investigations are solidly researched, openly discussed and made readily available, as demonstrated by the most-studied geoengineering approach, ocean iron fertilization. Much of the work drew from ocean biogeochemistry and has involved lab experiments, pilot studies in the Southern Ocean and modelling across ocean basins. All of this activity showed that the method will not work as anticipated6. Fertilizing 1,000 square kilometres of the upper ocean would increase the growth of phytoplankton but could have alarming side effects. For example, sinking algae could release methane, a greenhouse gas that is many times more potent than CO2.
Less is known about change over the time in the number and share of Australians who are non-heterosexual. This is because most data collections only began asking about sexual orientation in recent years.Or perhaps Australians are slightly less "queer" than Americans? That would be hard to believe.
Estimates based on the 2001/2002 and 2012/2013 instalments of the Australian Study of Health and Relationships (each canvassing about 20,000 men and women age 16-59), suggest an increase in the prevalence of non-heterosexuality across different measures.
The share of men identifying as homosexual or bisexual went up from 2.5% to 3.2%. The share of women identifying as lesbian or bisexual also rose, from 2.2% to 3.8%. While the share of men expressing some same-sex sexual attraction increased slightly (6.8% and 7.4%), this increased more markedly for women (12.9% and 16%). Similarly, the prevalence of lifetime same-sex sexual experience increased for both sexes, with the increment being more pronounced among women (8.5% to 14.7%) than men (6% to 6.6%).
Until about 2010, the controversial practice of psychiatric euthanasia was rare, despite being permitted since the mid-1990s. Most Dutch psychiatrists—like most other doctors and the Dutch public—disapprove of psychiatric euthanasia. Still, there has been a steady increase, with 83 cases in 2017; the per-capita equivalent in the United States would be about 1,600 cases a year. Unlike euthanasia in general, psychiatric euthanasia is predominantly given to women. Most of these cases involve the End of Life Clinic, a network of facilities affiliated with the largest Dutch euthanasia-advocacy organization. These clinics routinely handle euthanasia requests refused by other doctors. (Noa Pothoven sought euthanasia there but was refused.)An obvious question arises: How can any physician be sure that any patient with a serious psychiatric disorder, much less an 18-year-old, meets the legal criteria for euthanasia? The short answer is that the law gives considerable weight to their professional judgment.Compared with cases involving cancer or other terminal illnesses, the application of the eligibility criteria in psychiatric euthanasia depends much more on doctors’ opinions. Psychiatric diagnosis is not based on an objective laboratory or imaging test; generally, it is a more subjective assessment based on standard criteria agreed on by professionals in the field. Some doctors reach conclusions with which other doctors might reasonably disagree. Indeed, an otherwise healthy Dutch woman was euthanized 12 months after her husband’s death for “prolonged grief disorder”—a diagnosis listed in the International Classification of Diseases but not in the Diagnostic and Statistical Manual of Mental Disorders used by psychiatrists and psychologists around the world.Psychiatric disorders can indeed be chronic, but their prognosis is difficult to predict for a variety of reasons. There is a paucity of relevant, large longitudinal studies. Patients may get better or worse due to psychosocial factors beyond the control of mental-health providers. Also affecting prognoses is the varying quality and availability of mental-health care—which, even in wealthy countries, patients with significant symptoms may not receive. Noa Pothoven and her family had criticized the dearth of care options available in their country for patients like her. Indeed, more than one in five Dutch patients receiving psychiatric euthanasia have not previously been hospitalized; a significant minority with personality disorders did not receive psychotherapy, the staple of treatment for such conditions. When treatments are available, doctors in the Netherlands have the discretion to judge that there are “no alternatives” if patients refuse treatment.
Although a practising Catholic, Sheridan is married to Jasbir Kaur “Jessie” Sheridan, who practises the Sikh religion along with their three sons.
A conservative, Sheridan describes himself as politically “bisexual” (or, if you prefer, ambidextrous). That is, he leans neither to the Labor nor the Liberal party. His position is summarised by former prime minister, John Howard, who has said: “Last time I checked, God voted neither Labor nor Liberal; he certainly didn’t vote Green.”I'd like to know when the "bisexual" Sheridan last voted Labor!
And more:A truly bizarre trend is having an impact on the economy — wealthy people and corporations have so much money they literally don't know what to do with it.Why it matters: At a time when growing income inequality is fueling voter discontent and underpinning an array of social movements, the top 1% of earners and big companies are holding record levels of unused cash.The big picture: U.S. companies raked in a record $2.3 trillion in corporate profits last year, while the country's total wealth increased by $6 trillion to $98.2 trillion (40% of which went to those with wealth over $100,000).So, where is all the money going? The IMF notes large companies around the world are overwhelmingly and uniformly choosing not to reinvest much of it into their businesses. They're hoarding it in cash and buying back stock."There are only 2 things that money can do — sit on a balance sheet unused, where it's just earned income earning an interest rate of zero," ICI chief economist Sean Collins points out. "Or it makes sense to release it to share buybacks or dividends."
- Companies could pay their workers more, but "that would be terrible for the stock market," says Neil Shearing, chief economist at Capital Economics — half-jokingly.
- Companies made a record $1.1 trillion in stock buybacks in 2018 and are on track to surpass that number this year. But they still have record cash holdings of close to $3 trillion.
Lots of people on Twitter are saying that if this is a surprise to anyone, they need to remember Marx. Lots of GIFS of guillotines are involved too - rather unhelpfully allowing the wingnut right to get hysterical that "Socialists!" really want another run at violent Marxist revolution. (Actually, they just want wingnuts to stop being idiots who count their money and hug their guns at night.)But even that hasn't been enough to account for all the new money. The top 1% of U.S. households are holding a record $303.9 billion of cash, a quantum leap from the under $15 billion they held just before the financial crisis.How we got here:
- The Fed's quantitative easing program pushed the cost of borrowing money to next to nothing for nearly a decade, allowing companies to splurge on debt for mergers and acquisitions and to boost revenue.
- At the same time, globalization allowed them to reduce labor costs, meaning that gains effectively were returned as profit and used by public companies to boost stock prices.
Between the lines: These factors, combined with legislative policies that have consistently favored business owners over workers, eroded unions and reduced employees ability to demand higher wages.
By now it is clear that something is fundamentally wrong with modern capitalism. The 2008 global financial crisis showed that the system as currently constructed is neither efficient nor stable. If a slew of data hasn’t already convinced us that during forty years of slow economic growth in advanced economies the benefits overwhelmingly went to the top 1 per cent – or 0.1 per cent – the anti-establishment votes in the United States and United Kingdom certainly should. The mainstream economists, central bank governors and “centrist” Blairite and Clintonite politicians who set us on and maintained this dismal course and confidently pronounced that globalization and financial-market liberalization would bring sustained growth and financial benefits for all, have been soundly discredited.
Considering the devastation wrought by misguided financial policies over the past decade in particular, one might reasonably have expected a revolution in the economics profession akin to the Keynesian one in the aftermath of the Great Depression. But we tend to forget that, back in the 1930s, as the economy sank ever deeper into depression, many economists in the US and UK stuck to laissez-faire. Markets would correct themselves, they said; no need to meddle. And even after John Maynard Keynes brilliantly articulated what was wrong, and how government actions could set things right, a great number of economists did not want to follow his prescriptions, out of ideological fear of excessive government intervention. So it is no surprise, really, that the economics profession’s response to the 2008 crisis has been slow and halting.
Our current economic system is often referred to as capitalism, a term – as Fred L. Block points out in Capitalism: The future of an illusion – that the left once used pejoratively and the right now champions as if it’s an unchanging and noble framework that delivers miraculous, never-ending growth from which everyone benefits, or would if only government didn’t interfere. But all the underlying premisses of this blanket term are wrong: no economy, and certainly no modern economy, has a private sector that functions in a vacuum. The government is right there alongside it, enacting rules and regulations, enforcing trading standards, backing up the banking system and stabilizing the market economy. Capitalism isn’t one, rigid system. It’s ever changing. And the promises made by its most reductive advocates – that deregulation, privatization and globalization will bring wellbeing to most citizens in all countries – have proven to be horribly wrong. (Globalization, to its credit, has contributed to the enormous decrease in global poverty: the successes in East Asia, in particular in China, where some 740 million have been moved out of poverty, wouldn’t have been possible without it. Still, mismanaged and inequitable globalization, with large agriculture subsidies for corporate farms in the advanced countries, has hurt the poorest of the poor: rural workers in the least developed countries.)But read the whole thing...
Two other crises accompany the crisis in our economy. The first is a crisis in our democracy, for the two are inseparable. It is through our political system that the rules of the economy are set, and when the outcomes of those rules are unacceptable – as in the 2008 crisis – the consequences must be addressed, and addressed through radical change. And those kinds of changes have to be made through the political system – otherwise, matters will only get worse, especially when a third interconnecting crisis is taken into consideration: the environment. Unfortunately, none of these books faces up to our system’s failure to address the existential question of the moment: climate change.
